Xu Y, Fu W Z, He J W, Yue H, Zhang Z L
Metabolic Bone Disease and Genetics Research Unit, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
Zhonghua Nei Ke Za Zhi. 2019 Jul 1;58(7):508-513. doi: 10.3760/cma.j.issn.0578-1426.2019.07.005.
Proteus syndrome is a rare disease. The aim of the present study was to analyze the clinical characteristics and gene mutations of Proteus syndrome with a case report and relevant literature review. Clinical data of the patient with Proteus syndrome were collected in detail and biochemical measurements and radiological examinations were conducted. Tissues from phalanges with lesions were obtained to extract DNA, and Sanger sequencing of AKT1 gene was carried on. The pathogenic mutation was further tested in peripheral blood samples of the patient, his parents and 250 healthy volunteers. Orthopaedic surgery was performed on the affected limbs of the patient. The patient was presented with progressive overgrowth of the right extremity, scoliosis, cerebral connective tissue nevus and lower extremity venous. A heterozygous mutation of AKT1 gene (c. 49G>A) was identified in DNA extracted from the affected bone tissue of the patient, but not be found in genomic DNA of peripheral blood samples from the patient, his parents and 250 healthy volunteers. Movement function of the affected limb improved significantly after the operations. The prominent features of Proteus syndrome are overgrowth of one extremity and cerebral connective tissue nevus. A mosaic somatic mutation of AKT1 gene is one of the pathogenic mutations for Proteus syndrome, and orthopedic surgery may be a good way to improve symptoms of the disease.
变形综合征是一种罕见疾病。本研究旨在通过病例报告及相关文献回顾分析变形综合征的临床特征和基因突变情况。详细收集了变形综合征患者的临床资料,并进行了生化检测和影像学检查。获取有病变的指骨组织提取DNA,对AKT1基因进行桑格测序。在患者及其父母以及250名健康志愿者的外周血样本中进一步检测该致病突变。对患者的患肢进行了骨科手术。该患者表现为右下肢进行性过度生长、脊柱侧弯、脑结缔组织痣和下肢静脉病变。在从患者受影响的骨组织提取的DNA中鉴定出AKT1基因的杂合突变(c. 49G>A),但在患者及其父母以及250名健康志愿者的外周血样本基因组DNA中未发现。手术后患肢的运动功能明显改善。变形综合征的突出特征是单肢过度生长和脑结缔组织痣。AKT1基因的嵌合体细胞突变是变形综合征的致病突变之一,骨科手术可能是改善该疾病症状的一种好方法。