Chang Li-Xian, Zhang Li, Gao Yi-Man, Zhu Xiao-Fan
Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/State Key Laboratory of Experimental Hematology/National Clinical Research Center for Blood Diseases/Haihe Laboratory of Cell Ecosystem, Tianjin 300020, China (Email: changlixian@ihcams. ac.cn).
Zhongguo Dang Dai Er Ke Za Zhi. 2024 Apr 15;26(4):410-413. doi: 10.7499/j.issn.1008-8830.2311058.
The first patient, a 10-year-old girl, presented with pancytopenia and recurrent epistaxis, along with a history of repeated upper respiratory infections, café-au-lait spots, and microcephaly. Genetic testing revealed compound heterozygous mutations in the DNA ligase IV () gene, leading to a diagnosis of LIG4 syndrome. The second patient, a 6-year-old girl, was seen for persistent thrombocytopenia lasting over two years and was noted to have short stature, hyperpigmented skin, and hand malformations. She had a positive result from chromosome breakage test. She was diagnosed with Fanconi anemia complementation group A. Despite similar clinical presentations, the two children were diagnosed with different disorders, suggesting that children with hemocytopenia and malformations should not only be evaluated for hematological diseases but also be screened for other potential underlying conditions such as immune system disorders.
首例患者为一名10岁女孩,表现为全血细胞减少和反复鼻出血,伴有反复上呼吸道感染、咖啡牛奶斑和小头畸形病史。基因检测显示DNA连接酶IV()基因存在复合杂合突变,诊断为LIG4综合征。第二例患者为一名6岁女孩,因持续两年多的持续性血小板减少前来就诊,发现有身材矮小、皮肤色素沉着和手部畸形。她的染色体断裂试验结果呈阳性。她被诊断为范可尼贫血A互补组。尽管临床表现相似,但这两名儿童被诊断为不同的疾病,这表明血细胞减少和畸形的儿童不仅应评估血液系统疾病,还应筛查其他潜在的基础疾病,如免疫系统疾病。