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中国激活钙敏感受体基因变异:一例低钙血症病例报告及文献综述

Activating calcium-sensing receptor gene variants in China: a case report of hypocalcaemia and literature review.

作者信息

Guo Shuzhen, Li Xiaolin, Shan Xiaoou

机构信息

Department of Pediatric Genetic Metabolic Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.

Children's Health Section, Taizhou Women and Children's Hospital of Wenzhou Medical University, Wenzhou, China.

出版信息

J Pediatr Endocrinol Metab. 2023 Mar 21;36(5):500-504. doi: 10.1515/jpem-2022-0623. Print 2023 May 25.

Abstract

OBJECTIVES

Autosomal dominant hypocalcaemia 1 (ADH1) is a rare autosomal dominant genetic disease, due to the activating mutations of the calcium-sensing receptor () gene. The current paper presents a severe case of ADH1 with intellectual backwardness, and systematically reviews the reported 17 ADH1 patients in China.

CASE PRESENTATION

A 7 years old boy with recurrent seizures over 1 year was admitted at Yuying children' hospital, the clinical centre of south province of Zhejiang. Auxiliary examinations demonstrated hypocalcaemia, hyperphosphatemia, hypomagnesemia, hypercalciuria, low parathyroid hormone (PTH), basal ganglia calcifications, normal range of serum creatinine, and 25-hydroxyvitamin D. Wechsler's intelligence test result indicated intellectually backward. The patient's genotype found a heterozygous variant in gene, c.T416C p. (Ile139Thr). This article also systematically reviews the literatures on ADH1 in China and summarises the clinical characteristics and treatment.

CONCLUSIONS

ADH1 can be a cause of idiopathic hypoparathyroidism. Recognition and rational treatment is important for symptom improvement and reducing high potential adverse effects.

摘要

目的

常染色体显性遗传性低钙血症1型(ADH1)是一种罕见的常染色体显性遗传病,由钙敏感受体( )基因的激活突变引起。本文报道1例伴有智力发育迟缓的重症ADH1患者,并对国内已报道的17例ADH1患者进行系统综述。

病例介绍

一名7岁男性患儿,因反复惊厥1年余入住浙江省南部临床中心育英儿童医院。辅助检查显示低钙血症、高磷血症、低镁血症、高钙尿症、甲状旁腺激素(PTH)降低、基底节钙化、血清肌酐及25-羟维生素D水平正常。韦氏智力测验结果显示智力发育迟缓。患者基因型检测发现 基因存在杂合变异,c.T416C p.(Ile139Thr)。本文还对国内ADH1相关文献进行系统综述,并总结其临床特征及治疗方法。

结论

ADH1可能是特发性甲状旁腺功能减退症的病因之一。认识并合理治疗对改善症状及减少潜在不良反应至关重要。

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