Zhang Na, Liu Jian-Hua, Chu Ya-Juan, Shuai Jin-Feng, Huang Kun-Ling
Graduate School of Hebei Medical University, Shijiazhuang 050017, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2022 Jul 15;24(7):771-777. doi: 10.7499/j.issn.1008-8830.2203015.
To study the clinical features and gene mutation sites of children with cystic fibrosis (CF), in order to improve the understanding of CF to reduce misdiagnosis and missed diagnosis.
A retrospective analysis was performed on the medical records of 8 children with CF who were diagnosed in Hebei Children's Hospital from 2018 to 2021.
Among the 8 children with CF, there were 5 boys and 3 girls, with an age of 3-48 months (median 8 months) at diagnosis, and the age of onset ranged from 0 to 24 months (median 2.5 months). Clinical manifestations included recurrent respiratory infection in 7 children, sinusitis in 3 children, bronchiectasis in 4 children, diarrhea in 8 children, fatty diarrhea in 3 children, suspected pancreatic insufficiency in 6 children, pancreatic cystic fibrosis in 1 child, malnutrition in 5 children, and pseudo-Bartter syndrome in 4 children. The most common respiratory pathogens were (4 children). A total of 16 mutation sites were identified by high-throughput sequencing, multiplex ligation-dependent probe amplification, and Sanger sequencing, including 5 frameshift mutations, 4 nonsense mutations, 4 missense mutations, 2 exon deletions, and 1 splice mutation. mutations were found in all 8 children. p.G970D was the most common mutation (3 children), and F508del mutation was observed in one child. Four novel mutations were noted: deletion exon15, c.3796_3797dupGA(p.I1267Kfs12), c.2328dupA(p.V777Sfs2), and c.2950G>A(p.D984N).
p.G970D is the most common mutation type in children with CF. CF should be considered for children who have recurrent respiratory infection or test positive for , with or without digestive manifestations or pseudo-Bartter syndrome.
研究儿童囊性纤维化(CF)的临床特征及基因突变位点,以提高对CF的认识,减少误诊和漏诊。
对2018年至2021年在河北省儿童医院确诊的8例CF患儿的病历进行回顾性分析。
8例CF患儿中,男5例,女3例,确诊年龄3至48个月(中位年龄8个月),发病年龄0至24个月(中位年龄2.5个月)。临床表现包括7例反复呼吸道感染、3例鼻窦炎、4例支气管扩张、8例腹泻、3例脂肪泻、6例疑似胰腺功能不全、1例胰腺囊性纤维化、5例营养不良、4例假性巴特综合征。最常见的呼吸道病原体是(4例患儿)。通过高通量测序、多重连接依赖探针扩增和桑格测序共鉴定出16个突变位点,包括5个移码突变、4个无义突变、4个错义突变、2个外显子缺失和1个剪接突变。8例患儿均发现突变。p.G970D是最常见的突变(3例患儿),1例患儿检测到F508del突变。发现4个新突变:外显子15缺失、c.3796_3797dupGA(p.I1267Kfs12)、c.2328dupA(p.V777Sfs2)和c.2950G>A(p.D984N)。
p.G970D是儿童CF最常见的突变类型。对于反复呼吸道感染或检测呈阳性,无论有无消化表现或假性巴特综合征的儿童,均应考虑CF。