SCN2A;新生儿;抽搐;钠通道," /> SCN2A;新生儿;抽搐;钠通道,"/> SCN2A,Neonate,Spasm,Sodium channel,"/> <span style="line-height:2;font-size:14px;">Na+通道基因SCN2A变异致新生儿抽搐</span><span style="line-height:2;font-size:14px;">一例及文献复习</span>
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发育医学电子杂志  2018, Vol. 6 Issue (1): 50-54    
  临床遗传   临床经验交流 |新生儿 |
Na+通道基因SCN2A变异致新生儿抽搐一例及文献复习
李荣业 王柱 杜岚岚 等
李荣业1 王柱1 杜岚岚1 杨洋1 张巍2 唐雯3 杨杰1(1.广东省妇幼保健院 新生儿科,广东 广州 510000; 2.嘉检医学检测有限公司,广东 广州 510000;3.中山大学第一附属医院 儿科重症监护病房,广东 广州 510000)
A carrier of pathogenic variant of SLC10A1 gene presenting transient infantile hypercholanemia and cholestasis
LI Xiao-wei, DENG mei, QIU Jian-wu, et al
LI Rong-ye1, WANG Zhu1,DU Lan-lan1, YANG Yang1, ZHANG Wei2, TANG Wen3, YANG Jie1 (1.Neonatology, Guangdong Women and Children Hospital, Guangdong, Guangzhou 510000, China; 2.AmCare Genomics Laboratory, Guangdong, Guangzhou 510000, China; 3. Pediatric Intensive Care Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangdong, Guangzhou 510000, China)
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摘要  目的  探讨Na+通道基因SCN2A变异致新生儿抽搐的临床特征及基因检测结果,为临床提供参考。方法 20165月,广东省妇幼保健院收治1SCN2A基因变异致新生儿抽搐的女性患儿,采用高通量测序检测方法对患儿及父母进行基因检测。回顾性分析其临床特征、辅助检查结果、基因检测结果,并对相关文献进行复习。 结果  患儿生后第13天无明显诱因出现短暂舞蹈样抽搐,可自行缓解,1天发作达数十次。电解质提示血钠轻度下降,脑电图提示爆发-抑制改变。先后采用苯巴比妥、左乙拉西坦、丙戊酸钠治疗无明显效果。基因检测结果提示患儿SCN2A基因发生错义变异c.1261T>Gp.Leu421Val),患儿父母均不携带此变异。改用奥卡西平口服,同时予以生酮饮食,2周后抽搐逐渐减少至消失,脑电图较前改善。随访至1.5岁,患儿仍伴有严重的生长发育迟缓和智力障碍。结论 对于抽搐原因不明确的患儿,应尽快完善基因检测,根据发病机制精准用药。
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关键词:  font-size:14px  SCN2A;新生儿;抽搐;钠通道')" href="#">">SCN2A;新生儿;抽搐;钠通道    
Abstract: Objective To investigate the clinical characteristics and genetic test results of neonatal spasm induced by Na+ channel gene SCN2A mutation, and to provide reference for clinical practice. Methods A newborn baby girl with spasm induced by SCN2A mutation was received in Guangdong Women and Children Hospital in May 2016. The genes of baby and her parents were detected by high-throughput assay. The clinical features, examinations, gene detection were retrospectively analyzed and relevant literatures were reviewed. Results On the 13th day of the neonate, the infant started with transient choreography, which relieved on its own, and the seizures were dozens of times per day. Electrolyte suggested moderate decrease of blood sodium and the electroencephalogram (EEG) presented a burst-suppression pattern. After the therapy of phenobarbital, levetiracetam and valproate successively, there were no effect. Gene detection suggested that the gene SCN2A mutation, c.1261T>G (p.Leu421Val) occured in the infant, but the parents did not carry the mutation. Oxcarbazepine and ketogenic diet prepared for her, seizures decreased and disappeared gradually 2 weeks later, the EEG was better than before. Follow up to 1.5 years old, the patient still accompanied by severe growth and psychomotor retardation. Conclusion For the infants who have no definite diagnosis for the causes of spasm, the gene detection should be perfected as soon as possible and the accurate medication should be practiced based on the pathogenesis
Key words:  SCN2A')" href="#">SCN2A    Neonate    Spasm    Sodium channel
收稿日期:  2017-12-01                出版日期:  2018-01-30      发布日期:  2018-04-02      期的出版日期:  2018-01-30
基金资助: 广州市科学研究专项(2060404)
引用本文:    
李荣业 王柱 杜岚岚 等. Na+通道基因SCN2A变异致新生儿抽搐一例及文献复习[J]. 发育医学电子杂志, 2018, 6(1): 50-54.
LI Xiao-wei, DENG mei, QIU Jian-wu, et al. A carrier of pathogenic variant of SLC10A1 gene presenting transient infantile hypercholanemia and cholestasis. Journal of Developmental Medicine(Electronic Version), 2018, 6(1): 50-54.
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