Please wait a minute...
浙江大学学报(医学版)  2020, Vol. 49 Issue (3): 406-409    DOI: 10.3785/j.issn.1008-9292.2020.04.13
病例报告     
UGT1A1基因复合杂合突变致吉尔伯特综合征一例
欧伟杰(),林苏,吴奕隆,朱月永*()
福建医科大学附属第一医院肝病中心, 福建 福州 350005
A case of Gilbert syndrome caused by UGT1A1 gene compound heterozygous mutations
OU Weijie(),LIN Su,WU Yilong,ZHU Yueyong*()
Liver Research Center, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
 全文: PDF(2086 KB)   HTML( 7 )
摘要:

一例吉尔伯特综合征患儿自幼反复出现巩膜黄染,无其他自觉症状;血清胆红素水平升高,以非结合胆红素为主;排除胆道梗阻、溶血等其他引起黄疸的因素;基因检测发现患儿尿苷二磷酸葡糖苷酸转移酶1A1(UGT1A1)基因存在UGT1A1*28和c.211G>A杂合突变。

关键词: 吉尔伯特病尿苷二磷酸葡萄糖醛酸基转移酶基因突变病例报告    
Abstract:

A case of Gilbert syndrome (GS) with a heterozygous mutation in the UGT1A1 gene is reported. The patient had no symptoms except for recurrent sclera icterus since childhood. Laboratory examinations revealed an elevated unconjugated bilirubin. Biliary obstruction, hemolysis and other diseases that might cause jaundice were excluded. UGT1A1*28 and c.211G>A heterozygous mutations in UGT1A1 gene were found, which may be another type of mutation causing GS in Chinese population.

Key words: Gilbert disease    Uridine diphosphate    Glucuronosyl transferase    Genes    Mutation    Case reports
收稿日期: 2019-10-14 出版日期: 2020-04-16
CLC:  R575.5  
基金资助: 国家科技重大专项(2017ZX10202201);医学科学研究基金晴众专项(YWJKJJHKYJJ-B17344);福建省卫生计生中青年骨干人才培养项目(2018-ZQN-54)
通讯作者: 朱月永     E-mail: ouweijie@fjmu.edu.cn;zhuyueyong@fjmu.edu.cn
作者简介: 欧伟杰(1995—), 男, 硕士研究生, 主要从事肝脏疾病研究; E-mail:ouweijie@fjmu.edu.cn; https://orcid.org/0000-0002-9038-7549
服务  
把本文推荐给朋友
加入引用管理器
E-mail Alert
RSS
作者相关文章  
欧伟杰
林苏
吴奕隆
朱月永

引用本文:

欧伟杰,林苏,吴奕隆,朱月永. UGT1A1基因复合杂合突变致吉尔伯特综合征一例[J]. 浙江大学学报(医学版), 2020, 49(3): 406-409.

OU Weijie,LIN Su,WU Yilong,ZHU Yueyong. A case of Gilbert syndrome caused by UGT1A1 gene compound heterozygous mutations. J Zhejiang Univ (Med Sci), 2020, 49(3): 406-409.

链接本文:

http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2020.04.13        http://www.zjujournals.com/med/CN/Y2020/V49/I3/406

图 1  一例UGT1A1基因复合杂合突变(UGT1A1*28;c.211G>A)患者的家系图
1 FRETZAYAS A , MOUSTAKI M , LIAPI O et al. Gilbert syndrome[J]. Eur J Pediatr, 2012, 171 (1): 11- 15
doi: 10.1007/s00431-011-1641-0
2 HIRSCHFIELD G M , ALEXANDER G J . Gilbert's syndrome:an overview for clinical biochemists[J]. Ann Clin Biochem, 2006, 43 (Pt 5): 340- 343
doi: 10.1258/000456306778520034
3 KAMAL S , ABDELHAKAM S , GHORABA D et al. The frequency, clinical course, and health related quality of life in adults with Gilbert's syndrome:a longitudinal study[J]. BMC Gastroenterol, 2019, 19 (1): 22
doi: 10.1186/s12876-019-0931-2
4 KADAKOL A , GHOSH S S , SAPPAL B S et al. Genetic lesions of bilirubin uridine-diphospho-glucuronate glucuronosyltransferase (UGT1A1) causing Crigler-Najjar and Gilbert syndromes:correlation of genotype to phenotype[J]. Hum Mutat, 2000, 16 (4): 297- 306
doi: 10.1002/1098-1004(200010)16:4<297:AID-HUMU2>3.0.CO;2-Z
5 SAPPAL B S , GHOSH S S , SHNEIDER B et al. A novel intronic mutation results in the use of a cryptic splice acceptor site within the coding region of UGT1A1, causing Crigler-Najjar syndrome type 1[J]. Mol Genet Metab, 2002, 75 (2): 134- 142
doi: 10.1006/mgme.2001.3284
6 WAGNER K H , SHIELS R G , LANG C A et al. Diagnostic criteria and contributors to Gilbert's syndrome[J]. Crit Rev Clin Lab Sci, 2018, 55 (2): 129- 139
doi: 10.1080/10408363.2018.1428526
7 CANU G , MINUCCI A , ZUPPI C et al. Gilbert and Crigler Najjar syndromes:an update of the UDP-glucuronosyltransferase 1A1(UGT1A1) gene mutation database[J]. Blood Cells Mol Dis, 2013, 50 (4): 273- 280
doi: 10.1016/j.bcmd.2013.01.003
8 BEUTLER E , GELBART T , DEMINA A . Racial variability in the UDP-glucuronosyltransferase 1(UGT1A1) promoter:a balanced polymorphism for regulation of bilirubin metabolism?[J]. Proc Natl Acad Sci U S A, 1998, 95 (14): 8170- 8174
doi: 10.1073/pnas.95.14.8170
9 KANAI M , KIJIMA K , SHIRAHATA E et al. Neonatal hyperbilirubinemia and the bilirubin uridine diphosphate-glucuronosyltransferase gene:the common -3263T > G mutation of phenobarbital response enhancer module is not associated with the neonatal hyperbilirubinemia in Japanese[J]. Pediatr Int, 2005, 47 (2): 137- 141
doi: 10.1111/j.1442-200x.2005.02030.x
10 YANG H , WANG Q , ZHENG L et al. Clinical significance of UGT1A1 genetic analysis in Chinese neonates with severe hyperbilirubinemia[J]. Pediatr Neonatol, 2016, 57 (4): 310- 317
doi: 10.1016/j.pedneo.2015.08.008
11 YU Z , ZHU K , WANG L et al. Association of neonatal hyperbilirubinemia with UGT1A1 gene polymorphisms:a meta-analysis[J]. Med Sci Monit, 2015, 21 3104- 3114
doi: 10.12659/msm.894043
12 MARUO Y , NAKAHARA S , YANAGI T et al. Genotype of UGT1A1 and phenotype correlation between Crigler-Najjar syndrome type Ⅱ and Gilbert syndrome[J]. J Gastroenterol Hepatol, 2016, 31 (2): 403- 408
doi: 10.1111/jgh.13071
13 KALOTYCHOU V , KARAKOSTA M , TZANETEA R et al. Contribution of G71R mutation to Gilbert's syndrome phenotype in a Greek patient:A case report[J]. World J Gastrointest Pharmacol Ther, 2011, 2 (5): 42- 45
doi: 10.4292/wjgpt.v2.i5.42
14 LI Y , BUCKLEY D , WANG S et al. Genetic polymorphisms in the TATA box and upstream phenobarbital-responsive enhancer module of the UGT1A1 promoter have combined effects on UDP-glucuronosyltransferase 1A1 transcription mediated by constitutive androstane receptor, pregnane X receptor, or glucocorticoid receptor in human liver[J]. Drug Metab Dispos, 2009, 37 (9): 1978- 1986
doi: 10.1124/dmd.109.027409
15 KADAKOL A , GHOSH S S , SAPPAL B S et al. Genetic lesions of bilirubin uridine-diphospho-glucuronate glucuronosyltransferase (UGT1A1) causing Crigler-Najjar and Gilbert syndromes:correlation of genotype to phenotype[J]. Hum Mutat, 2000, 16 (4): 297- 306
doi: 10.1002/1098-1004(200010)16:4<297::AID-HUMU2>3.0.CO;2-Z
16 ABUDUXIKUER K, FANG L J, LI L T, et al. UGT1A1 genotypes and unconjugated hyperbilirubine-mia phenotypes in post-neonatal Chinese children: A retrospective analysis and quantitative correlation[J/OL]. Medicine (Baltimore), 2018, 97(49): e13576. DOI: 10.1097/MD.0000000000013576.
[1] 康仙慧,张荣,何慧梁,姚永兴,郑跃英,温小红,祝胜美. 一例妊娠合并2019冠状病毒病(COVID-19)患者的剖宫产麻醉管理[J]. 浙江大学学报(医学版), 2020, 49(2): 249-252.
[2] 李艾,张添源,高建青. 间充质干细胞的肿瘤归巢特性及其肿瘤靶向治疗应用研究进展[J]. 浙江大学学报(医学版), 2020, 49(1): 20-34.
[3] 宛昱君,刘君妍,王妤婷,成小雨,沙莎,贾婉莹,胡德邻,李昕宇,郭凤. 钙调蛋白及其突变体与电压门控钠离子通道1.2异亮氨酸-谷氨酰胺基序的结合作用[J]. 浙江大学学报(医学版), 2020, 49(1): 71-75.
[4] 方娟,潘志成,郭晓纲. INK4基因座中反义非编码RNA调控细胞增殖与凋亡影响动脉粥样硬化的研究进展[J]. 浙江大学学报(医学版), 2020, 49(1): 113-117.
[5] 潘宗富,胡晓平,张轶雯,李莉,黄萍. 缺血性脑损伤大鼠外周血动态共表达网络分析[J]. 浙江大学学报(医学版), 2019, 48(6): 587-593.
[6] 米爽,吴燕君,洪正华,王章富,冯兴兵,郑光彬. TLR4/MyD88/NF-κB通路基因及相关炎症因子在继发性脊髓损伤患者中的表达[J]. 浙江大学学报(医学版), 2019, 48(6): 609-616.
[7] 沈洁,王启闻,高东若,吕媛媛,汤谷平. 基于聚天冬氨酸骨架的药物/基因共运输载体的制备及细胞生物学特性[J]. 浙江大学学报(医学版), 2019, 48(6): 657-667.
[8] 陈钿雨,祁鸣. 单亲二体及其在癌症中的作用研究进展[J]. 浙江大学学报(医学版), 2019, 48(5): 560-566.
[9] 黄淑敏,赵正言. 重症联合免疫缺陷病新生儿筛查及免疫系统重建研究进展[J]. 浙江大学学报(医学版), 2019, 48(4): 351-357.
[10] 刘蓓,杨艳梅,严恺,陈敏,王丽雅,黄颖之,钱叶青,董旻岳. Ⅰ型神经纤维瘤一家系的基因检测及产前诊断[J]. 浙江大学学报(医学版), 2019, 48(4): 367-372.
[11] 楼铁,黄颖之,董旻岳. CLN6基因复合杂合突变导致神经元蜡样脂褐质沉积症一家系遗传学研究[J]. 浙江大学学报(医学版), 2019, 48(4): 373-377.
[12] 许雨晴,钱叶青,姚维妙,董旻岳. Van der Woude综合征一家系遗传学分析[J]. 浙江大学学报(医学版), 2019, 48(4): 378-383.
[13] 叶青,张莹莹,王晶晶,毛建华. Ⅳ型胶原α5链基因突变致奥尔波特综合征两家系遗传学分析[J]. 浙江大学学报(医学版), 2019, 48(4): 384-389.
[14] 吴鼎文,芦斌,杨建滨,杨茹莱,黄新文,童凡,郑静,赵正言. 3-羟基异戊酰基肉碱代谢异常新生儿遗传学分析[J]. 浙江大学学报(医学版), 2019, 48(4): 390-396.
[15] 童凡,杨茹莱,刘畅,吴鼎文,张婷,黄新文,洪芳,钱古柃,黄晓磊,周雪莲,舒强,赵正言. 新生儿酪氨酸血症筛查及基因谱分析[J]. 浙江大学学报(医学版), 2019, 48(4): 459-464.