Zhang Yun-Yan, Lou Yan, Yan Han, Tang Hao
Department of Respiratory and Critical Care Medicine, Changzheng Hospital, Naval Military Medical University, Shanghai 200003, China.
Department of Orthopedic Oncology, Spine Tumor Center, Changzheng Hospital, Naval Military Medical University, Shanghai 200003, China.
World J Clin Cases. 2022 Sep 6;10(25):9148-9155. doi: 10.12998/wjcc.v10.i25.9148.
Primary ciliary dyskinesia (PCD) is an uncommon and genetically diverse condition. According to reports, most patients had more than 50 visits before being diagnosed with PCD, and the age at diagnosis was mostly in preschool, with an average age of about (10.9 ± 14.4) years old. is a pathogenic gene that regulates the cell cycle, and its mutation is linked to the uncommon human genetic disorder PCD. Although the prevalence of the mutation is regarded to be exceptionally low, new reports of this mutation have increased in comparison to prior ones. PCD patients with are rare, and the incidence rate is no more than 2% in whole PCD patients.
Here, we report a case of a young Chinese woman diagnosed with PCD, who was found to carry the gene by whole exon gene sequencing. In this case, a young non-smoking Chinese female exhibiting recurrent cough and sputum at birth. Chest computed tomography (CT) showed bronchiectasis with infection, and sinus CT showed chronic sinusitis. However, the patient had no visceral transposition and no history of infertility. Under electron microscope, it was found that cilia were short and reduced in number, and no power arm of cilia was observed. Whole exon sequencing analysis of the genome of the patient showed that the patient carried pathogenic gene, exon c.303C>A nonsense mutation and c.248_252dup frameshift mutation. Her clinical symptoms and CT images were improved after two months of treatment with aerosol inhalation and oral azithromycin.
The results showed that is an important cause of PCD. More mutant genes that may contribute to genetically diverse disorders like PCD have been discovered as sequencing technology has advanced. Furthermore, the increase of genetic information makes it easier to diagnose uncommon diseases in clinical practice.
原发性纤毛运动障碍(PCD)是一种罕见的、具有遗传异质性的疾病。据报道,大多数患者在被诊断为PCD之前就诊次数超过50次,诊断年龄多在学龄前,平均年龄约为(10.9±14.4)岁。[基因名称]是一种调节细胞周期的致病基因,其突变与罕见的人类遗传病PCD相关。尽管该基因突变的患病率被认为极低,但与之前相比,关于这种突变的新报道有所增加。携带[基因名称]突变的PCD患者很少见,在整个PCD患者中的发病率不超过2%。
在此,我们报告一例年轻中国女性被诊断为PCD的病例,通过全外显子基因测序发现其携带[基因名称]基因。在该病例中,一名年轻的不吸烟中国女性自出生起就反复咳嗽、咳痰。胸部计算机断层扫描(CT)显示支气管扩张伴感染,鼻窦CT显示慢性鼻窦炎。然而,该患者没有内脏转位,也没有不孕史。在电子显微镜下,发现纤毛短且数量减少,未观察到纤毛的动力臂。对该患者基因组进行的全外显子测序分析显示,患者携带[基因名称]致病基因,外显子c.303C>A无义突变和c.248_252dup移码突变。经过两个月的雾化吸入和口服阿奇霉素治疗后,她的临床症状和CT图像有所改善。
结果表明,[基因名称]是PCD的一个重要病因。随着测序技术的进步,已发现更多可能导致如PCD等具有遗传异质性疾病的突变基因。此外,遗传信息的增加使得在临床实践中更容易诊断罕见疾病。