一例 DMD基因完全缺失型杜氏肌营养不良邻近基因缺失综合征患者的诊断
Diagnosis of a patient with adjacent gene deletion syndrome with DMD complete deletion type of Duchenne muscular dystrophy
摘要目的:明确1例症状严重杜氏肌营养不良(Duchenne muscular dystrophy,DMD)患者的可能致病基因,为其遗传咨询及临床干预提供依据。方法:应用多重连接探针扩增技术(multiplex ligation-dependent probe amplification,MLPA)对患者 DMD基因进行外显子缺失/重复变异分析,进一步通过外周血G显带、荧光原位杂交(fluorescence in situ hybridization,FISH)和单核苷酸多态性微阵列(single nucleotide polymorphism array,SNP array)分析患者确切基因变异。 结果:MLPA结果显示患者 DMD基因第1~79外显子全部缺失,G显带核型为46,XY; FISH检测出X染色体短臂存在缺失。SNP array结果显示染色体Xp21.2p21.1区存在5.8 Mb (29 628 158~35 434 714)片段缺失,内含IL1RAPL、MAGEB1-4、ROB、CXorf2、GM、AP3K7IP、FTHL1、DMD、FAM47A、TMEM47、FAM47B等基因的邻近基因缺失综合征。 结论:该患者确切致病位点为染色体Xp21.2p21.1区5.8 Mb (29 628 158~35 434 714)片段缺失,对家系成员可以进行携带者筛查及产前诊断,高分辨SNP array技术在发现患者潜在的染色体异常中起着重要作用。
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abstractsObjective:To identify the etiology of a patient with severe symptoms of DMD and to trace its pathogenic gene, so as to provide a basis for genetic counseling and clinical intervention.Methods:Multiple ligation-dependent probe amplification (MLPA) technique was used to analyze exon deletion / repetitive variant of DMD gene, and further analysis was performed by chromosome G-banding, fluorescence in situ hybridization (FISH) and SNP array analysis. Results:The MLPA results of the proband showed that the exon 1-79 of DMD gene were deleted, the G-banding karyotype of blood sample was 46, XY, and the deletion of the short arm of X chromosome was found by FISH. SNP array results showed that 5.8Mb (29 628 158-35 434 714) deletion occurred in the Xp21.2p21.1 region of X chromosome, and the patient was diagnosed as the contiguous deletion syndrome involving the genes of IL1RAPL, MAGEB1-4, ROB, CXorf2, GM, AP3K7IP, FTHL1, DMD, FAM47A, TMEM47, and FAM47B. Conclusion:The exact pathogenic site of this family is the deletion of 5.8 Mb (29 628 158-35 434 714) in the Xp21.2p21.1 region of X chromosome, which can be used for prenatal diagnosis. High resolution SNP array technique plays an important role in detecting potential chromosome abnormalities in patients.
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