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近亲家庭中罕见遗传疾病的共存:KLHL24相关肥厚型心肌病和查尔综合征的病例研究

Coexistence of Rare Genetic Disorders in a Consanguineous Family: Case Study of KLHL24-Related Hypertrophic Cardiomyopathy and Char Syndrome.

作者信息

Linnenkamp Bianca Domit Werner, Lacerda Pires Lucas Vieira, Stephan Bruno de Oliveira, Vilalva Kelvin Henrique, Lombardi Peres de Carvalho Mariana, Vicente Pereira Lipari Layara Fernanda, Fernandes Fabio, Krieger Jose Eduardo

机构信息

Precision Medicine in Cardiology, Laboratory of Genetics and Molecular Cardiology, Heart Institute, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.

Myocardiopathies Unit, Heart Institue, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.

出版信息

Mol Syndromol. 2025 Apr;16(2):194-200. doi: 10.1159/000540786. Epub 2024 Sep 17.

Abstract

INTRODUCTION

Physicians often search for a single underlying cause that explains all of a patient's signs and symptoms. However, evidence from the literature suggests that the concurrent presence of two rare diseases, although uncommon, poses significant diagnostic challenges. Precision medicine is increasingly important in these scenarios, enabling more rapid diagnosis and tailored treatments.

CASE PRESENTATION

This report discusses a patient involving a consanguineous Brazilian family, where two sisters are diagnosed with autosomal recessive -related hypertrophic cardiomyopathy. Additionally, one sister is diagnosed with Char syndrome due to a deletion.

CONCLUSION

This case underscores the possibility that multiple rare genetic disorders can coexist, contributing to complex clinical phenotypes. Whole-exome sequencing proves to be a critical tool in identifying the genetic underpinnings of such complex cases, facilitating precise diagnosis and genetic counseling. The discovery of a homozygous variant further broadens the known mutation spectrum and underscores its significance in autosomal recessive hypertrophic cardiomyopathy.

摘要

引言

医生常常寻找一个能解释患者所有体征和症状的单一潜在病因。然而,文献证据表明,两种罕见疾病同时存在的情况虽然不常见,但会带来重大的诊断挑战。在这些情况下,精准医学变得越来越重要,它能够实现更快速的诊断和个性化治疗。

病例介绍

本报告讨论了一个涉及巴西近亲家庭的患者,该家庭中有两姐妹被诊断出患有常染色体隐性遗传相关的肥厚型心肌病。此外,其中一个姐妹因基因缺失被诊断出患有查尔综合征。

结论

该病例强调了多种罕见遗传疾病可能共存并导致复杂临床表型的可能性。全外显子测序被证明是识别此类复杂病例遗传基础的关键工具,有助于精准诊断和遗传咨询。纯合变异的发现进一步拓宽了已知的突变谱,并突出了其在常染色体隐性遗传肥厚型心肌病中的重要性。

本文引用的文献

1
2
Clinical Outcome in Cardiomyopathy.心肌病的临床结果
Circ Genom Precis Med. 2023 Aug;16(4):401-403. doi: 10.1161/CIRCGEN.122.003998. Epub 2023 May 16.
5
Categorized Genetic Analysis in Childhood-Onset Cardiomyopathy.小儿起病型心肌病的分类遗传学分析。
Circ Genom Precis Med. 2020 Oct;13(5):504-514. doi: 10.1161/CIRCGEN.120.002969. Epub 2020 Sep 1.

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