Zhang Ting, Hong Fang, Qian Guling, Tong Fan, Zhou Xuelian, Huang Xiaolei, Yang Rulai, Huang Xinwen
Department of Genetics and Metabolism, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310052, China.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2017 Jun 10;34(3):382-386. doi: 10.3760/cma.j.issn.1003-9406.2017.03.015.
To delineate the clinical, biochemical and genetic mutational characteristics of a child with mitochondrial complex III deficiency.
Clinical information and results of auxiliary examination of the patient were analyzed. Next-generation sequencing of the mitochondrial genome and related nuclear genes was carried out. Suspected mutation was confirmed in both parents with Sanger sequencing. Heterozygous deletion was mapped with chromosomal microarray analysis and confirmed with real-time PCR.
The patient presented with vomiting, polypnea, fever, metabolic acidosis, hyperlactatemia, hypoglycemia, dysfunction of coagulation and immune system, in addition with increased lactate dehydrogenase and creatine kinase isoenzyme. Elevation of blood alanine and acylcarnitines as well as urinary ketotic dicarboxylic acid were also noted. The patient also presented development delay, mental retardation and hypotonia. Sequence analysis revealed two mutations in the nuclear gene UQCRB, which included a previously reported frameshift mutation c.306_309delAAAA(p.Arg105Lysfs*22) and a novel large deletion encompassing the entire UQCRB gene.
The clinical, biochemical and gene mutation characteristics of a child with mitochondrial complex III deficiency caused by mutations of the UQCRB gene have been delineated.
明确一名线粒体复合物III缺乏症患儿的临床、生化及基因突变特征。
分析患者的临床资料及辅助检查结果。对线粒体基因组及相关核基因进行二代测序。通过桑格测序在双亲中确认疑似突变。采用染色体微阵列分析对杂合缺失进行定位,并通过实时PCR进行确认。
该患者出现呕吐、呼吸急促、发热、代谢性酸中毒、高乳酸血症、低血糖、凝血及免疫系统功能障碍,同时乳酸脱氢酶和肌酸激酶同工酶升高。还注意到血丙氨酸和酰基肉碱升高以及尿酮性二羧酸。患者还存在发育迟缓、智力障碍和肌张力低下。序列分析显示核基因UQCRB中有两个突变,其中一个是先前报道的移码突变c.306_309delAAAA(p.Arg105Lysfs*22),另一个是包含整个UQCRB基因的新型大片段缺失。
已明确由UQCRB基因突变导致的线粒体复合物III缺乏症患儿的临床、生化及基因突变特征。