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39 岁男性患者疑患肢端肥大症,伴 Simpson-Golabi-Behmel 综合征——病例研究。

Simpson-Golabi-Behmel syndrome in a 39-year-old male patient with suspected acromegaly-A case study.

机构信息

Pomeranian Medical University, Department of Endocrinology, Metabolic and Internal Diseases, Szczecin, Poland.

Pomeranian Medical University, Independent Unit of Propaedeutic and Dental Physical Diagnostics, Faculty of Medicine and Dentistry, Szczecin, Poland.

出版信息

Am J Med Genet A. 2019 Feb;179(2):322-328. doi: 10.1002/ajmg.a.61013. Epub 2018 Dec 28.

Abstract

Simpson-Golabi-Behmel syndrome (SGBS) is a rare genetic condition and is inherited in an X-linked recessive manner. The disease is caused by a change in the nucleotide sequence of an X-linked gene encoding glypican 3, a protein belonging to the heparan-sulfate membrane proteoglycan family. SGBS case studies are almost entirely restricted to the pediatric population. Scarce literature describing SGBS course in adults may be due to both the high mortality of SGBS patients in childhood and low rate of SGBS diagnosis in adults. We present a case of a 39-year-old man with an initial diagnosis of acromegaly. Genetic tests revealed a hitherto unreported deletion in the GPC3 gene. SGBS manifestations in our patient included tall stature, dysmorphic features, and central nervous system (CNS) anatomical pathology. MRI of the head visualized abnormalities of median line structures, a feature consistent with SGBS: an unclosed craniopharyngeal canal, a sellar-suprasellar cyst, dysmorphic pituitary gland, and a cyst of the septum pellucidum. Moreover, cardiomyopathy complicated by life-threatening paroxysmal ventricular tachycardia was diagnosed. Although various cardiac anomalies are often found in SGBS, their pathogenesis is unclear and may be multifactorial. We believe that the presented case contributes to a better understanding of SGBS and may help clinicians in introducing prophylaxis and treatment for its comorbidities.

摘要

辛普森-高拉比-比姆综合征(Simpson-Golabi-Behmel syndrome,SGBS)是一种罕见的遗传疾病,呈 X 连锁隐性遗传方式。该病是由编码蛋白聚糖 3(glypican 3)的 X 连锁基因突变引起的,蛋白聚糖 3 属于硫酸乙酰肝素膜蛋白聚糖家族。SGBS 的病例研究几乎全部局限于儿科人群。成人 SGBS 病程描述的文献稀缺可能是由于 SGBS 患儿在儿童期的死亡率高,以及成人 SGBS 的诊断率低。我们报告了 1 例 39 岁男性患者,最初诊断为肢端肥大症。基因检测显示 GPC3 基因存在以前未报道的缺失。我们患者的 SGBS 表现包括身材高大、畸形特征和中枢神经系统(central nervous system,CNS)解剖病理学改变。头部 MRI 显示中线结构异常,这一特征与 SGBS 一致:未闭合的颅咽管、蝶鞍上囊肿、垂体畸形和透明隔囊肿。此外,还诊断出并发危及生命的阵发性室性心动过速的心肌病。尽管 SGBS 常伴有各种心脏异常,但它们的发病机制尚不清楚,可能是多因素的。我们认为,所报告的病例有助于更好地了解 SGBS,并可能有助于临床医生为其并发症提供预防和治疗。

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