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一名患有β-地中海贫血特征和 SPTA1 基因新型复合杂合突变的儿科患者,遗传性球形红细胞增多症被忽视 7 年。

Hereditary spherocytosis overlooked for 7 years in a pediatric patient with β-thalassemia trait and novel compound heterozygous mutations of SPTA1 gene.

机构信息

Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China.

Department of Pediatrics, First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China.

出版信息

Hematology. 2020 Dec;25(1):438-445. doi: 10.1080/16078454.2020.1846874.

Abstract

We aimed to determine the clinical and genetic characteristics of a boy diagnosed with the β-thalassemia trait. He also had hereditary spherocytosis (HS) that had been overlooked for 7 years. Blood samples collected from the proband and his family were assessed by laboratory tests, and next-generation sequencing (NGS) and Sanger sequencing. The β-thalassemia trait was complicated with HS in the proband. Compound heterozygous mutations of the () gene c.83G > A and c.190G > A in the proband were inherited from his mother and father, respectively, and he also had the heterozygous c.126_129delCTTT mutation in the ) gene. The c.190G > A mutation has not yet been added to the Human Gene Mutation Database (HGMD®). The heterozygous HBB c.126_129delCTTT mutation was inherited from his mother, and his older brother also had this mutation. Compared with other patients with either HS or β-thalassemia, this proband with both HS and the β-thalassemia trait had very complicated laboratory findings, which resulted in HS being overlooked for 7 years. Genetic testing is invaluable for the differential diagnosis of hereditary anemias with overlapping clinical features.

摘要

我们旨在确定一名被诊断患有β-地中海贫血特征的男孩的临床和遗传特征。他还患有遗传性球形红细胞增多症(HS),该病已被忽视了 7 年。从先证者及其家族采集的血液样本通过实验室检测、下一代测序(NGS)和 Sanger 测序进行评估。先证者的β-地中海贫血特征合并有 HS。先证者从母亲和父亲分别遗传了()基因 c.83G > A 和 c.190G > A 的复合杂合突变,并且他还在()基因中具有杂合 c.126_129delCTTT 突变。c.190G > A 突变尚未被添加到人类基因突变数据库(HGMD®)中。杂合 HBB c.126_129delCTTT 突变从母亲遗传而来,他的哥哥也有这种突变。与其他患有 HS 或β-地中海贫血的患者相比,该先证者同时患有 HS 和β-地中海贫血特征,其实验室检查结果非常复杂,导致 HS 被忽视了 7 年。遗传检测对于具有重叠临床特征的遗传性贫血的鉴别诊断具有重要意义。

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