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[与Ⅱ型糖基化先天性疾病相关的SLC35A2基因变异的临床特征]

[Clinical characteristics of SLC35A2 gene variants related congenital disorders of glycosylation typeⅡ].

作者信息

Lang C H, Yang Y, Niu X Y, Yang X L, Chen Y, Zhang Y H

机构信息

Deparment of Pediatrics, Peking University First Hospital, Beijing 100034, China (Lang Changhui is working on the Department of Pediatrics, First Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China).

Deparment of Pediatrics, Peking University First Hospital, Beijing 100034, China.

出版信息

Zhonghua Er Ke Za Zhi. 2020 Jul 2;58(7):586-590. doi: 10.3760/cma.j.cn112140-20200308-00198.

Abstract

To summarize the clinical characteristics of children with SLC35A2 gene variants related congenital disorders of glycosylation (SLC35A2-CDG), so as to improve the clinicians' understanding of this disease. Clinical data and gene detection results of 6 epilepsy children with SLC35A2 gene variants were treated in the Department of Pediatrics Peking University First Hospital from April 2019 to February 2020 were analyzed retrospectively. Six children with SLC35A2 gene variants were identified, including 1 male and 5 females. The onset age of seizure was 5.5 (ranged from 2 to 20) months. All 6 cases had epileptic spasms, 2 cases had focal seizures, 2 cases had myoclonic seizures, 1 case had tonic seizures and 1 case had generalized tonic-clonic seizures. All patients with SLC35A2 gene variants were diagnosed as infantile spasm with developmental delay. Four cases had microcephaly, 4 cases had micro skeletal abnormalities, 3 cases had hypotonia and facial dysmorphism, 2 cases had inverted nipples. Visual abnormality, auditory anomaly, congenital cardiac disease and feeding difficulty were observed in one patient. The electroencephalography showed hypsarrhythmia in 6 patients. The brain magnetic resonance imaging (MRI) showed thinning of corpus callosum in 3 patients, delayed myelination in 2 patients and normal brain MRI in 3 patients. There were 2 cases of in-frame deletions, 1 case of missense variant, 1 case of splice site variant, 1 case of 2.14 kb deletion in Xp11.23 (only containing SLC35A2 gene) and 1 case of SLC35A2 gene mosaicism. All 6 cases had de novo variants. The last follow-up age ranged from 18 to 52 months. One patient was seizure free and 5 patients still had frequent seizures after treatment with antiepileptic drugs. SLC35A2 gene variants are mainly de novo variants. The characteristics of patients with SLC35A2-CDG are seizures and developmental delay, infantile spasms are most common diagnosis, micro skeletal anomaly, microcephaly, hypotonia, facial dysmorphism were accompanied features.

摘要

总结伴SLC35A2基因变异的先天性糖基化障碍(SLC35A2-CDG)患儿的临床特征,以提高临床医生对该病的认识。回顾性分析2019年4月至2020年2月在北京大学第一医院儿科就诊的6例伴SLC35A2基因变异的癫痫患儿的临床资料及基因检测结果。共鉴定出6例SLC35A2基因变异患儿,其中男性1例,女性5例。癫痫发作起病年龄为5.5(2至20)个月。6例均有婴儿痉挛症,2例有局灶性发作,2例有肌阵挛发作,1例有强直发作,1例有全身强直-阵挛发作。所有SLC35A2基因变异患者均被诊断为伴有发育迟缓的婴儿痉挛症。4例有小头畸形,4例有微小骨骼异常,3例有肌张力低下和面部畸形,2例有乳头内陷。1例患者有视觉异常、听觉异常、先天性心脏病和喂养困难。脑电图显示6例均有高峰失律。脑磁共振成像(MRI)显示3例胼胝体变薄,2例髓鞘形成延迟,3例脑MRI正常。有2例框内缺失,1例错义变异,1例剪接位点变异,1例Xp11.23处2.14 kb缺失(仅含SLC35A2基因),1例SLC35A2基因镶嵌现象。6例均为新发变异。末次随访年龄为18至52个月。1例患者经抗癫痫药物治疗后无癫痫发作,5例仍频繁发作。SLC35A2基因变异主要为新发变异。SLC35A2-CDG患者的特征为癫痫发作和发育迟缓,最常见诊断为婴儿痉挛症,微小骨骼异常、小头畸形、肌张力低下、面部畸形为伴随特征。

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