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云南省第一人民医院儿科,昆明,650032
纸质出版日期:2020,
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白冰, 章锦曼, 苏洁, 等. 一例Bainbridge-Ropers综合征患儿遗传病因分析[J]. 重庆医科大学学报, 2020,45(11):1593.
Bai Bing, Zhang Jinman, Su Jie, et al. Identifying the genetic etiology of a child with Bainbridge-Ropers syndrome[J]. Journal of Chongqing Medical University, 2020,45(11):1593.
目的:运用遗传学检测方法分析一例具有重度发育迟缓合并先天性心脏病等多发畸形的罕见病患儿的遗传学病因。方法:采集患儿病史、进行临床辅助检查,提取患儿及父母的外周血基因组DNA。用Agilent SureSelect系统构建患儿DNA全外显子组测序文库,用Illumina平台进行测序,对检测到的疑似致病突变在患者及其父母亲血样中进行Sanger测序法验证。结果:全外显子组测序和家系验证发现患儿ASXL3基因存在c.1349dupT;p.I450fs杂合移码突变,为新发突变,根据ACMG变异解读标准与指南判定该变异为致病变异,该突变国内外未见报道。患儿具有喉骨软化、手指背屈特征,目前尚无Bainbridge-Ropers综合征(Bainbridge-Ropers syndrome,BRS)患者携带上述表型的报道。同时患儿DCHS1基因携带已知二尖瓣脱垂 2(mitral valve prolapse 2
MVP 2)杂合致病突变c.G7538A;p.R2513H,该突变已经过细胞和动物试验验证。敲除DCHS1基因可导致斑马鱼房室管畸形,因此DCHS1基因c.G7538A突变可能与患儿房间隔缺损(asparagine,Asn)有关。DCHS1基因突变遗传自患儿父亲,但其父经超声心动图和心电图检查未见心脏结构及功能异常,该致病突变在本家系中外显不全。结论:本研究丰富了ASXL3基因的致病突变谱和BRS表型谱,第一次报道了携带多个致病突变的BRS患者。
Objective:To analyze the genetic etiology of a child affected by severely developmental delay,atrial septal defect and a series of complicated phenotypes. Methods:The child has undergone history taking and physical examination. Genome DNA was extracted from peripheral blood samples of the proband and his parents. Candidate genes were captured with Agilent SureSelect and sequenced on an lllumina platform. Suspected mutation was identified and verified by Sanger sequencing. Results:By whole exome sequencing,we found a heterozygous frameshift mutation in proband’s ASXL3 gene(ASXL3;c.1349dupT;p.I450fs) and identified it as pathogenic variant according to the ACMG standards and guidelines for the interpretation of sequence variants. And our candidate has cartilaginous ossification of larynx and dorsiflexion of finger,which are never been reported in other Bainbridge-Ropers syndrome(BRS) patients. Meanwhile,we found a reported mital valve prolapsed 2(MVP2) pathogenic variant DCHS1;c.G7538A;p.R2513H. The function of this variant has been proved by cell and animal experiments. The knock-out of DCHS1 in zebra fish resulted in a cardiac atrioventricular canal defect and the atrial septal defect in our proband could also be attributed to DCHS1 mutation. The proband’s mutant is inherited from his father,however no cardiac function and structure abnormality were observed in his father by ultrasonic cardiogram and electrocardiogram. This might be due to nonpenetrance. Conclusion:Our study broadened the mutant and phenotype spectrum of ASXL3. And we reported the first Bainbridge-Ropers patient with other pathogenic variant.
Bainbridge-Ropers综合征房间隔缺损全外显子组测序
Bainbridge-Ropers syndromeasparaginewhole exome sequencing
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