Takaura Natsuko, Tanaka Akemi, Yoshida Toshiko, Takeshita Yukiko, Shimizu Norikazu, Aoki Tsugutoshi, Tamai Hiroshi, Yamano Tsunekazu
Department of Pediatrics, Osaka City University Graduate School of Medicine, Osaka.
No To Hattatsu. 2006 Jan;38(1):49-53.
A 5-year-old boy visited a hospital because of macrocephalus, mental retardation and hepatic dysfunction, and was suspected to have Wilson's disease since his father had this disease. The serum level of ceruloplasmin was low, but urinary copper excretion was not increased markedly. He was treated with D-penicillamine. He was then reffered to our hospital because of his facial features suggesting mucopolysaccharidosis. Based on mucopolysacchariduria and the deficiency of N-acetylglucosaminidase, the diagnosis of Sanfilippo syndrome type B was made. Molecular analyses identified him as a compound heterozygote for both the ATP7B (A844V/2659delG) and alpha-N-acetylglucosaminidase (V241M/R482W) genes, responsible for Wilson's disease and Sanfilippo syndrome type B, respectively. Although born to non-consanguineous parents, he had two rare autosomal recessive diseases. In this case, liver dysfunction was attributed to Wilson's disease, and mental retardation to Sanfilippo syndrome.
一名5岁男孩因巨头畸形、智力发育迟缓及肝功能障碍前往医院就诊。由于其父亲患有威尔逊病,故怀疑他也患有该病。其血清铜蓝蛋白水平较低,但尿铜排泄并未显著增加。他接受了D-青霉胺治疗。随后,因其面部特征提示黏多糖贮积症,他被转诊至我院。基于黏多糖尿症及N-乙酰氨基葡萄糖苷酶缺乏,诊断为B型Sanfilippo综合征。分子分析确定他分别是ATP7B基因(A844V/2659delG)和α-N-乙酰氨基葡萄糖苷酶基因(V241M/R482W)的复合杂合子,这两个基因分别导致威尔逊病和B型Sanfilippo综合征。尽管他的父母并非近亲结婚,但他却患有两种罕见的常染色体隐性疾病。在这种情况下,肝功能障碍归因于威尔逊病,智力发育迟缓归因于Sanfilippo综合征。