基因检测诊断Merosin缺陷性先天性肌营养不良1例及文献复习

Case report of LAMA2 gene mutation in a patient of merosin-deficient congenital muscular dystrophy type 1A and literature review

目的利用基因检测技术对拟诊先天性肌营养不良(CMD)患儿进行明确诊断,为CMD的早期诊断提供参考。方法收集1例拟诊CMD患儿临床资料,采集患儿及父母血标本,采用基因测序检测致病基因。结果该患儿于出生后发病,运动发育落后、肌张力降低,血清肌酸激酶升高,肌电图示肌源性损害,肌肉组织呈典型先天性肌营养不良样的病理改变,头颅MRI示双侧额颞部脑沟及蛛网膜下腔较宽。基因测序发现LAMA2基因c.3735+2-3735+8delinsAAAGAAGGA纯合剪切变异,来自于患儿父亲,经基因检测确诊为先天性肌营养不良1A型(MDC1A)。结论若患儿临床表现为运动发育落后,肌酸激酶增高及肌电图提示肌源性损害应考虑CMD,可行基因检测以明确诊断。

Objective To perform prenatal gene diagnosis on sporadic case with congenital muscular dystrophy （CMD）. Method The clinical data of 1 patient with CMD and blood samples of the child and parents were collected,pathogenic genes were detected using gene sequencing. Results The child with the onset of after birth,appeared motor retardation,hypotonia,increased of serum creatine kinase. EMG showed myogenic damage. Cranial MRI showed that the bilateral frontal and temporal cerebral sulcus and subarachnoid space were wider. Gene sequencing revealed that the c. 3735＋ 2-3735 ＋ 8delinsAAAGAAGGA gene LAMA2 homozygous mutated from the children＇s father. The genetic test confirmed the diagnosis of MDCIA. Conclusions If the child＇s clinical manifestations of motor retardation, increased creatine kinase and EMG showed myogenic damage,CMD should he promptly considered,and early genetic testing can confirm the diagnosis.