Congenital Generalized

  • 文章类型: Case Reports
    术语层粘连蛋白病是指一组以人体组织加速变性为特征的先天性疾病。LMNA突变,LMNB,ZMPSTE24和其他基因导致与层粘连蛋白相关的结构和功能异常。椎板病变的一个亚型是全身性脂肪营养不良相关的孕激素综合征(GLPS),发生在LMNA基因c.29C>T杂合突变的患者中(p。T10I)。本文报道了我国首例GLPS病例,并将其他GLPS患者的临床特征与文献报道进行了比较。一名16岁男性患者因糖尿病酮症酸中毒接受治疗,呈现过早老化的外观,全身性脂肪营养不良,重度脂肪肝,骨密度下降。经过外周血DNA提取和第二代测序,LMNA基因c.29C>T的外显子1的杂合突变(p。检测到T10I)。此例GLPS可能为潜在患者提供诊断和治疗依据。
    The term laminopathies refers to a group of congenital diseases characterized by accelerated degeneration of human tissues. Mutations in LMNA, LMNB, ZMPSTE24, and other genes lead to structural and functional abnormalities associated with lamins. One subtype of laminopathy is the generalized lipodystrophy-associated progeroid syndrome (GLPS), which occurs in patients with heterozygous mutations of the LMNA gene c.29C>T(p.T10I). This paper reports the first case of GLPS in China and compares the clinical features of other GLPS patients with literature reports. A 16-year-old male patient was treated for diabetic ketoacidosis, presenting with premature aging appearance, systemic lipodystrophy, severe fatty liver, and decreased bone density. After peripheral blood DNA extraction and second-generation sequencing, a heterozygous mutation of exon 1 of the LMNA gene c.29C>T(p.T10I) was detected. This case of GLPS may provide a diagnostic and therapeutic basis for potential patients.
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  • 文章类型: Case Reports
    在Berardinelli-Seip先天性脂肪营养不良(BSCL)中,严重的代谢并发症通常在早期出现,其管理尤其具有挑战性。专家认为,在与药物治疗相关的情况下,低脂饮食的营养干预是治疗该疾病的基础。然而,关于单独的饮食干预的有益效果知之甚少。
    强调BSCL患者结构良好的低脂饮食的重要性。
    一名BSCL男性患者严格遵循低热量低脂饮食(60%碳水化合物,22%的脂肪和18%的蛋白质)自1岁的临床诊断以来。有趣的是,在随访期间的任何时间点都不需要药物干预.16岁的患者被转诊到我们的中心。生物化学,荷尔蒙评估,75毫克口服葡萄糖耐量试验,进行心脏评估和腹部超声检查,没有发现异常.进行了遗传分析和瘦素剂量,确认BSCL1型(AGPAT2基因中c.493-1G>C致病性变异的纯合性)的诊断,并显示未检测到的瘦素循环水平(<0.2mcg/L)。因此,单独的饮食治疗得以维持,安排每六个月的随访,从那以后就有了可接受的疾病控制。
    该报告证明了低脂饮食如何对BSCL及其并发症的管理有很大帮助。此外,一个特定的降血脂饮食可以单独使用作为一个有效的治疗在选定的病例高依从性,可能,温和的表型。
    Severe metabolic complications generally manifest at an early age in Berardinelli - Seip congenital lipodystrophy (BSCL) and their management is especially challenging. Nutritional intervention with low lipid diets is considered by experts to be fundamental in treating the disease when associated with medical therapy, however little is known about the beneficial effects of dietary interventions alone.
    To underline the importance of a well-structured low-fat diet in BSCL patients.
    A BSCL male patient strictly followed a hypocaloric hypolipemic diet (60% carbohydrates, 22% fats and 18% proteins) since clinical diagnosis at the age of one year. Interestingly, pharmacological interventions were not required at any point during the follow-up. Aged 16 years the patient was referred to our center. Biochemistry, hormonal evaluation, 75 mg oral glucose tolerance test, cardiac evaluation and abdominal ultrasound were performed, revealing no abnormalities. Genetic analysis and leptin dosage were carried out, confirming the diagnosis of BSCL type 1 (homozygosity for c.493-1G>C pathogenic variant in AGPAT2 gene) and showing undetectable circulating levels of leptin (< 0.2 mcg/L). Diet therapy alone was therefore maintained, scheduling follow-up visits every six months, with acceptable disease control ever since.
    This report proves how a low-fat diet is of great help in the management of BSCL and its complications. In addition, a specific hypolipemic diet could be used alone as an effective treatment in selected cases with high compliance and, probably, a milder phenotype.
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