SLC35A2基因变异相关的先天性糖基化障碍Ⅱ型临床表型特点

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目的:总结SLC35A2基因变异相关的先天性糖基化障碍Ⅱ型的临床特点,以提高临床医生对本病的认识。方法:回顾性收集2019年4月至2020年2月在北京大学第一医院儿科就诊的SLC35A2基因变异致先天性糖基化障碍Ⅱ型的6例癫痫患儿病例资料,对其临床表现和基因检测结果进行分析。结果:6例SLC35A2基因变异致先天性糖基化障碍Ⅱ型患儿中女5例、男1例;癫痫起病年龄为5.5月龄(2月龄~1岁8月龄);癫痫发作类型多样,6例均有痉挛发作,局灶性发作2例,肌阵挛发作2例,强直发作1例,全面强直-阵挛发作1例;6例诊断为婴儿痉挛症伴发育落后,小头、微小骨骼畸形4例,肌张力低下及面容异常3例,乳头内陷2例,视觉异常、听觉诱发电位异常、先天性心脏病及喂养困难见于同1例,脑电图高峰失律6例。头颅磁共振成像异常3例,显示胼胝体薄3例,髓鞘发育落后2例,正常3例。SLC35A2基因框内缺失2例,错义变异1例,剪切位点变异1例,1例在Xp11.23位点缺失2.14 kb(仅含SLC35A2基因),嵌合变异1例;6例均为新发变异。末次随访年龄1岁6月龄~4岁4月龄,其中1例癫痫发作已缓解,5例发作未控制。结论:SLC35A2基因以新生变异为主,该基因导致的先天性糖基化障碍Ⅱ型表型特点为癫痫发作和发育迟缓,以婴儿痉挛症最常见,多伴小头、微小骨骼畸形、肌张力低下及面容异常。“,”Objective:To summarize the clinical characteristics of children with SLC35A2 gene variants related congenital disorders of glycosylation (SLC35A2-CDG), so as to improve the clinicians′ understanding of this disease.Methods:Clinical data and gene detection results of 6 epilepsy children with SLC35A2 gene variants were treated in the Department of Pediatrics Peking University First Hospital from April 2019 to February 2020 were analyzed retrospectively.Results:Six children with SLC35A2 gene variants were identified, including 1 male and 5 females. The onset age of seizure was 5.5 (ranged from 2 to 20) months. All 6 cases had epileptic spasms, 2 cases had focal seizures, 2 cases had myoclonic seizures, 1 case had tonic seizures and 1 case had generalized tonic-clonic seizures. All patients with SLC35A2 gene variants were diagnosed as infantile spasm with developmental delay. Four cases had microcephaly, 4 cases had micro skeletal abnormalities, 3 cases had hypotonia and facial dysmorphism, 2 cases had inverted nipples. Visual abnormality, auditory anomaly, congenital cardiac disease and feeding difficulty were observed in one patient. The electroencephalography showed hypsarrhythmia in 6 patients. The brain magnetic resonance imaging (MRI) showed thinning of corpus callosum in 3 patients, delayed myelination in 2 patients and normal brain MRI in 3 patients. There were 2 cases of in-frame deletions, 1 case of missense variant, 1 case of splice site variant, 1 case of 2.14 kb deletion in Xp11.23 (only containing SLC35A2 gene) and 1 case of SLC35A2 gene mosaicism. All 6 cases had de novo variants. The last follow-up age ranged from 18 to 52 months. One patient was seizure free and 5 patients still had frequent seizures after treatment with antiepileptic drugs.Conclusions:SLC35A2 gene variants are mainly de novo variants. The characteristics of patients with SLC35A2-CDG are seizures and developmental delay, infantile spasms are most common diagnosis, micro skeletal anomaly, microcephaly, hypotonia, facial dysmorphism were accompanied features.
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