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ZBTB18基因的一个新发变异导致常染色体显性非综合征性智力障碍22型综合征:一例报告及文献综述

A de novo variant in ZBTB18 gene caused autosomal dominant non-syndromic intellectual disability 22 syndrome: A case report and literature review.

作者信息

Yang Fan, Ding Yu, Wang Yirou, Zhang Qingwen, Li Hao, Yu Tingting, Chang Guoying, Wang Xiumin

机构信息

Clinical Research Ward, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Department of Endocrinology and Metabolism, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Medicine (Baltimore). 2024 Jan 12;103(2):e35908. doi: 10.1097/MD.0000000000035908.

Abstract

RATIONALE

Autosomal dominant non-syndromic intellectual disability 22 is a rare genetic disorder caused by the ZBTB18 gene. This disorder affects various parts of the body, leading to intellectual disability. It is noteworthy that only 31 cases of this disorder have been reported thus far. As the symptom severity may differ, doctors may face challenges in diagnosing it accurately. It is crucial to be familiar with this disorder's symptoms to receive proper diagnosis and essential medical care.

PATIENT CONCERNS

There is a case report of a 6-year-old boy who had an unexplained thyroid abnormality, global developmental delay, and an abnormal signal of white matter in brain MRI. However, he did not have growth retardation, microcephaly, corpus callosum hypoplasia, epilepsy, or dysmorphic facial features. Clinical whole exome sequencing revealed a de novo pathogenic variant in the ZBTB18 gene (c.1207delC, p. Arg403Alafs*60), which is a previously unreported site. This variant causes the premature termination of peptide chain synthesis, leading to incomplete polypeptide chains.

DIAGNOSES

Autosomal dominant non-syndromic intellectual and disability 22 syndrome and thyroid dysfunction.

INTERVENTIONS

Rehabilitation training.

OUTCOMES

The individual is experiencing difficulty with their motor skills, appearing clumsier while running. He struggles with expressing themselves and forming complete sentences, relying mostly on gestures and pointing.

LESSONS

The clinical presentations of mental retardation, autosomal dominant, type 22 (MRD22) are complicated and varied. Although early diagnosis can be made according to typical clinical symptoms, whole exome sequencing is necessary for diagnosing MRD22, as our study indicates.

摘要

理论依据

常染色体显性非综合征性智力障碍22型是一种由ZBTB18基因引起的罕见遗传疾病。这种疾病会影响身体的各个部位,导致智力障碍。值得注意的是,迄今为止仅报道了31例这种疾病。由于症状严重程度可能不同,医生在准确诊断方面可能会面临挑战。熟悉这种疾病的症状对于获得正确的诊断和必要的医疗护理至关重要。

患者情况

有一例6岁男孩的病例报告,该男孩有不明原因的甲状腺异常、全面发育迟缓以及脑部磁共振成像(MRI)中白质信号异常。然而,他没有生长发育迟缓、小头畸形、胼胝体发育不全、癫痫或面部畸形特征。临床全外显子测序显示ZBTB18基因存在一个新生的致病变异(c.1207delC,p.Arg403Alafs*60),这是一个此前未报道的位点。这种变异导致肽链合成过早终止,从而产生不完整的多肽链。

诊断结果

常染色体显性非综合征性智力障碍22型综合征和甲状腺功能障碍。

干预措施

康复训练。

治疗结果

该个体运动技能存在困难,跑步时显得更加笨拙。他在表达自己和组成完整句子方面存在困难,主要依靠手势和指物来交流。

经验教训

智力障碍,常染色体显性,22型(MRD22)的临床表现复杂多样。尽管根据典型临床症状可进行早期诊断,但正如我们的研究所表明的,全外显子测序对于诊断MRD22是必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92fb/10783315/8951996d7bca/medi-103-e35908-g001.jpg

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