Zhao Yun-Jing, Ma Hong-Wei
Department of Developmental Pediatrics, Shengjing Hospital of China Medical University, Shenyang 110004, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2018 May;20(5):387-391. doi: 10.7499/j.issn.1008-8830.2018.05.010.
Both children (one boy and one girl) experienced disease onset in infancy and visited the hospital due to growth retardation. They had unusual facies including thick hair, arched and confluent eyebrows, long and curly eyelashes, short nose, and micrognathia. Patient 1 had congenital heart disease (atrial septal defect and pulmonary stenosis) and special dermatoglyph (a single palmar crease). Patient 2 had cleft palate and moderate-to-severe deafness. Clinical features suggested Cornelia de Lange syndrome in both children. High-throughput sequencing was used to detect the seven known pathogenic genes of Cornelia de Lange syndrome, i.e., the NIPBL, SMC1A, SMC3, HDAC8, RAD21, EP300, and ANKRD11 genes. Sanger sequencing was used to analyze and verify gene mutations. Both patients were found to have novel mutations in the NIPBL gene. One patient had a frameshift mutation in exon 45, c.7834dupA, which caused early termination of translation and produced truncated protein p.R2612fsX20. The other patient had a nonsense mutation, c.505C>T, which caused a premature stop codon and produced truncated protein Q169X. Such mutations were not found in their parents or 50 unrelated healthy individuals.
两个孩子(一男一女)均在婴儿期发病,因生长发育迟缓就医。他们面容异常,包括毛发浓密、眉毛拱形且相连、睫毛长且卷曲、鼻子短以及小颌畸形。患者1患有先天性心脏病(房间隔缺损和肺动脉狭窄)以及特殊皮纹(单一掌纹)。患者2患有腭裂和中重度耳聋。临床特征提示两个孩子均患有科妮莉亚·德·朗格综合征。采用高通量测序检测科妮莉亚·德·朗格综合征的7个已知致病基因,即NIPBL、SMC1A、SMC3、HDAC8、RAD21、EP300和ANKRD11基因。使用桑格测序法分析并验证基因突变。两名患者均被发现NIPBL基因存在新的突变。一名患者在第45外显子发生移码突变,c.7834dupA,导致翻译提前终止,产生截短蛋白p.R2612fsX20。另一名患者发生无义突变,c.505C>T,导致提前出现终止密码子,产生截短蛋白Q169X。在他们的父母或50名无关健康个体中未发现此类突变。