Aylan Gelen Sema, Kara Bülent, Eser Şimsek Isil, Güngör Mesut, Zengin Emine, Sarper Nazan
Department of Pediatrics, Division of Pediatric Hematology, Kocaeli University Medical Faculty, Kocaeli, Türkiye.
Department of Pediatrics, Division of Pediatric Neurology, Kocaeli University Medical Faculty, Kocaeli, Türkiye.
J Pediatr Genet. 2021 Nov 2;13(1):50-56. doi: 10.1055/s-0041-1736560. eCollection 2024 Mar.
Spondyloenchondrodysplasia (SPENCD) is a rare spondylometaphyseal skeletal dysplasia with characteristic lesions mimicking enchondromatosis and resulting in short stature. A large spectrum of immunologic abnormalities may be seen in SPENCD, including immune deficiencies and autoimmune disorders. SPENCD is caused by loss of tartrate-resistant acid phosphatase activity, due to homozygous mutations in , playing a role in nonnucleic-acid-related stimulation/regulation of the type I interferon pathway. In this article, we presented a 19-year-old boy with SPENCD, presenting with recurrent autoimmune hemolytic anemia episodes since he was 5 years old. He had short stature, platyspondyly, metaphyseal changes, intracranial calcification, spastic paraparesis, and mild intellectual disability. He also had recurrent pneumonia attacks. The clinical diagnosis of SPENCD was confirmed by sequencing of the gene, and a homozygous c.155A > C (p.K52T) variation was found, which was reported before as pathogenic. In conclusion, in early onset chronic autoimmune cytopenias an immune dysregulation may often have a role in the etiology. Associating findings and immunologic functions should be carefully evaluated in such patients in the light of the literature. The present case shows the importance of multisystemic evaluation for the detection of SPENCD that has a monogenic etiology.
脊椎骨骺发育不良(SPENCD)是一种罕见的脊椎干骺端骨骼发育不良,具有类似内生软骨瘤病的特征性病变,导致身材矮小。在SPENCD中可见多种免疫异常,包括免疫缺陷和自身免疫性疾病。SPENCD是由抗酒石酸酸性磷酸酶活性丧失引起的,这是由于 基因的纯合突变所致,该基因在I型干扰素途径的非核酸相关刺激/调节中起作用。在本文中,我们介绍了一名19岁患有SPENCD的男孩,自5岁起就反复出现自身免疫性溶血性贫血发作。他身材矮小、椎体扁平、干骺端改变、颅内钙化、痉挛性截瘫和轻度智力障碍。他还反复发生肺炎。通过对 基因进行测序证实了SPENCD的临床诊断,并发现了一个纯合的c.155A > C(p.K52T)变异,该变异之前已被报道为致病性变异。总之,在早发性慢性自身免疫性血细胞减少症中,免疫失调在病因学中可能常常起作用。鉴于文献,对此类患者的相关发现和免疫功能应进行仔细评估。本病例显示了多系统评估对于检测具有单基因病因的SPENCD的重要性。