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Infantile hypophosphatasia caused by compound heterozygous variants in the ALPL gene: a case report
Qian Wu1, Min Xiang1, Wei Xiong1
1Department of Neonatology, Affiliated Hospital of Guizhou Medical University/Guizhou Hospital, First Affiliated Hospital of Sun Yat-Sen University Guiyang 550000, Guizhou, China.
Insights
This study details an infantile hypophosphatasia case caused by compound heterozygous alkaline phosphatase-liver/bone/kidney (ALPL) gene mutations. The infant exhibited severe symptoms, highlighting the genetic basis of this rare bone disorder.
Area of Science:
- Genetics
- Pediatrics
- Biochemistry
Background:
- Infantile hypophosphatasia (HPP) is a severe genetic disorder characterized by defective bone mineralization.
- It is caused by mutations in the alkaline phosphatase-liver/bone/kidney (ALPL) gene, leading to deficient enzyme activity.
Abstract:
This article reports a case of infantile hypophosphatasia (HPP) due to compound heterozygous alkaline phosphatase-liver/bone/kidney (ALPL) gene mutations, and analyzes its clinical phenotype and genetic characteristics. A retrospective analysis was conducted on the clinical data, genetic testing results, and family history of a male infant with HPP. The infant presented with intrauterine and postpartum growth retardation, respiratory failure, feeding difficulties, vitamin B6-responsive epileptic seizures, bone hypomineralization, hypercalcemia, and very low alkaline phosphatase (ALP). Genetic testing revealed compound heterozygous ALPL mutations: c.533A>G (p.Tyr178Cys) and c.644T>A (p.Ile215Asn), inherited from his father and mother, respectively, both parents being phenotypically normal. The mother had previously terminated a pregnancy due to fetal bone deformity. This case of infantile HPP resulted from compound heterozygous ALPL mutations, with typical clinical features including bone hypomineralization, hypercalcemia, and profoundly low ALP. Without enzyme replacement therapy, the disease is progressing.
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