Yu Shufeng, Zhang Ying, Chen Zhihong, Song Jiye, Wang Caixia
Qingdao University, Qingdao, Shandong, China.
Children's Medical Center, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
Endocr Metab Immune Disord Drug Targets. 2023;23(2):235-241. doi: 10.2174/1871530322666220607123739.
Congenital disorder of glycosylation caused by mutation of the DOLK(DOLK-CDG) is a group of rare autosomal recessive diseases with an early-onset age and poor prognosis. DOLK-CDG can cause the dysfunction of multiple systems and organs such as the heart, skin, nerves, and bones.
We report a child with DOLK-CDG diagnosed and treated in the Affiliated Hospital of Qingdao University. The child was born with neonatal asphyxia, Ichthyoid rash, and congenital heart disease. His fingers of both the hands looked like lotus roots, and the palm and foot were covered by a white membrane. He was hospitalized with a severe infection at 4 months after birth. Physical examination showed that he was complicated with development delay and hypotonia. He experienced convulsions 1 hour after admission and died of multiple organ failure 2 hours after admission. Blood samples were taken for genetic testing before the child died. The results showed that there was a novel compound heterozygous mutation in DOLK, c.1268C>G (P.P423R) and c.1581_1583del (P.527_528del).
This mutation is new and not included in the human gene mutation library. The discovery of the novel mutation broadened the mutation spectrum of DOLK. At the same time, we sorted out the DOLK-CDG gene mutation sites and related clinical manifestations reported by August 2021 through a literature review.
由DOLK(DOLK-CDG)突变引起的先天性糖基化障碍是一组罕见的常染色体隐性疾病,起病早且预后差。DOLK-CDG可导致心脏、皮肤、神经和骨骼等多个系统和器官功能障碍。
我们报告一名在青岛大学附属医院确诊并接受治疗的DOLK-CDG患儿。该患儿出生时伴有新生儿窒息、鱼鳞病样皮疹和先天性心脏病。他的双手手指呈莲藕状,手掌和脚底覆盖着一层白色薄膜。出生后4个月因严重感染住院。体格检查显示他伴有发育迟缓及肌张力减退。入院1小时后出现惊厥,入院2小时后死于多器官功能衰竭。在患儿死亡前采集血样进行基因检测。结果显示,DOLK基因存在一种新的复合杂合突变,即c.1268C>G(P.P423R)和c.1581_1583del(P.527_528del)。
该突变是新发现的,未包含在人类基因突变库中。新突变的发现拓宽了DOLK的突变谱。同时,我们通过文献复习梳理了截至2021年8月报道的DOLK-CDG基因突变位点及相关临床表现。