简介:摘要目的探索11β-羟化酶缺陷症(11β-hydroxylase deficiency, 11β-OHD)患者的临床和遗传学特点,以提高对该病的认识。方法回顾性分析2016年至2021年在河南省儿童医院确诊的5例11β-OHD患儿的临床表现、激素水平、影像学检查、基因突变特点及随访结果。结果5例患儿中3例男性,2例女性,诊断时年龄1岁5个月~7岁(平均3岁9个月),骨龄3岁6个月~16岁(平均10岁3个月),均无阳性家族史,被误诊为21-羟化酶缺陷症(21-hydroxylase deficiency,21-OHD)2例,且长期合用盐皮质激素治疗。3例合并高血压,1例睾丸肾上腺残余瘤。5例肾上腺CT均提示肾上腺增粗,5例患儿ACTH、17-羟孕酮、睾酮、雄烯二酮不同程度地升高,低钾血症1例。基因分析结果为1例纯合突变,4例复合杂合突变,携带错义突变的4例,2例患者携带缺失,1例患者携带有CYP11B2 exon1-6/CYP11B1 exon7-9形成的嵌合基因。其中CYP11B1 c.1385T>C(p.L462P)、c.1354G>A(p.G452R)和c.64C>T(p.Q22*)为新的突变位点。随访结果:2例男性患儿终身高分别为164.4 cm和150.2 cm,余3例患儿复查相关激素水平正常。结论11β-OHD易于被误诊,导致终身高严重受损。CYP11B1基因突变复杂多样,需要多种基因检测手段协助分析。
简介:摘要目的探讨11β-羟化酶缺乏症(11β-OHD)的临床特点和诊断。方法回顾性分析1例11β-OHD患儿的临床资料及基因检测结果。结果9岁男性患儿,男性性早熟、高血压、低血钾,伴有双侧肾上腺增生。基因检测发现CYP11B1基因移码突变,确诊为11β-羟化酶缺乏症。结论11β-羟化酶缺乏症是一种罕见病,诊断主要是通过临床表现,实验室检测及CYP11B1基因检测。
简介:AbstractImportance:Cadherin-11 (CDH11), a cell-to-cell adhesion molecule, is implicated in the fibrotic process of several organs. Biliary atresia (BA) is a common cholestatic liver disease featuring cholestasis and progressive liver fibrosis in children. Cholestatic liver fibrosis may progress to liver cirrhosis and lacks effective therapeutic strategies. Currently, the role of CDH11 in cholestatic liver fibrosis remains unclear.Objective:This study aimed to explore the functions of CDH11 in cholestatic liver fibrosis.Methods:The expression of CDH11 in BA livers was evaluated by database analysis and immunostaining. Seven BA liver samples were used for immunostaining. The wild type (Wt) and CDH11 knockout (CDH11-/-) mice were subjected to bile duct ligation (BDL) to induce cholestatic liver fibrosis. The serum biochemical analysis, liver histology, and western blotting were used to assess the extent of liver injury and fibrosis as well as activation of transforming growth factor-β (TGF-β)/Smad pathway. The effect of CDH11 on the activation of hepatic stellate cell line LX-2 cells was investigated.Results:Analysis of public RNA-seq datasets showed that CDH11 expression levels were significantly increased in livers of BA, and CDH11 was correlated with liver fibrosis in BA. BDL-induced liver injury and liver fibrosis were attenuated in CDH11-/- mice compared to Wt mice. The protein expression levels of phosphorylated Smad2/3 were decreased in livers of CDH11-/- BDL mice compared to Wt BDL mice. CDH11 knockdown inhibited the activation of LX-2 cells.Interpretation:CDH11 plays an important role in cholestatic liver fibrosis and may represent a potential therapeutic target for cholestatic liver disease, such as BA.
简介:摘要本文回顾性分析了2017年1月至2021年12月湖南省人民医院收治的11例胰管结石患儿的临床资料,其中男性4例,女性7例,中位年龄13岁,年龄范围8~17岁。所有患儿均经CT及MRI+磁共振胆胰管造影确诊,并行手术治疗。全组患儿无死亡病例,术后出现A级胰漏1例,经保守治疗后痊愈。随访时间3~60个月,随访期间无胰腺内外分泌功能不全表现;术后腹痛明显较前缓解。外科手术是治疗儿童胰管结石的重要手段,积极的手术治疗对于提高患儿生存质量具有重要意义。