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X-linked frontometaphyseal dysplasia 1 X 连锁前骨骺发育不良 1
Pub Date : 2024-07-13 DOI: 10.21508/1027-4065-2024-69-3-110-117
O. C. Mazur, S. V. Baiko, A. V. Kilchevsky, E. P. Mikhalenko, S. L. Morozov, Yu. S. Stankevich, T. S. Kursova, Yu. A. Poleshchuk
X-linked filaminopathies are a diverse group of orphan diseases caused by mutations in the FLNA gene which encodes the cytoskeletal actin-binding protein filamin A. Pathogenic variants in this gene cause a wide range of genetic syndromes with signs of organ and tissue damage — skeletal dysplasia, cardiovascular and renal abnormalities. One of a group X-linked filaminopathies is frontometaphyseal dysplasia 1 (OMIM 305620). A clinical case of a 15-year-old boy with congenital anomalies of the kidney and urinary tract: posterior urethral valves, bilateral megaureter, neurogenic bladder was presented. In addition, the patient had congenital heart disease: atrial septal defect, valvular pulmonary artery stenosis and secondary chronic cicatricial-granular stenosis of the larynx. Phenotypic deviations were manifested by skeletal abnormalities that included facial dysmorphism — prominent brow ridges, wide bridge of the nose, orbital hypertelorism, small pointed chin; high-degree scoliosis; valgus deformity of the lower extremities; contractures of various joints. The child was short stature and had multiple congenital developmental features. New-generation whole-exome sequencing (Illumina, NextSeq 550) made it possible to detect a non-synonymous hemizygous variant of the FLNA gene: c.3557G>A (p.S1186L, rs137853312). The identified mutation was confirmed by Sanger sequencing. Genetic testing of the parents was carried out and the c.3557G>A hemizygous mutation was found in the patient’s mother. The use of NGS makes it possible to identify rare hereditary syndromes and make an accurate diagnosis, which is very important for choosing the right management of patient. 
该基因编码细胞骨架肌动蛋白结合蛋白丝胺 A。该基因的致病变体可导致多种遗传综合征,并伴有器官和组织损伤的症状--骨骼发育不良、心血管和肾功能异常。前骨骺发育不良 1(OMIM 305620)是一组 X 连锁丝裂蛋白病之一。临床上有一例 15 岁男孩患有先天性肾脏和泌尿道异常:后尿道瓣膜、双侧巨输尿管、神经源性膀胱。此外,患者还患有先天性心脏病:房间隔缺损、瓣膜性肺动脉狭窄和继发性慢性喉瓣狭窄。表型偏差表现为骨骼异常,包括面部畸形--突出的眉脊、宽鼻梁、眼眶肥大、小尖下巴;脊柱高度侧弯;下肢外翻畸形;各种关节挛缩。孩子身材矮小,有多种先天发育特征。新一代全外显子组测序(Illumina,NextSeq 550)检测出FLNA基因的一个非同义半杂合子变异:c.3557G>A(p.S1186L,rs137853312)。通过桑格测序确认了所发现的变异。对患者父母进行了基因检测,在患者母亲体内发现了 c.3557G>A 半杂合子突变。使用 NGS 可以识别罕见的遗传性综合征并做出准确诊断,这对选择正确的患者治疗方法非常重要。
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引用次数: 0
A rare variant of primary immunodeficiency with a STAT1 GOF defect in the practice of a pulmonologist 一位肺科医生诊治的带有 STAT1 GOF 缺陷的原发性免疫缺陷症罕见变体
Pub Date : 2024-07-13 DOI: 10.21508/1027-4065-2024-69-3-125-131
Y. Mizernitskiy, I. E. Zorina, A. R. Shudueva, D. V. Bogdanova, D. Yukhacheva, M. Fadeeva, D. Pershin, Y. Rodina, A. Shcherbina
Chronic mucocutaneous candidiasis is a complication occurring in patients with congenital immune disorders, characterized by recurrent infections of the skin, nails, and mucous membranes caused by C. albicans. The STAT1 gain of function (GOF) defect is a primary immunodeficiency condition resulting from heterozygous gain of function mutations in the STAT1 gene. STAT1 is a regulatory transcription factor and a key component of the JAK-STAT pathway mediating interferon-α/β/γ signaling. GOF mutations in the STAT1 gene lead to hyperphosphorylation of the protein of the same name and increased signaling along the JAK-STAT pathway, which also leads to impaired development of type 17 T helper cells (Th17). This disease most often debuts in childhood, and clinically, it is characterized by chronic mucocutaneous candidiasis, multiorgan autoimmune complications and an increased risk of infectious complications. The article describes the clinical observation of a girl with a rare variant of primary immunodeficiency STAT1 GOF. 
慢性皮肤粘膜念珠菌病是先天性免疫失调患者的一种并发症,其特征是白念珠菌引起的皮肤、指甲和粘膜的反复感染。STAT1 功能增益(GOF)缺陷是一种由 STAT1 基因杂合性功能增益突变导致的原发性免疫缺陷病。STAT1 是一种调节性转录因子,也是介导干扰素-α/β/γ 信号传导的 JAK-STAT 通路的关键组成部分。STAT1 基因中的 GOF 突变会导致同名蛋白过度磷酸化和 JAK-STAT 通路信号的增加,这也会导致 17 型 T 辅助细胞(Th17)的发育受损。这种疾病多发于儿童期,临床特点是慢性皮肤粘膜念珠菌病、多器官自身免疫并发症和感染并发症风险增加。文章描述了对一名患有罕见变异型原发性免疫缺陷 STAT1 GOF 的女孩的临床观察。
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引用次数: 0
Mucolipidosis type IV in the practice of pediatricians and medical geneticists 儿科医生和医学遗传学家诊疗中的IV型粘脂症
Pub Date : 2024-07-13 DOI: 10.21508/1027-4065-2024-69-3-118-124
A. Semyachkina, E. A. Nikolaeva, E. Voskoboeva, R. G. Kuramagomedova, S. V. Bochenkov
Mucolipidosis type IV is a rare autosomal recessive disease from the group of lysosomal accumulation diseases caused by a malfunction of the cation channel due to mutations in the MCOLN1 gene. The clinical symptom complex includes a combination of neurological symptoms (impaired speech and motor development, spasticity, rigidity), corneal opacity and achlorhydria with iron deficiency anemia. The literature data on this disease and the medical history of a 13-year-old girl who was observed in the Department of Clinical Genetics of the Veltischev Institute are presented. The child had a characteristic clinical picture, including damage to the nervous system: decreased intelligence, muscular dystonia and spasticity, salivation, strabismus, hypoplasia of the corpus callosum; damage to the organ of vision — corneal opacity, cataracts, myopia, photophobia in combination with persistent iron deficiency anemia (apparently due to achlorhydria). The diagnosis was confirmed by the results of DNA diagnostics — a known pathogenic mutation NM_02533.3 was detected in the MCOLN1 gene: c.304C>T (p.Arg102Term) in a homozygous state; in the girl’s mother — in a heterozygous state. A differential diagnosis was made with phenotypically similar diseases, primarily with cerebral palsy, mucopolysaccharidosis, and other types of mucolipidosis. Further medical supervision of the child should be carried out with the obligatory participation of a neurologist, an optometrist, a gastroenterologist, an orthopedist and a nephrologist. Knowledge of the clinical features of pathology ensures more successful medical care with the prevention of complications. 
粘脂病 IV 型是一种罕见的常染色体隐性遗传病,属于溶酶体蓄积病,由 MCOLN1 基因突变导致阳离子通道功能失常引起。临床症状综合征包括神经系统症状(言语和运动发育障碍、痉挛、僵硬)、角膜混浊、无色素性贫血伴缺铁性贫血。本文介绍了有关这种疾病的文献资料以及维尔季舍夫研究所临床遗传学系所观察的一名 13 岁女孩的病史。该患儿具有特征性的临床表现,包括神经系统损伤:智力下降、肌肉肌张力障碍和痉挛、流涎、斜视、胼胝体发育不良;视觉器官损伤--角膜混浊、白内障、近视、畏光,并伴有持续性缺铁性贫血(显然是由于无色素性贫血引起的)。DNA 诊断结果证实了这一诊断--在 MCOLN1 基因中检测到一个已知的致病突变 NM_02533.3:c.304C>T (p.Arg102Term),为同源突变;女孩的母亲为异源突变。与表型相似的疾病进行了鉴别诊断,主要是脑瘫、粘多糖病和其他类型的粘脂病。在对患儿进行进一步的医疗监护时,神经科医生、验光师、消化科医生、整形外科医生和肾脏科医生必须参与其中。了解病理的临床特征可确保医疗护理更加成功,预防并发症。
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引用次数: 0
Smoking among children and adolescents as a modern multidisciplinary problem 儿童和青少年吸烟是一个现代多学科问题
Pub Date : 2024-07-13 DOI: 10.21508/1027-4065-2024-69-3-101-109
R. M. Fayzullina, N. Geppe, A. Sannikova, Z. Shangareeva, T. N. Kozhevnikova, O. Y. Panchikhina, O. A. Arslanova
The prevalence of smoking, use of tobacco and nicotine-containing products among children and adolescents is a significant problem of our time. The continuing high prevalence of child and adolescent smoking and contradictory statistical data for certain regions of the Russian Federation determine the need to study this topic.Purpose. To study the prevalence and risk factors of smoking among children and adolescents in the Republic of Bashkortostan. Material and methods. A one-stage continuous study oftobacco smoking among children aged 7 to 17 years was conducted using an anonymous voluntary online questionnaire of schoolchildren using the Google questionnaire form. 76 543 respondents took part in the study.Results. The study showed that 2.5% of children and adolescents are smokers. More than 3/4 of them smoke daily, most of them prefer electronic cigarettes. Every fourth child is not motivated to quit smoking. Half of smoking children first try smoking at the age of 12–17 years, 1/3 — at the age of 10 years. The reasons for introducing children to smoking are the example of parents, friends and classmates, the availability of smoking products. Every third child who smokes feels a deterioration in their health. Every second child is open to communication with adults and is ready to listen to medical conversations.Conclusion. To reduce the prevalence of smoking among children and adolescents, competent, scientifically based multidisciplinary work is needed with the introduction of regional multicomponent prevention programs.
儿童和青少年普遍吸烟、使用烟草和含尼古丁产品是当今时代的一个重大问题。儿童和青少年吸烟率居高不下,而俄罗斯联邦某些地区的统计数据又相互矛盾,因此有必要对这一问题进行研究。研究巴什科尔托斯坦共和国儿童和青少年的吸烟率及其风险因素。材料和方法使用谷歌问卷调查表对在校学生进行匿名自愿在线问卷调查,对 7 至 17 岁儿童吸烟情况进行了一个阶段的连续研究。76 543 名受访者参加了研究。研究表明,2.5% 的儿童和青少年是烟民。其中超过 3/4 的人每天吸烟,大多数人喜欢电子香烟。每四名儿童中就有一名没有戒烟的动力。半数吸烟儿童在 12-17 岁时首次尝试吸烟,1/3 的儿童在 10 岁时首次尝试吸烟。让儿童开始吸烟的原因是父母、朋友和同学的榜样,以及吸烟产品的供应。每三个吸烟儿童中就有一个感到健康状况恶化。每三个吸烟儿童中就有一个感到自己的健康状况恶化。为了降低儿童和青少年的吸烟率,需要开展有能力、有科学依据的多学科工作,并引入地区性多成分预防计划。
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引用次数: 0
Prader–Willi syndrome with atypical 15q deletion due to an unbalanced translocation between chromosomes 13 and 15 普拉德-威利综合征伴有非典型 15q 缺失,原因是 13 号和 15 号染色体之间的不平衡易位
Pub Date : 2024-07-12 DOI: 10.21508/1027-4065-2024-69-3-80-85
N. Shilova, M. Minzhenkova, ZhG Markova, G. N. Matyschenko
Prader-Willi syndrome (PWS) (OMIM #176270) is a neurobehavioral disorder that is caused by various genetic mechanisms. These mechanisms include a deletion in the q11.2–q13 region of the paternal chromosome 15, maternal uniparental disomy of chromosome 15, or a pathology of gene imprinting in the proximal part of the long arm of chromosome 15. The most common cause of PWS is a 15q11.2–q13 deletion of approximately 6 Mb, which typically occurs spontaneously. However, there have been rare cases of 15q11.2–q13 deletion associated with unbalanced translocations involving chromosome 15. In order to accurately diagnose PWS and determine the mechanisms behind the chromosomal imbalance, various diagnostic methods such as conventional cytogenetics, fluorescence in situ hybridization (FISH) or microarray comparative genomic hybridization are necessary.The aim. To determine the origin of an atypical 15q deletion in a patient with Prader–Willi syndrome.Methods. Conventional cytogenetic study, FISH with DNA probes for chromosomes 13 and 15, and chromosomal microarray analysis.Results. Showed that the patient had an 8.7 Mb deletion in the 15q11.2–q13.3 region, which was found to be a consequence of a meiotic malsegregation of a reciprocal translocation between chromosomes 13 and 15 in the patient’s father. The scope of the results is in informing medical genetic counseling of patients and families with a hereditary disease.Conclusion. A comprehensive cytogenomic approach in diagnosis of genetic variations associated with Prader–Willi syndrome allows for accurate determination of copy number variations and provides information on the structure and origin of genomic imbalance. This information can be valuable for guiding medical genetic counseling and making decisions regarding future prenatal or preimplantation diagnoses.
普拉德-威利综合征(Prader-Willi syndrome,PWS)(OMIM #176270)是一种由多种遗传机制引起的神经行为障碍。这些机制包括父方 15 号染色体 q11.2-q13 区缺失、母方 15 号染色体单亲裂殖或 15 号染色体长臂近端基因印记病变。PWS 最常见的病因是 15q11.2-q13 约 6 Mb 的缺失,通常会自发发生。不过,也有罕见的 15q11.2-q13 缺失病例与涉及 15 号染色体的不平衡易位有关。为了准确诊断 PWS 并确定染色体失衡背后的机制,有必要采用常规细胞遗传学、荧光原位杂交(FISH)或芯片比较基因组杂交等各种诊断方法。确定普拉德-威利综合征患者非典型 15q 缺失的来源。常规细胞遗传学研究、使用 13 号和 15 号染色体 DNA 探针进行 FISH 分析以及染色体芯片分析。结果显示,患者的 15q11.2-q13.3 区有一个 8.7 Mb 的缺失,这是患者父亲的 13 号染色体和 15 号染色体之间的互易易位减数分裂错位的结果。该结果可为遗传病患者和家庭的遗传咨询提供参考。在诊断与普拉德-威利综合征相关的基因变异时,采用全面的细胞基因组学方法可准确确定拷贝数变异,并提供有关基因组失衡的结构和起源的信息。这些信息对于指导医学遗传咨询和未来产前或植入前诊断决策非常有价值。
{"title":"Prader–Willi syndrome with atypical 15q deletion due to an unbalanced translocation between chromosomes 13 and 15","authors":"N. Shilova, M. Minzhenkova, ZhG Markova, G. N. Matyschenko","doi":"10.21508/1027-4065-2024-69-3-80-85","DOIUrl":"https://doi.org/10.21508/1027-4065-2024-69-3-80-85","url":null,"abstract":"Prader-Willi syndrome (PWS) (OMIM #176270) is a neurobehavioral disorder that is caused by various genetic mechanisms. These mechanisms include a deletion in the q11.2–q13 region of the paternal chromosome 15, maternal uniparental disomy of chromosome 15, or a pathology of gene imprinting in the proximal part of the long arm of chromosome 15. The most common cause of PWS is a 15q11.2–q13 deletion of approximately 6 Mb, which typically occurs spontaneously. However, there have been rare cases of 15q11.2–q13 deletion associated with unbalanced translocations involving chromosome 15. In order to accurately diagnose PWS and determine the mechanisms behind the chromosomal imbalance, various diagnostic methods such as conventional cytogenetics, fluorescence in situ hybridization (FISH) or microarray comparative genomic hybridization are necessary.The aim. To determine the origin of an atypical 15q deletion in a patient with Prader–Willi syndrome.Methods. Conventional cytogenetic study, FISH with DNA probes for chromosomes 13 and 15, and chromosomal microarray analysis.Results. Showed that the patient had an 8.7 Mb deletion in the 15q11.2–q13.3 region, which was found to be a consequence of a meiotic malsegregation of a reciprocal translocation between chromosomes 13 and 15 in the patient’s father. The scope of the results is in informing medical genetic counseling of patients and families with a hereditary disease.Conclusion. A comprehensive cytogenomic approach in diagnosis of genetic variations associated with Prader–Willi syndrome allows for accurate determination of copy number variations and provides information on the structure and origin of genomic imbalance. This information can be valuable for guiding medical genetic counseling and making decisions regarding future prenatal or preimplantation diagnoses.","PeriodicalId":21550,"journal":{"name":"Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)","volume":"59 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141654538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical variability of the neonatal form of Marfan syndrome in patients with FBN1 gene mutations FBN1 基因突变患者新生儿型马凡氏综合征的临床变异性
Pub Date : 2024-07-12 DOI: 10.21508/1027-4065-2024-69-3-55-64
D. Gritsevskaya, R. G. Kuramagomedova, E. V. Vasiliev, M. A. Shkolnikova, V. Voinova
Neonatal Marfan syndrome (ORPHA:284979) is a severe form of the syndrome that manifests in infancy and rapidly progresses in childhood. The causative variant of the disease is most often localized in exons 24–32 of the FBN1 gene, in the so-called “neonatal region.” The range of clinical manifestations and their severity depend on the type of mutation, its location and the influence of genetic modifiers. Four clinical cases of the neonatal form of Marfan syndrome are presented. Two patients with the same missense mutations and different clinical presentations, a milder patient with a splice site mutation leading to protein shortening, and a girl with severe skeletal damage with deletion of exons 25–29. The purpose of this publication is to analyze the genotype-phenotype correlation of neonatal Marfan syndrome patients with mutations in exons 24–32 of the FBN1 gene.
新生儿马凡氏综合征(ORPHA:284979)是一种严重的综合征,表现为婴儿期发病,并在儿童期迅速恶化。该病的致病变异体通常位于 FBN1 基因的 24-32 号外显子,即所谓的 "新生儿区域"。临床表现的范围及其严重程度取决于基因突变的类型、位置和遗传修饰因子的影响。本文介绍了四例新生儿型马凡氏综合征的临床病例。两名患者具有相同的错义突变,但临床表现不同;一名患者病情较轻,其剪接位点突变导致蛋白质缩短;一名女孩因外显子25-29缺失而导致严重的骨骼损伤。本论文旨在分析新生儿马凡氏综合征患者的基因型与表型之间的相关性,这些患者的FBN1基因24-32外显子存在突变。
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引用次数: 0
Association of genetic variants of hemostatic system genes with venous thrombosis in children born to mothers with a burdened obstetric and gynecological history 有妇产科病史的母亲所生子女的止血系统基因变异与静脉血栓形成的关系
Pub Date : 2024-07-12 DOI: 10.21508/1027-4065-2024-69-3-73-79
O. A. Perevezentsev, I. S. Mamedov, D. V. Burtsev
Thrombophilias are hereditary and acquired conditions characterized by an excessive tendency of the body to form thrombi in the blood vessels. Idiopathic venous thrombosis can often occur in childhood and can also be associated with certain genetic variants of hereditary predisposition to thrombophilia.Purpose. To analyze the association of 8 genetic variants (F2 20210G>A, F5 1691G>A, F7 10976G>A, F13 G>T, ITGA2 807C>T, ITGB3 1565 T>C, PAI-1–675 5G>4G) with venous thrombosis in children born to mothers with a burdened obstetric and gynecological history.Material and methods. The patient group included 322 children aged 7 to 14 years (average age 9.3 years), who had a history of episodes of venous thrombosis of various locations, born to mothers with obstetric and gynecological history. The comparison group included 159 healthy children also aged from 7 to 14 years (average age 9.5 years), who did not have a history of episodes of venous thrombosis and who were also born to mothers with obstetric and gynecological history. Molecular genetic analysis was carried out using real-time PCR with automatic analysis of melting curves.Results. Based on the results of an analysis of the association of genetic variants with venous thrombosis in children born to mothers with obstetric and gynecological history, a connection with this pathology was established for genetic variants F5 1691G>A (genotype GA+AA, OR=3.33, 95% CI: 1.19 — 9.36), ITGA2 807C >T (TT genotype (OR=1.92, 95% CI:1.20 — 3.06) and heterozygous CT (OR=1.46, 95% CI: 1.10 — 1.93)) and ITGB3 1565 T>C (CC genotype (OR=2.77 95% CI:1.08 — 7.02) and TC (OR=1.40, 95% CI: 1.07 — 1.83)).Conclusion. Thus, we established an association of 3 genetic variants (Leiden mutation, ITGA2 807C>T and ITGB3 1565 T>C) with venous thrombosis in children born to mothers with obstetric and gynecological history.
血栓性疾病是一种遗传性和获得性疾病,其特征是人体血管内过度倾向于形成血栓。特发性静脉血栓通常发生在儿童时期,也可能与血栓性疾病遗传倾向的某些基因变异有关。目的:分析8个遗传变异(F2 20210G>A、F5 1691G>A、F7 10976G>A、F13 G>T、ITGA2 807C>T、ITGB3 1565 T>C、PAI-1-675 5G>4G)与有妇产科病史的母亲所生儿童静脉血栓形成的相关性。患者组包括 322 名 7 至 14 岁的儿童(平均年龄为 9.3 岁),他们都有不同部位的静脉血栓病史,其母亲有妇产科病史。对比组包括 159 名同样年龄在 7-14 岁(平均年龄 9.5 岁)的健康儿童,他们没有静脉血栓病史,母亲也有妇产科病史。采用实时 PCR 技术进行了分子遗传分析,并对熔解曲线进行了自动分析。根据对有妇产科病史的母亲所生子女的遗传变异与静脉血栓相关性的分析结果,确定了遗传变异 F5 1691G>A(基因型 GA+AA,OR=3.33,95% CI:1.19 - 9.36)、ITGA2 807C>T(TT 基因型(OR=1.92,95% CI:1.20 - 3.06)和杂合子 CT(OR=1.46,95% CI:1.10 - 1.93))和 ITGB3 1565 T>C(CC 基因型(OR=2.77,95% CI:1.08 - 7.02)和 TC(OR=1.40,95% CI:1.07 - 1.83))。因此,我们确定了3种遗传变异(莱登突变、ITGA2 807C>T和ITGB3 1565 T>C)与有妇产科病史的母亲所生子女的静脉血栓形成有关。
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引用次数: 0
Features of the onset of juvenile psoriatic arthritis 幼年银屑病关节炎的发病特点
Pub Date : 2024-07-12 DOI: 10.21508/1027-4065-2024-69-3-94-100
S. Chebysheva, N. Geppe, I. Korsunskaya, V. Sobolev, A. V. Polyanskaya, L. Khachatryan, M. Nikolaeva, E. Afonina
Juvenile psoriatic arthritis is a chronic inflammatory disease of the peripheral joints, spinal joints and entheses, which occurs in 10–25% of patients with psoriasis. Studying the features of the juvenile psoriatic arthritis debut will increase early diagnosis and will help to avoid disability, socialize and integrate the child into society.Purpose. To identify the relationship between the onset of juvenile psoriatic arthritis and the age and gender of the child, to trace the nature of the articular syndrome in our patients from the onset to the height of the disease.Methods. 155 patients with an established diagnosis of juvenile psoriatic arthritis were examined. To analyze the data, universal nonparametric (randomization-permutation) algorithms for constructing confidence intervals (CI) and statistical comparisons based on the bootstrap and Monte Carlo methods were used.Results. It was possible to identify a relationship between the onset variant and the gender of the child. The incidence of asymmetric oligoarthritis in boys and girls at onset was approximately the same, 68% and 59%, respectively, and did not differ significantly. At onset, girls had a higher incidence of rheumatoid-like arthritis (37%) (p<0.005), and boys had a higher incidence of spondyloarthritis (26%) (p<0.005). A relationship was also revealed between the onset, gender and age of the child. Girls aged 0–6 years most often debuted with asymmetric oligoarthritis (90%) (p<0.005), and at the age of 11–15 years — with the rheumatoid-like (polyarticular) variant (73%) (p<0.005). In boys aged 0–6 and 7–10 years, asymmetric oligoarthritis predominated (100% and 100%, respectively) (p <0.005), and at the age of 11–15 years, spondyloarthritis with damage to peripheral joints was more common (73%) (p<0.005). A transformation of the articular syndrome was revealed: if at the onset of the disease asymmetric oligoarthritis was most common (63%), then 5 years from the onset of the disease, 40.7% of the observed children had a rheumatoid-like (polyarticular) variant of the disease.Conclusion. The course of juvenile psoriatic arthritis may be influenced by the gender and age of the child at onset; a certain pattern of the course of juvenile psoriatic arthritis from oligoarthritis to the polyarticular (rheumatoid-like) variant has been identified.
青少年银屑病关节炎是一种外周关节、脊柱关节和内膜的慢性炎症性疾病,在银屑病患者中的发病率为10%-25%。研究幼年银屑病关节炎的首发特征将提高早期诊断率,并有助于避免残疾、使儿童社会化和融入社会。确定幼年银屑病关节炎的发病与患儿年龄和性别之间的关系,追溯我们的患者从发病到病重期间关节综合征的性质。研究对象为155名确诊为幼年银屑病关节炎的患者。在分析数据时,使用了基于引导法和蒙特卡罗法的通用非参数(随机化-畸变)算法来构建置信区间(CI)和进行统计比较。结果表明,发病变异与儿童性别之间存在关系。男孩和女孩发病时的非对称性少关节炎发病率大致相同,分别为68%和59%,没有显著差异。发病时,女孩类风湿关节炎的发病率较高(37%)(P<0.005),男孩脊柱关节炎的发病率较高(26%)(P<0.005)。儿童的发病、性别和年龄之间也存在一定的关系。0-6岁的女孩最常见的是不对称少关节炎(90%)(p<0.005),11-15岁的女孩则是类风湿(多关节)变异型(73%)(p<0.005)。在0-6岁和7-10岁的男孩中,非对称性少关节炎占多数(分别为100%和100%)(p<0.005),而在11-15岁的男孩中,脊柱关节炎伴有外周关节损伤的情况更为常见(73%)(p<0.005)。研究还发现了关节综合征的转变:如果说发病时最常见的是非对称少关节炎(63%),那么在发病5年后,40.7%的被观察儿童出现了类风湿样(多关节)变异。结论:幼年银屑病关节炎的病程可能受儿童性别和发病年龄的影响;幼年银屑病关节炎从少关节炎到多关节炎(类风湿样)变异型的病程有一定的规律可循。
{"title":"Features of the onset of juvenile psoriatic arthritis","authors":"S. Chebysheva, N. Geppe, I. Korsunskaya, V. Sobolev, A. V. Polyanskaya, L. Khachatryan, M. Nikolaeva, E. Afonina","doi":"10.21508/1027-4065-2024-69-3-94-100","DOIUrl":"https://doi.org/10.21508/1027-4065-2024-69-3-94-100","url":null,"abstract":"Juvenile psoriatic arthritis is a chronic inflammatory disease of the peripheral joints, spinal joints and entheses, which occurs in 10–25% of patients with psoriasis. Studying the features of the juvenile psoriatic arthritis debut will increase early diagnosis and will help to avoid disability, socialize and integrate the child into society.Purpose. To identify the relationship between the onset of juvenile psoriatic arthritis and the age and gender of the child, to trace the nature of the articular syndrome in our patients from the onset to the height of the disease.Methods. 155 patients with an established diagnosis of juvenile psoriatic arthritis were examined. To analyze the data, universal nonparametric (randomization-permutation) algorithms for constructing confidence intervals (CI) and statistical comparisons based on the bootstrap and Monte Carlo methods were used.Results. It was possible to identify a relationship between the onset variant and the gender of the child. The incidence of asymmetric oligoarthritis in boys and girls at onset was approximately the same, 68% and 59%, respectively, and did not differ significantly. At onset, girls had a higher incidence of rheumatoid-like arthritis (37%) (p<0.005), and boys had a higher incidence of spondyloarthritis (26%) (p<0.005). A relationship was also revealed between the onset, gender and age of the child. Girls aged 0–6 years most often debuted with asymmetric oligoarthritis (90%) (p<0.005), and at the age of 11–15 years — with the rheumatoid-like (polyarticular) variant (73%) (p<0.005). In boys aged 0–6 and 7–10 years, asymmetric oligoarthritis predominated (100% and 100%, respectively) (p <0.005), and at the age of 11–15 years, spondyloarthritis with damage to peripheral joints was more common (73%) (p<0.005). A transformation of the articular syndrome was revealed: if at the onset of the disease asymmetric oligoarthritis was most common (63%), then 5 years from the onset of the disease, 40.7% of the observed children had a rheumatoid-like (polyarticular) variant of the disease.Conclusion. The course of juvenile psoriatic arthritis may be influenced by the gender and age of the child at onset; a certain pattern of the course of juvenile psoriatic arthritis from oligoarthritis to the polyarticular (rheumatoid-like) variant has been identified.","PeriodicalId":21550,"journal":{"name":"Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)","volume":"41 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141655017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Course and outcome of pregnancy in women with Alport syndrome 阿尔波特综合征妇女的妊娠过程和结果
Pub Date : 2024-07-12 DOI: 10.21508/1027-4065-2024-69-3-51-54
M. Aksenova, V. V. Dlin
Pregnancy in patients with CKD is associated with maternal and fetal risks.Purpose. To evaluate course and outcome of pregnancy in Alport syndrome women.Material and methods. Single-center retrospective study included 88 women with genetically confirmed disease. The information about clinical data at conception, course of pregnancy, delivery (preterm delivery <37 gestation weeks; early preterm delivery <34 gestation weeks), fetus characteristics (intrauterine fetal growth restriction: height <2 z-score for gestation age; small for gestation age: weight <2 z-score) were obtained from medical charts and a cross-sectional survey of women.Results. Information about 117 term pregnancies (2 — in 26, 3 — in 3 patients) was obtained. The 1/3 of women (q=0.37) had complications of pregnancy: proteinuria (q=0.23), blood hypertension (q=0.1), threat of miscarriage (q=0.21). Preterm and early preterm delivery were seen in 1/4 of women (q=0.26), including early preterm in 3% of cases. Intrauterine fetal growth restriction and small for gestation age were recorded in 9% and 11% neonates, respectively; 7% of babies required a neonatal intensive care unit stay. Proteinuria was the risk factor for preeclampsia (OR=42.35 3±1.1; p<0.001), preterm delivery (OR=11.8±0.5; p<0.001), intrauterine fetal growth restriction (OR=12.2±0.7; p<0.001), small for gestation age (OR=7.2±0.6; p<0.001).Conclusion. The risk of preeclampsia and fetal growth restriction in women with Alport syndrome and normal kidney function appears comparable to that in the general population. But the disease should be considered as a potential risk factor for preterm delivery. Proteinuria is associated with unfavorable pregnancy and fetal outcome in Alport syndrome.
CKD 患者妊娠与母体和胎儿风险相关。评估 Alport 综合征妇女的妊娠过程和结果。单中心回顾性研究纳入了 88 名经基因确诊的女性患者。受孕时的临床数据、妊娠过程、分娩(早产<37孕周;早期早产<34孕周)、胎儿特征(宫内胎儿生长受限:身高<2孕龄z分数;小于孕龄:体重<2孕龄z分数)等信息均来自病历和对妇女的横断面调查。结果获得了 117 例足月妊娠(26 例中有 2 例,3 例中有 3 例)的信息。1/3的妇女(q=0.37)有妊娠并发症:蛋白尿(q=0.23)、高血压(q=0.1)、流产威胁(q=0.21)。1/4的妇女出现早产和早期早产(q=0.26),其中 3%的病例为早期早产。宫内胎儿生长受限和胎龄偏小的新生儿分别占 9% 和 11%;7% 的婴儿需要入住新生儿重症监护室。蛋白尿是子痫前期(OR=42.35 3±1.1;p<0.001)、早产(OR=11.8±0.5;p<0.001)、宫内胎儿生长受限(OR=12.2±0.7;p<0.001)、胎龄小(OR=7.2±0.6;p<0.001)的风险因素。患有阿尔波特综合征且肾功能正常的妇女发生子痫前期和胎儿生长受限的风险与普通人群相当。但这种疾病应被视为早产的潜在风险因素。蛋白尿与阿尔波特综合征患者不利的妊娠和胎儿结局有关。
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引用次数: 0
Methods of non-invasive electrocardiology in the detection of myocardial damage after COVID-19 (SARS-CoV-2) infection in young elite athletes 检测年轻精英运动员感染 COVID-19(SARS-CoV-2)后心肌损伤的无创心电图方法
Pub Date : 2024-07-12 DOI: 10.21508/1027-4065-2024-69-3-65-72
L. Makarov, V. Komoliatova, I. Kiseleva, D. A. Bessportochny, A. Akopyan, A. Dmitrieva, N. Aksenova
The impact of the new coronavirus infection (SARS-CoV-2) on the state of the cardiovascular system in minor athletes is uncertain. The “golden” standard for their detection is cardiac magnetic resonance imaging with gadolinium contrast. However, mass screening of athletes using magnetic resonance imaging has not shown any advantage over conducting research according to indications. An analysis of the results of an in-depth medical examination of 1505 young athletes, members of youth teams of the Russian Federation, who were examined at the Center for Syncope and Cardiac Arrhythmias from September 1, 2021 to June 31, 2022, was carried out. 236 athletes (15.7%) suffered SARS-CoV-2 infection for the 6 months preceding the in-depth medical examination. Stage I of the examination included examination, electrocardiography, echocardiography, and bicycle ergometry. 22 athletes (9.3%) required a more in-depth examination due to the identified changes in the first stage (stage II). It included Holter monitoring with assessment of heart rate turbulence, microvolt alternation of the T wave and heart rate variability, and high-resolution electrocardiography. Seven athletes (32%), with changes identified at this stage, were sent for magnetic resonance imaging (stage III). Based on its results, myopericarditis was diagnosed in 4 cases (1.7% of 236), and the necessary treatment and observation were prescribed. Conclusion. There is a low (less than 2%) involvement of myocardial damage in young elite athletes who have had SARS-CoV-2 infection. Additional methods of non-invasive electrocardiology, such as high-resolution electrocardiography, Holter monitoring with assessment of heart rate variability, heart rate turbulence and microvolt alternation of the T wave, make it possible to determine indications for cardiac magnetic resonance imaging.
新型冠状病毒感染(SARS-CoV-2)对未成年运动员心血管系统状况的影响尚不确定。检测他们的 "黄金 "标准是使用钆对比剂的心脏磁共振成像。然而,使用磁共振成像对运动员进行大规模筛查并没有显示出比根据适应症进行研究更有优势。对 2021 年 9 月 1 日至 2022 年 6 月 31 日期间在 "晕厥和心律失常中心 "接受检查的 1505 名年轻运动员(俄罗斯联邦青年队成员)的深入体检结果进行了分析。236名运动员(15.7%)在进行深入体检前的6个月内感染过SARS-CoV-2病毒。第一阶段检查包括体格检查、心电图、超声心动图和自行车测力。22 名运动员(9.3%)由于在第一阶段(第二阶段)发现了变化,需要进行更深入的检查。其中包括 Holter 监测,评估心率湍流、T 波的微伏交替和心率变异性,以及高分辨率心电图。七名运动员(32%)在这一阶段发现了变化,被送去进行磁共振成像检查(第三阶段)。根据检查结果,4 例(占 236 例的 1.7%)被确诊为心肌炎,并进行了必要的治疗和观察。结论感染过 SARS-CoV-2 的年轻精英运动员心肌受损的比例较低(低于 2%)。无创心电图的其他方法,如高分辨率心电图、Holter 监测(评估心率变异性、心率湍流和 T 波的微伏交替),可以确定心脏磁共振成像的适应症。
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引用次数: 0
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Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)
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