Neonatal Crohn's disease with Oral ulcer as the first symptom caused by a compound heterozygote mutation in IL-10RA: a case report

Hereditas. 2019 Dec 26:156:38. doi: 10.1186/s41065-019-0114-8. eCollection 2019.

Abstract

Objective: To investigate the clinical and genetic characteristics of neonatal Crohn's disease (CD), improve recognition of neonatal CD, and reduce the number of patients that are missed or misdiagnosed.

Methods: A 10-day-old Chinese girl with oral ulcers was admitted to the Department of Neonatology. She later developed a rash and perianal disease, but without diarrhea and stool abnormalities. The patient and her parents underwent next-generation sequencing.

Results: The results showed that the patient carries a compound heterozygous mutation in the interleukin-10 receptor A (IL-10RA) (NM_001558.3) gene. One heterozygous mutation was c.301 c > T, P. (Arg 101 Trp) in exon 3 of IL-10RA (a missense mutation), and the other was c. 537G > A, P. (Thr 179 =) in exon 4 of IL 10RA (a synonymous mutation). The patient's father also carries the c.301 c > T, P. (Arg 101 Trp) heterozygous mutation in exon 3 of IL-10RA, whereas her mother carries the c.537G > A, P. (Thr 179 =) heterozygous mutation in exon 4 of IL-10RA.

Conclusions: The results show that a compound heterozygous mutation in IL-10RA is associated with neonatal CD. Oral ulcers with a rash and perianal disease may be an early symptom of neonatal CD; therefore, such patients should undergo genetic identification as soon as possible.

Keywords: Crohn’s disease; Genetic mutation; Inflammatory bowel disease; Interleukin-10 receptor a; Neonate; Oral ulcer.

Publication types

  • Case Reports

MeSH terms

  • Alleles
  • Crohn Disease / complications*
  • Crohn Disease / genetics*
  • Disease Susceptibility
  • Exons
  • Female
  • Genetic Association Studies
  • Heterozygote*
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Infant, Newborn
  • Interleukin-10 Receptor alpha Subunit / genetics*
  • Mutation*
  • Oral Ulcer / complications*
  • Oral Ulcer / diagnosis*
  • Phenotype

Substances

  • Interleukin-10 Receptor alpha Subunit