Xu Xin-Yu, Zhou Qing-Mei, Tian Yun-Fen, Zhao Qiong, Pan Han, Chen Qian-Ting, Luo Yu-Mei, Guo Zheng-Zheng, Li Tian-He, Yang Jing-Hui
Department of Pediatrics, First People's Hospital of Yunnan Province, Kunming 650032, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2024;26(9):954-960. doi: 10.7499/j.issn.1008-8830.2401066.
A 5-year-old girl was admitted due to one episode of melena and one episode of hematemesis. Upon admission, gastroscopy revealed esophageal and gastric varices. Abdominal CT scan, MRI, and color Doppler ultrasound suggested cirrhosis, intrahepatic bile duct dilation, and bilateral kidney enlargement. Genetic testing identified compound heterozygous mutations in the gene: c.2264C>T (p.Pro755Leu) and c.1886T>C (p.Val629Ala). The c.2264C>T (p.Pro755Leu) mutation is a known pathogenic variant with previous reports, while c.1886T>C (p.Val629Ala) is a novel mutation predicted to have pathogenic potential according to Mutation Taster and PolyPhen2. The child was diagnosed with autosomal recessive polycystic kidney disease. In children presenting with gastrointestinal bleeding without obvious causes, particularly those with liver or kidney disease, consideration should be given to the possibility of autosomal recessive polycystic kidney disease, and genetic testing should be conducted for definitive diagnosis when necessary.
一名5岁女孩因一次黑便和一次呕血入院。入院时,胃镜检查发现食管和胃静脉曲张。腹部CT扫描、MRI和彩色多普勒超声提示肝硬化、肝内胆管扩张和双侧肾脏增大。基因检测在该基因中发现复合杂合突变:c.2264C>T(p.Pro755Leu)和c.1886T>C(p.Val629Ala)。c.2264C>T(p.Pro755Leu)突变是一个已知的致病变异,此前已有报道,而c.1886T>C(p.Val629Ala)是一个新突变,根据Mutation Taster和PolyPhen2预测具有致病潜力。该患儿被诊断为常染色体隐性遗传性多囊肾病。对于无明显原因出现胃肠道出血的儿童,尤其是患有肝脏或肾脏疾病的儿童,应考虑常染色体隐性遗传性多囊肾病的可能性,必要时应进行基因检测以明确诊断。