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17α-羟化酶/17,20-裂合酶缺陷症 1 例:临床和遗传学发现及随访结果。

A rare case of 17α-hydroxylase/17, 20-lyase deficiency: Clinical and genetic findings and follow-up outcomes.

机构信息

Department of Endocrinology, The Third Clinical Medical College of Fujian Medical University, Xiamen, China.

Department of Endocrinology, Zhongshan Hospital Xiamen University, Xiamen, China.

出版信息

Womens Health (Lond). 2022 Jan-Dec;18:17455057221122597. doi: 10.1177/17455057221122597.

Abstract

Here, we reported a case of a 16-year-old Chinese female patient (46, XX) diagnosed as 17α-hydroxylase/17, 20-lyase deficiency (17-OHD) in June 2018 and over 3 years follow-up outcomes; 17-OHD is a rare form of congenital adrenal hyperplasia. The patient presented with primary amenorrhea, underdeveloped secondary sexual characteristics, hypertension and hypokalemia. Hormonal findings revealed decreased estrogen and androgen, increased progesterone, low cortisol concentration and compensatory high adrenocorticotropic hormone level. Mutation analysis of the gene identified the c.1459_1467del GACTCTTTC homozygous deletion in exon 8, namely, D487_F489del mutation, resulting in the deletion of Aspartate-Serine-Phenylalanine amino acids. The patient's father and mother were all heterozygous carriers of this mutation. The diagnosis and follow-up outcomes provided useful insights to support clinical decision-making and appropriate treatment.

摘要

这里,我们报道了一例 16 岁的中国女性患者(46,XX),该患者于 2018 年 6 月诊断为 17α-羟化酶/17,20-裂合酶缺乏症(17-OHD),并进行了 3 年以上的随访;17-OHD 是一种罕见的先天性肾上腺皮质增生症。该患者表现为原发性闭经、第二性征发育不良、高血压和低钾血症。激素检查结果显示雌激素和雄激素降低,孕激素升高,皮质醇浓度降低,促肾上腺皮质激素水平代偿性升高。基因的突变分析发现第 8 外显子 c.1459_1467del GACTCTTTC 纯合缺失,即 D487_F489del 突变,导致天冬氨酸-丝氨酸-苯丙氨酸氨基酸缺失。该患者的父亲和母亲均为该突变的杂合携带者。该诊断和随访结果为临床决策和适当治疗提供了有用的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ded/9502244/a990b1b3c651/10.1177_17455057221122597-fig1.jpg

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