Yeşil Gözde, Lebre Anne Sophie, Santos Sofia Dos, Güran Omer, Özahi Ilke Ipek, Daire Valeria Cormier, Güran Tülay
Department of Medical Genetics, Bezmialem Vakif University of Medicine, Istanbul, Turkey.
Am J Med Genet A. 2014 Sep;164A(9):2200-5. doi: 10.1002/ajmg.a.36626. Epub 2014 Jul 2.
Stuve-Wiedemann Syndrome (SWS) (OMIM #601559) is an autosomal recessive disorder characterized by skeletal changes, bowing of the lower limb, severe osteoporosis and joint contractures, episodic hyperthermia, frequent respiratory infections, feeding problems and high mortality in early life. It is caused by mutation in the leukemia inhibitory factor receptor gene (LIFR; 151443) on chromosome 5p13. We provide the clinical follow-up and molecular aspects of six new patients who carried the same novel mutation in the LIFR gene (p.Arg692X) and three patients carried a common haplotype at the LIFR locus supporting a founder effect in the Turkish population. The probable pathogenesis of the features is also discussed. Osseous findings in the presence of other above-mentioned morbid conditions should raise the suspicion of SWS in neonates especially in Arabic and Eastern Mediterranean countries with high rate of consanguineous marriages like in Turkey. Severe osteoporosis, bone deformities, milias, leukocoria, inflammatory lesions on distal extremities, tongue biting behavior and oral ulcers could be more prominent features of the survivors beyond the neonatal period while respiratory and feeding problems are remitting. It is of crucial importance to diagnose such babies earlier in order to prevent extensive laboratory workup and to provide proper genetic counseling.
施图韦-维德曼综合征(SWS)(OMIM编号#601559)是一种常染色体隐性疾病,其特征包括骨骼变化、下肢弯曲、严重骨质疏松和关节挛缩、间歇性高热、频繁呼吸道感染、喂养问题以及早年高死亡率。它由5号染色体p13区域的白血病抑制因子受体基因(LIFR;151443)突变引起。我们报告了6例携带LIFR基因相同新突变(p.Arg692X)的新患者以及3例在LIFR基因座携带常见单倍型的患者的临床随访及分子学情况,这支持了土耳其人群中的奠基者效应。我们还讨论了这些特征可能的发病机制。在存在上述其他病态情况时出现的骨骼表现应引起对新生儿施图韦-维德曼综合征的怀疑,尤其是在像土耳其这样近亲结婚率高的阿拉伯和东地中海国家。严重骨质疏松、骨骼畸形、粟丘疹、白瞳症、远端肢体炎症性病变、咬舌行为和口腔溃疡可能是新生儿期后幸存者更突出的特征,而呼吸和喂养问题会逐渐缓解。早期诊断此类婴儿对于避免大量实验室检查以及提供适当的遗传咨询至关重要。