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婴儿期严重高甘油三酯血症的一个极罕见病因:甘油-3-磷酸脱氢酶 1()基因的一个新突变。

A very rare cause of hypertrygliseridemia in infancy: a novel mutation in glycerol-3-phosphate dehydrogenase 1 () gene.

机构信息

Division of Inborn Metabolic Disease, Department of Pediatrics, Bezmialem Vakif University Hospital, Fatih/İstanbul, Türkiye.

Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Küçükçekmece/İstanbul, Türkiye.

出版信息

J Pediatr Endocrinol Metab. 2023 May 23;36(7):704-707. doi: 10.1515/jpem-2023-0053. Print 2023 Jul 26.

Abstract

OBJECTIVES

Transient infantile hypertriglyceridemia (HTGTI) is caused by mutations in the glycerol-3-phosphate dehydrogenase 1 () gene. HTGTI is characterized by hypertriglyceridemia, hepatomegaly, hepatic steatosis and fibrosis in infancy. Here, we reported first Turkish HTGTI patient with a novel mutation of , having hypertriglyceridemia, hepatomegaly, growth retardation and hepatic steatosis. He is the first case who needs transfusion until 6th month in GPD1.

CASE PRESENTATION

A 2-month-27-day-old boy, who had growth retardation, hepatomegaly and anemia suffered to our hospital with vomiting. Triglyceride level was 1603 mg/dL (n<150). Liver transaminases were elevated and hepatic steatosis was developed. He needed transfusion with erythrocyte suspension until 6th month. Etiology could not be elucidated by clinical and biochemical parameters. A novel homozygous c.936_940del (p.His312GlnfsTer24) variant was detected in the gene by Clinical Exome Analysis.

CONCLUSIONS

GPD1 deficiency should be investigated in the presence of unexplained hypertriglyceridemia and hepatic steatosis in children especially in infants.

摘要

目的

瞬态婴儿期高甘油三酯血症(HTGTI)是由甘油-3-磷酸脱氢酶 1()基因突变引起的。HTGTI 的特征是婴儿期高甘油三酯血症、肝肿大、肝脂肪变性和纤维化。在这里,我们报告了首例土耳其 HTGTI 患者,其存在新的基因突变,表现为高甘油三酯血症、肝肿大、生长迟缓以及肝脂肪变性。他是 GPD1 中第一个需要输血到 6 个月的病例。

病例介绍

一名 2 个月 27 天大的男孩,因生长迟缓、肝肿大和贫血到我院就诊,伴有呕吐。甘油三酯水平为 1603mg/dL(n<150)。肝转氨酶升高,肝脂肪变性。他需要输血红细胞悬液直到 6 个月。通过临床和生化参数无法阐明病因。通过临床外显子组分析,在基因中检测到一个新的纯合 c.936_940del(p.His312GlnfsTer24)变异。

结论

在儿童,特别是婴儿中,存在不明原因的高甘油三酯血症和肝脂肪变性时,应调查 GPD1 缺乏症。

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