基础医学与临床 ›› 2013, Vol. 33 ›› Issue (10): 1223-1228.

• 研究论文 •    下一篇

罕见的肾上腺脑白质营养不良家系的临床特点及基因突变

周沛然1,胡莹莹2,卢琳3,陆召麟2,夏维波2,邢小平2,4,李梅5   

  1. 1. 北京协和医院
    2. 北京协和医院内分泌科
    3. 中国医学科学院 北京协和医学院 北京协和医院内分泌科 卫生部内分泌重点实验室
    4.
    5. 中国医学科学院 北京协和医学院 北京协和医院
  • 收稿日期:2013-01-03 修回日期:2013-01-25 出版日期:2013-10-05 发布日期:2013-09-25
  • 通讯作者: 李梅 E-mail:limeilzh@yahoo.com
  • 基金资助:
    国家自然科学基金面上项目;国家临床重点专科课题

A clinical and genetic study of a rare adrenoleukodystrophy kindred

  • Received:2013-01-03 Revised:2013-01-25 Online:2013-10-05 Published:2013-09-25
  • Contact: Mei LI E-mail:limeilzh@yahoo.com

摘要: 目的 分析1个肾上腺脑白质营养不良(ALD)家系患者的临床特点,并检测致病基因ABCD1的突变类型。 方法 纳入一个4代受累、4例发病的汉族ALD家系。根据临床表现、头颅核磁共振显像及血清极长链脂肪酸浓度检测,明确ALD诊断。用聚合酶链反应及其产物直接测序法检测ABCD1突变。 结果 患者均为男性,表现为原发性肾上腺皮质功能减退和神经系统功能异常,大脑白质广泛脱髓鞘改变,血清极长链脂肪酸浓度明显升高。患者ABCD1基因第8外显子存在c.1850 G>T半合子突变,而女性携带者基因型为杂合子。 结论 原发性肾上腺皮质功能减退和神经系统功能异常是ALD的典型临床表现,ABCD1的c.1850 G>T错义突变是我国该疾病致病基因新的突变类型。

关键词: 肾上腺脑白质营养不良, ABCD1基因, 突变检测

Abstract: Objective To analyse the clinical features of a kindred with adrenoleukodystrophy (ALD) and detect the mutation of ABCD1 gene. Methods A Chinese ALD kindred with four affected males in four-generation was studied. ALD was diagnosed according to clinical manifestations, cranial MRI image and serum very long chain fatty acid (VLCFA) levels. Mutation of ABCD1 was detected by direct DNA sequencing of polymerase chain reaction amplification product. Results Primary adrenocortical insufficiency and neurological dysfunction were the main manifestations of the patients. MRI image indicated extensive cerebral white matter demyelination. Serum VLCFA level was significantly high. A novel missense substitution (c.4037 C>T) in exon 8 of ABCD1 was identified. All affected males were hemizygotes and female carriers were heterzygotes. Conclusions The typical manifestations of ALD were primary adrenocortical insufficiency and neurological dysfunction. A missense substitution (c.4037 C>T) in exon 8 of ABCD1 was novel mutation firstly detected in this Chinese pedigree with ALD.

Key words: adrenoleukodystrophy, ABCD1 gene, mutation detection

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