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遗传性周期性发热综合征在西班牙裔患者中的临床和遗传特征:智利经验。

Clinical and genetic features of hereditary periodic fever syndromes in Hispanic patients: the Chilean experience.

机构信息

Department of Rheumatology and Clinical Immunology, Pontificia Universidad Católica de Chile, Santiago, Chile.

出版信息

Clin Rheumatol. 2012 May;31(5):829-34. doi: 10.1007/s10067-012-1942-3. Epub 2012 Jan 28.

Abstract

Hereditary periodic fever syndromes (HPFS) are rare genetic diseases characterized by recurrent episodes of inflammation. Little information is available concerning HPFS in Latin American Hispanic population. The purpose of this study was to determine the clinical and genetic features of HPFS in Chilean population. A multicenter retrospective study of Hispanic Chilean patients with genetically confirmed HPFS was performed. We included 13 patients, 8 with familial Mediterranean fever (FMF) and 5 with TNF receptor-associated periodic syndrome (TRAPS), evaluated at rheumatology or pediatric rheumatology clinics between January 2007 and December 2010. Median age of symptoms onset was 8 years (range 1-35) and 8 years (range 0.3-21) for FMF and TRAPS, respectively. Median duration of fever was 3 days (range 2.5-15) for FMF and 21 days (range 9.5-30) for TRAPS. Genotyping of the MEFV gene in FMF patients revealed a homozygous M694V missense mutation in one patient, and heterozygous missense mutations in seven patients: M694V (n = 3), E148Q, R717H, A744S, and A511V. Sequencing of the TNFRSF1A gene in TRAPS patients revealed heterozygous missense mutations in four patients: T50M, C30R, R92Q, and IVS3+30:G→A, and a two-base pair deletion (IVS2-17_18del2bpCT) in one patient. Mutation in MEFV R717H and mutations in TNFRSF1A IVS2-17_18del2bpCT and IVS3+30:G→A are novel and have not been described previously. This study reports the largest series of genetically confirmed HPFS in Latin America, and adds evidence regarding the clinical and genetic characteristics of patients with FMF and TRAPS in Hispanic population. Mutations identified in MEFV and TNFRSF1A genes include defects reported in other ethnicities and novel mutations.

摘要

遗传性周期性发热综合征(HPFS)是一种罕见的遗传性疾病,其特征为反复发作的炎症。关于拉丁美洲西班牙裔人群中的 HPFS,相关信息有限。本研究的目的是确定智利人群中 HPFS 的临床和遗传特征。我们进行了一项多中心回顾性研究,纳入了 13 名经基因证实的 HPFS 西班牙裔智利患者,这些患者分别于 2007 年 1 月至 2010 年 12 月在风湿病或儿科风湿病门诊接受评估。首发症状的中位年龄为 8 岁(范围 1-35 岁),FMF 和 TRAPS 的中位年龄分别为 8 岁(范围 0.3-21 岁)。FMF 的发热中位持续时间为 3 天(范围 2.5-15 天),TRAPS 的发热中位持续时间为 21 天(范围 9.5-30 天)。FMF 患者 MEFV 基因的基因分型显示,1 名患者存在纯合 M694V 错义突变,7 名患者存在杂合错义突变:M694V(n=3)、E148Q、R717H、A744S 和 A511V。TRAPS 患者 TNFRSF1A 基因的测序显示,4 名患者存在杂合错义突变:T50M、C30R、R92Q 和 IVS3+30:G→A,1 名患者存在两个碱基对缺失(IVS2-17_18del2bpCT)。MEFV 的 R717H 突变以及 TNFRSF1A 的 IVS2-17_18del2bpCT 和 IVS3+30:G→A 突变均为新发现的突变,以前未曾报道过。本研究报告了拉丁美洲最大的一系列经基因证实的 HPFS,为西班牙裔人群中 FMF 和 TRAPS 患者的临床和遗传特征提供了证据。MEFV 和 TNFRSF1A 基因中发现的突变包括其他种族报道的缺陷和新突变。

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