Aicardi-Goutières综合征4型1例临床和基因分析

Clinical and genetic analysis in a patient with type 4 Aicardi-Goutières syndrome

目的探讨Aicardi-Goutières综合征(AGS)的临床、影像及遗传学特点。方法回顾分析1例AGS 4型患儿的临床资料及二代基因测序结果,并复习相关文献。结果患儿,女,5个月,临床表现为反复发热,精神运动发育落后,癫痫,小头畸形,痉挛状态。脑脊液淋巴细胞增多;头颅磁共振成像示脑萎缩、脑白质异常;头颅CT示双侧基底节区及脑白质钙化。基因检测发现RNASEH2A基因存在c.199G>C、c.322C>T复合杂合突变;c.322C>T致病性已有文献报道,与AGS 4型相关;c.199 G>C致病性尚未见文献报道。结论首次报道我国RNASEH2A基因变异所致AGS。

Objective To explore the clinical characteristics, imaging and genetic features of Type 4 Aicardi-Gouti6res syn＆ome （AGS）. Methods The clinical data were collected, genetic changes were tested using next generation sequencing, and relevant literatures were reviewed. Results A 5 months old girl present with recurrent fever, intelligence and motor developmental delay, epilepsy, microcephaly, spasticity, cerebrospinal fluid pleocytosis. Brain MRI displayed cerebral atrophy and white matter lesions. Brain CT displayed intra-cranial multiple calcifications. Two missense mutations were identified in RNASEH2A, c.199G〉C was a novel mutation, and c. 322C〉T was a known pathogenic mutation. Conclusions RNASEH2A gene mutations can lead to type 4 AGS.