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[胱氨酸病:通过高效液相色谱法测定白细胞胱氨酸含量进行诊断]

[Cystinosis: diagnosis through the measurement of the leukocyte cystine content by HPLC].

作者信息

Martínez Llamas María Soledad, Cabrera Morales Carmen M, Bravo Soto Juan Antonio, Cantón Julia, Pedrinaci Susana

机构信息

Servicio de Análisis Clínicos, Hospital Universitario Virgen de las Nieves, Granada, Spain.

出版信息

Med Clin (Barc). 2004 Jun 19;123(3):97-9. doi: 10.1157/13063485.

Abstract

BACKGROUND AND OBJECTIVE

Cystinosis is an autosomal recessive disorder characterized by an accumulation of intralysosomal cystine. Three disease forms exist, infantile, juvenile or late-onset, and ocular nonnephropathic cystinosis, delineated on the basis of severity of symptoms and age of onset. The knowledge of early clinic manifestations and the onset of the appropriate therapy delay the evolution of the disease and improve the general conditions. Therefore, it is necessary to develop a sensible diagnostic method for early detection and treatment of the disease. CLINICAL CASE AND METHODS: The leukocyte cystine content was determined by HPLC in a 42 years old female patient after renal transplantation, and with the clinical characteristic complications of the intermediate cystinosis. Equally, the molecular characterization of the structural defects of the cystinosin (CTNS) gene was made in the patient and in all family members.

RESULTS

By measuring of the leukocyte cystine content in the patient and family members, we have determined 5 family members as heterozygous. This result was confirmed by molecular analysis that showed the approximately 65 kb deletion in the 5 family members. The patient was heterozygous for the approximately 65 kb deletion, and the second alteration was not determined.

CONCLUSIONS

We presented a useful diagnostic method, based in the determination of cystine content of polymorphonuclear leukocytes, which permits to detect the heterozygous individuals.

摘要

背景与目的

胱氨酸病是一种常染色体隐性疾病,其特征为溶酶体内胱氨酸蓄积。根据症状严重程度和发病年龄,存在三种疾病形式,即婴儿型、青少年型或晚发型以及眼部非肾病性胱氨酸病。了解早期临床表现并及时开始适当治疗可延缓疾病进展并改善总体状况。因此,有必要开发一种合理的诊断方法以早期发现和治疗该疾病。

临床病例与方法

对一名42岁肾移植术后女性患者进行了高效液相色谱法检测白细胞胱氨酸含量,该患者具有中间型胱氨酸病的临床特征性并发症。同样,对该患者及其所有家庭成员进行了胱氨酸转运体(CTNS)基因结构缺陷的分子特征分析。

结果

通过检测患者及其家庭成员的白细胞胱氨酸含量,我们确定了5名家庭成员为杂合子。分子分析证实了这一结果,显示这5名家庭成员存在约65 kb的缺失。该患者为约65 kb缺失的杂合子,未确定第二种改变。

结论

我们提出了一种基于检测多形核白细胞胱氨酸含量的有用诊断方法,该方法可检测杂合子个体。

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