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一个越南完全雄激素不敏感综合征家系中雄激素受体基因的极为罕见的错义突变。

An extremely rare missense mutation of the androgen receptor gene in a Vietnamese family with complete androgen insensitivity syndrome.

机构信息

Department of Medical Genetics, University of Medicine and Pharmacy, Hue University, Hue, Vietnam.

Center of Prenatal and Neonatal Screening - Diagnosis, University of Medicine and Pharmacy Hospital, Hue University, Hue, Vietnam.

出版信息

Nagoya J Med Sci. 2023 May;85(2):362-368. doi: 10.18999/nagjms.85.2.362.

Abstract

We report a Vietnamese family with complete androgen insensitivity syndrome that included several phenotypic females who have a 46,XY karyotype with an extremely rare mutation of the androgen receptor gene. The proband was a 27-year-old phenotypic adult female referred to our department for karyotyping due to primary amenorrhea. Ultrasound examination revealed a small uterus. Chromosomal analysis showed a 46,XY karyotype. A polymerase chain reaction assay revealed the presence of the sex-determining region Y gene. Next-generation sequencing detected the NM_000044.6():c.2170C>T(p.Pro274Ser) mutation, which was confirmed by Sanger sequencing. There is only one previous report of this mutation in a child with complete androgen insensitivity syndrome. In the family presented in this study, there were four more phenotypic adult females with primary amenorrhea and a phenotypic female infant with testes in the inguinal canals. The infant (first cousin once removed of the proband) presented with inguinal hernia/swelling in a phenotypic female and one of the four abovementioned adults had similar genetic analysis results. This is the second report of a missense mutation NM 000044.6():c.2170C>T in the world and the first study to document a pedigree consisting of several individuals with CAIS as a result of this mutation. The presence of a tiny uterus in the proband, which is a rare occurrence in complete androgen insensitivity syndrome, is a unique clinical indicator of the disorder's variable expressivity.

摘要

我们报告了一个越南家族性完全雄激素不敏感综合征家系,其中包括几名表型女性,她们均具有 46,XY 核型和极其罕见的雄激素受体基因突变。先证者是一名 27 岁的表型成年女性,因原发性闭经就诊于我院行染色体核型分析。超声检查显示子宫较小。染色体分析显示 46,XY 核型。聚合酶链反应检测显示存在性别决定区 Y 基因。下一代测序检测到 NM_000044.6():c.2170C>T(p.Pro274Ser) 突变,经 Sanger 测序证实。此前仅在一名完全雄激素不敏感综合征患儿中报道过该突变。在本研究中,该家系还存在另外 4 名表型成年女性,均为原发性闭经,还有 1 名表型女性婴儿存在腹股沟隐睾。该婴儿(先证者的一级表亲)表现为腹股沟疝/肿胀,表型女性和上述 4 名成年女性之一具有相似的遗传分析结果。这是世界上第二个关于 NM 000044.6():c.2170C>T 错义突变的报道,也是第一个记录由该突变引起的 CAIS 多个个体家系的研究。先证者存在小子宫,这在完全雄激素不敏感综合征中较为罕见,是该疾病表现度可变的独特临床指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2976/10281845/3bac96c9303d/2186-3326-85-0362-g002.jpg

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