目的 总结一例失盐型3β-羟类固醇脱氢酶(3βHSD)缺乏症患儿的临床特点及HSD3B2基因突变结果,并结合文献分析,以提高临床医生对该病的认识.方法 2013年8月广州市妇女儿童医疗中心采用PCR及DNA直接测序法对1例13岁女性失盐型先天性肾上腺皮质增生症(CAH)伴反复卵巢囊肿患儿进行HSD3 B2基因分析,回顾患儿临床资料,并进行文献复习.结果 13岁女孩,新生儿期因失盐及轻度阴蒂肥大诊断为CAH,并予糖皮质激素替代治疗.9岁乳房发育,12岁月经初潮,初潮后曾因反复卵巢囊肿先后行腹腔镜手术及卵巢囊肿穿刺术,最大囊肿90 mm ×80 mm×80 mm.身高165 cm,体重55 kg,皮肤黝黑,氢化可的松替代治疗中血浆ACTH 17.10 pmol/L(参考值0 ～ 10.12 pmol/L),血清睾酮1.31 nmol/L(参考值＜0.7 nmol/L),硫酸脱氢表雄酮13.30μmol/L(参考值0.95 ～ 11.67 μmol/L),皮质醇720 nmol/L(参考值130 ～ 772.8 nmol/L),雄烯二酮、孕酮及17-羟孕酮正常,卵泡期雌二醇461 pmol/L,卵泡刺激素3.04 IU/L,黄体生成素8.52 IU/L.盆腔超声显示右侧附件58 mm×50 mm×35 mm卵巢囊肿,左侧卵巢正常及中期子宫内膜.HSD3B2基因分析显示2号外显子存在新纯合无义突变c.73G＞ T(p.E25X),母亲为该突变携带者,生物学父亲未见异
Objective 3 β-hydroxysteroid dehydrogenase deficiency (3βHSD),a rare form of congenital adrenal hyperplasia (CAH) resulted from mutations in the HSD3B2 gene that impair steroidogenesis in both adrenals and gonads.We report clinical features and the results of HSD3B2 gene analysis of a Chinese pubertal girl with salt wasting 3βHSD deficiency.Method We retrospectively reviewed clinical presentations and steroid profiles of the patient diagnosed in Guangzhou Women and Children''s Medical Center in 2013.PCR and direct sequencing were used to identify any mutation in the HSD3B2 gene.Result A 13-year-old girl was diagnosed as CAH after birth because of salt-wasting with mild clitorimegaly and then was treated with glucocorticoid replacement.Breast and pubic hair development were normal,and menarche occurred at 12 yr,followed by menstrual bleeding about every 45 days.In the last one year laparoscopic operation and ovariocentesis were performed one after another for recurrent ovar
