Zhang Z H, Zheng B X, Zhuo Y J, Jin Y, Liu Z F, Zheng Y C
Department of Gastroenterology, Children's Hospital of Nanjing Medical University, Nanjing 210008, China.
Nanjing Key Laboratory of Pediatrics, Children's Hospital of Nanjing Medical University, Nanjing 210008, China.
Zhonghua Gan Zang Bing Za Zhi. 2023 Apr 20;31(4):428-432. doi: 10.3760/cma.j.cn501113-20220120-00034.
Glycogen storage disease type IX (GSD-IX) is a rare primary glucose metabolism abnormality caused by phosphorylase kinase deficiency and a series of pathogenic gene mutations. The clinical characteristics, gene analysis, and functional verification of a mutation in a child with hepatomegaly are summarized here to clarify the pathogenic cause of the disease. The clinical data of a child with GSD-IX was collected. Peripheral blood from the child and his parents was collected for genomic DNA extraction. The patient's gene diagnosis was performed by second-generation sequencing. The suspected mutations were verified by Sanger sequencing and bioinformatics analysis. The suspected splicing mutations were verified in vivo by RT-PCR and first-generation sequencing. Hepatomegaly, transaminitis, and hypertriglyceridemia were present in children. Liver biopsy pathological examination results indicated glycogen storage disease. Gene sequencing revealed that the child had a c.285 + 2_285 + 5delTAGG hemizygous mutation in the gene. Sanger sequencing verification showed that the mother of the child was heterozygous and the father of the child was of the wild type. Software such as HSF3.1 and ESEfinder predicted that the gene mutation affected splicing. RT-PCR of peripheral blood from children and his mother confirmed that the mutation had caused the skipping of exon 3 during the constitutive splicing of the gene. The hemizygous mutation in the gene (c.285 + 2_285 + 5delTAGG) is the pathogenic cause of the patient's disease. The detection of the novel mutation site enriches the mutation spectrum of the gene and serves as a basis for the family's genetic counseling.
IX型糖原贮积病(GSD-IX)是一种由磷酸化酶激酶缺乏和一系列致病基因突变引起的罕见原发性葡萄糖代谢异常。本文总结了一名肝肿大患儿的临床特征、基因分析及突变的功能验证,以明确该疾病的致病原因。收集了一名GSD-IX患儿的临床资料。采集患儿及其父母的外周血用于提取基因组DNA。通过二代测序对患者进行基因诊断。通过Sanger测序和生物信息学分析验证疑似突变。通过RT-PCR和一代测序在体内验证疑似剪接突变。患儿存在肝肿大、转氨酶升高和高甘油三酯血症。肝活检病理检查结果提示糖原贮积病。基因测序显示该患儿在基因中有一个c.285 + 2_285 + 5delTAGG半合子突变。Sanger测序验证显示患儿母亲为杂合子,患儿父亲为野生型。HSF3.1和ESEfinder等软件预测该基因突变影响剪接。对患儿及其母亲外周血进行RT-PCR证实该突变导致基因组成型剪接过程中外显子3跳跃。基因(c.285 + 2_285 + 5delTAGG)中的半合子突变是患者疾病的致病原因。新突变位点的检测丰富了该基因的突变谱,为该家庭的遗传咨询提供了依据。