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一个与严重智力残疾和癫痫相关的新型杂合突变:病例报告。

A novel hemizygous mutation associated with severe intellectual disability and epilepsy: a case report.

机构信息

Division of Pediatrics, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, Sichuan University, Chengdu, China.

Division of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, Chengdu, China.

出版信息

J Int Med Res. 2021 Nov;49(11):3000605211058372. doi: 10.1177/03000605211058372.

Abstract

encodes collybistin, a brain-specific guanosine diphosphate-guanosine-5'-triphosphate exchange factor that plays an important role in clustering of gephyrin and γ-aminobutyric acid type A receptors in the postsynaptic membrane. Overwhelming evidence suggests that defects in this protein can cause X-linked intellectual disability, which comprises a series of clinical phenotypes, including autism spectrum disorder, behavior disorder, intellectual disability, and febrile seizures. Here, we report a boy with clinical symptoms of severe intellectual disability, epilepsy, and developmental delay and regression. Trio exome sequencing (-clinical exome sequencing) identified a novel hemizygous deletion, c.656_c.669delACTTCTTTGAGGCC (p. His219Leu fs*9), in exon 5 of . This variant was not reported in either the Genome Aggregation Database or our database of 309 patients with neurodevelopmental disorders. Oxcarbazepine and levetiracetam reduced the frequency of the patient's epileptic seizures to a certain extent, but psychomotor developmental delay and developmental regression became more obvious with age. This case study seeks to report a loss-of-function mutation of aiming to emphasize the genetic diagnosis of X-linked intellectual disability and further improve knowledge of the ethnic distribution of mutations.

摘要

编码 collybistin,一种脑特异性鸟苷二磷酸鸟苷-5'-三磷酸交换因子,在突触后膜中网格蛋白和γ-氨基丁酸 A 型受体的聚类中发挥重要作用。大量证据表明,该蛋白的缺陷可导致 X 连锁智力障碍,其包含一系列临床表型,包括自闭症谱系障碍、行为障碍、智力障碍和热性惊厥。在这里,我们报告了一名男孩,他具有严重智力障碍、癫痫和发育迟缓及倒退的临床症状。三重外显子组测序(-临床外显子组测序)发现 5 号外显子中存在一个新的杂合性缺失 c.656_c.669delACTTCTTTGAGGCC(p.His219Leufs*9)。该变体未在基因组聚集数据库或我们的 309 名神经发育障碍患者数据库中报道过。奥卡西平和左乙拉西坦在一定程度上降低了患者癫痫发作的频率,但随着年龄的增长,精神运动发育迟缓及倒退变得更加明显。本病例研究旨在报告一个 的功能丧失突变,旨在强调 X 连锁智力障碍的遗传诊断,并进一步提高对 突变的种族分布的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48ff/8647271/dbfea2bea7d7/10.1177_03000605211058372-fig1.jpg

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