Sanrı Aslıhan, Demir Selma, Gurkan Hakan
Department of Pediatric Genetics, Health Sciences University Samsun Education and Research Hospital, Samsun, Turkey.
Department of Medical Genetics, Trakya University Faculty of Medicine, Edirne, Turkey.
Mol Syndromol. 2023 Apr;14(2):129-135. doi: 10.1159/000524832. Epub 2022 Nov 7.
Brittle cornea syndrome (BCS) is a rare connective tissue disorder with ocular and systemic features. Extreme corneal thinning and fragility are the main hallmarks of BCS.
A 4-year-old boy presented with recurrent spontaneous corneal perforation. He had blue sclera, corneal leucoma, irregular iris, shallow anterior chamber, corneal astigmatism, and bilateral corneal thinning. He also had several systemic features including hearing loss, skin hyperelasticity, joint hypermobility, scoliosis, and umbilical hernia. A diagnosis of BCS was confirmed with molecular analysis. A homozygous c.17T>G, p.(Val6Gly) variation was identified in the gene.
p.(Val6Gly) variation in was previously reported in 2 patients with BCS. We also considered c.17T>G, p.(Val6Gly) variation as pathogenic based on the following features: the absence of the variation in population databases, in silico predictions, segregation analysis, and clinical signs of our patient. Extremely thin and brittle corneas lead to corneal perforation spontaneously or after minor trauma. Nearly all patients have lost their vision because of corneal rupture and scars. The key challenge in the management of BCS is the prevention of ocular rupture which relies on early diagnosis. Early diagnosis allows for taking prompt measures to prevent ocular rupture.
脆性角膜综合征(BCS)是一种罕见的具有眼部和全身特征的结缔组织疾病。角膜极度变薄和脆弱是BCS的主要特征。
一名4岁男孩出现反复自发性角膜穿孔。他有蓝色巩膜、角膜白斑、虹膜不规则、前房浅、角膜散光和双侧角膜变薄。他还具有一些全身特征,包括听力丧失、皮肤弹性过度、关节活动过度、脊柱侧弯和脐疝。通过分子分析确诊为BCS。在该基因中鉴定出纯合的c.17T>G,p.(Val6Gly)变异。
先前在2例BCS患者中报道过该基因的p.(Val6Gly)变异。基于以下特征,我们也将该基因的c.17T>G,p.(Val6Gly)变异视为致病性变异:人群数据库中不存在该变异、计算机模拟预测、家系分析以及我们患者的临床体征。极度薄且脆弱的角膜会导致角膜自发穿孔或在轻微创伤后穿孔。几乎所有患者都因角膜破裂和瘢痕而失明。BCS治疗的关键挑战在于预防眼部破裂,这依赖于早期诊断。早期诊断能够采取及时措施预防眼部破裂。