Huang J, Zhan X Y, Zhao A L, Wu B, Yang Y, Tan P, Wan L J, Lu Y H
Department of Hematology, Maternal and Child Hospital of Tongji Medical College of HUST, Maternal and Child Hospital of Hubei Province, Wuhan 430030, China.
Zhonghua Xue Ye Xue Za Zhi. 2021 Feb 14;42(2):129-134. doi: 10.3760/cma.j.issn.0253-2727.2021.02.007.
To report the clinical manifestations and total exon detection results of one case of MYSM1 gene complex heterozygosity mutation of bone marrow failure syndrome 4 and the results of total exon detection of her family to provide a case phenotype for the early diagnosis of bone marrow failure syndrome 4. A 1-month-old girl with severe anemia was sequenced with trio-WES. Similarly, the family was also sequenced with tribe-WES to confirm the molecular diagnosis. BWA, GATK, and other software were used for annotation analysis of sequencing results. After polymerase chain reaction, Sanger sequencing was performed by ABI3730 sequencer to verify the target sequence. Moreover, the verification results were obtained by the sequence analysis software. The clinical diagnosis of this girl was reported and the relevant pieces of literature were reviewed. The girl presented with pancytopenia, polydactylism, nonspecific white matter changes, and cysts. However, CD3(-)CD19(+) B decreased. The child was identified with MYSM1 complex heterozygous mutation by whole-exome sequencing, NM_001085487.2:c.1607_c.1611delAAGAG and c.1432C>T, which was respectively inherited from his parents. Genealogy verification confirmed that the c.1432C>T mutation carried by the father was from the grandfather (father's father) , whereas the c.1607_c.1611delAAGAG mutation carried by the mother was from the grandfather (mother's father) , whereas the grandmothers, aunts, and uncle did not carry the mutation. The child was diagnosed with BMFS4 combined with clinical phenotypic and molecular genetic findings. This case provides a case phenotype for the early diagnosis of BMFS4 and extends the pathogenicity variation and phenotype spectrum of the MYSM1 gene. The newly discovered pathogenic variant of MYSM1 c. 1607_c.1611delAAGAG has not been reported at home or abroad.
报告1例骨髓衰竭综合征4型MYSM1基因复合杂合突变的临床表现、全外显子检测结果及其家系全外显子检测结果,为骨髓衰竭综合征4型的早期诊断提供病例表型。对1例重度贫血的1月龄女童进行三联全外显子测序(trio-WES)。同样,对其家系也进行家系全外显子测序(tribe-WES)以确诊分子诊断。使用BWA、GATK等软件对测序结果进行注释分析。聚合酶链反应后,通过ABI3730测序仪进行Sanger测序以验证目标序列。此外,通过序列分析软件获得验证结果。报告该女童的临床诊断并复习相关文献。该女童表现为全血细胞减少、多指畸形、非特异性白质改变和囊肿。然而,CD3(-)CD19(+) B细胞减少。通过全外显子测序鉴定该患儿存在MYSM1复合杂合突变,即NM_001085487.2:c.1607_c.1611delAAGAG和c.1432C>T,分别遗传自其父母。家系验证证实父亲携带的c.1432C>T突变来自祖父(父亲的父亲),而母亲携带的c.1607_c.1611delAAGAG突变来自外祖父(母亲的父亲),而祖母、姑姑和叔叔未携带该突变。结合临床表型和分子遗传学结果,该患儿被诊断为骨髓衰竭综合征4型。本病例为骨髓衰竭综合征4型的早期诊断提供了病例表型,并扩展了MYSM1基因的致病性变异和表型谱。新发现的MYSM1基因致病性变异c.1607_c.1611delAAGAG在国内外均未见报道。