解读 DREAM-PL:关于挑战和管理的案例报告

Mohammed M. Barrak, S. R. Al-Aidy, Morteza Bonyadi
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摘要

一种不常见的常染色体隐性遗传病名为 DREAM-PL 综合征,主要表现为面部特征畸形、肾脏发育不全、男性生殖器畸形、小头畸形、多指畸形和裂头畸形。在该综合征中,负责 tRNA 转录后修饰的 CTU2 基因发生了突变。这种改变是基因正确翻译所必需的,它的破坏会导致多种异常胚胎过程。DREAM-PL 综合征的严重程度从中度到重度不等,临床特征也多种多样。一些患者可能只表现出部分特征,而另一些患者则可能具有所有特征。最常见的特征包括生殖器畸形、面部畸形和小头畸形。DREAM-PL 综合征的诊断通常以临床症状为依据,并通过基因检测进行确诊,基因检测可确定 CTU2 基因的突变。 材料和方法:在作为研究对象的病例中,一名 37 周大的男性新生儿是通过下段剖宫产术分娩的。婴儿出生时体重为 2.760 千克,通过全外显子组测序(WES)证实其 CTU2 基因存在杂合性 CMP 突变。遗憾的是,目前还没有治疗 DREAM-PL 综合征的方法。治疗结果治疗重点是控制症状和提供支持性护理。在某些情况下,手术矫正先天缺陷可能会有所帮助。
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Unraveling DREAM-PL: A Case Report on Challenges and Management
An uncommon autosomal recessive condition called DREAM-PL syndrome is typified by dysmorphic facial features, renal agenesis, male ambiguous genitalia, microcephaly, polydactyly, and lissencephaly. The CTU2 gene, which is in charge of tRNA post-transcriptional modification, is mutated in the syndrome. This alteration is necessary for the correct translation of genes, and its disruption can result in several aberrant embryonic processes. The severity of DREAM-PL syndrome can vary from moderate to severe, and the clinical characteristics can be diverse. While some patients may exhibit only some of the distinguishing features, others may have all of them. The most common characteristics include ambiguous genitalia, dysmorphic facies, and microcephaly. Diagnosis of DREAM-PL syndrome is typically based on clinical signs and confirmed through genetic testing, which can identify mutations in the CTU2 gene.  Material and methodology: In the case being referred to as a study, a 37-week-old male neonate was delivered by lower segment cesarean section. The baby's birth weight was 2.760 Kg, and a heterozygous CMP mutation of the CTU2 gene was confirmed through whole-exome sequencing (WES). Unfortunately, there is currently no known cure for DREAM-PL syndrome. Result: Treatment focuses on managing the symptoms and providing supportive care. In some cases, surgical correction of birth defects may be beneficial.
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