Sun Yifan, Sun Jingjing, Li Na, Cai Cheng, Gong Xiaohui, Ma Li
Department of Neonatology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, China.
Transl Pediatr. 2020 Apr;9(2):180-186. doi: 10.21037/tp.2020.03.09.
CHARGE syndrome is a rare and complex disorder, causing multiple birth defects and sensory deficits. The gene was proved to be the major pathogenic gene in CHARGE syndrome. To date, the phenotype of neonatal CHARGE syndrome is still poorly recognized. In this paper, we report a Chinese neonate with typical CHARGE syndrome. During his stay in the neonatal intensive care unit of our hospital, the patient presented with various appearance abnormalities, severe dyspnea, dysphagia and recurrent infection. Integrated analysis of the clinical manifestations and examinations suggested a diagnosis of CHARGE syndrome. Later, the genetic analysis revealed a null heterozygous pathogenic mutation in the patient's gene [c.6292C>T (p.Arg2098*)]. Taken together, the patient was diagnostic confirmed as typical CHARGE syndrome. The physicians provided symptomatic treatments for the patient which significantly alleviated his condition, including infection control, laryngoplasty, nasogastric tube feeding and respiratory support. To our knowledge, this case broadens the clinical phenotypic spectrum of typical CHARGE syndrome in neonatal period due to the null mutation of gene [c.6292C>T (p.Arg2098*)]. It also demonstrates that genetic analysis is essential in the diagnosis of CHARGE syndrome early in life. Clinicians should focus on providing supportive and corrective therapies in early treatment, particularly in controlling infection, and improving breathing and feeding.
CHARGE综合征是一种罕见且复杂的疾病,会导致多种出生缺陷和感觉缺陷。该基因被证明是CHARGE综合征的主要致病基因。迄今为止,新生儿CHARGE综合征的表型仍未得到充分认识。在本文中,我们报告了一名患有典型CHARGE综合征的中国新生儿。在我院新生儿重症监护病房住院期间,该患者出现了各种外观异常、严重呼吸困难、吞咽困难和反复感染。对临床表现和检查结果的综合分析提示诊断为CHARGE综合征。后来,基因分析显示该患者的基因存在一个无效杂合致病性突变[c.6292C>T (p.Arg2098*)]。综上所述,该患者被确诊为典型CHARGE综合征。医生为患者提供了对症治疗,显著缓解了他的病情,包括控制感染、喉成形术、鼻饲喂养和呼吸支持。据我们所知,由于基因[c.6292C>T (p.Arg2098*)]的无效突变,该病例拓宽了新生儿期典型CHARGE综合征的临床表型谱。它还表明基因分析在CHARGE综合征的早期诊断中至关重要。临床医生在早期治疗中应注重提供支持性和矫正性治疗,特别是控制感染,以及改善呼吸和喂养。