关于卡尼丁棕转移酶II缺乏症的经验:肌病性形式的诊断挑战
Havva Yazıcı1, Gunes Ak2, Merve Yoldas Çelik1
1Department of Inborn Errors of Metabolism, Ege University Faculty of Medicine, Izmir, Türkiye.
Journal of pediatric endocrinology & metabolism : JPEM
|November 5, 2023
概括
卡尼丁棕基转移酶II (CPT II) 缺乏,脂肪酸氧化障碍,可以导致复发性狂犬病. 基因分析对于诊断至关重要,即使是正常的甲蛋白样本,也有助于理解这种肌病性形式.
科学领域:
- 生物化学 生化学
- 遗传学 是一个遗传学.
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 卡尼丁棕基转移酶II (CPT II) 缺乏症是一种自体逆性疾病,影响长链脂肪酸氧化.
- 它呈现出多样化的表型,包括一种由反复发生的狂犬病症特征的肌病性形式,通常是轻微的,从婴儿期到成年期呈现.
研究的目的:
- 调查13名患有肌病性形式的CPT II缺乏症患者的临床,生化,本病学和遗传特征.
- 评估CPT II缺陷的诊断方法,特别是在复发性狂犬病溶解的情况下.
主要方法:
- 对13名被诊断患有肌痛性形式的CPT II缺乏症的患者进行了回顾性分析.
- 包括人口统计数据,拉布地质溶解触发因素,生化查 (乙卡尼蛋白档案) 和分子遗传分析.
主要成果:
- 十名患者呈现出源不明的体溶解;两名通过家族查诊断,一名通过升高的肝功能测试.
- 在狂犬病发作期间,五名患者的阿基尔卡尼丁概况正常.
- 遗传分析显示,在10名患者中存在同卵性c.338C>T (p.Ser113Leu) 变异,在1名患者中存在复合异卵性与新型框架转移变异.
结论:
- 血乙烯基胺分析优于干血斑点 (DBS) 乙烯基胺分析,用于诊断CPT II缺乏症.
- 当血乙尼丁分析是不可行的或不确定的时,建议进行CPT2基因分析.
- 在复发性狂犬病的差异诊断中,即使没有典型的甲酸升高,也应该考虑CPT II缺乏.
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