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[小头畸形毛细血管畸形综合征患儿的耐药性癫痫性脑病]

[Resistant epileptic encephalopathy in a child with microcephalic capillary malformation syndrome].

作者信息

Shchugareva L M, Poteshkina O V, Shumeeva A G, Galaktionova S M

机构信息

Pediatric Hospital No. 1, St. Petersburg, Russia.

Mechnikov North-Western State Medical University, St. Petersburg, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2020;120(8):110-116. doi: 10.17116/jnevro2020120081110.

Abstract

Treatment resistant epileptic encephalopathy (EE) in childhood in a significant amount due to genetic damage or congenital abnormalities of the brain. The literature described a rare microcephalic-capillary malformation syndrome (Microcephaly-capillary malformation, MIC-CAP), manifested from the first month of life by the early onset of treatment-resistant epilepsy, severe progressive microcephaly, spastic tetraparesis, severe delay in psychomotor development, multiple, small-sized capillary angiomas on the body and underdevelopment of the fingers. The boy was diagnosed with a previously described variant of the nucleotide sequence in exon 2 of the chr2 gene:74058171rs781694797 188A>G in the homozygous state, leading to the replacement of the amino acid p.Tyr63Cys in 63 protein position. This type of mutation chr2:74058171rs781694797 188A>G was also detected in the father and mother in the heterozygous state. This variant is considered as pathogenic, related to the patient's phenotype. The article presents a literature review of this syndrome and the case report.

摘要

儿童期难治性癫痫性脑病(EE)很大一部分是由脑遗传损伤或先天性异常所致。文献中描述了一种罕见的小头畸形 - 毛细血管畸形综合征(小头畸形 - 毛细血管畸形,MIC - CAP),从出生后第一个月起就表现为早期发作的难治性癫痫、严重进行性小头畸形、痉挛性四肢瘫、精神运动发育严重迟缓、身体上有多个小尺寸毛细血管血管瘤以及手指发育不全。该男孩被诊断出chr2基因外显子2中核苷酸序列的一种先前描述的变体:74058171rs781694797 188A>G处于纯合状态,导致蛋白质第63位氨基酸p.Tyr63Cys被替换。这种chr2:74058171rs781694797 188A>G类型的突变在父亲和母亲中也被检测到,处于杂合状态。该变体被认为是致病的,与患者的表型相关。本文对该综合征进行了文献综述并报告了病例。

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