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韩国遗传性转甲状腺素蛋白淀粉样变性患者的特征。

Characteristics of South Korean Patients with Hereditary Transthyretin Amyloidosis.

作者信息

Choi Kyomin, Seok Jin Myoung, Kim Byoung Joon, Choi Young Cheol, Shin Ha Young, Sunwoo Il Nam, Kim Dae Seong, Sung Jung Joon, Lee Ga Yeon, Jeon Eun Seok, Kim Nam Hee, Min Ju Hong, Oh Jeeyoung

机构信息

Department of Neurology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.

Department of Neurology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.

出版信息

J Clin Neurol. 2018 Oct;14(4):537-541. doi: 10.3988/jcn.2018.14.4.537.

Abstract

BACKGROUND AND PURPOSE

This retrospective cross-sectional study included 18 patients from unrelated families harboring mutations of the transthyretin gene (), and analyzed their characteristics and geographical distribution in South Korea.

METHODS

The included patients had a diagnosis of systemic amyloidosis, clinical symptoms, such as amyloid neuropathy or cardiomyopathy, and confirmation of a gene mutation using genetic analysis recorded between April 1995 and November 2014.

RESULTS

The mean age at disease onset was 49.6 years, and the mean disease duration from symptom onset to diagnosis was 3.67 years. Fifteen of the 18 patients were classified as mixed phenotype, 2 as the neurological phenotype, and only 1 patient as the cardiac phenotype. The most-common mutation pattern in South Korea was Asp38Ala, which was detected in eight patients. Thirteen patients reported their family hometowns, and five of the eight harboring the Asp38Ala mutation were from the Gyeongsang province in southeast Korea. The other eight patients exhibited a widespread geographical distribution. A particularly noteworthy finding was that the valine at position 30 (Val30Met) mutation, which was previously reported as the most-common mutation worldwide and also the most common in the Japanese population, was not detected in the present South Korean patients.

CONCLUSIONS

South Korean patients with hereditary TTR amyloidosis exhibited heterogeneous TTR genotypes and clinical phenotypes. The findings of this study suggest that the distribution of TTR amyloidosis in South Korea is due to de novo mutations and/or related to the other countries in East Asia.

摘要

背景与目的

这项回顾性横断面研究纳入了18名来自非亲缘家庭且携带转甲状腺素蛋白基因(TTR)突变的患者,并分析了他们在韩国的特征及地理分布。

方法

纳入的患者被诊断为系统性淀粉样变性,有诸如淀粉样神经病变或心肌病等临床症状,并通过基因分析确认在1995年4月至2014年11月期间记录到TTR基因突变。

结果

发病的平均年龄为49.6岁,从症状出现到诊断的平均病程为3.67年。18名患者中有15名被归类为混合型表型,2名是神经型表型,只有1名患者是心脏型表型。韩国最常见的突变模式是Asp38Ala,在8名患者中检测到。13名患者报告了他们的家乡,8名携带Asp38Ala突变的患者中有5名来自韩国东南部的庆尚省。其他8名患者呈现广泛的地理分布。一个特别值得注意的发现是,先前报道为全球最常见的TTR突变以及在日本人群中最常见的30位缬氨酸(Val30Met)突变,在目前的韩国患者中未检测到。

结论

韩国遗传性TTR淀粉样变性患者表现出异质性的TTR基因型和临床表型。本研究结果表明,韩国TTR淀粉样变性的分布是由于新发突变和/或与东亚其他国家有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e72/6172511/043710181f52/jcn-14-537-g001.jpg

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