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一个家族中由原纤蛋白1突变引起的肢端短小发育不良:一例报告。

Acromicric dysplasia caused by a mutation of fibrillin 1 in a family: A case report.

作者信息

Shen Ren, Feng Jian-Hua, Yang Shan-Pu

机构信息

Department of Pediatrics, The People's Hospital of Yuhuan, Taizhou 317600, Zhejiang Province, China.

Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.

出版信息

World J Clin Cases. 2023 Mar 26;11(9):2036-2042. doi: 10.12998/wjcc.v11.i9.2036.

Abstract

BACKGROUND

Acromicric dysplasia (AD) is a rare skeletal dysplasia. Its incidence is < 1/1000000, and only approximately 60 cases are reported worldwide. It is a disease characterized by severe short stature, short hands and feet, facial abnormalities, normal intelligence, and bone abnormalities. Unlike other skeletal dysplasia, AD has a mild clinical phenotype, mainly characterized by short stature. Extensive endocrine examination has not revealed a potential cause. The clinical effect of growth hormone therapy is still uncertain.

CASE SUMMARY

We report a clinical phenotype of AD associated with mutations in the fibrillin 1 () (OMIM 102370) gene c.5183C>T (p. Ala1728Val) in three people from a Chinese family. A 4-year-old member of the family first visited the hospital because of slow growth and short stature for 2 years, but no abnormalities were found after a series of laboratory tests, echocardiography, pituitary magnetic resonance imaging, and ophthalmological examination. Recombinant human growth hormone (rhGH) was used to treat the patient for > 5 years. The efficacy of rhGH was apparent in the first year of treatment; the height increased from -3.64 standard deviation score (SDS) to -2.88 SDS, while the efficacy weakened from the second year. However, long-term follow-up is required to clarify the efficacy of rhGH.

CONCLUSION

-related AD has genetic heterogeneity and/or clinical variability, which brings challenges to the evaluation of clinical treatment. rhGH is effective for treatment of AD, but long-term follow-up is needed to clarify the effect.

摘要

背景

肢端短小发育不良(AD)是一种罕见的骨骼发育不良疾病。其发病率小于1/1000000,全球仅报道约60例。该疾病的特征为严重身材矮小、手足短小、面部异常、智力正常以及骨骼异常。与其他骨骼发育不良不同,AD具有轻度的临床表型,主要表现为身材矮小。广泛的内分泌检查未发现潜在病因。生长激素治疗的临床效果仍不确定。

病例摘要

我们报告了一个中国家庭中三名成员的AD临床表型,其与原纤维蛋白1(FBN1)(OMIM 102370)基因c.5183C>T(p.Ala1728Val)突变相关。该家庭中一名4岁成员因生长缓慢和身材矮小2年首次就诊,经过一系列实验室检查、超声心动图、垂体磁共振成像和眼科检查后未发现异常。使用重组人生长激素(rhGH)对该患者进行了5年多的治疗。rhGH在治疗的第一年效果明显;身高从-3.64标准差评分(SDS)增加到-2.88 SDS,而从第二年起效果减弱。然而,需要长期随访以明确rhGH的疗效。

结论

与FBN1相关的AD具有遗传异质性和/或临床变异性,这给临床治疗评估带来了挑战。rhGH对AD治疗有效,但需要长期随访以明确效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0741/10044957/6a083dd19d1d/WJCC-11-2036-g001.jpg

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