Chen Min, Li Si-Tao, Cai Yao, Xiao Xin, Shi Cong-Cong, Hao Hu
Department of Pediatrics, Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2020 Oct;22(10):1114-1118. doi: 10.7499/j.issn.1008-8830.2004078.
This article reports the clinical and genetic features of a case of Tatton-Brown-Rahman syndrome (TBRS) caused by DNMT3A gene mutation. A girl, aged 8 months and 14 days, had the clinical manifestations of psychomotor retardation, hypotonia, ventricular enlargement, and tonsillar hernia malformation. Gene analysis identified a novel heterozygous mutation, c.134C>T(p.A45V), in the DNMT3A gene, and the wild type was observed at this locus in her parents. This mutation was determined as a possible pathogenic mutation according to the guidelines of American College of Medical Genetics and Genomics, which had not been reported in previous studies and conformed to autosomal dominant inheritance. This child was diagnosed with TBRS. TBRS often has a good prognosis, with overgrowth and mental retardation as the most common clinical manifestations, and behavioral and psychiatric problems, scoliosis, and afebrile seizures are possible complications of TBRS. The possibility of TBRS should be considered for children with overgrowth and mental retardation, and genetic diagnosis should be conducted when necessary.
本文报道了一例由DNMT3A基因突变引起的塔顿-布朗-拉赫曼综合征(TBRS)的临床和遗传特征。一名8个月14天大的女孩,有精神运动发育迟缓、肌张力低下、脑室扩大和扁桃体疝畸形等临床表现。基因分析在DNMT3A基因中鉴定出一个新的杂合突变,c.134C>T(p.A45V),其父母该位点为野生型。根据美国医学遗传学与基因组学学会的指南,该突变被确定为可能的致病突变,此前研究中未见报道,符合常染色体显性遗传。该患儿被诊断为TBRS。TBRS通常预后良好,生长过速和智力迟钝是最常见的临床表现,行为和精神问题、脊柱侧弯和无热惊厥是TBRS可能的并发症。对于生长过速和智力迟钝的儿童应考虑TBRS的可能性,必要时应进行基因诊断。