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囊性纤维化的临床及基因突变特征:8例病例分析

[Clinical and gene mutation features of cystic fibrosis: an analysis of 8 cases].

作者信息

Zhang Na, Liu Jian-Hua, Chu Ya-Juan, Shuai Jin-Feng, Huang Kun-Ling

机构信息

Graduate School of Hebei Medical University, Shijiazhuang 050017, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2022 Jul 15;24(7):771-777. doi: 10.7499/j.issn.1008-8830.2203015.

Abstract

OBJECTIVES

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

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