Chen Jie, Zhang Xing-Xing, Wu Xiao-Chuan, Li Jian
Department of Pediatrics, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2019 Jul;21(7):685-689. doi: 10.7499/j.issn.1008-8830.2019.07.013.
This paper reports the clinical and genetic characteristics of a case of combined pituitary hormone deficiency type I (CPHD1) caused by POU domain, class 1, transcription factor 1 (POU1F1) gene variation. A 2 years and 3 months old girl mainly presented with short stature, special facial features of prominent forehead, enophthalmos, and short mandible, loose skin, central hypothyroidism, complete growth hormone deficiency, and anterior pituitary hypoplasia. Gene analysis identified a novel heterozygous mutation, c.889C>T (p.R297W), in POU1F1 gene, and this locus of her parents was wild-type. This mutation was analyzed as a possible pathogenic variant according to the guidelines of the American College of Medical Genetics and Genomics, which has not been previously reported in the literature and conforms to the autosomal dominant inheritance. This child was diagnosed with CPHD1. Her height increased by 19.8 cm and showed a catch-up growth trend after one year of combined treatment with growth hormone and euthyrox. This study enriches the mutation spectrum of POU1F1 gene and has important significance for the diagnosis and classification of combined pituitary hormone deficiency.
本文报道了一例由POU结构域第1类转录因子1(POU1F1)基因变异引起的I型联合垂体激素缺乏症(CPHD1)的临床和遗传特征。一名2岁3个月大的女孩主要表现为身材矮小、特殊面容,前额突出、眼球内陷、下颌短小、皮肤松弛,中枢性甲状腺功能减退、完全性生长激素缺乏以及垂体前叶发育不全。基因分析在POU1F1基因中鉴定出一个新的杂合突变c.889C>T(p.R297W),其父母该位点为野生型。根据美国医学遗传学与基因组学学会的指南,该突变被分析为可能的致病变异,此前文献中未见报道,符合常染色体显性遗传。该患儿被诊断为CPHD1。经生长激素和优甲乐联合治疗一年后,其身高增长了19.8 cm,并呈现追赶生长趋势。本研究丰富了POU1F1基因的突变谱,对联合垂体激素缺乏症的诊断和分类具有重要意义。