Li Xiaoli, Shen Jian
Department of Pediatrics, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Front Pediatr. 2022 Nov 7;10:1029004. doi: 10.3389/fped.2022.1029004. eCollection 2022.
Carnitine-acylcarnitine translocase deficiency (CACT deficiency) is a rare and life-threatening autosomal recessive disorder of mitochondrial fatty acid oxidation caused by variant of gene. The most prevalent missense variant in the gene in Asia was c.199-10T > G. Due to the c.199-10T > G variant, CACT deficiency is a severe phenotype.
Herein, we present a neonatal case with c.199-10T > G variant in China and analyze the clinical, biochemical, and genetic aspects of 78 patients previously identified with CACT deficiency.
The patient presented with a series of severe metabolic crises that rapidly deteriorated and eventually died 3 days after delivery. The sequencing of the patient's genome indicated that he was homozygous for the c.199-10T > G variant. 30 patients were found to have the c.199-10T > G mutation, of which 23 were Chinese and 22 were afflicted by the c.199-10T > G splicing variation. In China, c.199-10T > G allele frequency was 82.6%.
In CACT deficiency, prompt recognition and treatment are critical. Our data suggested that c.199-10T > G may be a potential hotspot gene mutation in the Chinese population. Detection of single nucleotide polymorphism is possible for high-risk patients and parents in China.
肉碱 - 脂酰肉碱转位酶缺乏症(CACT缺乏症)是一种由基因变异引起的罕见且危及生命的常染色体隐性线粒体脂肪酸氧化障碍疾病。亚洲人群中该基因最常见的错义变异是c.199 - 10T>G。由于c.199 - 10T>G变异,CACT缺乏症表现为严重的表型。
在此,我们报告了中国一名携带c.199 - 10T>G变异的新生儿病例,并分析了先前确诊为CACT缺乏症的78例患者的临床、生化和基因方面情况。
该患者出现一系列严重的代谢危机,病情迅速恶化,最终在出生后3天死亡。对患者基因组测序表明,他是c.199 - 10T>G变异的纯合子。发现30例患者有c.199 - 10T>G突变,其中23例为中国人,22例受c.199 - 10T>G剪接变异影响。在中国,c.199 - 10T>G等位基因频率为82.6%。
在CACT缺乏症中,及时识别和治疗至关重要。我们的数据表明,c.199 - 10T>G可能是中国人群中潜在的热点基因突变。对中国的高危患者及其父母进行单核苷酸多态性检测是可行的。