Wang Jingna, Li Rongmin, Wang Jieying, Wu Di, Lei Shuqin, Sang Yanmei, Chang Jie
Baoding Hospital, Beijing Children's Hospital Affiliated with Capital Medical University, Baoding, China.
Key Discipline of Pediatrics, Endocrinology Genetics and Metabolism Center, National Center for Children's Health (Beijing), Beijing Children's Hospital Affiliated with Capital Medical University, Beijing, China.
Front Endocrinol (Lausanne). 2024 Dec 20;15:1491664. doi: 10.3389/fendo.2024.1491664. eCollection 2024.
The objective of this study is to investigate the clinical presentation and underlying genetic etiology of a Chinese child diagnosed with idiopathic central precocious puberty (ICPP).
Clinical data from a pediatric patient with ICPP, including medical history, physical examination findings, laboratory results, and imaging studies, were collected and analyzed. Whole exome sequencing (WES) was performed to identify potential pathogenic genetic variants underlying the patient's ICPP.
A 4 ¾-year-old female patient presented with precocious puberty, characterized by accelerated growth, Tanner stage II breast development, and Tanner stage I pubic hair. A café-au-lait macule was observed on the patient's right flank. WES revealed a novel makorin RING finger protein 3 () gene heterozygous frameshift pathogenic variant c.1219delA (p.R407Gfs*75), which was inherited from the patient's asymptomatic father, and leading to a truncated protein 73 amino acids downstream from the mutation site.
This case underscores the genetic heterogeneity of ICPP and further implicates gene mutations in its pathogenesis. The identification of this novel pathogenic variant expands the known mutational spectrum associated with ICPP, particularly within the Chinese pediatric population. Comprehensive genetic testing should be considered in pediatric patients presenting with early-onset ICPP to facilitate accurate diagnosis, inform genetic counseling, and guide personalized management strategies.
本研究旨在调查一名被诊断为特发性中枢性性早熟(ICPP)的中国儿童的临床表现及潜在遗传病因。
收集并分析一名ICPP儿科患者的临床资料,包括病史、体格检查结果、实验室检查结果及影像学检查。进行全外显子组测序(WES)以确定该患者ICPP潜在的致病基因变异。
一名4¾岁女性患者出现性早熟,表现为生长加速、坦纳Ⅱ期乳房发育及坦纳Ⅰ期阴毛。在患者右侧胁腹观察到一个咖啡斑。WES发现一个新的环指蛋白3(MKRN3)基因杂合移码致病变异c.1219delA(p.R407Gfs*75),该变异遗传自患者无症状的父亲,导致突变位点下游73个氨基酸处产生截短蛋白。
该病例强调了ICPP的遗传异质性,并进一步提示MKRN3基因突变在其发病机制中的作用。这一新致病变异的鉴定扩展了与ICPP相关的已知突变谱,尤其是在中国儿科人群中。对于出现早发性ICPP的儿科患者,应考虑进行全面的基因检测,以促进准确诊断、提供遗传咨询并指导个性化管理策略。