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分析两例儿童 - 相关血小板减少症的临床特征和治疗效果。

Analysis of clinical characteristics and treatment efficacy in two pediatric cases of -related thrombocytopenia.

机构信息

Department of Pediatrics, The Sixth Affiliated Hospital of Guangxi Medical University: The First People's Hospital of Yulin, Yulin, Guangxi, P.R. China.

Department of Pediatrics, Red Cross Hospital of Yulin city, Yulin, Guangxi, P.R. China.

出版信息

Platelets. 2023 Dec;34(1):2262607. doi: 10.1080/09537104.2023.2262607. Epub 2023 Oct 18.

Abstract

-related thrombocytopenia (-RT or THC2, MIM 188 000), an autosomal dominant thrombocytopenia, is unresponsive to immunosuppressive therapy and susceptible to hematological malignancies. A large number of pediatric patients are diagnosed with immune thrombocytopenia (ITP) every year; however, thrombocytopenia of genetic origin is often missed. Extensive characterization of -RT will help prevent missed diagnosis and misdiagnosis. Furthermore, identification of -RT will help in the formulation of an accurate diagnosis and a treatment plan. In our study, we report cases of two Chinese pediatric patients with -RT and analyze their clinical characteristics, gene mutations, and treatment modalities. Both patients were 1-year-old and presented with mild bleeding (World Health Organization(WHO) score grade 1), different degrees of platelet reduction, normal mean platelet volume, and megakaryocyte maturation impairment not obvious. Genetic tests revealed that both patients had 26 gene mutations.Patient 1 had a mutation c.-140C>G of the 5' untranslated region (UTR), and patient 2 had a mutation of c.-127A>T of 5'UTR. Both patients were treated with eltrombopag, and the treatment was no response, with no adverse reactions.

摘要

相关血小板减少症(-RT 或 THC2,MIM 188000)是一种常染色体显性血小板减少症,对免疫抑制治疗无反应,易发生血液恶性肿瘤。每年都有大量儿科患者被诊断为免疫性血小板减少症(ITP);然而,遗传来源的血小板减少症往往会被漏诊。对 -RT 进行广泛的特征描述将有助于预防漏诊和误诊。此外,确定 -RT 将有助于制定准确的诊断和治疗计划。在我们的研究中,我们报告了两例中国儿科 -RT 患者的病例,并分析了他们的临床特征、基因突变和治疗方式。两名患者均为 1 岁,均有轻度出血(世界卫生组织[WHO]评分 1 级),血小板减少程度不同,平均血小板体积正常,巨核细胞成熟受损不明显。基因检测显示两名患者均存在 26 种基因突变。患者 1 存在 5'非翻译区(UTR)c.-140C>G 突变,患者 2 存在 5'UTR 的 c.-127A>T 突变。两名患者均接受了艾曲波帕治疗,但治疗无反应,无不良反应。

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