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对神经肌肉疾病患者的临床表现和遗传测试方法的评估
Amanda Rosenberg1,2, Cuixia Tian1,2, Hua He1
1Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
American journal of medical genetics. Part A
|July 28, 2023
概括
诊断遗传神经肌肉疾病 (NMDs) 可能是由于遗传复杂性的挑战. 这项研究发现,高CPK水平是NMD患者遗传诊断中最有信息的症状.
科学领域:
- 遗传学 遗传学 是一个
- 神经学 神经学
- 分子生物学分子生物学
背景情况:
- 遗传神经肌肉疾病 (NMDs) 涵盖了影响神经和肌肉功能的各种遗传疾病.
- 临床和遗传异质性,以及可变的发病期,使NMD诊断复杂化.
- 分子遗传学越来越重要,但测试选择和表型模糊性带来了挑战.
研究的目的:
- 为了评估临床表现,基因测试策略,和诊断产量在疑似NMDs的患者.
- 确定影响NMD成功基因诊断的因素.
- 为基因测试推提供信息,并改善NMD患者的诊断途径.
主要方法:
- 对155名怀疑患有NMD的患者进行了回顾性图表审查.
- 分析临床发现,订购的基因测试 (共262项,平均为每名患者1.7),以及诊断结果.
- 临床症状与遗传诊断确认的相关性.
主要成果:
- 总体而言,21%的患者接受了基因诊断.
- 肌肉衰弱或没有肌肉衰弱,肌酸酸酶 (CPK) 水平升高是积极遗传结果的最重要的临床预测因子.
- 基因测试的产量差异很大,在26个不同的测试中,从0%到66%不等.
结论:
- 对NMDs的基因测试在诊断结果中呈现出差异性.
- 升高的CPK水平是疑似NMD病例基因检测的关键指标.
- 了解测试考虑对于预测咨询和NMD诊断中的患者同意至关重要.
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