Department of Pediatrics, The Second Hospital of Lanzhou University, Lanzhou, China.
Department of Radiotherapy, The First Hospital of Lanzhou University, Lanzhou, China.
Acta Haematol. 2020;143(1):60-64. doi: 10.1159/000500797. Epub 2019 Jul 12.
Bernard-Soulier syndrome (BSS) is an extremely rare autosomal recessive bleeding disorder clinically characterized by macrothrombocytopenia and a mucocutaneous bleeding tendency. A 1-year-old Chinese patient who was born to consanguineous parents was diagnosed with early onset of BSS. Gene sequencing and bioinformatics analysis were conducted. We identified a novel homozygous missense mutation (c.790T>C) in the GP1BAgene that causes an amino acid residue substitution of a cysteine with an arginine that might have a deleterious effect on the protein function as predicted by bioinformatics analysis. If a patient has clinical manifestations that include recurrent mucocutaneous bleeding, a mean platelet volume and platelet-large cell ratio above normal levels, and giant platelets on a peripheral smear and has consanguineous parents, a diagnosis of BSS can be suspected. In these situations, gene sequencing for mutations in the GPIb-IX-V complex is necessary.
伯纳德-苏利耶综合征(BSS)是一种极为罕见的常染色体隐性遗传性出血性疾病,临床上以巨血小板减少和黏膜皮肤出血倾向为特征。我们诊断了一名 1 岁的中国患儿,其父母为近亲,患有早发型 BSS。对患儿进行了基因测序和生物信息学分析,在 GP1BA 基因中发现了一个新的纯合错义突变(c.790T>C),导致一个半胱氨酸突变为精氨酸,该突变可能会对蛋白功能产生有害影响,这一预测结果通过生物信息学分析得到了验证。如果患者有以下临床表现:反复黏膜皮肤出血、血小板平均体积和血小板大细胞比率高于正常水平、外周血涂片上有巨大血小板,且父母为近亲,那么可以怀疑为 BSS。在这些情况下,需要对 GPIb-IX-V 复合物的突变进行基因测序。