Liu Weihua, Min Xiaoyang, Wang Hongli, Lu Qianqian, Li Lulu, Chu Haiping
Department of Pediatrics, Xi'an First Hospital, The First Affiliated Hospital of Northwestern University, China.
Pucheng County Hospital of Weinan City, Shaanxi Province, China.
Clin Med Insights Pediatr. 2024 Jun 17;18:11795565241256615. doi: 10.1177/11795565241256615. eCollection 2024.
Mutations in dental hypophosphatasia (HPP) have been reported less than those in other types of HPP because the symptoms are mild or the dental lesions are only partial manifestations of other types of HPP. In this case, we observe the clinical manifestation of dental hypoalkaline phosphatase by analyzing the genetic mutation and biochemical parameters in child. The clinical data of the child with odonto HPP were collected and analyzed. The blood samples of the child and his parents were sequenced and verified using Sanger through a specific probe capture and high-throughput second-generation sequencing technology. Major clinical manifestations in the patient were early loss of deciduous teeth, significantly lower serum alkaline phosphatase (ALP) levels, lower active vitamin D, and increased blood phosphorus, but no abnormality was observed in the oral X-ray. Two missense mutations-c.542C>T (p. ser181leu) and c.644 T> C (p.Ile215Thr)-were found in exon 6 of the gene from the father and mother, respectively. The clinical manifestations of odonto hypophosphatasia were early loss of deciduous teeth and significantly reduced serum ALP levels. Of 2 mutations-c.542C>T (p.ser181leu) and c.644 T> C (p.Ile215Thr)-in the gene, c.644 T> C (p.Ile215Thr) was a new mutation.
与其他类型的低磷性佝偻病(HPP)相比,牙型低磷性佝偻病的突变报道较少,因为其症状较轻或牙齿病变只是其他类型HPP的部分表现。在本病例中,我们通过分析患儿的基因突变和生化参数来观察牙型低碱性磷酸酶的临床表现。收集并分析了一名患有牙型HPP患儿的临床资料。采用特定探针捕获和高通量第二代测序技术,通过桑格测序法对患儿及其父母的血样进行测序和验证。该患者的主要临床表现为乳牙早失、血清碱性磷酸酶(ALP)水平显著降低、活性维生素D水平降低以及血磷升高,但口腔X线检查未发现异常。分别在患儿父亲和母亲的该基因第6外显子中发现了两个错义突变——c.542C>T(p.ser181leu)和c.644T>C(p.Ile215Thr)。牙型低磷性佝偻病的临床表现为乳牙早失和血清ALP水平显著降低。在该基因的两个突变——c.542C>T(p.ser181leu)和c.644T>C(p.Ile215Thr)中,c.644T>C(p.Ile215Thr)是一个新突变。