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一种与结节性硬化症相关的新型c.2489T>C错义变异:病例报告

A Novel c.2489T>C Missense Variant Associated With Tuberous Sclerosis Complex: Case Report.

作者信息

Lai Yujie, Ma Yuanye, Luo Biao, Long Yan

机构信息

From the Department of Neurology and Center for Clinical Neuroscience (Y. Lai, Y.M., B.L.); and Department of Health Management (Y. Long), Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China.

出版信息

Neurol Genet. 2024 Feb 16;10(2):e200127. doi: 10.1212/NXG.0000000000200127. eCollection 2024 Apr.

DOI:10.1212/NXG.0000000000200127
PMID:38715652
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11073876/
Abstract

OBJECTIVES

Tuberous sclerosis complex (TSC) is a genetic disorder caused by a or gene variation characterized by widespread hamartomas in organs such as the skin, brain, heart, lungs, liver, and kidneys.

METHODS

We report a case of a patient with TSC who presented with broad clinical manifestations, including epilepsy.

RESULTS

An 18-year-old man was diagnosed with recurrent drug-resistant epilepsy. Neuroimaging revealed bilateral cortical and subcortical tubers with multiple calcified subependymal nodules. His skin involvement and psychomotor retardation raised the suspicion of TSC. Genetic testing confirmed the diagnosis, and a combined treatment including mTOR inhibitors was initiated.

DISCUSSION

TSC, although considered rare, needs to be considered when evaluating patients with broad clinical manifestations. Our report has significant implications for understanding the impact of genotype on the prognosis of TSC and the selection of treatment strategies for TSC-related refractory epilepsy.

摘要

目的

结节性硬化症(TSC)是一种由TSC1或TSC2基因变异引起的遗传性疾病,其特征是在皮肤、大脑、心脏、肺、肝脏和肾脏等器官中广泛存在错构瘤。

方法

我们报告一例结节性硬化症患者,该患者临床表现广泛,包括癫痫。

结果

一名18岁男性被诊断为复发性耐药癫痫。神经影像学检查显示双侧皮质和皮质下结节,伴有多个钙化的室管膜下结节。他的皮肤受累和精神运动发育迟缓引发了对结节性硬化症的怀疑。基因检测确诊了该疾病,并开始了包括mTOR抑制剂在内的联合治疗。

讨论

结节性硬化症虽然被认为罕见,但在评估临床表现广泛的患者时需要考虑。我们的报告对于理解基因型对结节性硬化症预后的影响以及结节性硬化症相关难治性癫痫治疗策略的选择具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8a1/11073876/cc87fa6ef7d8/NXG-2023-000278f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8a1/11073876/84906594f797/NXG-2023-000278f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8a1/11073876/cc87fa6ef7d8/NXG-2023-000278f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8a1/11073876/84906594f797/NXG-2023-000278f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8a1/11073876/cc87fa6ef7d8/NXG-2023-000278f2.jpg

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本文引用的文献

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The importance of imaging in tuberous sclerosis complex (tsc) in children: Two cases.影像学在儿童结节性硬化症(TSC)中的重要性:两例病例
Radiol Case Rep. 2021 Dec 3;17(2):399-403. doi: 10.1016/j.radcr.2021.11.007. eCollection 2022 Feb.
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Risk Factors Associated with Refractory Epilepsy in Patients with Tuberous Sclerosis Complex: A Systematic Review.结节性硬化症患者难治性癫痫的相关危险因素:一项系统评价
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Epilepsy in the mTORopathies: opportunities for precision medicine.
mTOR 病中的癫痫:精准医学的机遇
Brain Commun. 2021 Sep 25;3(4):fcab222. doi: 10.1093/braincomms/fcab222. eCollection 2021.
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Lymphangioleiomyomatosis: pathogenesis, clinical features, diagnosis, and management.淋巴管平滑肌瘤病:发病机制、临床特征、诊断和治疗。
Lancet Respir Med. 2021 Nov;9(11):1313-1327. doi: 10.1016/S2213-2600(21)00228-9. Epub 2021 Aug 27.
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Updated International Tuberous Sclerosis Complex Diagnostic Criteria and Surveillance and Management Recommendations.更新后的国际结节性硬化症复合体诊断标准及监测与管理建议。
Pediatr Neurol. 2021 Oct;123:50-66. doi: 10.1016/j.pediatrneurol.2021.07.011. Epub 2021 Jul 24.
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Add-on Cannabidiol Treatment for Drug-Resistant Seizures in Tuberous Sclerosis Complex: A Placebo-Controlled Randomized Clinical Trial.添加用大麻二酚治疗结节性硬化症耐药性癫痫发作:一项安慰剂对照随机临床试验。
JAMA Neurol. 2021 Mar 1;78(3):285-292. doi: 10.1001/jamaneurol.2020.4607.
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A novel TSC2 c.4511 T > C missense variant associated with tuberous sclerosis complex.一种与结节性硬化症相关的新型TSC2基因c.4511 T>C错义变异。
BMC Med Genet. 2020 Sep 11;21(1):180. doi: 10.1186/s12881-020-01120-z.
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Developmental outcomes in children/adolescents and one adult with tuberous sclerosis complex (TSC) and refractory epilepsy treated with everolimus.患有结节性硬化症(TSC)和耐药性癫痫的儿童/青少年和一名成人接受依维莫司治疗的发育结果。
Epilepsy Behav. 2020 Oct;111:107182. doi: 10.1016/j.yebeh.2020.107182. Epub 2020 Jun 11.
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Neuroimaging in tuberous sclerosis complex.结节性硬化症的神经影像学
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