病例报告:全基因组测序确定了X链接阿尔波特综合征中不确定的新型深层内基因COL4A5变异
Hoon Seok Kim1,2, Myungshin Kim1,2, Jin-Soon Suh3
1Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Frontiers in pediatrics
|August 25, 2025
概括
通过标准的基因检测来诊断阿尔波特综合征是很困难的, 全基因组测序 (WGS) 发现了COL4A5中的新型深层内基因变异,有助于在具有挑战性的X链接阿尔波特综合征病例中进行诊断.
科学领域:
- 遗传学
- 分子生物学
- 肝脏病学
背景情况:
- 阿尔波特综合征是一种遗传性病,由IV型原基因 (COL4A3, COL4A4, COL4A5) 的突变引起.
- 与X相关的阿尔波特综合征 (XLAS) 是最常见的形式,约占80%的病例.
- 诊断阿尔波特综合征可能具有挑战性,特别是当致病变体没有通过针对性的测序检测到时,例如基于面板的下一代测序 (NGS).
研究的目的:
- 报告使用全基因组测序 (WGS) 诊断的X链接阿尔波特综合征病例.
- 突出WGS在识别传统遗传检测中遗漏的深层内基变异中的有用性.
- 强调全面基因组测序对于早期诊断和治疗阿尔波特综合征的重要性.
主要方法:
- 在怀疑患有阿尔波特综合征的儿科患者身上进行了全基因组测序 (WGS).
- 桑格测序用于确认患者及其母亲的鉴定变异.
- 收集了临床数据,包括尿液分析和脏超声波.
主要成果:
- 通过WGS识别了COL4A5基因中的一种新型的内源性半导体变体 (c.2395+2723T>G).
- 这种变异在患者及其异卵性母亲中得到证实.
- 患者保持正常的功能,视力和听力,持续的微观出血.
结论:
- 针对性测序失败时,全基因组测序是诊断X链接阿尔波特综合征的一个有价值的工具.
- COL4A5 中的深层内基因变异可能导致阿尔波特综合征,需要全面的基因组方法来检测.
- 通过WGS进行早期遗传诊断有助于及时干预,避免儿科患者的侵袭性手术.
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