Bonet Alcaina M, García-Algar O, Herrero Pérez S, Mombiela Vidal R, Pérez Jurado L A, Mur Sierra A
Unidad de Endocrinología Pediátrica, Hospital del Mar, Barcelona, Spain.
An Esp Pediatr. 2002 Jun;56(6):567-70.
A female neonate was born after a 37.4-week pregnancy to a healthy primipara. There was a family history of diabetes on the father's side. The neonate's birth weight was 1,955 g and she was 43 cm long. Physical examination showed bilateral palpebral edema, macroglossia, umbilical hernia and abdominal distension. At 29 hours of life she presented hyperglycemia without acidosis or ketosis. Insulin treatment was started and maintained intermittently until 38 days of life. The patient presented anemia from the second day of life, which required iron therapy and blood transfusion one month after birth. The karyotype was 46, XX with paternal uniparental isodisomy of chromosome 6. Paternal uniparental isodisomy of chromosome 6 has been described as the pathogenic mechanism of transient neonatal diabetes, which provides evidence for an imprinted gene exclusively of paternal expression. In paternal isodisomy (as in regional duplications) there is overexpression due to the existence of two functional copies of the gene, which is responsible for transient neonatal diabetes mellitus. Transient neonatal diabetes associated with macroglossia, umbilical hernia and anemia has been described in only a few cases.
一名女新生儿在孕37.4周后出生,母亲为健康初产妇。父亲一方有糖尿病家族史。新生儿出生体重1955克,身长43厘米。体格检查发现双侧睑水肿、巨舌、脐疝和腹胀。出生29小时时出现高血糖,无酸中毒或酮症。开始胰岛素治疗并间断维持至出生38天。患儿自出生第二天起出现贫血,出生后一个月需要铁剂治疗和输血。核型为46, XX,伴有6号染色体父源单亲二体。6号染色体父源单亲二体已被描述为短暂性新生儿糖尿病的致病机制,这为仅由父源表达的印迹基因提供了证据。在父源单亲二体(如区域重复)中,由于该基因存在两个功能拷贝而导致过表达,该基因负责短暂性新生儿糖尿病。仅在少数病例中描述过与巨舌、脐疝和贫血相关的短暂性新生儿糖尿病。