1. School of Medicine, Kunming University of Science and Technology, Kunming 650500, China.
2. Department of Pediatrics, the First People's Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming 650032, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2022 Jun 25;51(3):306-313. doi: 10.3724/zdxbyxb-2022-0199.
To investigate molecular and clinical characteristics of children with permanent congenital hypothyroidism (CH) in Yunnan, China.
The clinical data of 40 children with CH diagnosed and treated in the First People's Hospital of Yunnan Province during January 2016 and January 2019 were retrospectively analyzed. All children were followed up to 3 years old, and Gesell intelligent score was evaluated at age of 1, 2 and 3 years, respectively. Developmental status and prognosis were evaluated. Next-generation sequencing (NGS) was used to screen all exons and exon-intron boundary sequences of the 27 known CH associated genes, and the relationship between genotypes and clinical phenotypes was analyzed.
Among the 40 children, the thyroid related pathogenic gene mutations were detected in 23 cases with a rate of 57.5%, and a total of 32 mutations of 8 genes were detected. Mutations in , and genes were the most common ones with mutation frequencies of 65.9%(29/44), 11.4%(5/44) and 9.1%(4/44), respectively. gene mutations were detected in 17 children with CH, and a total of 17 mutation types were detected. p.K530* was the most common mutation in gene, accounting for 20.7%(6/29). There was no significant difference in physical development and intelligence assessment between children with heterozygous mutation and compound heterozygous mutations. None of patients could terminate medication at 3 years of the follow-up and all of them were provisionally assessed as permanent CH. The physical and mental development assessment of children with other gene mutations were also in the normal range.
The detection rate of , and pathogenic mutations are high among children with permanent CH in Yunnan area, and no correlation is observed between gene mutation types and prognosis in children with CH.
探讨中国云南地区永久性先天性甲状腺功能减退症(CH)患儿的分子和临床特征。
回顾性分析 2016 年 1 月至 2019 年 1 月云南省第一人民医院收治的 40 例 CH 患儿的临床资料。所有患儿均随访至 3 岁,分别于 1、2、3 岁时进行盖塞尔智能评分评估,评估其发育状况及预后。采用下一代测序(NGS)技术对 27 个已知的 CH 相关基因的所有外显子和外显子-内含子边界序列进行筛查,分析基因型与临床表型的关系。
40 例患儿中,检测出甲状腺相关致病基因突变 23 例,突变率为 57.5%,共检出 8 个基因的 32 种突变。 、 、 基因突变最为常见,突变频率分别为 65.9%(29/44)、11.4%(5/44)和 9.1%(4/44)。在 17 例 CH 患儿中检测到 基因突变,共检出 17 种突变类型。 基因中 p.K530*突变最为常见,占 20.7%(6/29)。 基因杂合突变和复合杂合突变患儿的体格发育和智力评估无显著差异。随访 3 年时,所有患儿均不能停药,均暂定为永久性 CH。其他基因突变患儿的身心发育评估也在正常范围内。
云南地区永久性 CH 患儿 、 、 基因的致病性突变检出率较高,CH 患儿基因突变类型与预后无相关性。