南方医科大学学报 ›› 2015, Vol. 35 ›› Issue (04): 553-.

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先天性角化不良症患儿的临床特征和基因分析:附1例报告

袁姗姗,陆一丹,吴翠玲,李惠萍,戈慧,张玉明   

  • 出版日期:2015-04-20 发布日期:2015-04-20

Clinical features and genotype analysis in a case of dyskeratosis congenita

  • Online:2015-04-20 Published:2015-04-20

摘要: 目的探讨先天性角化不良症(dyskeratosis congenita, DC)患儿的临床特征和基因特点。方法回顾我院收治的1例DC患
儿的临床资料,提取患儿外周血DNA,PCR 扩增DC 的7 个热点基因,包括DKC1、TERT、TERC、TINF2、NOP10、NHP2、
WRAP53,进行DNA测序和基因分析。结果患儿外周血标本检测出DKC1基因中一个半合子变异:c.85-15T>C。其母亲为相
应变异杂合携带者,并出现部分先天性角化不良的临床表现如指(趾)甲变形等。结论当低龄患儿出现典型皮肤黏膜改变、骨
髓衰竭、肿瘤易感性、有肿瘤家族史时,应考虑到DC可能。早期行相关基因检测可提高临床诊断的诊断率,减少误诊、漏诊。

Abstract: Objective To analyze the clinical features and genotype in a 8-year-old boy with dyskeratosis congenita (DC).
Methods We reviewed the clinical data of the case and amplified 7 DC-related genes (including DKC1,TERT,TERC,TINF2,
NOP10, NHP2 and WRAP53) using polymerase chain reaction for DNA sequence analysis to identify the abnormal exons.
Results DNA sequence analysis showed a c.85-15T>C mutation in DKC1 gene of the patient. His mother was a carrier of the
mutated gene and presented with partial clinical features such as abnormal nails. Conclusion The mutation of c.85-15T>C in
DKC1 gene was reported for the first time in China. The diagnosis of DC should be considered if a young patient presents with
mucocutaneous abnormalities, bone marrow failure, cancer susceptibility and a family history of cancer. Early genetic tests can
improve the diagnosis rates and reduce misdiagnosis and missed diagnosis.