Wu Siqi, Han Jin, Zhang Yongling, Ye Zhichao, Lu Ping, Tian Kege
Department of Prenatal Diagnosis, Dongguan Kanghua Hospital, Dongguan, China.
Department of Obstetrics and Gynecology, Guangzhou Medical University, Guangzhou, China.
J Obstet Gynaecol Res. 2019 Nov;45(11):2280-2283. doi: 10.1111/jog.14089. Epub 2019 Sep 9.
Congenital chloride diarrhea (CCD) is an autosomal recessive hereditary disease manifested by persistent, watery, profuse diarrhea with high chloride concentration (>90 mmol/L). Postnatally, neonates suffer from hypochloremia, hyponatremia, hypokalemia, metabolic alkalosis, dehydration, developmental retardation, or even death. Prenatal diagnosis is of great importance for the prognosis of CCD. We report a prenatal recurrent case of CCD. Prenatal ultrasound revealed fetal diffuse intestinal dilation with the typical honeycomb sign and polyhydramnios with high amniotic fluid index. The whole exome capture and massively-parallel DNA sequencing showed an abnormal mutation of Solute Carrier Family 26, Member 3 (SLC26A3), c.1039G>A (p.Ala347Thr), and the mutation sites were verified by sanger sequencing. When prenatal ultrasound shows polyhydramnios and diffuse intestinal dilation, CCD should be suspected. Molecular genetic testing can be helpful for the diagnosis.
先天性氯化物腹泻(CCD)是一种常染色体隐性遗传病,表现为持续性、水样、大量腹泻,氯化物浓度高(>90 mmol/L)。出生后,新生儿会出现低氯血症、低钠血症、低钾血症、代谢性碱中毒、脱水、发育迟缓,甚至死亡。产前诊断对CCD的预后至关重要。我们报告一例产前复发性CCD病例。产前超声显示胎儿弥漫性肠扩张,具有典型的蜂窝状征象和羊水过多,羊水指数高。全外显子捕获和大规模平行DNA测序显示溶质载体家族26成员3(SLC26A3)发生异常突变,c.1039G>A(p.Ala347Thr),突变位点通过桑格测序验证。当产前超声显示羊水过多和弥漫性肠扩张时,应怀疑CCD。分子遗传学检测有助于诊断。