Al-Tamemi Salem, Al-Zadjali Shoaib, Al-Ghafri Fahad, Dennison David
Departments of *Child Health †Hematology, Sultan Qaboos University Hospital, Muscat, Oman.
J Pediatr Hematol Oncol. 2014 May;36(4):e248-50. doi: 10.1097/MPH.0000000000000025.
Chediak-Higashi syndrome (CHS) is a rare, autosomal, recessive lysosomal disorder with hematological and immunologic abnormalities; however, stem-cell transplantation from a matched or related donor may be curative. Many mutations of the CHS1/LYST gene have been reported to date. We report a novel nonsense mutation of the CHS1/LYST gene in 3 Omani patients.
Three patients from 2 different families presented with clinical and laboratory features of CHS and a history of death of a previous sibling because of a severe illness, suggestive of the accelerated phase of CHS. Giant granules were present in the myeloid cell lines. Before the stem-cell transplant, the first patient underwent gene sequencing of all exons of the lysosome trafficking regulator (CHS1/LYST) gene and revealed a nonsense mutation in exon 5 (c.925C>T, p.R309X). Subsequently, upon presentation, the second and third patients' direct gene sequencing of exon 5 revealed the same mutation.
We report a nonsense mutation in exon 5 (c.925C>T, p.R309X). This supports the allelic heterogeneity of CHS and is in line with most reported mutation types that lead to a truncated protein. Identification of the mutation type will facilitate timely diagnosis, management, and family counseling for those with affected children in Oman.
切迪阿克-东综合征(CHS)是一种罕见的常染色体隐性溶酶体疾病,伴有血液学和免疫学异常;然而,来自匹配或相关供体的干细胞移植可能具有治愈作用。迄今为止,已报道了许多CHS1/LYST基因的突变。我们报告了3例阿曼患者中CHS1/LYST基因的一种新的无义突变。
来自2个不同家庭的3例患者表现出CHS的临床和实验室特征,且有一名同胞因重病死亡的病史,提示处于CHS的加速期。髓系细胞系中存在巨大颗粒。在干细胞移植前,首例患者对溶酶体运输调节因子(CHS1/LYST)基因的所有外显子进行了基因测序,结果显示外显子5存在无义突变(c.925C>T,p.R309X)。随后,第二例和第三例患者在就诊时对外显子5进行直接基因测序,结果显示相同的突变。
我们报告了外显子5的无义突变(c.925C>T,p.R309X)。这支持了CHS的等位基因异质性,并且与大多数导致截短蛋白的报道突变类型一致。该突变类型的鉴定将有助于阿曼患有患病儿童的家庭进行及时诊断、管理和遗传咨询。