Travessa André M, Díaz-González Francisca, Mirco Teresa, Oliveira-Ramos Filipa, Parrón-Pajares Manuel, Heath Karen E, Sousa Ana Berta
Department of Medical Genetics, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.
Institute of Histology and Developmental Biology, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
Am J Med Genet A. 2020 Nov;182(11):2715-2721. doi: 10.1002/ajmg.a.61817. Epub 2020 Aug 28.
Spondyloepiphyseal dysplasia type Stanescu (SED-S) is a very rare type II collagenopathy. We describe an 8-year-old boy who presented with short trunk, C2-C3 vertebral fusion, hand, foot, leg and thigh pain, stiffness and limited joint mobility, and waddling gait. Radiographs showed platyspondyly with anterior wedging and endplate irregularities, broad femoral necks, and large epiphyses and epiphyseal equivalents. Differential diagnosis included progressive pseudorheumatoid dysplasia and SED-S. A skeletal dysplasia custom-designed NGS panel was performed and the heterozygous pathogenic variant c.620G>A; p.(Gly207Glu) in COL2A1 was detected, establishing the diagnosis of SED-S. Vertebral fusions, observed in our patient, have not been previously described in this dysplasia. This variant has not been previously associated with SED-S, but was reported in two other families with spondyloepiphyseal dysplasia. Thus, this case expands the clinical and mutational spectrum of SED-S and demonstrates that SED-S significantly overlaps with other skeletal dysplasias.
斯唐埃斯库型脊椎骨骺发育不良(SED-S)是一种非常罕见的II型胶原蛋白病。我们描述了一名8岁男孩,他表现为躯干短小、C2 - C3椎体融合、手、足、腿和大腿疼痛、僵硬以及关节活动受限,还有蹒跚步态。X线片显示椎体扁平并伴有前缘楔形变和终板不规则、股骨颈增宽以及大的骨骺和类骨骺结构。鉴别诊断包括进行性假类风湿性发育不良和SED-S。进行了骨骼发育不良定制设计的二代测序(NGS)检测,检测到COL2A1基因中的杂合致病性变异c.620G>A;p.(Gly207Glu),从而确诊为SED-S。在我们的患者中观察到的椎体融合,此前在这种发育不良中尚未有过描述。该变异此前未与SED-S相关联,但在另外两个脊椎骨骺发育不良的家族中被报道过。因此,该病例扩展了SED-S的临床和突变谱,并表明SED-S与其他骨骼发育不良有显著重叠。