oculocutaneous albinism

眼皮肤白化病
  • 文章类型: Journal Article
    背景:眼皮肤白化病(OCA)是一组影响黑色素生物合成的常染色体隐性遗传性疾病,导致头发异常,皮肤,和眼睛。早产儿视网膜病变(ROP)是一种增殖性视网膜病变,主要见于低出生体重和胎龄较早的早产儿。但它也会影响足月婴儿或体重正常的儿童,特别是在发展中国家。ROP和OCA的共存是罕见的。关于治疗方法的文件有限,由于缺乏黑色素,很少有研究报告激光治疗的积极结果。这项研究讨论了诊断为ROP和OCA的女婴的治疗挑战,并强调了遗传分析在指导这种罕见的合并症的治疗决策中的重要性。
    方法:本研究报告1例ROP与OCA同时发生。基因检测显示两种变异,c.727C>T(p。R243C)和c.1832T>C(p。L611P),在OCA2基因中,从病人的母亲和父亲那里继承下来,分别。鉴定的突变与OCA2的诊断一致,被分类为OCA的亚型。患者最初接受玻璃体内注射抗血管内皮生长因子(抗VEGF),然后是激光光凝治疗复发事件.在2个月的随访期间观察到良好的结果。
    结论:ROP和OCA的同时出现是一种罕见的现象,这是中国人口中记录的第一例。当前病例支持使用激光作为部分色素沉着受损的OCA2患者ROP的主要治疗方式。此外,遗传分析可以帮助预测该患者人群中激光光凝的有效性.
    BACKGROUND: Oculocutaneous albinism (OCA) is a group of autosomal recessive hereditary disorders that affect melanin biosynthesis, resulting in abnormalities in hair, skin, and eyes. Retinopathy of prematurity (ROP) is a proliferative retinopathy mainly observed in premature infants with low birth weight and early gestational age, but it can also affect full-term infants or children with normal weight, particularly in developing countries. The coexistence of ROP and OCA is rare. There is limited documentation regarding treatment approaches, with few studies reporting positive outcomes with laser treatment due to the absence of melanin pigment. This study discusses the treatment challenges in a female infant diagnosed with ROP and OCA, and underscores the importance of genetic analysis in guiding therapeutic decisions for this rare comorbid condition.
    METHODS: The study presents a case of ROP occurring concurrently with OCA. Genetic testing revealed two variants, c.727C > T (p.R243C) and c.1832 T > C (p.L611P), in the OCA2 gene, inherited from the patient\'s mother and father, respectively. The identified mutations were consistent with a diagnosis of OCA2, classified as a subtype of OCA. The patient initially received intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection, followed by laser photocoagulation therapy for a recurrent event. A favorable outcome was observed during the 2-month follow-up period.
    CONCLUSIONS: The co-occurrence of ROP and OCA is a rare phenomenon, and this is the first recorded case in the Chinese population. The current case supports the use of laser as the primary treatment modality for ROP in OCA2 patients with partial pigmentation impairment. Furthermore, genetic analysis can aid in predicting the effectiveness of laser photocoagulation in this patient population.
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  • 文章类型: Case Reports
    我们报告了一例由肌缩短素结合蛋白1基因(DTNBP1)纯合变异引起的7型Hermansky-Pudlak综合征(HPS-7),并强调了与这种罕见疾病相关的遗传挑战。
    病例报告。文献综述是在2023年5月通过搜索PubMed进行的,没有语言或日期限制,使用以下术语:Hermansky-Pudlak综合征,Hermansky-Pudlak综合征7型,和肌短菌素结合蛋白1基因。
    我们报告了一例69岁的葡萄牙女性,因长期严重的视力障碍而接受眼科评估,明显的畏光,右眼内斜视,和双侧摆动性眼球震颤。前节检查显示虹膜透照缺陷,而眼底表现为色素减退和中央凹反射的缺失。该患者有眼皮肤白化病(OCA)和复发性鼻出血的病史。她的家族史对一级血缘关系的父母和年轻时已故的姐姐呈阳性,他们也表现出OCA和复发性鼻出血。遗传测试在DTNBP1,c.307C>Tp.(Gln103*)中鉴定了纯合致病性无义变体。患者的临床特征和基因检测支持HPS-7的诊断。已鉴定的变体先前已在文献中报道,葡萄牙血统的成年患者。
    这项工作突出了HPS-7的遗传复杂性,并强调了基因检测在诊断这种罕见疾病中的重要性。罕见致病变异的鉴定扩大了我们对HPS-7遗传学的理解,并暗示了葡萄牙人口中可能的创始人效应。
    UNASSIGNED: We report a case of Hermansky-Pudlak Syndrome type 7 (HPS-7) caused by a homozygous variant in the dystrobrevin-binding protein 1 gene (DTNBP1) and highlight the genetic challenges associated with this rare disorder.
    UNASSIGNED: Case report. Literature review was performed by searching PubMed on May 2023, without language or date restriction, using the following terms: Hermansky-Pudlak syndrome, Hermansky-Pudlak syndrome type 7, and dystrobrevin-binding protein 1 gene.
    UNASSIGNED: We report a case of a 69-year-old Portuguese female who presented for ophthalmic evaluation with long-standing severe visual impairment, pronounced photophobia, right-eye esotropia, and bilateral pendular nystagmus. Anterior segment examination revealed iris transillumination defects, while the ocular fundus showed hypopigmentation and the absence of the foveal reflex. The patient had a history of oculocutaneous albinism (OCA) and recurrent epistaxis. Her family history was positive for first-degree consanguineous parents and a deceased sister at young age who also exhibited OCA and recurrent epistaxis. Genetic testing identified a homozygous pathogenic nonsense variant in the DTNBP1, c.307C>T p.(Gln103*). The patient\'s clinical features and genetic testing support the diagnosis of HPS-7. The identified variant has been previously reported in the literature, in adult patients of Portuguese descent.
    UNASSIGNED: This work highlights the genetic complexity of HPS-7 and emphasizes the importance of genetic testing in the diagnosis of this rare disorder. The identification of a rare pathogenic variant expands our understanding of HPS-7 genetics and suggests a possible founder effect in the Portuguese population.
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    文章类型: Review
    总结1例Angelman综合征(AS)合并2型眼皮肤白化病(OCA2)患儿的临床诊治过程和基因检测结果及特点,并回顾文献。以\"Angelmansyndrome\"\"P基因\"和\"眼皮肤白化病2型\"为关键词在CNKI检索,万方,和PubMed数据库(从创建到2019年12月)。然后对所有患者进行分析。该研究中的患者是1岁的女孩。出生后,她被发现是白色尸体,黄色的头发,和眼球震颤.她可以在2个月大的时候抬起头,在7个月大的时候翻身。头围为42厘米,她目前无法独自坐下或说话。基于三重奏的外显子组测序显示,该患者携带c.168del的纯合突变(p。Gln58ArgfsTer44)在P基因中,她的父亲是杂合子,母亲是野生型。拷贝数变异的检测显示患者的母体染色体上15q11.2-13.1区(P基因位于该区域)的缺失。截至2019年12月,4篇文献中共报告4例。在这里加上我们的案例,对这5例病例进行总结,发现所有病例都显示白色皮肤,金色的头发,出生后虹膜浅。在出生后6个月左右发现了全面的发育迟缓,在2例病例中,语言仍未发育,直到儿童期随访。4例患者发生癫痫发作。2例共济失调。5例均为获得性小头畸形。2例有白化病家族史。3例完成脑电图监测,结果异常。基因检测显示,5例患者母体染色体15q11-13区缺失。4例父系染色体上携带P基因突变。1例临床诊断为OCA2,无P基因检测。AS与OCA2结合相对罕见。根据出生后明显的临床表现,OCA2很容易诊断。当结合临床表现如神经发育迟缓时,这可能表明早期很难在临床上诊断的AS的可能性。遗传测试可以揭示AS和OCA2的交叉遗传现象,最终可以诊断出它们的复合物。
    To summarize the clinical diagnosis and treatment process and genetic test results and characteristics of one child with Angelman syndrome (AS) complicated with oculocutaneous albinism type 2 (OCA2), and to review the literature. \"Angelman syndrome\" \"P gene\" and \"Oculocutaneous albinism type 2\" were used as keywords to search at CNKI, Wanfang, and PubMed databases (from creation to December 2019). Then all the patients were analyzed. The patient in this study was a girl aged 1 year. After birth, she was found to present as white body, yellow hair, and nystagmus. She could raise her head at the age of 2 months and turn over at the age of 7 months. The head circumference was 42 cm and she could not sit alone or speak at present. Trio-based exome sequencing revealed that the patient carried a homozygous mutation of c.168del (p.Gln58ArgfsTer44) in the P gene, and her father was heterozygous and her mother was wild-type. The detection of copy number variation showed deletion on the maternal chromosome at 15q11.2-13.1 region (P gene located in this region) in the patient. Until December 2019, a total of 4 cases in the 4 literature had been reported. Adding our case here, the 5 cases were summarized and found that all the cases showed white skin, golden hair, and shallow iris after birth. Comprehensive developmental delay was found around 6 months of age after birth, and the language remained undeveloped in 2 cases till follow-up into childhood. Seizures occurred in 4 patients. Two cases had ataxia. All the 5 cases had acquired microcephaly. Two cases had a family history of albinism. Electroencephalogram monitoring was completed in 3 cases and the results were abnormal. Genetic tests showed that all the 5 cases had deletion on maternal chromosome at 15q11-13 region. Four cases carried mutation of P gene on paternal chromosome. And 1 case was clinically diagnosed as OCA2 without P gene test. AS combined with OCA2 is relatively rare. OCA2 is easily diagnosed based on the obvious clinical manifestations after birth. When combined with clinical manifestations such as neurodevelopmental delay, it might indicate the possibility of AS that is hardly diagnosed clinically at an early stage. Genetic tests can reveal the cross-genetic phenomenon of AS and OCA2 and the complex of them can be eventually diagnosed.
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  • 文章类型: Journal Article
    BACKGROUND: Hermansky-Pudlak syndrome (HPS) is a rare autosomal-recessive disorder with clinical manifestations of bleeding diathesis, multi-organ disease and variable oculocutaneous albinism (OCA). In women, it can cause life-threatening obstetric and gynecological (OB/GYN) bleeding.
    OBJECTIVE: To summarize OB/GYN presentations, outcomes, and management strategies in women with HPS.
    METHODS: Main databases (MEDLINE, EMBASE, Cochrane, PubMed, Web of Science Core Collection and Google Scholar) were searched from inception until June 30, 2020.
    METHODS: Case reports/series of women with confirmed HPS.
    METHODS: A systematic review using PRISMA guidelines. Methodological quality assessment performed using adapted Newcastle Ottawa scale.
    RESULTS: A total 29 pregnancies in 15 women and 2 gynecological patients were identified. Heavy menstrual bleeding (HMB), the most common bleeding symptom, was reported in 8/15 (53%) of women. HMB and post-partum hemorrhage (PPH) led to diagnosis of HPS in 5/17 (29%) women. Primary PPH was reported in 12/27 (44%) of viable pregnancies; half were major PPH. In 17 pregnancies with known HPS diagnosis, 9 had hemostatic cover with desmopressin and 8 with platelet transfusion. Major PPH occurred in 3/9 (33%) pregnancies covered with desmopressin compared with none in the platelet group.
    CONCLUSIONS: Diagnosis of HPS should be considered in women with OCA presenting with HMB or PPH. Hemostatic management options include desmopressin and platelet transfusion. Management should be multidisciplinary with close collaboration between OB/GYN and hematology teams.
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