Zhang Hui-Jie, Wang Shi-Biao, Guo Xiao-Feng, Weng Bin, Lin Ling, Hao Yan
Pediatric Intensive Care Unit, Fujian Provincial Maternity and Child Care Center Affiliated to Fujian Medical University, Fuzhou 350001, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2019 Feb;21(2):176-179. doi: 10.7499/j.issn.1008-8830.2019.02.014.
The patient was a female infant aged 1 month and 29 days. She was admitted to the hospital due to convulsions for 6 days and increased blood glucose level for 5 days. She had unstable blood glucose levels. The level of glycosylated hemoglobin was too high to measure. Urine glucose was positive (+ - ++++). The levels of fasting C-peptide and insulin were 0.19 ng/mL and 11.68 μIU/mL respectively. High-throughput sequencing of the genetic endocrine disease gene Panel (412 detected genes, including 49 known diabetes-related genes) showed that the EIF2AK3 gene in the infant had two novel compound heterozygous mutations, c.2731_2732delAG and c.2980G>A, both of which were located in the kinase domain. The infant was diagnosed with Wolcott-Rallison syndrome (WRS). As a rare autosomal recessive disease, WRS is characterized by neonatal diabetes, multiple epiphyseal dysphasia and liver disease. Neonatal diabetes is a prerequisite for the diagnosis of WRS. The EIF2AK3 gene is the pathogenic gene of WRS.
该患者为一名1个月29天大的女婴。她因惊厥6天和血糖水平升高5天入院。她的血糖水平不稳定。糖化血红蛋白水平过高无法测量。尿糖呈阳性(+ - ++++)。空腹C肽和胰岛素水平分别为0.19 ng/mL和11.68 μIU/mL。对遗传内分泌疾病基因面板(检测412个基因,包括49个已知糖尿病相关基因)进行高通量测序显示,该婴儿的EIF2AK3基因有两个新的复合杂合突变,即c.2731_2732delAG和c.2980G>A,均位于激酶结构域。该婴儿被诊断为沃尔科特-拉利森综合征(WRS)。作为一种罕见的常染色体隐性疾病,WRS的特征为新生儿糖尿病、多发性骨骺发育异常和肝病。新生儿糖尿病是诊断WRS的先决条件。EIF2AK3基因是WRS的致病基因。