Faculty of Medicine and Biomedical Sciences of the University of Yaounde I, Mother and Child Centre of Chantal Biya Foundation, Yaoundé, Cameroon.
Faculty of Medicine and Pharmaceutical Sciences of the University of Douala, Laquintinie Hospital of Douala, Douala, Cameroon.
J Pediatr Endocrinol Metab. 2022 May 2;35(6):777-783. doi: 10.1515/jpem-2021-0696. Print 2022 Jun 27.
Congenital adrenal hyperplasia (CAH) remains one of the most challenging endocrine disorders to diagnose, manage, and treat, especially in Africa where there is lack of neonatal screening program, and limited access to care. Data on biomolecular anomaly are sparse, therefore type of mutations are unknown, increasing management challenges and genetic counseling. The present study aims to describe clinical, biomolecular aspects of a group of Cameroonian patients.
We did an observational retrospective study at the pediatric endocrinology unit of the Mother and Child Centre of the Chantal Biya Foundation in Yaounde from May 2013 to December 2019, including all patients diagnosed with CAH.
We consecutively included 31 patients aged less than 21 years, diagnosed CAH. Median age at diagnosis was 1.71 years (IQR 0.08-2.57 years). Abnormal genitalia was the main complain in 48.4%(n=15). The most prevalent genetic anomaly found in our study population (n=24) was on CYP11, found in 16 patients (66.6%) followed by CYP21A2 mutation found in 8 patients. Homozygous mutation of p.Q356X was found in half of patients with 11 hydroxylase deficiency. This mutation was mostly found in people from semi-Bantu tribes, declared non consanguineous.
11 hydroxylase deficiency is the most prevalent form of CAH found in this group of Cameroonian children.
先天性肾上腺皮质增生症(CAH)仍然是诊断、管理和治疗最具挑战性的内分泌疾病之一,尤其是在非洲,那里缺乏新生儿筛查计划,获得护理的机会有限。关于生物分子异常的数据很少,因此突变类型未知,增加了管理挑战和遗传咨询的难度。本研究旨在描述一组喀麦隆患者的临床、生物分子方面。
我们在雅温得的 Chantal Biya 基金会母婴中心儿科内分泌科进行了一项回顾性观察研究,时间为 2013 年 5 月至 2019 年 12 月,包括所有诊断为 CAH 的患者。
我们连续纳入了 31 名年龄小于 21 岁的患者,诊断为 CAH。诊断时的中位年龄为 1.71 岁(IQR 0.08-2.57 岁)。异常生殖器是 48.4%(n=15)患者的主要主诉。在我们的研究人群中发现的最常见的遗传异常(n=24)是 CYP11,在 16 名患者(66.6%)中发现,其次是 CYP21A2 突变,在 8 名患者中发现。11 羟化酶缺乏症患者中有一半发现了 p.Q356X 纯合突变。这种突变主要发生在来自半班图部落的人群中,他们声称没有血缘关系。
11 羟化酶缺乏症是在这组喀麦隆儿童中发现的最常见的 CAH 形式。