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一家系同时存在先天性眼球震颤伴 X 连锁隐性遗传及先天性白内障伴常染色体显性遗传:病例报告并文献复习

X-linked inheritances recessive of congenital nystagmus and autosomal dominant inheritances of congenital cataracts coexist in a Chinese family: a case report and literature review.

机构信息

Research Laboratory of Ophthalmology and Vision Sciences, Torsten-Wiesel Research Institute of World Eye Organization, West China Hospital, Sichuan University, Chengdu, 610041, China.

Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, China.

出版信息

BMC Med Genet. 2019 Mar 19;20(1):41. doi: 10.1186/s12881-019-0780-4.

Abstract

BACKGROUND

Congenital nystagmus (CN) and congenital cataracts are distinct eye diseases and are usually isolated. Cases with CN and congenital cataracts caused by different genes in one family have been rarely reported.

CASE PRESENTATION

A 27-year-old man presented with CN and congenital cataracts and he underwent cataract extraction 2 weeks after birth. Three years later, he had posterior chamber intraocular lens implantation. The proband's mother was only afflicted by bilateral lens opacities. Lensectomy was performed in both eyes at age 15. The proband's daughter had bilateral central cataracts and no nystagmus. She had undergone cataract extraction when she was two months old. In this family, 8 affected individuals were affected by bilateral cataracts, and three of them presented with CN. The genetic analysis was performed using a specific Hereditary Ophthalmological Disease Gene Panel on proband and his parents (one of which was a patient). PCR and Sanger sequencing verified the presence of these variants in all members of the family. The novel mutation, c.498-3C > T, in FRMD7 explains why X-Linked recessive inheritance of CN was found in a subset of patients. A heterozygous mutation of the GJA8 gene (c.139G > C), was identified in all patients and thus explains the autosomal dominant pattern of inheritance of congenital cataracts within the family.

CONCLUSIONS

This is the first time that FRMD7 and GJA8 gene mutations have been linked to the pathogenesis of a family with both CN and congenital cataracts. The phenomenon of two different genetic patterns coexisting in one family is rare.

摘要

背景

先天性眼球震颤(CN)和先天性白内障是两种不同的眼部疾病,通常是孤立存在的。由一个家族中不同基因引起的同时患有 CN 和先天性白内障的病例很少见。

病例介绍

一名 27 岁男性,患有先天性眼球震颤和先天性白内障,出生后 2 周行白内障摘除术。3 年后,行后房型人工晶状体植入术。先证者的母亲仅患有双眼晶状体混浊。15 岁时,在双眼行晶状体切除术。先证者的女儿患有双眼中央白内障,无眼球震颤。两个月大时行白内障摘除术。该家系中共有 8 名成员患有双眼白内障,其中 3 名患有先天性眼球震颤。对先证者及其父母(其中 1 名是患者)进行特定遗传性眼病基因panel 分析。PCR 和 Sanger 测序证实所有家族成员均存在这些变体。FRMD7 中的 c.498-3C>T 新突变解释了为什么在部分患者中发现 X 连锁隐性遗传的 CN。在所有患者中均发现 GJA8 基因(c.139G>C)的杂合突变,因此解释了该家系中先天性白内障的常染色体显性遗传模式。

结论

这是首次将 FRMD7 和 GJA8 基因突变与同时患有 CN 和先天性白内障的家系的发病机制联系起来。两种不同遗传模式共存于一个家系的现象较为罕见。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04fa/6423883/6b9cb302f92e/12881_2019_780_Fig1_HTML.jpg

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