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[三例表面活性蛋白C p.V39L突变的临床表现]

[Clinical manifestations of three cases of surfactant protein C p. V39L mutation].

作者信息

Chen J H, Zhao D Y, An S H, Zheng Y J, Wang H P, Ma H L

机构信息

Department of Respiratory Disease, Shenzhen Children's Hospital, Shenzhen 518026, China; Chen Jiehua contributed equally to the article.

Department of Respiratory Disease, Nanjing Children's Hospital, Nanjing Medical University, Nanjing 210008, China; Zhao Deyu contributed equally to the article.

出版信息

Zhonghua Er Ke Za Zhi. 2017 Jun 2;55(6):457-461. doi: 10.3760/cma.j.issn.0578-1310.2017.06.013.

Abstract

To investigate the clinical manifestations of surfactant protein C gene (SFTPC) exon-2 c. 115G>G/T (p.V39L). Patients were screened for the entire coding sequence of SFTPC. Three cases from three children's hospital with mutation in p. V39L were reported. All the three cases were females. The age of onset ranged from 2 months to 7 years. Two cases had recurrent lower respiratory tract infection and failed to thrive. One had chronic anoxia and clubbing fingers. Chest computed tomography (CT) showed diffused ground glass pattern, localized emphysema and intralobular septal thickening. In one case, early sign of cyst formation was also shown on CT. Two were lost to follow-up after alleviation of acute respiratory infection. One was treated with oral low-dose azithromycin and nebulized budesonide and terbutaline. She had recurrent lower respiratory tract infection in more than one year of follow-up. Mutations in SFTPC p. V39L cause interstitial lung diseases. Clinical manifestations included recurrent respiratory tract infections, chronic lung disease. Chest CT showing diffused ground glass pattern, localized emphysema, intralobular septal thickening and early sign of cyst formation. The treatment and prognosis need further study.

摘要

为研究表面活性蛋白C基因(SFTPC)外显子2 c.115G>G/T(p.V39L)的临床表现。对患者进行SFTPC全编码序列筛查。报告了来自三家儿童医院的3例p.V39L突变患儿。3例均为女性。发病年龄为2个月至7岁。2例有反复下呼吸道感染且生长发育不良。1例有慢性缺氧和杵状指。胸部计算机断层扫描(CT)显示弥漫性磨玻璃影、局限性肺气肿和小叶内间隔增厚。1例CT还显示有囊肿形成的早期征象。2例在急性呼吸道感染缓解后失访。1例接受口服小剂量阿奇霉素及布地奈德和特布他林雾化治疗。在1年多的随访中她有反复下呼吸道感染。SFTPC p.V39L突变导致间质性肺疾病。临床表现包括反复呼吸道感染、慢性肺病。胸部CT显示弥漫性磨玻璃影、局限性肺气肿、小叶内间隔增厚及囊肿形成的早期征象。治疗及预后需进一步研究。

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