Xu Dan, Xie Jia-Yang, Zhang Xiao-Li, Wang Meng-Yue, Chu Man-Man, Han Rui, Wang Jun-Ling, Li Xiao-Li, Jia Tian-Ming
Department of Pediatric Internal Medicine, Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2025 Jul 15;27(7):859-863. doi: 10.7499/j.issn.1008-8830.2412177.
This article reports the clinical features and gene mutation types of a large family with Nascimento form of syndromic X-linked intellectual developmental disorder (MRXSN), involving 9 individuals across 3 generations, and a literature review was conducted. In this family, 9 individuals had similar manifestations including mental retardation and unusual facies, and 4 of them had passed away. Genetic testing showed that the proband had the deletion of exons 2-3 of the gene, which was inherited from the mother. Fluorescent quantitative polymerase chain reaction showed that the proband and his uncle had the deletion of exons 2-3 of the gene; the proband's mother, grandmother, and great-aunt had a heterozygous deletion of exons 2-3 of the gene; the proband's father, sister, and aunt had a normal copy number of exons 2-3 of the gene. The 34 patients reported in the literature had diverse clinical phenotypes, and gene mutations (22/34, 65%) and large fragment deletions (12/34, 35%) were the main mutation types. Moderate to severe mental retardation (34/34, 100%), speech and language impairment (33/34, 97%), and unusual facies (32/34, 94%) were the main clinical manifestations of MRXSN patients. The disease has obvious phenotypic heterogeneity, and early diagnosis facilitates optimal prenatal and postnatal management to improve reproductive outcomes.
本文报道了一个患有纳西门托型综合征性X连锁智力发育障碍(MRXSN)的大家庭的临床特征和基因突变类型,该家庭涉及3代9人,并进行了文献综述。在这个家庭中,9人有相似表现,包括智力发育迟缓及特殊面容,其中4人已去世。基因检测显示,先证者存在该基因外显子2 - 3的缺失,此缺失遗传自其母亲。荧光定量聚合酶链反应显示,先证者及其叔叔存在该基因外显子2 - 3的缺失;先证者的母亲、祖母和姑奶奶存在该基因外显子2 - 3的杂合缺失;先证者的父亲、姐姐和姑姑该基因外显子2 - 3的拷贝数正常。文献报道的34例患者临床表型多样,基因突变(22/34,65%)和大片段缺失(12/34,35%)是主要突变类型。中度至重度智力发育迟缓(34/34,100%)、言语和语言障碍(33/34,97%)以及特殊面容(32/34,94%)是MRXSN患者的主要临床表现。该疾病具有明显的表型异质性,早期诊断有助于优化产前和产后管理,以改善生殖结局。