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中国先天性全身性脂肪营养不良新生儿的新生儿发病型糖尿病 2:一例报告。

The neonatal onset diabetes mellitus of Chinese neonate with congenital generalized lipodystrophy 2: a case report.

机构信息

Department of Neonatology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, China.

出版信息

BMC Endocr Disord. 2022 Mar 29;22(1):83. doi: 10.1186/s12902-022-00992-x.

Abstract

BACKGROUND

Congenital generalized lipodystrophy (CGL) is a clinically heterogeneous disorder characterized by near total absence of adipose tissue along with metabolic complications. Diabetes mellitus developed from CGL usually present between ages 15 and 20 years, and there are few reports in neonate.

CASE PRESENTATION

In this report, we described a rare clinical presentation of CGL in a 12-day-old Chinese female neonates with hyperglycemia, hyperlipidemia, and subsequently appeared diabetes, hepatomegaly and fatty liver. The two clinical-exome sequencing identified heterozygous null mutations (c.793C > T and c.565G > T) in BSCL2 gene which was inherited from father and mother respectively. To date, it was the firstly reported CGL patient with neonatal onset diabetes. The neonate was treated with antibiotic, insulin and deeply hydrolyzed formula milk to significantly decrease FBG and serum trigylcerides levels.  CONCLUSIONS: Our case report analyzes the causes of early onset diabetes may relate with the locus of BSCL2 gene mutations and infection induction. It also suggests the importance of early identification, genetic analysis, and symptomatic treatment in the CGL, which are essential for improving the prognosis of children.

摘要

背景

先天性全身性脂肪营养不良(CGL)是一种临床表现高度异质性的疾病,其特征为几乎完全缺乏脂肪组织,并伴有代谢并发症。由 CGL 导致的糖尿病通常在 15 至 20 岁之间发病,新生儿中鲜有报道。

病例介绍

本报告描述了一例罕见的 12 天大的中国女性新生儿 CGL 临床表现,其表现为高血糖、高血脂,随后出现糖尿病、肝肿大和脂肪肝。两次临床外显子组测序分别在 BSCL2 基因上发现杂合性无义突变(c.793C>T 和 c.565G>T),该突变分别来自父亲和母亲。迄今为止,这是首例报道的新生儿起病的 CGL 患者。该新生儿接受了抗生素、胰岛素和深度水解配方奶治疗,显著降低了 FBG 和血清三酰甘油水平。

结论

我们的病例报告分析了早发糖尿病的原因可能与 BSCL2 基因突变的位置和感染诱导有关。它还提示了在 CGL 中早期识别、基因分析和症状治疗的重要性,这对于改善患儿的预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c30/8961907/260aa353ad14/12902_2022_992_Fig1_HTML.jpg

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