Toumba Meropi, Neocleous Vassos, Shammas Christos, Anastasiadou Violetta, Allgrove Jeremy, Phylactou Leonidas A, Skordis Nicos
J Pediatr Endocrinol Metab. 2013;26(9-10):987-93. doi: 10.1515/jpem-2013-0019.
Camurati-Engelmann disease (CED) is a rare form of progressive bone dysplasia due to mutations in the transforming factor gene TGFB1 on chromosome 19q13.1-q13.3. Endocrine complications such as osteoporosis, vitamin D deficiency, delayed puberty and hypogonadotrophic hypogonadism may be present.
Genetic analysis of the TGFB1 gene revealed a heterozygous missense mutation p.R218C in exon 4 of chromosome 19q13.1-q13.3 in a 14-year-old girl who presented with typical symptoms of CED, hyperprolactinaemia and menstrual irregularity. The patient responded well to prednisone 5 mg/kg per day as well as calcium and vitamin D supplements.
The role of p.R218C in TGFB1 on the mechanism of the disease itself and the complications of it in bones and endocrine glands remain unclear. Early recognition as well as a detailed understanding of the pathogenesis of the disease is important for future treatment options and better quality of life of such patients.
卡穆拉蒂 - 恩格尔曼病(CED)是一种罕见的进行性骨发育异常,由19号染色体q13.1 - q13.3上的转化因子基因TGFB1突变引起。可能存在骨质疏松、维生素D缺乏、青春期延迟和低促性腺激素性性腺功能减退等内分泌并发症。
对一名14岁女孩进行TGFB1基因的遗传分析,该女孩表现出CED的典型症状、高泌乳素血症和月经不调,结果显示在19号染色体q13.1 - q13.3的第4外显子中有一个杂合错义突变p.R218C。该患者对每天5mg/kg的泼尼松以及钙和维生素D补充剂反应良好。
TGFB1中的p.R218C在疾病本身的机制以及其在骨骼和内分泌腺中的并发症方面的作用仍不清楚。早期识别以及对疾病发病机制的详细了解对于此类患者未来的治疗选择和更好的生活质量很重要。