在一个患有风的家庭中,同时出现PHEX和ALPL突变的新案例
Carmen Polanco Santos1, Juana Cordero Garate2, Leila Zeinab Khan1
1Endocrinology and Metabolism Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
JCEM case reports
|December 11, 2023
概括
这项研究报告了第一个已知的X链接低度血症 (XLH) 和成人低度血症 (HPP) 的已知病例,原因是PHEX和ALPL基因中的致病变异. 诊断需要仔细的遗传和实验室测试,因为重叠的症状.
科学领域:
- 遗传学 是一个遗传学.
- 内分泌学 在内分泌学.
- 代谢性骨疾病 代谢性骨疾病
背景情况:
- 与X相关的低度血症 (XLH) 和成人低度血症 (HPP) 是影响代谢的罕见遗传疾病.
- 这两种情况都有重叠的临床特征,使得差异诊断具有挑战性.
- 通常缺乏标准化的诊断标准,特别是在成年人呈现时.
研究的目的:
- 描述第一个报告的家族与PHEX (XLH) 和ALPL (HPP) 的同时发生的致病变体.
- 突出与这些共同发生的遗传变异相关的诊断挑战和临床异质性.
- 强调对罕见骨疾病进行综合遗传和实验室检测的重要性.
主要方法:
- 一个母亲和女儿的临床病例介绍,双边腿曲和矮身.
- 生物化学分析包括血清,1,25-二氧维生素D和性酸酶 (ALP).
- 基因检测用于识别PHEX和ALPL基因中的致病变体.
主要成果:
- 一名61岁的妇女和她的42岁女儿出现了暗示骨疾病的症状.
- 生物化学发现包括低血清和1,25-二氧维生素D,与正常的ALP水平.
- 遗传分析证实了两个人的PHEX和ALPL基因中的致病变体.
- 患者接受和维生素D治疗,其中一名患者后来接受了burosumab-twza.
结论:
- 同时的XLH和HPP虽然很少发生,但可能会发生并带来诊断挑战.
- 在低酸血症存在的情况下,正常的ALP水平可以表明XLH,但需要遗传确认.
- 鉴定到的双重遗传变异在罕见的骨疾病中显示出显著的临床表达异质性.
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