目的 探讨Cornelia de Lange综合征(Cornelia de Lange syndrome, CdLS)2型双胞胎患儿的临床表型及基因检测结果,明确患儿的致病原因。方法 收集1例CdLS患儿及父母的临床资料,采集外周血进行家系高通量测序分析。结果 患儿具有特殊面容...目的 探讨Cornelia de Lange综合征(Cornelia de Lange syndrome, CdLS)2型双胞胎患儿的临床表型及基因检测结果,明确患儿的致病原因。方法 收集1例CdLS患儿及父母的临床资料,采集外周血进行家系高通量测序分析。结果 患儿具有特殊面容,眉毛浓密,鼻梁高,上唇薄,嘴角下斜。心脏超声提示动脉导管未闭,卵圆孔未闭。凝血及生化检测发现患儿凝血功能异常,低蛋白血症,胆红素升高。遗传代谢病串联质谱筛查未见明显异常;染色体非整倍体分析:染色体组成46,XY,染色体数目正常。家系全外显子组检测发现:患儿、弟弟及母亲均携带SMC1A基因c.897C>G变异,父亲为野生型。参考ACMG变异解读指南,该变异初步判定为可能致病变异。结论 双胞胎均携带SMC1A基因c.897C>G变异位点,该变异为新发变异,扩大了SMC1A基因变异谱,为临床诊断及患儿家系再生育指导提供了重要依据。展开更多
Osteogenesis imperfecta(OI)is a genetically heterogeneous monogenic disease characterized by decreased bone mass,bone fragility,and recurrent fractures.The phenotypic spectrum varies considerably ranging from prenatal...Osteogenesis imperfecta(OI)is a genetically heterogeneous monogenic disease characterized by decreased bone mass,bone fragility,and recurrent fractures.The phenotypic spectrum varies considerably ranging from prenatal fractures with lethal outcomes to mild forms with few fractures and normal stature.The basic mechanism is a collagen-related defect,not only in synthesis but also in folding,processing,bone mineralization,or osteoblast function.In recent years,great progress has been made in identifying new genes and molecular mechanisms underlying OI.In this context,the classification of OI has been revised several times and different types are used.The Sillence classification,based on clinical and radiological characteristics,is currently used as a grading of clinical severity.Based on the metabolic pathway,the functional classification allows identifying regulatory elements and targeting specific therapeutic approaches.Genetic classification has the advantage of identifying the inheritance pattern,an essential element for genetic counseling and prophylaxis.Although genotype-phenotype correlations may sometimes be challenging,genetic diagnosis allows a personalized management strategy,accurate family planning,and pregnancy management decisions including options for mode of delivery,or early antenatal OI treatment.Future research on molecular pathways and pathogenic variants involved could lead to the development of genotype-based therapeutic approaches.This narrative review summarizes our current understanding of genes,molecular mechanisms involved in OI,classifications,and their utility in prophylaxis.展开更多
文摘目的 探讨Cornelia de Lange综合征(Cornelia de Lange syndrome, CdLS)2型双胞胎患儿的临床表型及基因检测结果,明确患儿的致病原因。方法 收集1例CdLS患儿及父母的临床资料,采集外周血进行家系高通量测序分析。结果 患儿具有特殊面容,眉毛浓密,鼻梁高,上唇薄,嘴角下斜。心脏超声提示动脉导管未闭,卵圆孔未闭。凝血及生化检测发现患儿凝血功能异常,低蛋白血症,胆红素升高。遗传代谢病串联质谱筛查未见明显异常;染色体非整倍体分析:染色体组成46,XY,染色体数目正常。家系全外显子组检测发现:患儿、弟弟及母亲均携带SMC1A基因c.897C>G变异,父亲为野生型。参考ACMG变异解读指南,该变异初步判定为可能致病变异。结论 双胞胎均携带SMC1A基因c.897C>G变异位点,该变异为新发变异,扩大了SMC1A基因变异谱,为临床诊断及患儿家系再生育指导提供了重要依据。
文摘Osteogenesis imperfecta(OI)is a genetically heterogeneous monogenic disease characterized by decreased bone mass,bone fragility,and recurrent fractures.The phenotypic spectrum varies considerably ranging from prenatal fractures with lethal outcomes to mild forms with few fractures and normal stature.The basic mechanism is a collagen-related defect,not only in synthesis but also in folding,processing,bone mineralization,or osteoblast function.In recent years,great progress has been made in identifying new genes and molecular mechanisms underlying OI.In this context,the classification of OI has been revised several times and different types are used.The Sillence classification,based on clinical and radiological characteristics,is currently used as a grading of clinical severity.Based on the metabolic pathway,the functional classification allows identifying regulatory elements and targeting specific therapeutic approaches.Genetic classification has the advantage of identifying the inheritance pattern,an essential element for genetic counseling and prophylaxis.Although genotype-phenotype correlations may sometimes be challenging,genetic diagnosis allows a personalized management strategy,accurate family planning,and pregnancy management decisions including options for mode of delivery,or early antenatal OI treatment.Future research on molecular pathways and pathogenic variants involved could lead to the development of genotype-based therapeutic approaches.This narrative review summarizes our current understanding of genes,molecular mechanisms involved in OI,classifications,and their utility in prophylaxis.
