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新生儿 X 连锁肌小管肌病伴从头突变:病例报告及文献复习。

Neonatal X-linked myotubular myopathy with a de novo mutation: A case report and literature review.

机构信息

Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610041.

Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2024 Mar 28;49(3):491-496. doi: 10.11817/j.issn.1672-7347.2024.230450.

Abstract

X-linked myotubular myopathy (XLMTM) is a rare congenital myopathy. In February 2021, a male neonate was admitted to the West China Second University Hospital, Sichuan University, with clinical manifestations of hypotonia, accompanied by distinctive facial features, and requiring continuous ventilatory support. He was born prematurely at 36 weeks gestation and developed respiratory distress postnatally, followed by difficulty in weaning from mechanical ventilation. Additional clinical features included hypotonia of the limbs, swallowing dysfunction, and specific facial characteristics (elongated limbs, narrow face, high-arched palate, wrist drop, empty scrotum, elongated fingers/toes). Genetic testing confirmed the diagnosis of XLMTM. Whole-exome sequencing analysis of the family revealed no mutations in the father, paternal grandfather, or paternal grandmother, while the mother had a heterozygous mutation. The pathogenic mutation was identified as gene (: 300415), chromosome position chrX-150649714, with a nucleotide change of c.868-2A>C. The patient exhibited typical facial features. Genetic testing is crucial for accurate diagnosis of XLMTM in infants presenting with abnormal muscle tone and distinctive facial features.

摘要

X 连锁肌小管肌病(XLMTM)是一种罕见的先天性肌病。2021 年 2 月,一名男性新生儿因临床表现为肌无力,伴有独特的面部特征,需要持续通气支持而入住四川大学华西第二医院。他孕 36 周早产,出生后出现呼吸窘迫,随后难以从机械通气中脱机。其他临床特征包括四肢肌无力、吞咽功能障碍和特定的面部特征(肢体细长、脸窄、高拱形腭、腕下垂、阴囊空虚、手指/脚趾细长)。基因检测证实了 XLMTM 的诊断。对家族的全外显子组测序分析显示,父亲、祖父和祖母均无突变,而母亲存在杂合突变。致病突变被确定为 基因(:300415),染色体位置 chrX-150649714,核苷酸变化为 c.868-2A>C。患者表现出典型的面部特征。对于表现为异常肌肉张力和独特面部特征的婴儿,基因检测对于 XLMTM 的准确诊断至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf29/11208411/1f78d063eb47/ZhongNanDaXueXueBaoYiXueBan-49-3-491-g001.jpg

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