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Objectives To analyze SLC37A4 gene mutations in glycogen storage disease type Ⅰb patients and to investigate the correlation between genotype and phenotype. Methods The clinical data and SLC37A4 gene detection results of 3 cases of glycogen storage disease type Ⅰb were analyzed retrospectively. Results Two males and one female aged 6 years, 9 years, and 16 years respectively were presented with hepatomegaly, fasting hypoglycemia, slactic academia, hyperlipidemia, and granulocytopenia. The analysis of 6 alleles in SLC37A4 gene by direct sequencing of peripheral blood DNA found 4 mutations, including 2 missense mutation (p. Leu23Arg and p.Pro191Leu), one shear mutation (c.870+5G>A), and one deletion mutation (c.1042_1043 del CT). The genotypes of these 3 cases were p.Pro191Leu, p.Pro191Leu;p. Leu23Arg, c.870+5G>A;p.Pro191Leu, p.Leu347ValfsX53 respectively. Conclusions There were 4 mutations detected among these 3 cases of glycogen storage disease type Ⅰb. All of those were known mutations. The most common mutation was p.Pro191Leu. It can not be excluded that P.Gly149Glu homozygous mutation is associated with repeated infections.
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Objective To analyze and summarize the clinical characteristics of patients with spontaneous hemor -rhage of hepatic adenoma in glycogen storage disease type Ⅰa.Methods Reporting 1 case in our hospital and making a summary about general situation , category, etiology, diagnosis and treatment of the hemorrhage of hepatic adenoma with glycogen storage disease type Ⅰa through checking literatures .Results The patient was a 27 year old male who had been diagnosed as glycogen storage disease for 14 years, as well as was first found hepatic adeno-ma at the age of 17 .He once was diagnosed as intra-adenoma bleeding with persistent abdominal pain and dizziness and was underwent selective hepatic artery embolization at the age of 22.Hepatic adenoma in glycogen storage dis-ease typeⅠa generally appeared at the age of puberty .One common complication of this disease was hemorrhage of hepatic adenoma , which can be found by ultrasonography and CT .Clinical management includs observation , selec-tive hepatic artery embolization , radiofrequency ablation , surgical resection and liver transplantation .Conclusions Glycogen storage disease type Ⅰa is an autosomal recessive genetic disease with hepatic adenoma as a common complication of GSD Ⅰa, serious liver adenoma's hemorrhage can be life threatening , the radiological examination can be helpful to detect hepatic adenoma .Then appropriate intervention can improve the life quality and prognosis .
ABSTRACT
<p><b>OBJECTIVE</b>Schimke immuno-osseous dysplasia (SIOD), is an autosomal recessive inherited disease caused by SMARCAL1 (MIM:20606622) mutations, while in about half of the patients no any mutation in SMARCAL1 could be found. This disease involves multiple systems and is characterized by short and dissymmetric stature with spondyloepiphyseal dysplasia, progressive renal failure, lymphopenia with recurrent infections, and hyperpigmented macules. This study aimed to analyze SMARCAL1 gene of 2 unrelated suspected SIOD children, to make definite diagnosis, and find more SMARCAL1 mutation types of Chinese SIOD.</p><p><b>METHOD</b>Two suspected Chinese Han male SIOD children who visited our hospital from 2008 to 2014, aged 3 y 6 m and 7 y 8 m, both were short and had spondyloepiphyseal dysplasia, progressive renal failure, lymphopenia with recurrent infections. After informed consent, they and their parents's DNA were extracted from blood. PCRs for all 16 exons of SMARCAL1 were performed and PCR products were purified by 2% gel electrophoresis and sequenced directly. Pathogenicity of missense variations was confirmed by SIFT and sequencing SMARCAL1 of fifty normal controls.</p><p><b>RESULT</b>(1) Four gene variations were found in the two children: Two reported missense mutations c.1129G>C, p.Glu377Gln and c.1933C>T, p. Arg645Cys. Two splicing mutations c.1334+1G>A and c.2142-1 G>A were detected. (2) c.1129G>C, p.Glu377Gln were reported as a disease-causing mutations before, but it was an single nucleotide polymorphism (SNP) which was found in 15 of 50 normal controls. (3) Two novel splicing mutations were found in this study: c.1334+1G>A and c.2142-1 G>A.</p><p><b>CONCLUSION</b>(1) We detected 3 disease-causing mutations in 2 SIOD children by SMARCAL1 gene analysis, while 2 splicing mutations were novel mutations. (2) c.1129G>C, p.Glu377Gln was a SNP but not a disease-causing mutation at least in Chinese population.</p>