Sakakibara Kanae, Okayama Yoshiki, Fukushima Kenji, Kaji Shunsaku, Muraoka Michiko, Arao Yujiro, Shimada Akira
Division of Medical Support, Okayama University Hospital, Tsuyama, Okayama, Japan.
Field of Medical Technology, Okayama University Graduate School of Health Sciences, Tsuyama, Okayama, Japan.
Pediatr Int. 2015 Oct;57(5):1023-4. doi: 10.1111/ped.12696. Epub 2015 Aug 26.
Congenital factor VII (FVII) deficiency is a rare bleeding disorder with autosomal recessive inheritance. The present female patient was diagnosed with congenital FVII deficiency because of low hepaplastin test (HPT), although vitamin K was given. Heterozygous p.A191T mutation was detected in the peripheral blood, and the same mutation was also found in the mother and sister. To the best of our knowledge, this is the fourth reported case of p.A191T mutation of FVII in the literature and the first to be reported in Japan. FVII coagulation activity (FVII:C) in asymptomatic heterozygous carriers is mildly reduced. Therefore, some patients may not be accurately diagnosed with congenital FVII deficiency. In infants with low HPT without vitamin K deficiency, congenital FVII deficiency should be considered.
先天性因子VII(FVII)缺乏症是一种罕见的常染色体隐性遗传性出血性疾病。该女性患者尽管接受了维生素K治疗,但由于肝促凝血酶原激酶试验(HPT)结果偏低,被诊断为先天性FVII缺乏症。在外周血中检测到杂合子p.A191T突变,其母亲和姐姐也存在相同突变。据我们所知,这是文献中第四例报道的FVII p.A191T突变病例,也是日本首例报道的此类病例。无症状杂合子携带者的FVII凝血活性(FVII:C)轻度降低。因此,一些患者可能无法被准确诊断为先天性FVII缺乏症。对于HPT偏低且无维生素K缺乏的婴儿,应考虑先天性FVII缺乏症。