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由于TSHB基因突变引起的中央先天性甲状腺功能低下症:25年随访
Adlyne Reena Asirvatham1, Vaishnavi Reddy Deva Reddy2, Sujatha Jagadeesh3
1Endocrinology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamilnadu, India.
BMJ case reports
|January 28, 2025
概括
由于TSHB基因突变而导致的孤立中央先天性甲状腺功能低下症 (iCCH) 的早期诊断至关重要. 新生儿及时接受levothyroxine治疗可以预防神经认知障碍,即使是严重的突变.
科学领域:
- 遗传学 遗传学 是一个
- 内分泌学 在内分泌学.
- 新生儿医学 新生儿医学
背景情况:
- 孤立的中央先天性甲状腺功能低下症 (iCCH) 通常是晚诊断,导致潜在的神经认知缺陷.
- 甲状腺刺激激素 (TSH) 基因突变是已知的iCCH的原因之一.
- 新生儿高 bilirubinemia 有时可以掩盖或推迟诊断的甲状腺功能低下症.
研究的目的:
- 报告在新生儿中诊断出iCCH的病例,该病例呈现出长期非结合性高 bilirubinemia.
- 突出早期诊断和治疗iCCH的重要性.
- 为了证明及时启动勒沃西的长期结果.
主要方法:
- 怀疑甲状腺功能低下的新生儿的临床表现和诊断工作.
- 甲状腺功能测试,前垂体激素评估和垂体MRI.
- 对TSHB基因进行遗传分析,以确定致病突变.
主要成果:
- 一名女性新生儿出现了长期的非结合性高 bilirubinemia 和临床怀疑的甲状腺功能低下症.
- 基因分析显示TSHB基因 (exon 2中的c.108-109) 中存在缺失.
- 在生命的第11天及时启动levothyroxine治疗,避免了神经认知后果,患者在25年内保持良好随访.
结论:
- TSHB基因突变可以导致iCCH,有时会出现非典型的初始发现,如高白血症.
- 早期诊断和及时的勒沃西治疗对于预防iCCH婴儿的神经认知障碍至关重要.
- 对TSHB突变的遗传确认有助于了解疾病的严重程度和预后,强调早期干预的好处.
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