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成骨不全Ⅴ型的临床与分子特征

Clinical and Molecular Characterization of Osteogenesis Imperfecta Type V.

作者信息

Brizola Evelise, Mattos Eduardo P, Ferrari Jessica, Freire Patricia O A, Germer Raquel, Llerena Juan C, Félix Têmis M

机构信息

Postgraduate Programs in Child and Adolescent Health, Porto Alegre, Brazil.

Genetics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

出版信息

Mol Syndromol. 2015 Oct;6(4):164-72. doi: 10.1159/000439506. Epub 2015 Sep 3.

Abstract

Osteogenesis imperfecta type V (OI-V) has a wide clinical variability, with distinct clinical/radiological features, such as calcification of the interosseous membrane (CIM) between the radius-ulna and/or tibia-fibula, hyperplastic callus (HPC) formation, dislocation of the radial head (DRH), and absence of dentinogenesis imperfecta (DI). Recently, a single heterozygous mutation (c.-14C>T) in the 5'UTR of the IFITM5 gene was identified to be causative for OI-V. Here, we describe 7 individuals from 5 unrelated families that carry the c.-14C>T IFITM5 mutation. The clinical findings in these cases are: absence of DI in all patients, presence of blue sclera in 2 cases, and 4 patients with DRH. Radiographic findings revealed HPC in 3 cases. All patients presented CIM between the radius and ulna, while 4 patients presented additional CIM between the tibia and fibula. Spinal fractures by vertebral compression were observed in all individuals. The proportion of cases identified with this mutation represents 4% of OI cases at our institution. The clinical identification of OI-V is crucial, as this mutation has an autosomal dominant inheritance with variable expressivity.

摘要

V型成骨不全症(OI-V)具有广泛的临床变异性,具有独特的临床/放射学特征,如桡骨-尺骨和/或胫骨-腓骨之间的骨间膜钙化(CIM)、增生性骨痂(HPC)形成、桡骨头脱位(DRH)以及无牙本质发育不全(DI)。最近,IFITM5基因5'UTR中的一个杂合突变(c.-14C>T)被确定为OI-V的致病原因。在此,我们描述了来自5个无关家庭的7名携带c.-14C>T IFITM5突变的个体。这些病例的临床发现为:所有患者均无DI,2例有蓝色巩膜,4例有DRH。影像学检查发现3例有HPC。所有患者均有桡骨和尺骨之间的CIM,4例患者胫骨和腓骨之间还有额外的CIM。所有个体均观察到椎体压缩性脊柱骨折。在我们机构,通过该突变确诊的病例占OI病例的4%。OI-V的临床诊断至关重要,因为该突变具有常染色体显性遗传且表达可变。

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