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病例报告:3p缺失综合征的病例报告及文献综述

Case Report: A Case Report and Literature Review of 3p Deletion Syndrome.

作者信息

Fu Junxian, Wang Ting, Fu Zhuo, Li Tianxia, Zhang Xiaomeng, Zhao Jingjing, Yang Guanglu

机构信息

Department of Pediatric, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.

出版信息

Front Pediatr. 2021 Feb 10;9:618059. doi: 10.3389/fped.2021.618059. eCollection 2021.

Abstract

The aim of the present study is to explore the clinical and genetic characteristics of 3p deletion syndrome to improve clinicians' understanding of the disease. The clinical manifestations, process of diagnosis and treatment, and genetic characteristics of an individual case of 3p deletion syndrome were analyzed. CNKI, Wanfang Data, and the Biomedical Literature Database (PubMed) were searched. The search time limit, using "3p deletion syndrome" and "" as keywords, was from the creation of the database up to June 2020. Related data were reviewed. The proband was a male child with general developmental and intellectual disabilities, special facial features and congenital heart disease. The child was the parents' first pregnancy and first born. Gene microarray analysis showed a 10.095 Mb deletion in the 3p26.3-p25.3 region, resulting in a heterozygous mutation of the gene; thus, the patient was diagnosed with 3p deletion syndrome. At the time of diagnosis, the child was 1 year of age and was responding to comprehensive rehabilitation training. A total of 29 well-documented cases were found in the literature, of which 19 cases had an onset within 1 year of birth, and mainly manifested with mental and motor development disabilities and abnormal facial features, with different gene deletions, depending on the size and location of the 3p deletion. The genetic test results of the child in this study indicated a heterozygous deletion of the gene on the short arm of chromosome 3, which was a unique feature of this study, since it was rarely mentioned in other reports of 3p deletion syndrome. The clinical phenotype of this syndrome is complex as it can include intellectual and motor development backwardness, low muscle tone, certain abnormal facial features (low hairline, bilateral ptosis, widely spaced eyes, a forward nose, left ear auricle deformity, a high-arched palate, a small jaw), and the deformation of systems such as the gastrointestinal tract and the urinary tract malformation or symptoms of epilepsy. As clinical manifestations can be relatively mild, the syndrome is easy to miss or misdiagnose. Clinical workers need to be aware of this disease when they find that children have special features, such as stunted growth, low muscle tone or ptosis, and it needs to be diagnosed through genetic testing. Most children are able to develop certain social skills after rehabilitation treatment.

摘要

本研究旨在探讨3p缺失综合征的临床及遗传学特征,以提高临床医生对该疾病的认识。分析了1例3p缺失综合征患者的临床表现、诊疗过程及遗传学特征。检索了中国知网、万方数据和生物医学文献数据库(PubMed)。检索时间范围为数据库创建至2020年6月,以“3p缺失综合征”等为关键词进行检索,并对相关数据进行了回顾。先证者为一名男童,有全面发育和智力障碍、特殊面容及先天性心脏病。该患儿为父母的头胎及头产。基因芯片分析显示3p26.3-p25.3区域存在10.095 Mb的缺失,导致该基因杂合突变,因此该患者被诊断为3p缺失综合征。确诊时患儿1岁,正在接受综合康复训练。文献中共找到29例记录完整的病例,其中19例在出生1年内发病,主要表现为智力和运动发育障碍及面容异常,根据3p缺失的大小和位置不同,基因缺失情况也不同。本研究中患儿的基因检测结果显示3号染色体短臂上该基因杂合缺失,这是本研究的一个独特之处,因为在其他3p缺失综合征报告中很少提及。该综合征的临床表型复杂,可包括智力和运动发育迟缓、肌张力低下、某些特殊面容特征(发际线低、双侧上睑下垂、眼距宽、鼻前突、左耳廓畸形、高拱腭、小颌)以及胃肠道等系统畸形、泌尿系统畸形或癫痫症状。由于临床表现可能相对较轻,该综合征容易漏诊或误诊。临床工作者在发现儿童有生长发育迟缓低、肌张力低下或上睑下垂等特殊特征时,需警惕该疾病,且需要通过基因检测来确诊。大多数患儿经康复治疗后能够发展出一定的社交技能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/777c/7902511/6949f90582ab/fped-09-618059-g0001.jpg

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