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[两个伴有热性惊厥附加症的全身性癫痫家系的临床分析及SCN1A基因突变筛查]

[Clinical analysis and screening for SCN1A gene mutation in two pedigrees of generalized epilepsies with febrile seizures plus].

作者信息

Wang Xin-hua, Zhou Shui-zhen, Guo Qian, Sun Dao-kai

机构信息

Department of Neurology, Pediatric Hospital of Fudan University, Shanghai 201102, China.

出版信息

Zhonghua Er Ke Za Zhi. 2009 Aug;47(8):570-4.

Abstract

OBJECTIVE

To study the clinical and genetic characteristics of generalized epilepsy with febrile seizures plus (GEFS).

METHODS

Data of two probands of the disease were collected through outpatient clinic. DNA was extracted from peripheral blood leukocytes using RelaxGene Blood DNA System. Twenty-six exons of SCN1A were amplified by polymerase chain reaction (PCR), the PCR products were screened by denaturing high performance liquid chromatography (DHPLC), then the abnormal fragments were sequenced by Sanger method in order to find the mutations of SCNIA gene.

RESULTS

(1) There were 28 affected individuals in the two families of GEFS+ (14 males and 14 females). Febrile seizures (FS) were present in 7 cases, febrile seizures plus (FS+) in 6 cases, FS+ and absence seizures in 1 case, FS+ and myoclonic seizures in 1 case, uncertain type in 13 cases. No severe phenotype was seen. Bilineal inheritance occured in one GEFS+ family. (2) A samesense mutation (c. 1212A > G) of SCN1A gene was found in the proband and an unaffected individual of pedigree B of GEFS.

CONCLUSIONS

(1) GEFS+ is a syndrome with the characteristics of heterogeneous clinical phenotypes; bilineal inheritance suggests the possibility of complex inheritance with additive gene effects. (2) Our study failed to provide evidence supporting a causal relation between the SCN1A mutation and the etiologic gene in the GEFS+ family B, which indicates that GEFS+ has the phenotypic and genotypic heterogeneity.

摘要

目的

研究伴有热性惊厥附加症(GEFS)的全面性癫痫的临床及遗传特征。

方法

通过门诊收集该疾病两名先证者的数据。使用RelaxGene Blood DNA系统从外周血白细胞中提取DNA。采用聚合酶链反应(PCR)扩增SCN1A基因的26个外显子,PCR产物经变性高效液相色谱(DHPLC)筛选,然后对异常片段进行Sanger测序,以查找SCN1A基因的突变。

结果

(1)GEFS+的两个家系中有28名受累个体(男14名,女14名)。热性惊厥(FS)7例,热性惊厥附加症(FS+)6例,FS+合并失神发作1例,FS+合并肌阵挛发作1例,不确定类型13例。未见严重表型。一个GEFS+家系呈双向遗传。(2)在GEFS家系B的先证者及一名未受累个体中发现SCN1A基因的同义突变(c. 1212A > G)。

结论

(1)GEFS+是一种具有临床表型异质性特征的综合征;双向遗传提示存在基因加性效应的复杂遗传可能性。(2)本研究未能提供证据支持GEFS+家系B中SCN1A突变与致病基因之间存在因果关系,这表明GEFS+具有表型和基因型异质性。

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