病例报告:一名患有切迪克-希加希综合征新型无义突变的女孩通过接受 HCST 和 UCBT 治疗成功缓解了病情。

IF 3 3区 医学 Q2 HEMATOLOGY Annals of Hematology Pub Date : 2024-10-16 DOI:10.1007/s00277-024-06039-6
CanLiu, Aijun Zou, Xianyu Wang, Qiang Yu
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引用次数: 0

摘要

切迪克-希加希综合征(CHS)是一种危及生命的常染色体隐性免疫缺陷病,表现为反复感染、色素沉着、进行性神经变性和嗜血细胞淋巴组织细胞增多症(HLH),即所谓的加速期。三分之二的患者会经历致命的加速期。CHS是由溶酶体转运调节因子(LYST)基因突变引起的。我们报告了一例出生时皮肤苍白、银发的 CHS 患者。骨髓穿刺显示粒细胞、单核细胞和淋巴细胞中有大量包涵体。基因分析显示,LYST 基因中存在一个新的无义突变:c.8186G > A (W2729Ter)。患儿出现发热、肝脾肿大和淋巴结肿大。实验室检查显示,患儿出现泛血细胞减少、低纤维蛋白原血症和高血清铁蛋白,表明患儿处于CHS的加速期。HLH相关化疗后,她接受了异基因造血干细胞移植(HCST)和脐带血移植(UCBT)。患者已存活九个月,且未复发。我们在LYST基因中发现了一种与严重表型相关的新型无义突变,造血干细胞移植联合脐带血移植是一种有效的治疗方法。
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A girl with a novel nonsense mutation in Chediak-Higashi syndrome was relieved successfully by treatment with HCST and UCBT: a case report.

Chediak-Higashi syndrome (CHS) is a life-threatening autosomal recessive immunodeficiency disease presenting with recurrent infections, hypopigmentation, progressive neurodegeneration, and hemophagocytic lymphohistiocytosis (HLH), known as the accelerated stage. Two-thirds of patients experience a fatal accelerated phase. CHS is caused by lysosomal transport regulator (LYST) gene mutations. We report the case of CHS, who was born with pale skin and silver hair. Bone marrow aspirate revealed large inclusions in granulocytes, monocytes, and lymphocytes. Genetic analysis revealed a new nonsense mutation in the LYST gene: c.8186G > A (W2729Ter). The child presented with fever, hepatosplenomegaly, and lymphadenectasis. Laboratory tests showed pancytopenia, hypofibrinogenemia, and high serum ferritin, indicating an accelerated phase of CHS. She underwent allogeneic hematopoietic stem cell transplantation (HCST) combined with umbilical cord blood transplantation (UCBT) after HLH-related chemotherapy. The patient has been alive for nine months without recurrence. We have identified a novel nonsense mutation in the LYST gene that correlates with a severe phenotype, and HSCT combined with UCBT is an effective treatment.

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来源期刊
Annals of Hematology
Annals of Hematology 医学-血液学
CiteScore
5.60
自引率
2.90%
发文量
304
审稿时长
2 months
期刊介绍: Annals of Hematology covers the whole spectrum of clinical and experimental hematology, hemostaseology, blood transfusion, and related aspects of medical oncology, including diagnosis and treatment of leukemias, lymphatic neoplasias and solid tumors, and transplantation of hematopoietic stem cells. Coverage includes general aspects of oncology, molecular biology and immunology as pertinent to problems of human blood disease. The journal is associated with the German Society for Hematology and Medical Oncology, and the Austrian Society for Hematology and Oncology.
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