12例Gitelman综合征患者表型及基因型分析

    Analysis of phenotype and genotype in 12 Chinese patients with Gitelman syndrome

    • 摘要: 目的回顾性分析Gitelman综合征患者的表型及SLC12A3基因型特点,为进一步认识该病提供新的证据。方法对2019年1月至2020年12月在空军军医大学第一附属医院就诊,且临床和基因检查明确确诊为Gitelman综合征的患者及其家系成员进行临床特征和基因变异分析。先收集患者临床资料,采用高通量测序筛查基因变异,再以Sanger测序对患者及其家系成员进行验证。结果共纳入12例来自不同家系的Gitelman综合征患者。所有患者均存在低血钾、低血镁、低尿钙,仅4例患者可能存在低氯性代谢性碱中毒。1例患者诊断为糖尿病,1例患者诊断为糖尿病前期。2例患者因反复心悸多次于急诊科诊治,分别诊断为阵发性室性心动过速和频发室性早搏。共检出变异位点19个,其中检出频率较高的变异位点依次为c.179C>T(3/12)、c.1456G>A(2/12)和c.2582G>A(2/12),未报道的新变异位点为c.2178+1G>T和外显子4~6缺失变异。治疗随访阶段只有2例患者的血钾和血镁恢复正常。结论我们检出2处新的SLC12A3基因变异位点。Gitelman综合征患者电解质紊乱难以纠正至正常,但临床症状可不同程度改善,且相比普通人群具有更高的糖代谢紊乱风险。对表现为心悸的Gitelman综合征患者应保持警惕,防治心律失常。

       

      Abstract: Objective To explore the clinical and genetic characteristics of Chinese patients with Gitelman syndrome(GS)and take new evidence into further understanding of this disease.Methods From January 2019 to December 2020,patients diagnosed as GS by clinical and SLC12A3 gene examination and their family members were included. Clinical data were reviewed. High-throughput sequencing was performed for detecting potential variants. And Sanger's sequencing was employed for verifying the results. Clinical characteristics and genetic variants were analyzed.Results A total of 12 pedigrees were included. All patients showed hypokalemia,hypomagnesemia,and hypocalciuria. Four patients developed hypochloremic metabolic alkalosis. There were diabetes(n=1)and prediabetes(n=1). At emergency department,2 cases of recurrent palpitation were treated. The diagnoses were paroxysmal ventricular tachycardia and frequent premature ventricular complexes. Among 19 gene variants,the common variants were c. 179C>T(3/12),c. 1456G>A(2/12)and c. 2582G>A(2/12). The unreported novel variants were c. 2178+1G>T and exon(4~6)deletion. During follow-ups,2 patients had normal serum levels of potassium or magnesium.Conclusion Two novel variants are detected. Rectifying hypokalemia and hypomagnesemia remains difficult in GS patients. However,clinical symptoms may improve to varying degrees. Compared with general population,GS patients are at an elevated risk of glucose metabolism disorders. Due to severe hypokalemia and arrhythmia,GS patients with palpitations deserve more attention.

       

    /

    返回文章
    返回