Shi Bing-Jun, Zhu Xiao-Juan, Liu Yi, Hao Jin, Yan Guo-Fu, Wang Su-Ping, Wang Xiu-Yong, Diao Qing-Chun
Department of Dermatology, Chongqing Hospital of Traditional Chinese Medicine (First People's Hospital of Chongqing City), Chongqing, China.
Int J Dermatol. 2015 Apr;54(4):438-42. doi: 10.1111/ijd.12704.
Bullous dermolysis of the newborn (BDN), an extremely rare clinical type of dystrophic epidermolysis bullosa (DEB), is characterized by subepidermal blistering at birth or shortly thereafter, followed by rapid improvement with minimal scarring or pigmentation. A total of 38 cases have been reported in the literature since the disease was initially described in 1985, but only 14 mutations in COL7A1, the gene responsible for the disease, have been detected in families with BDN.
We report a Chinese male infant with BDN and indirect inguinal hernia, in whom a novel de novo mutation in COL7A1 was demonstrated.
DNA was obtained from the blood of the patient and his parents. The coding exon and flanking regions of COL7A1 gene were amplified by polymerase chain reaction and subjected to sequence analysis.
Sequencing showed a heterozygous substitution of guanine by adenine at nucleotide position 6136 of exon 73 in the triple helical domain of type VII collagen, which predicts a change of glycine by serine at position p.G2046S. The mutation was considered to be a pathogenic and de novo mutation.
The coexistence of BDN and indirect inguinal hernia may simply be coincidental. These data contribute to the expanding database of COL7A1 mutations in DEB and should be useful for genetic counseling and prenatal diagnosis in affected families.
新生儿大疱性皮肤松解症(BDN)是营养不良性大疱性表皮松解症(DEB)一种极其罕见的临床类型,其特征为出生时或出生后不久出现表皮下水疱,随后迅速好转,瘢痕形成或色素沉着极少。自1985年该病首次被描述以来,文献中共报道了38例病例,但在BDN家族中仅检测到14种导致该疾病的基因——COL7A1的突变。
我们报告了一名患有BDN和腹股沟斜疝的中国男婴,在其体内发现了COL7A1基因一个新的新生突变。
从患者及其父母的血液中提取DNA。通过聚合酶链反应扩增COL7A1基因的编码外显子及其侧翼区域,并进行序列分析。
测序显示,在VII型胶原三螺旋结构域第73外显子核苷酸位置6136处,鸟嘌呤被腺嘌呤杂合取代,预测该位置的甘氨酸变为丝氨酸(p.G2046S)。该突变被认为是致病性新生突变。
BDN与腹股沟斜疝并存可能只是巧合。这些数据有助于扩大DEB中COL7A1突变的数据库,对受影响家庭的遗传咨询和产前诊断具有指导意义。