Department of Dermatology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi 321-0293, Japan.
Arch Dermatol Res. 2010 Jul;302(5):395-9. doi: 10.1007/s00403-009-0970-6. Epub 2009 Jun 20.
Vascular type of Ehlers-Danlos syndrome (EDS) is the most severe type of EDS. It is an autosomal dominantly inherited disorder that results from mutations within the alpha1 type III collagen gene (COL3A1). We report a novel point mutation at donor splice-site in intron 42 of type III collagen gene resulting in the inclusion of 30 nucleotides into the mature mRNA in a case of vascular type of EDS. Since the age of approximately 8 months, the patient had had repeated episodes of purpura and gradually developed thin, translucent skin. She had a past history of pneumothorax. At the initial examination, she was found to have the characteristic facies, i.e., bird-like face, of the vascular type of EDS, thinning of skin over the limbs and trunk, and scattered purpura. The blood vessels under the skin could be clearly visualized. She showed hypermobility of the small joints of all the four limbs and acrogeric changes of the hands and feet. Analysis of the amount of collagen synthesized from cultured dermal fibroblasts by SDS-polyacrylamide gel electrophoresis and fluorography was conducted based on the clinical suspicion of the vascular type of EDS, and a marked reduction in the synthesis of type III collagen was observed. Genetic analysis of the COL3A1 revealed a novel point mutation at the donor splice-site of intron 42, which resulted in the inclusion of 30 nucleotides into the mature mRNA of one allele.
血管型埃勒斯-当洛斯综合征(EDS)是最严重的 EDS 类型。它是一种常染色体显性遗传疾病,由 III 型胶原蛋白基因(COL3A1)内的突变引起。我们报告了一例血管型 EDS 中,在 III 型胶原蛋白基因内含子 42 的供体位点发生新的点突变,导致成熟 mRNA 中包含 30 个核苷酸。患者从大约 8 个月大开始,反复出现紫癜,并逐渐出现皮肤变薄、半透明。她曾有气胸病史。在最初的检查中,发现她具有血管型 EDS 的典型面容,即鸟脸,四肢和躯干皮肤变薄,有散在的紫癜。皮肤下的血管可以清晰地看到。她表现出四肢小关节的过度活动和手脚的肢端肥大性改变。根据临床疑似血管型 EDS,对培养的皮肤成纤维细胞中合成的胶原蛋白量进行 SDS-聚丙烯酰胺凝胶电泳和放射自显影分析,发现 III 型胶原蛋白的合成明显减少。COL3A1 的基因分析显示,在内含子 42 的供体位点发生了一个新的点突变,导致一个等位基因的成熟 mRNA 中包含 30 个核苷酸。