Jaouad Imane Cherkaoui, Guaoua Soukaina, Hajjioui Aicha, Sefiani Abdelaziz
Centre de Génomique Humaine, Faculté de Médecine et de Pharmacie, Université Mohammed V Souissi, Av, Mohamed Belarbi El Alaoui, Rabat 6203 Rabat, Morocco.
J Med Case Rep. 2014 Sep 3;8:291. doi: 10.1186/1752-1947-8-291.
Juvenile hyaline fibromatosis and infantile systemic hyalinosis are variants of the same autosomal recessive syndrome; hyaline fibromatosis syndrome, characterized by papulonodular skin lesions, gingival hypertrophy, flexion contractures of joints, osteolytic bone lesions and stunted growth. Infantile systemic hyalinosis is distinguished from juvenile hyaline fibromatosis by its more severe phenotype, which includes hyaline deposits in multiple organs, recurrent infections and death within the first two years of life.Hyaline fibromatosis syndrome is due to mutations of the gene-encoding capillary morphogenesis protein 2 (CMG2). Cases have been reported in different countries but to the best of our knowledge, this is the first reported Moroccan patient with hyaline fibromatosis syndrome and carrying the CMG2 mutation.
We report the case of an eight-year-old Moroccan male patient with typical features of hyaline fibromatosis syndrome: multiple recurring subcutaneous tumors, gingival hypertrophy, joint contractures and other anomalies carrying a homozygous mutation in the CMG2 gene. The identification of the mutation in our patient allowed us to do a presymptomatic diagnosis in our patient's sister, a two-day-old newborn, who is carrying the familial mutation in the heterozygous state. Early recognition of this condition is important for genetic counseling and early treatment.
Hyaline fibromatosis syndrome might be underdiagnosed. Molecular diagnosis will help clinicians and geneticists, firstly to conduct genetic counseling, prenatal diagnosis and early treatment, and secondly to gain better understanding of the disease and genotype-phenotype correlations.
青少年透明纤维瘤病和婴儿系统性透明变性是同一种常染色体隐性综合征——透明纤维瘤病综合征的不同变体,其特征为丘疹结节性皮肤病变、牙龈增生、关节屈曲挛缩、溶骨性骨病变和生长发育迟缓。婴儿系统性透明变性与青少年透明纤维瘤病的区别在于其表型更为严重,包括多个器官出现透明质沉积、反复感染以及在出生后两年内死亡。透明纤维瘤病综合征是由编码毛细血管形态发生蛋白2(CMG2)的基因突变引起的。不同国家均有病例报道,但据我们所知,这是首例报道的携带CMG2突变的摩洛哥透明纤维瘤病综合征患者。
我们报告了一例8岁摩洛哥男性患者,具有透明纤维瘤病综合征的典型特征:多发性复发性皮下肿瘤、牙龈增生、关节挛缩及其他异常,其CMG2基因存在纯合突变。在我们的患者中鉴定出该突变后,我们对其妹妹(一名2日龄新生儿)进行了症状前诊断,她为该家族突变的杂合携带者。早期识别这种疾病对于遗传咨询和早期治疗很重要。
透明纤维瘤病综合征可能诊断不足。分子诊断将有助于临床医生和遗传学家,首先进行遗传咨询、产前诊断和早期治疗,其次更好地了解该疾病以及基因型与表型的相关性。