Department of Pediatrics, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan.
Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Japan.
CEN Case Rep. 2021 May;10(2):241-243. doi: 10.1007/s13730-020-00551-0. Epub 2020 Nov 7.
HDR syndrome is characterized by the triad of primary hypoparathyroidism, sensorineural hearing loss and renal malformation with widely variable manifestations. It is an autosomal dominant inherited disease caused by a mutation of the GATA3 (NM_001002295.2), which is located on chromosome 10p14. Congenital heart disease, such as tetralogy of Fallot, a typical complication of DiGeorge syndrome, is a rare complication of HDR syndrome. We herein report a case of HDR syndrome coexisting tetralogy of Fallot with a novel mutation, c.964C > T (p.Gln322*). This case suggested that the screening of renal involvement should be carefully performed in patients with a phenotypic combination of hypoparathyroidism and sensorineural hearing loss, to facilitate the early diagnosis of HDR syndrome. In addition, when the deletion of chromosome 22q11.2 is not detected by a fluorescence in situ hybridization analysis in patients exhibiting the partial phenotype of DiGeorge syndrome, the possibility of HDR syndrome should be considered and the renal function should be repeatedly evaluated.
HDR 综合征的特征为三联征,即原发性甲状旁腺功能减退、感觉神经性耳聋和肾脏畸形,临床表现广泛多变。该病是一种常染色体显性遗传性疾病,由 GATA3(NM_001002295.2)基因突变引起,该基因位于 10p14 染色体上。先天性心脏病,如法洛四联症,是 DiGeorge 综合征的典型并发症,是 HDR 综合征的罕见并发症。本文报告了一例 HDR 综合征合并法洛四联症的病例,该病例存在 novel mutation,c.964C > T(p.Gln322*)。该病例提示对于甲状旁腺功能减退和感觉神经性耳聋表型组合的患者,应仔细进行肾脏受累筛查,以促进 HDR 综合征的早期诊断。此外,当荧光原位杂交分析未检测到 22q11.2 染色体缺失时,对于表现出 DiGeorge 综合征部分表型的患者,应考虑 HDR 综合征的可能性,并反复评估肾功能。