Zhao Mengwen, Chen Zhiheng, Shen Jie, Zhao Mingyi
Department of Pediatrics, Third Xiangya Hospital, Central South University, Changsha 410013, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2020 Nov 28;45(11):1378-1383. doi: 10.11817/j.issn.1672-7347.2020.190270.
Neurofibromatosis 1 (NF1) is an autosomal dominant genetic disease first manifesting in childhood, which affects multiple organs, childhood development and neurocognitive status. These patients have a high predisposition to develop both benign and malignant tumors. On September 30, 2018, a rare case of NF1 with B-lineage acute lymphocytic leukemia (ALL) was treated in the Department of Pediatrics, Third Xiangya Hospital, Central South University. The child presented with café au lait macules (CALM) since the date of birth. And the diagnosis of B-lineage ALL was made by bone marrow cytomorphologic examination and immunological phenotype detection. ETV6/RUNX1 fusion gene was positive. Also, a de novo mutation of c.2773delT (p.Leu925Ter) was found in the exon of NF1 gene by gene sequencing, which was a nonsense mutation and led to the premature termination of peptide synthesis. Molecular genetic testing is recommended to confirm NF1, particularly in children with only pigmentary features of the diagnostic criteria. NF1-affected individuals should be referred to a specialist of NF1 clinical network for long-term follow-up and surveillance.
神经纤维瘤病1型(NF1)是一种常染色体显性遗传病,在儿童期首次显现,会影响多个器官、儿童发育及神经认知状况。这些患者极易发生良性和恶性肿瘤。2018年9月30日,中南大学湘雅三医院儿科治疗了1例罕见的合并B系急性淋巴细胞白血病(ALL)的NF1患者。该患儿自出生起即出现牛奶咖啡斑(CALM)。通过骨髓细胞形态学检查和免疫表型检测确诊为B系ALL。ETV6/RUNX1融合基因呈阳性。此外,通过基因测序在NF1基因外显子中发现了c.2773delT(p.Leu925Ter)的新发突变,这是一个无义突变,导致肽合成提前终止。建议进行分子遗传学检测以确诊NF1,尤其是对于仅具有诊断标准中色素沉着特征的儿童。NF1患者应转诊至NF1临床网络专家处进行长期随访和监测。