腺嘌呤磷酸核糖转移酶基因突变导致2,8二羟基腺嘌呤结晶性肾病1例
A case of 2,8-dihydroxyadenine crystalline nephropathy caused by mutation of adenine phosphoribosyltransferase gene
摘要该文报道1例由腺嘌呤磷酸核糖转移酶(adenine phosphoribosyltransferase, APRT)基因突变导致的2,8-二羟基腺嘌呤(2,8-dihydroxyadenine,2,8-DHA)结晶性肾病病例。患者,女,60岁,因发现“尿泡沫增多半年”就诊。肾活检光镜下可见不规则的棕黄色、偏振光下具有折光性的2,8-DHA结晶,尿沉渣检测发现2,8-DHA结晶,基因检测发现 APRT基因5号外显子纯合缺失(c.521_523delTCT),最终确诊为2,8-DHA结晶性肾病。经别嘌醇治疗后,患者肾功能好转。该病例报告旨在提高临床医师对2,8-DHA结晶性肾病的认识,早期识别、正确诊断及早期药物干预可延缓肾衰竭进展,改善预后。
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abstractsThe paper reports a case of 2,8-dihydroxyadenine (2,8-DHA) crystalline nephropathy caused by mutation of adenine phosphoribosyltransferase ( APRT) gene. The female patient was 60 years old, and sought medical advice due to "foaming urine increased for half a year". Renal biopsy result showed irregular yellowish brown 2,8-DHA crystals with refraction under polarized light. 2,8-DHA crystals were found by urine sediment detection, and homozygous deletion of c.521_523delTCT on exon 5 of APRT gene was found by genetic testing. Finally this patient was diagnosed as 2,8-DHA crystalline nephropathy. Renal function improved after treatment with allopurinol. The case report aims to improve the clinician's understanding of 2,8-DHA crystalline nephropathy. Early recognition, correct diagnosis, and early drug intervention may delay the progression of renal failure and improve the prognosis.
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