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一例 FGFR3 基因 c.2419T>C(p. Ter807Arg)(X807R)突变导致的Ⅰ型致死性骨发育不全新生儿的临床特征和分子遗传学分析。

Clinical features and molecular genetic analysis of thanatophoric dysplasia type I in a neonate with a de novo c.2419 T > C (p. Ter807Arg) (X807R) mutation in FGFR3.

机构信息

Pneumology Department of the Children's Hospital of Fudan University, Shanghai, China.

Neonatology Department of the Meizhou City People Hospital, Guangdong, China.

出版信息

Exp Mol Pathol. 2019 Dec;111:104297. doi: 10.1016/j.yexmp.2019.104297. Epub 2019 Aug 30.

Abstract

We present a case report that entails prenatal ultrasonography, postnatal characteristics, and molecular genetic analysis of a newborn who presented with thanatophoric dysplasia type I (TDI) with a mutation in the fibroblast growth factor receptor 3 gene (FGFR3). A malformed newborn with tachypnea, delivered by caesarean at the gestational age of 39 weeks, was the first child of nonconsanguineous parents by a spontaneous pregnancy. Features in prenatal ultrasonography and postnatal radiography were consistent with the diagnosis of TDI, presenting with short body length (38 cm, <3rd percentile), redundant skin folds, a narrow thorax with a bust of 29.5 cm (3-5th percentile), and macrocephaly with a head circumference of 36 cm (>97th percentile). The proposita had postnatal dyspnea and unfortunately died of respiratory failure at the age of 13 days. Molecular genetic analysis revealed a mutation of c.2419 T > C (p. Ter807Arg) (X807R) in FGFR3. Live-born infants with TDI are exceedingly rare, and we hereby report a newborn with a c.2419 T > C mutation in FGFR3, emphasizing phenotype with clinical characteristics and ultrasonographic and X-ray findings, to raise awareness about the heterogeneous patterns of TD.

摘要

我们呈现了一例病例报告,该病例涉及一名新生儿的产前超声、产后特征和分子遗传学分析,其患有成纤维细胞生长因子受体 3 基因(FGFR3)突变导致的Ⅰ型致死性骨发育不全(TDI)。一名患有呼吸急促的畸形新生儿,经剖宫产分娩,孕龄为 39 周,为非近亲父母通过自然妊娠所生的第一胎。产前超声和产后 X 线摄影的特征与 TDI 的诊断一致,表现为体长较短(38cm,<第 3 百分位数)、皮肤褶皱过多、胸廓狭窄,胸围为 29.5cm(第 3-5 百分位数),以及头部较大,头围为 36cm(>第 97 百分位数)。患儿出生后出现呼吸困难,不幸在 13 天时因呼吸衰竭死亡。分子遗传学分析显示 FGFR3 中的 c.2419T>C(p.Ter807Arg)(X807R)突变。TDI 的活产婴儿极为罕见,我们在此报告一例 FGFR3 中的 c.2419T>C 突变的新生儿,强调表型与临床特征以及超声和 X 射线表现,以提高对 TD 异质性模式的认识。

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