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[Allgrove syndrome in the mainland of China: clinical report and mutation analysis].
[triple a syndrome]
Allgrove
syndrome
is
a
rare
autosomal
recessive
disorder
characterized
by
the
triad
of
adrenal
insufficiency
,
achalasia
and
alacrima
and
many
cases
have
multi-systems
disorder
:
endocrine
,
gastrointestinal
tract
,
eyes
and
nervous
system
.
This
syndrome
is
also
known
as
achalasia
-addisonianism-
alacrima
syndrome
or
triple
A
syndrome
.
Allgrove
syndrome
is
now
known
to
be
caused
by
mutations
of
AAAS
gene
encoding
the
aladin
protein
.
In
the
present
paper
,
we
report
a
Chinese
mainland
girl
with
Allgrove
syndrome
with
mutations
in
the
AAAS
gene
.
T
he
patient
was
a
7
-
year
-old
girl
complained
of
coma
and
dark
skin
;
she
was
treated
as
Addison
disease
for
2
years
and
had
vomiting
for
9
months
before
the
second
admission
.
Gene
analysis
was
performed
after
extracting
genomic
DNA
by
amplification
and
sequencing
of
the
specific
fragments
of
AAA
gene
.
The
patient
was
confirmed
to
have
adrenal
insufficiency
at
the
age
of
5
years
and
6
months
.
During
the
second
hospitalization
,
she
was
found
to
have
a
remarkable
brisk
reflexion
,
bilateral
optic
nerve
atrophy
,
alacrima
and
achalasia
besides
ACTH
resistance
.
The
girl
was
born
to
consanguineous
parents
.
Based
on
these
findings
,
she
was
diagnosed
as
having
Allgrove
syndrome
.
Mutation
analysis
revealed
a
novel
homozygous
deletion
of
a
single
G
,
c
.
771
delG
,
in
exon
8
of
the
AAAS
gene
.
This
frame
shift
mutation
was
predicted
to
create
a
premature
stop
codon
at
locus
290
,
p
.
R
258
GfsX
33
,
leading
to
a
truncated
and
non-functioning
aladin
protein
.
Both
the
parents
were
heterozygous
for
the
mutation
.
The
clinical
manifestations
and
AAAS
gene
mutations
analysis
confirmed
the
diagnosis
of
Allgrove
syndrome
.
Gene
analysis
indicated
that
this
syndrome
is
an
autosomal
recessive
inherent
disorder
.
ALADIN
is
significant
for
the
normal
cell
function
.
When
compared
with
reported
cases
,
it
seems
that
there
are
no
remarkable
relation
between
gene
mutation
loci
and
clinical
manifestations
in
Allgrove
syndrome
.
Diseases
Validation
Diseases presenting
"alacrima and achalasia besides acth resistance"
symptom
triple a syndrome
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