BACKGROUND Combined pituitary hormone deficiency 3(CPHD3;OMIM:221750)is caused by mutations within the LHX3 gene(OMIM:600577),which located on the subtelomeric region of chromosome 9 at band 9q34.3,has seven coding ex...BACKGROUND Combined pituitary hormone deficiency 3(CPHD3;OMIM:221750)is caused by mutations within the LHX3 gene(OMIM:600577),which located on the subtelomeric region of chromosome 9 at band 9q34.3,has seven coding exons and six introns.LIM homeobox(LHX)3 protein is the key regulator of pituitary development in fetal life.CASE SUMMARY We have diagnosed and treate an 11-year-old boy with combined pituitary hormone deficiency(CPHD).The main clinical manifestations were pituitary hormone deficiency,hydrocele of the tunica vaginalis,pituitary dwarfism,gonadal dysplasia,micropenis,clonic convulsion,and mild facial dysmorphic features.We collected peripheral blood from the patient,the patient's older brother,as well as their parents,and sequenced them by using high-throughput whole-exosome sequencing,which was verified by Sanger sequencing.The results showed that there were two compound heterozygous variants of c.613G>C(p.V205L)and c.220T>C(p.C74R)in the LHX3 gene.c.613G>C(p.V205L)was inherited from his mother and c.220T>C(p.C74R)from his father.His brother also has both variants and symptoms.CONCLUSION This study reported ununreported genetic mutations of LHX3,and recorded the treatment process of the patients,providing data for the diagnosis and treatment of CPHD.展开更多
目的探讨儿童垂体柄阻断综合征的临床表现及基因突变类型。方法选取2016年1月至2018年3月首都儿科研究所附属儿童医院内分泌科收治的垂体柄阻断综合征患儿16例,回顾性分析患儿的临床表现,并采用全外显子测序技术进行基因学检测,根据美...目的探讨儿童垂体柄阻断综合征的临床表现及基因突变类型。方法选取2016年1月至2018年3月首都儿科研究所附属儿童医院内分泌科收治的垂体柄阻断综合征患儿16例,回顾性分析患儿的临床表现,并采用全外显子测序技术进行基因学检测,根据美国医学遗传学与基因组学学会(American College of Medical Genetics and Genomics,ACMG)指南对其致病性进行分析。结果共纳入16例垂体柄阻断综合征患儿,诊断年龄为1.7～16.2岁,男11例,女5例;4例有臀位产病史,11例以"身高增长缓慢"就诊,4例以"反复无热抽搐"为主要表现。16例患儿均为生长激素缺乏,其中15例有中枢性甲状腺功能减退,11例继发性肾上腺皮质功能不全。2例发现致病性突变,其中1例为4.9岁男孩,为ROBO1基因c.1690C>T(p.Pro564Ser)杂合突变,1例为12.3岁女孩,为HS6ST1基因c.608C>T(p.Thr203Met)杂合突变,均符合ACMG致病性突变,生物学预测有害。结论垂体柄阻断综合征临床上以患儿身高增长缓慢最为常见,多表现为联合垂体功能减退,全外显子测序有利于发现致病性突变。展开更多
文摘BACKGROUND Combined pituitary hormone deficiency 3(CPHD3;OMIM:221750)is caused by mutations within the LHX3 gene(OMIM:600577),which located on the subtelomeric region of chromosome 9 at band 9q34.3,has seven coding exons and six introns.LIM homeobox(LHX)3 protein is the key regulator of pituitary development in fetal life.CASE SUMMARY We have diagnosed and treate an 11-year-old boy with combined pituitary hormone deficiency(CPHD).The main clinical manifestations were pituitary hormone deficiency,hydrocele of the tunica vaginalis,pituitary dwarfism,gonadal dysplasia,micropenis,clonic convulsion,and mild facial dysmorphic features.We collected peripheral blood from the patient,the patient's older brother,as well as their parents,and sequenced them by using high-throughput whole-exosome sequencing,which was verified by Sanger sequencing.The results showed that there were two compound heterozygous variants of c.613G>C(p.V205L)and c.220T>C(p.C74R)in the LHX3 gene.c.613G>C(p.V205L)was inherited from his mother and c.220T>C(p.C74R)from his father.His brother also has both variants and symptoms.CONCLUSION This study reported ununreported genetic mutations of LHX3,and recorded the treatment process of the patients,providing data for the diagnosis and treatment of CPHD.
文摘目的探讨儿童垂体柄阻断综合征的临床表现及基因突变类型。方法选取2016年1月至2018年3月首都儿科研究所附属儿童医院内分泌科收治的垂体柄阻断综合征患儿16例,回顾性分析患儿的临床表现,并采用全外显子测序技术进行基因学检测,根据美国医学遗传学与基因组学学会(American College of Medical Genetics and Genomics,ACMG)指南对其致病性进行分析。结果共纳入16例垂体柄阻断综合征患儿,诊断年龄为1.7～16.2岁,男11例,女5例;4例有臀位产病史,11例以"身高增长缓慢"就诊,4例以"反复无热抽搐"为主要表现。16例患儿均为生长激素缺乏,其中15例有中枢性甲状腺功能减退,11例继发性肾上腺皮质功能不全。2例发现致病性突变,其中1例为4.9岁男孩,为ROBO1基因c.1690C>T(p.Pro564Ser)杂合突变,1例为12.3岁女孩,为HS6ST1基因c.608C>T(p.Thr203Met)杂合突变,均符合ACMG致病性突变,生物学预测有害。结论垂体柄阻断综合征临床上以患儿身高增长缓慢最为常见,多表现为联合垂体功能减退,全外显子测序有利于发现致病性突变。
