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1.深圳市宝安区妇幼保健院儿科内分泌,广东 深圳 518000
2.中山大学孙逸仙纪念医院儿童医学中心,广东 广州 510289
3.中山大学孙逸仙纪念医院细胞分子诊断中心,广东 广州 510289
LIANG Liyang; E-mail: liangliy@mail.sysu.edu.cn
Received:04 March 2025,
Revised:2025-04-14,
Accepted:10 June 2025,
Published:20 July 2025
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曾群,黄思琪,欧辉等.NSD2基因突变致Rauch-Steindl综合征1例及生长激素治疗随访[J].中山大学学报(医学科学版),2025,46(04):714-720.
ZENG Qun,HUANG Siqi,OU Hui,et al.Rauch-Steindl Syndrome Caused by NSD2 Mutation: A Case Report and Follow-up of Growth Hormone Therapy[J].Journal of Sun Yat-sen University(Medical Sciences),2025,46(04):714-720.
曾群,黄思琪,欧辉等.NSD2基因突变致Rauch-Steindl综合征1例及生长激素治疗随访[J].中山大学学报(医学科学版),2025,46(04):714-720. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2025.0419.
ZENG Qun,HUANG Siqi,OU Hui,et al.Rauch-Steindl Syndrome Caused by NSD2 Mutation: A Case Report and Follow-up of Growth Hormone Therapy[J].Journal of Sun Yat-sen University(Medical Sciences),2025,46(04):714-720. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2025.0419.
目的
2
分析1例
NSD2
基因突变所致 Rauch-Steindl 综合征(RAUST)患儿的临床特征、生长激素治疗效果及随访情况,提升儿科医生对该病的认识。
方法
2
总结2017年4月中山大学孙逸仙纪念医院儿童内分泌专科收治的1例
NSD2
基因突变所致RAUST综合征患儿的临床特征、基因检测结果、生长激素治疗效果及随访情况并与国内外相关文献对比分析。
结果
2
患儿,男,初诊年龄2.9岁,孕36周早产,出生体质量1.7 kg,身长42.0 cm。其临床表现包括宫内生长发育迟缓、语言和运动发育迟缓、极端矮小(82.0 cm,-3.7 SD)、消瘦及特殊面容(三角脸、窄下颌、前额突出、拱形眉、眉毛稀疏、前发际线高、牙列拥挤),伴双侧隐睾。骨龄落后1.4年。染色体核型分析及染色体微阵列结果正常。于3.8岁开始GH治疗,治疗期间年生长速率为4.9~6.6 cm/年。至8.0岁停药时,患儿身高113.7 cm(-3.0 SD),停药后生长速率有所下降。2024年7月全外显子基因检测发现
NSD2
基因移码变异c.4028del (p.Pro1343Glnfs*49),经父母外周血一代验证,为新发致病性变异。
结论
2
:本研究报道了1例
NSD2
突变所致RAUST综合征的临床特征,并探讨了GH长期治疗的疗效。本研究有助于加深对这一罕见综合征的认识,进一步优化其诊疗策略。
Objective
2
To analyze the clinical characteristics, efficacy of growth hormone (GH) therapy, and follow-up of a child with Rauch-Steindl syndrome (RAUST) caused by
NSD2
gene mutation, aiming to enhance pediatricians’ understanding of this disorder.
Methods
2
We summarized the clinical features, gene test results, outcomes of GH therapy, and follow-up data of a child with RAUST syndrome caused by
NSD2
mutation admitted to the Pediatric Endocrinology Department of Sun Yat-sen Memorial Hospital in April 2017, and then conducted a comparative analysis with relevant literature.
Results
2
The 2.9-year-old boy at initial visit was born prematurely at 36 weeks of gestation, with a birth wei
ght of 1.7 kg and a body length of 42.0 cm. Clinical manifestations included intrauterine growth retardation, delayed language and motor development, extreme short stature (82.0 cm, -3.7 SD), emaciation, and distinctive facial features (triangular face, narrow jaw, prominent forehead, arched eyebrows, sparse eyebrows, high anterior hairline, crowded dentition), accompanied by bilateral cryptorchidism. Bone age was delayed by 1.4 years. Karyotyping and chromosomal microarray analysis were normal. GH therapy initiated at 3.8 years old yielded annual growth rates of 4.9–6.6 cm/year. When the treatment was discontinued at the age of 8.0, the boy's height was 113.7 cm (-3.0 SD), with subsequent decline in growth velocity. Whole exome sequencing in July 2024 identified a frameshift variant c.4028del (p.Pro1343Glnfs*49) in
NSD2,
which was confirmed as de novo pathogenic variation by parental Sanger sequencing.
Conclusions
2
This study reports the clinical features of RAUST syndrome caused by
NSD2
mutation and explores the long-term efficacy of GH therapy. The findings contribute to a better understanding of this rare syndrome and further optimize its diagnosis and management.
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