喀麦隆儿童和青少年先天性肾上腺增生的临床、生化和生物分子方面

S. Ngo Um, R. M. Betoko, I. Mekone, Adéle Bodieu Chetcha, V. Tardy, S. Dahoun, P. Mure, I. Plotton, Y. Morel, Martine Claude Etoa Etoga, Jocelyn Tony Nengom, B. Moifo, F. Tambo, E. Sobngwi, P. K. Ndombo
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摘要

先天性肾上腺增生(CAH)仍然是诊断、管理和治疗最具挑战性的内分泌疾病之一,特别是在缺乏新生儿筛查计划和有限的护理机会的非洲。关于生物分子异常的数据很少,因此突变类型未知,增加了管理挑战和遗传咨询。本研究旨在描述临床,生物分子方面的一组喀麦隆患者。方法2013年5月至2019年12月,我们在雅温得Chantal Biya基金会母婴中心儿科内分泌科进行了一项观察性回顾性研究,包括所有诊断为CAH的患者。结果我们连续纳入31例年龄小于21岁,诊断为CAH的患者。中位诊断年龄为1.71岁(IQR为0.08 ~ 2.57岁)。生殖器官异常占48.4%(n=15)。在我们的研究人群(n=24)中发现的最普遍的遗传异常是CYP11,在16例患者中发现(66.6%),其次是CYP21A2突变在8例患者中发现。11羟化酶缺乏症患者中半数存在p.Q356X纯合突变。这种突变主要发生在半班图部落的人身上,他们被宣布为非近亲。结论11羟化酶缺乏症是喀麦隆儿童CAH最常见的形式。
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Clinical, biochemical, and biomolecular aspects of congenital adrenal hyperplasia in a group of Cameroonian children and adolescents
Abstract Objectives Congenital adrenal hyperplasia (CAH) remains one of the most challenging endocrine disorders to diagnose, manage, and treat, especially in Africa where there is lack of neonatal screening program, and limited access to care. Data on biomolecular anomaly are sparse, therefore type of mutations are unknown, increasing management challenges and genetic counseling. The present study aims to describe clinical, biomolecular aspects of a group of Cameroonian patients. Methods We did an observational retrospective study at the pediatric endocrinology unit of the Mother and Child Centre of the Chantal Biya Foundation in Yaounde from May 2013 to December 2019, including all patients diagnosed with CAH. Results We consecutively included 31 patients aged less than 21 years, diagnosed CAH. Median age at diagnosis was 1.71 years (IQR 0.08–2.57 years). Abnormal genitalia was the main complain in 48.4%(n=15). The most prevalent genetic anomaly found in our study population (n=24) was on CYP11, found in 16 patients (66.6%) followed by CYP21A2 mutation found in 8 patients. Homozygous mutation of p.Q356X was found in half of patients with 11 hydroxylase deficiency. This mutation was mostly found in people from semi-Bantu tribes, declared non consanguineous. Conclusions 11 hydroxylase deficiency is the most prevalent form of CAH found in this group of Cameroonian children.
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