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一种罕见的先天性丝状睑缘粘连,与Hay-Wells综合征及TP63基因上的c.1709T>C突变相关。

A rare form of ankyloblepharon filiforme adnatum associated with the Hay-Wells syndrome and a c.1709T>C mutation on the TP63 gene.

作者信息

Koubek Michal, Strakošová Kristýna, Timkovič Juraj, Grečmalová Dagmar, Orlíková Aneta, Burčková Hana, Wiedermannová Hana, Mašek Petr

机构信息

a Clinic of Ophthalmology , University Hospital Ostrava , Czech Republic.

b Department of Medical Genetics , University Hospital Ostrava , Czech Republic.

出版信息

Ophthalmic Genet. 2018 Apr;39(2):251-254. doi: 10.1080/13816810.2017.1401091. Epub 2017 Nov 15.

Abstract

INTRODUCTION

Ankyloblepharon filiforme adnatum associated with Hay-Wells syndrome is a rare congenital disease caused by mutations in TP63 gene on the 3q27 chromosome. Here, we report a case of a new-born suffering from this syndrome in whom we detected a mutation c.1709T>C not previously included in the Ensemble database.

CASE DESCRIPTION

A girl delivered in the 34th week of gestation from a physiological pregnancy was born with extensive burn-like skin defects, ankyloblepharon filiforme adnatum, palate cleft, onychodystrophy of all limbs and syndactyly of toes. Hay-Wells syndrome was suspected and confirmed by genetic examination. A heterozygous missense change c.1709T>C was found in the TP63 gene. This variant leads to a 570th codon exchange of leucine for proline (p.Leu570Pro) on the protein level. The eyelid separation was performed surgically, burns were treated locally and cosmetic surgeries correcting other defects are planned for the near future. The girl is still monitored by a multidisciplinary team.

CONCLUSIONS

The mutation was not previously described in the literature or databases and should be included into these as probably pathogenic. A multidisciplinary approach is necessary to care for a patient with Hay-Wells syndrome, such care however can provide good results.

摘要

引言

与海-韦综合征相关的丝状粘连性睑缘融合是一种由3q27染色体上TP63基因突变引起的罕见先天性疾病。在此,我们报告一例患有该综合征的新生儿,我们在其身上检测到一个Ensemble数据库中未曾收录的c.1709T>C突变。

病例描述

一名孕34周自然分娩的女婴出生时患有大面积类似烧伤的皮肤缺损、丝状粘连性睑缘融合、腭裂、四肢甲营养不良和并趾畸形。怀疑为海-韦综合征并经基因检查确诊。在TP63基因中发现杂合错义改变c.1709T>C。该变异在蛋白质水平导致第570位密码子的亮氨酸替换为脯氨酸(p.Leu570Pro)。通过手术进行了眼睑分离,对烧伤进行了局部治疗,并计划在近期进行矫正其他缺陷的整形手术。该女孩仍由多学科团队进行监测。

结论

该突变此前在文献或数据库中均未被描述,应作为可能致病的突变纳入其中。对于海-韦综合征患者,多学科方法是必要的,然而这种护理可以取得良好效果。

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