Peng Fang, Zhong Lili, Zhang Bing, Zou Runying, Nie Shengdan, Tian Xin, Deng Shaoyang, He Xiangling
Department of Hematology and Oncology, Children's Medical Center, Hunan Provincial People's Hospital/The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan 410005, P.R. China.
Exp Ther Med. 2019 Apr;17(4):2931-2936. doi: 10.3892/etm.2019.7318. Epub 2019 Feb 26.
The present study describes the successful application of next-generation sequencing (NGS) in the clinical diagnosis, pathogenic gene identification, treatment and pre-natal diagnosis in a pedigree with chronic granulomatosis disease (CGD). A 36-day-old infant, born to non-consanguineous Chinese parents, was admitted to hospital due to a neck lump for 10 days. A blood sample was collected for NGS to identify the molecular etiology. Sanger sequencing was performed for the patient and his relatives, including the parents. Amniotic fluid exfoliative cells from the mother were collected for pre-natal diagnosis at week 16 of a subsequent pregnancy. A novel c.1520_1521del, p.Lys508Aspfs*10 (NM_000397) variant in the cytochrome b-245 β chain (CYBB) gene was identified in the proband, while the mother and the proband's 1-year-old sister were heterozygotes at this site. Karyotype analysis indicated that the fetus of the subsequent pregnancy was male. Sanger sequencing of amniotic cell DNA revealed that the fetus did not have the CYBB abnormality at the site. The results of the present study suggest that the variant in the CYBB gene was the cause of CGD in this pedigree and that pre-natal diagnosis using NGS is an effective method for providing genetic counseling to pedigrees with CGD.
本研究描述了下一代测序(NGS)在慢性肉芽肿病(CGD)家系的临床诊断、致病基因鉴定、治疗及产前诊断中的成功应用。一名36天大的婴儿,其父母为非近亲结婚的中国人,因颈部肿块10天入院。采集血样进行NGS以确定分子病因。对患者及其亲属(包括父母)进行了桑格测序。在后续妊娠第16周时,采集母亲的羊水脱落细胞进行产前诊断。先证者中鉴定出细胞色素b - 245β链(CYBB)基因的一个新的c.1520_1521del、p.Lys508Aspfs*10(NM_000397)变异,而母亲和先证者1岁的妹妹在此位点为杂合子。核型分析表明后续妊娠的胎儿为男性。羊水细胞DNA的桑格测序显示胎儿在此位点没有CYBB异常。本研究结果表明CYBB基因变异是该家系中CGD的病因,并且使用NGS进行产前诊断是为CGD家系提供遗传咨询的有效方法。