基础医学与临床 ›› 2018, Vol. 38 ›› Issue (8): 1145-1148.

• 临床研究 • 上一篇    下一篇

糖原累积症Ia型伴严重骨骼畸形1例报告

杜志荣1,柏小寅1,徐娜1,张昀2,孙晓川1,曾学军3   

  1. 1. 北京协和医院
    2. 中国医学科学院北京协和医院
    3. 中国医学科学院 北京协和医学院 北京协和医院普通内科
  • 收稿日期:2017-05-08 修回日期:2017-09-26 出版日期:2018-08-05 发布日期:2018-07-24
  • 通讯作者: 曾学军 E-mail:zxuejun@126.com

A case report of glycogen storage disease Ia with severe skeletal deformity

  • Received:2017-05-08 Revised:2017-09-26 Online:2018-08-05 Published:2018-07-24
  • Contact: Xue-jun ZENG E-mail:zxuejun@126.com

摘要: 目的 探讨1例糖原累积症Ia型(GSD Ia)患者的临床特点及治疗方法。方法 详细收集患者病史、体格检查和实验室检查结果等临床资料。提取患者及父母外周血 DNA,采用PCR-序列测定法,检测葡萄糖-6-磷酸催化亚基(G6PC) 基因的外显子 1 至外显子 5。结果 患者为 23 岁男性,有低血糖、肝肿大、高乳酸血症、高尿酸血症和高脂血症的典型临床表现,并同时存在罕见的严重骨骼畸形。患者在G6PC基因外显子 5 内检测到纯合 c.648G>T (p.Leu216Leu)剪切致病突变,母亲和父亲均在该位点为杂合。该基因突变为GSD Ia型中最常见的基因突变类型,但极少出现明显骨骼畸形。结论 GSD Ia型可出现罕见的骨骼畸形,早期诊断和治疗有助于提高生活质量和减轻器官损害。

关键词: 糖原累积症Ia型, 骨骼畸形, G6PC基因

Abstract: Objective To analyze the clinical features and treatment of a patient with glycogen storage disease type Ia (GSD Ia). Methods Medical history, physical examination and laboratory results of the patient were collected in detail. DNAs were extracted from peripheral blood of the patient and his parents. The first exon to the fifth exon of G6PC (glucose-6-phosphatase catalytic subunit) gene were analyzed by PCR sequencing. Results The patient was a 23-year-old male Chinese with typical symptoms of hypoglycemia, hepatomegaly, hyperlactacidemia, hyperuricemia and hyperlipidemia, at the same time he had severe skeletal deformity. Homozygosis c.648G>T(p.Leu216Leu)splice mutation in the fifth exon was detected in G6PC gene in this patient, which was separately carried in his mother and father respectively. This is a common genotype, but severe skeletal deformity is an uncommon phenotype. Conclusions GSD Ia can cause sever skeletal deformity. Early diagnosis and treatment can improve patients’ living quality and decrease organic damage.

Key words: glycogen storage disease type Ia, skeletal deformity, G6PC

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