Peranteau William H, Ganguly Arupa, Steinmuller Laura, Thornton Paul, Johnson Mark P, Howell Lori J, Stanley Charles A, Adzick N Scott
The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, The University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
Fetal Diagn Ther. 2006;21(6):515-8. doi: 10.1159/000095664. Epub 2006 Sep 12.
We present the first case of the prenatal diagnosis of congenital hyperinsulinism based on the genetic analysis of known family mutations in the SUR1 gene. An amniocentesis was performed at 16 weeks gestation at which time two mutations in the SUR1 gene were identified consistent with the diagnosis of diffuse hyperinsulinism. The mother was transported to our facility and underwent an elective caesarian section at 38 weeks gestation. The diagnosis was confirmed and treatment was initiated within the first minutes of life. After a short course of failed medical management, the patient underwent a 98% pancreatectomy with subsequent good glycemic control. This case highlights the benefits of the timely in utero diagnosis of hyperinsulinism by mutational analysis.
我们报告了首例基于SUR1基因已知家族突变的基因分析进行先天性高胰岛素血症产前诊断的病例。在妊娠16周时进行了羊膜穿刺术,当时在SUR1基因中鉴定出两个突变,与弥漫性高胰岛素血症的诊断一致。母亲被转运至我们的机构,并在妊娠38周时接受了择期剖宫产。诊断得到证实,并在出生后的第一分钟内开始治疗。经过短期药物治疗失败后,患者接受了98%的胰腺切除术,随后血糖得到良好控制。该病例突出了通过突变分析及时进行子宫内高胰岛素血症诊断的益处。