Sin3A基因变异致Witteveen-Kolk综合征遗传学分析

doi:10.3969/j.issn.1673-8640.2024.02.005

检验医学 ›› 2024, Vol. 39 ›› Issue (2): 126-131.DOI: 10.3969/j.issn.1673-8640.2024.02.005

• 基因组技术与罕见病、遗传病诊治专题 • 上一篇下一篇

Sin3A基因变异致Witteveen-Kolk综合征遗传学分析

卢亚亚¹, 彭慧芳², 王剑³, 娄丹¹

1.河南科技大学第一附属医院儿童保健科，河南洛阳 471003
2.河南科技大学第一附属医院内分泌代谢中心河南省罕见病重点实验室，河南洛阳 471003
3.上海交通大学医学院附属国际和平妇幼保健院，上海 200030

收稿日期:2023-06-05 修回日期:2023-10-14 出版日期:2024-02-28 发布日期:2024-03-26
作者简介:卢亚亚，女，1981年生，硕士，主治医师，主要从事儿童生长发育相关研究。
基金资助:
河南省医学教育研究项目(Wjlx2022113);河南省医学科技攻关计划联合共建项目(LHGJ20210598)

Genetic analysis of Witteveen-Kolk syndrome caused by Sin3A variation

LU Yaya¹, PENG Huifang², WANG Jian³, LOU Dan¹

1. Department of Child Health Care，the First Affiliated Hospital of Henan University of Science and Technology，Luoyang 471003，Henan，China
2. Endocrinology and Metabolism Center，the First Affiliated Hospital of Henan University of Science and Technology，Henan Key Laboratory of Rare Diseases，Luoyang 471003，Henan，China
3. The International Peace Maternity and Child Health Hospital，Shanghai Jiao Tong University School of Medicine，Shanghai 200030，China

Received:2023-06-05 Revised:2023-10-14 Online:2024-02-28 Published:2024-03-26

摘要/Abstract

摘要：

目的探讨开关不敏感3转录调节因子家族成员A(Sin3A)基因变异导致的Witteveen-Kolk综合征临床表型和遗传学特点。方法收集1例发育迟缓患儿的临床资料，对患儿及其父母进行全外显子基因测序，采用Sanger测序验证可疑变异，并进行家系分析。结合文献分析Witteveen-Kolk综合征的临床特征和基因变异特点。结果 Witteveen-Kolk综合征患儿临床表现主要为轻中度智力障碍或发育迟缓、特殊面容(长脸、前额突出、鼻梁凹陷、长人中等)、身材矮小。颅脑磁共振成像(MRI)显示不同程度的脑畸形。全外显子基因测序结果显示，患儿Sin3A基因存在移码变异c.803dupC(p.Leu269Thrfs*37)(杂合)。Sanger测序证实存在变异位点，患儿父母该位点均为正常基因型。gnomAD等对照人群数据库未收录该变异位点，根据美国医学遗传学和基因组学学会(ACMG)/美国分子病理学学会(AMP)指南归类为“致病性”变异。结论 Sin3A基因变异可导致Witteveen-Kolk综合征。基因检测可明确生长发育迟缓伴特殊面容患儿的病因。

关键词: 开关不敏感3转录调节因子家族成员A基因, 全外显子组测序, Witteveen-Kolk综合征, 智力发育障碍, 发育迟缓

Abstract:

Objective To investigate the clinical phenotypes and genetic characteristics of Witteveen-Kolk syndrome caused by switch-insensitive 3 transcription regulator family member A(Sin3A) variation. Methods The clinical data of a child with developmental delay were collected，and whole-exome sequencing was used to determine the child and his parents. The suspected variations were verified by Sanger sequencing. The clinical characteristics and variation characteristics of Witteveen-Kolk syndrome were analyzed based on literature. Results The main clinical manifestations of Witteveen-Kolk syndrome were mild to moderate mental retardation or developmental delay，special facial features(long face，prominent forehead，sunken nose bridge，long philtrum) and short stature. Brain magnetic resonance imaging (MRI) showed different degrees of brain malformations. Sin3A c.803dupC(p.Leu269Thrfs*37)(heterozygous) frameshift variation was found by whole-exome sequencing. Sanger sequencing showed that the parents of the child had normal genotypes at this locus. The variation was not included in gnomAD and other control population databases，which was classified as "pathogenic" variation according to American College of Medical Genetics and Genomics(ACMG)/the Association for Molecular Pathology(AMP)variation classification criteria. Conclusions Sin3A variation can lead to Witteveen-Kolk syndrome. Genetic testing can confirm the etiology diagnosis of children with developmental delay and special facial features.

Key words: Switch-insensitive 3 transcription regulator family member A gene, Whole-exome sequencing, Witteveen-Kolk syndrome, Mental retardation, Developmental delay

中图分类号:

R446.7

卢亚亚, 彭慧芳, 王剑, 娄丹. Sin3A基因变异致Witteveen-Kolk综合征遗传学分析[J]. 检验医学, 2024, 39(2): 126-131.

LU Yaya, PENG Huifang, WANG Jian, LOU Dan. Genetic analysis of Witteveen-Kolk syndrome caused by Sin3A variation[J]. Laboratory Medicine, 2024, 39(2): 126-131.

图/表 4

图1 本例患儿家系图注：□正常男性；○正常女性；■患病男性；→先证者。

图2 患儿颅脑MRI检查结果注：双侧侧脑室扩大，胼胝体压部细小。

图3 患儿及其父母Sanger测序结果注：患儿Sin3A基因(NM_001145358.2)存在移码变异c.803dupC(p.Leu269Thrfs*37)(杂合)，其父母基因正常，均未携带该变异(红色方框部分)。

表1 50例Witteveen-Kolk综合征病例的临床特征

临床特征	已报道病例/[%(例/例)]	本例患儿
智力障碍	73.47(36/49)	有
特殊面容	100.00(49/49)	有
异常脑MRI结果	57.89(11/19)	有
行为问题	44.90(22/49)	无
张力减退	34.69(17/49)	无
身材矮小	28.57(14/49)	有
小头畸形	24.39(10/41)	有
癫痫	14.29(7/49)	无

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Sin3A基因变异致Witteveen-Kolk综合征遗传学分析

Genetic analysis of Witteveen-Kolk syndrome caused by Sin3A variation

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