Department of Pathology, Children's Hospital of Michigan, Detroit, Michigan, USA.
Fetal Pediatr Pathol. 2022 Oct;41(5):749-758. doi: 10.1080/15513815.2021.1964656. Epub 2021 Aug 12.
Megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS) is a lethal congenital disorder characterized by a large, non-obstructed bladder, microcolon, and lack of proper peristalsis.
Five cases of MMIHS were identified, confirmed histologically and were predominantly female (F:M, 4:1). DNA sequencing was also performed.
Four cases showed mutations in the α3 and β4 nicotinic acetylcholine receptor (ηAChR) subunits (CHRNA3 and CHRNB4, respectively) on chromosome 15q24. The 5th case had a delayed clinical presentation of intussusception at 11 months and showed a novel missense mutation in ATP2B4 on Chromosome 1q32.
The first four patients showed a previously identified mutation. The 5th patient shows a novel mutation in ATP2B4. This novel gene was associated with a less severe presentation and increases success of multiorgan transplant than the other four patients. This highlights how identifying various mutations may impact prognosis and clinical treatment plans for MMIHS patients.
巨膀胱-小肠微细运动功能障碍综合征(MMIHS)是一种致命的先天性疾病,其特征为膀胱巨大但无梗阻、小肠细小以及缺乏正常蠕动。
我们共确诊了 5 例 MMIHS 患者,这些患者均经组织学证实,且主要为女性(女:男,4:1)。我们还对这些患者进行了 DNA 测序。
4 例患者的 15q24 染色体上的α3 和 β4 烟碱型乙酰胆碱受体(ηAChR)亚基(CHRNA3 和 CHRNB4)发生突变。第 5 例患者的临床表现为 11 个月时出现肠套叠,其 1q32 染色体上的 ATP2B4 发生了新的错义突变。
前 4 例患者均显示出先前已鉴定出的突变。第 5 例患者则显示出 ATP2B4 的新突变。这种新基因与病情较轻以及多器官移植成功率较高有关,而这优于其他 4 例患者。这突显了确定各种突变可能对 MMIHS 患者的预后和临床治疗计划产生影响。