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[一例散发型致死性家族性失眠症病例的临床及遗传学特征分析]

[Analysis for clinical and genetic characteristics of a sporadic FFI case].

作者信息

Xia Sheng-li, Xu Yu-ming, Xu Qiang, Xie Zhi-qiang, Shen Xiao-jing, Zhou Wei, Du Ran, Zhang Jin, Han Jun, Xu Bian-li, Dong Xiao-ping

机构信息

Institute for Infectious Disease Control and Prevention, Henan Center for Disease Control and Prevention, Zhengzhou 450016, China.

出版信息

Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2009 Apr;23(2):124-6.

Abstract

OBJECTIVE

To report and study a case of sporadic family fatal insomnia (SFFI) on its.

METHODS

Investigate clinical characteristics and family disease history of a suspect FFI patient. His clinical characteristic was analyzed, he and his 14 family members genomic DNA was extracted by standard techniques from their and blood detected with polymerase chain reaction (PCR) method and DNA sequencing to find out his prion protein (PrP) gene mutation. The patient's CSF was detected with Western-Blot method for 14-3-3 brain protein.

RESULTS

The patient was diagnosed as an sporadic FFI by his developed sleep disturbance and changes in sleep-awake rhythm, motor abnormalities, mental disorder, dementia, autonomic dysfunction; his family history; his 14-3-3 brain protein-positive (CSF) and analysis results of his PrP gene (codon point mutation D178N and methionine homozygosity at position 129M/M). Suggesting that in the future to identify CJD and FFI patients, screening should focus on clinical symptoms and laboratory results. The PrP gene of 14 family members did not appear Mutation, and there is no person suffering from the same disease.

CONCLUSIONS

The case was diagnosed as a sporadic familial fatal insomnia. Analysis of suspicious patients' genomic DNA for PrP gene mutation might be very important for FFI diagnosis because there exist many difficulties in clinical laboratory evaluation. This patient might be the first SFFI patient reported in China and the case finding might have momentousness in clinical and basical study.

摘要

目的

报告并研究一例散发性家族性致命性失眠症(SFFI)病例。

方法

调查一名疑似FFI患者的临床特征和家族病史。分析其临床特征,采用标准技术从该患者及其14名家庭成员的血液中提取基因组DNA,用聚合酶链反应(PCR)法和DNA测序进行检测,以找出其朊蛋白(PrP)基因突变情况。用蛋白质免疫印迹法检测患者脑脊液中的14-3-3脑蛋白。

结果

该患者因出现睡眠障碍、睡眠-觉醒节律改变、运动异常、精神障碍、痴呆、自主神经功能障碍,结合家族病史,脑脊液14-3-3脑蛋白阳性及PrP基因分析结果(密码子点突变D178N和第129位甲硫氨酸纯合子M/M),被诊断为散发性FFI。提示今后在鉴别克雅氏病(CJD)和FFI患者时,筛查应重点关注临床症状和实验室检查结果。14名家庭成员的PrP基因未出现突变,也无一人患相同疾病。

结论

该病例被诊断为散发性家族性致命性失眠症。对可疑患者的基因组DNA进行PrP基因突变分析对FFI诊断可能非常重要,因为临床实验室评估存在诸多困难。该患者可能是中国首例报告的SFFI患者,此病例的发现对临床和基础研究可能具有重要意义。

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