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1例伴有双侧肾结石的1型遗传性黄嘌呤尿症。

A case of hereditary xanthinuria type 1 accompanied by bilateral renal calculi.

作者信息

Fujiwara Yutaka, Kawakami Yoshikazu, Shinohara Yoshihiko, Ichida Kimiyoshi

机构信息

Department of Endocrinology and Metabolism, KKR Sapporo Medical Center, Japan.

出版信息

Intern Med. 2012;51(14):1879-84. doi: 10.2169/internalmedicine.51.6891. Epub 2012 Jul 15.

Abstract

Hereditary xanthinuria is an extremely rare purine metabolism disorder caused by a genetic abnormality in xanthine dehydrogenase. A new case of hereditary xanthinuria type 1 accompanied by bilateral renal calculi was encountered. We performed an allopurinol loading test and diagnosed classical type 1 xanthinuria. Through genetic diagnosis, we identified a mutation site in the xanthine dehydrogenase gene. Genetic analysis revealed a homozygous deletion of cytosine 2,567 in the xanthine dehydrogenase gene, and as a result, a stop codon was formed at position 928. Renal failure caused by the deposition of xanthine crystals is a known complication because xanthine is poorly soluble in water. With high fluid intake and low purine diet, no significant increase in calculi has been observed in this patient for 2 years.

摘要

遗传性黄嘌呤尿症是一种极其罕见的嘌呤代谢紊乱疾病,由黄嘌呤脱氢酶的基因异常引起。我们遇到了一例伴有双侧肾结石的1型遗传性黄嘌呤尿症新病例。我们进行了别嘌呤醇负荷试验,诊断为典型的1型黄嘌呤尿症。通过基因诊断,我们在黄嘌呤脱氢酶基因中鉴定出一个突变位点。基因分析显示黄嘌呤脱氢酶基因中第2567位胞嘧啶纯合缺失,结果在第928位形成了一个终止密码子。由于黄嘌呤在水中的溶解度很低,黄嘌呤晶体沉积导致的肾衰竭是一种已知的并发症。通过大量饮水和低嘌呤饮食,该患者在2年内未观察到结石有明显增加。

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