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1、萬方數(shù)據(jù)·66·Johanson—Blizzard綜合征一例及文劉志峰張志華李玫金玉練敏唐文偉.臨床研究與實(shí)踐.獻(xiàn)復(fù)習(xí)【摘要】目的提高對Johanson-Blizzard綜合征(JBS)的臨床和診斷特點(diǎn)的認(rèn)識。方法討論l例患兒的臨床表現(xiàn)及診斷過程,運(yùn)用基因檢測的結(jié)果對診斷加以明確。并綜合其他28例有詳細(xì)臨床資料的病例進(jìn)行分析。結(jié)果本例為女性,l歲9個(gè)月,以“脂肪瀉”收治入院,出生后伴有肛門閉鎖、鼻翼發(fā)育不全?,F(xiàn)生長發(fā)育落后,智力發(fā)育落后,伴有頭發(fā)稀疏及少牙畸形;便常規(guī)鏡檢脂肪球(++),血脂肪酶、淀粉酶及胰島素、C肽水平偏低;腹部CT掃描見胰腺組織為脂肪組織替代;UBRl基因檢測發(fā)
2、現(xiàn)雜合錯(cuò)義突變,確診JBS。在包括本例共計(jì)29例病例分析中,胰腺外分泌功能不全和鼻翼發(fā)育不全最為常見,分別為21例(72.4%)和27例(93%);18例(62%)伴有生長發(fā)育異常;17例(59%)伴有神經(jīng)性聽覺減退或喪失;頭皮缺損和頭發(fā)稀疏或異常卷曲分別有20例(69%)和13例(44.8%);甲狀腺功能低下13例(44.8%);牙齒畸形13例(44.8%);肛門閉鎖6例(2l%)。但是近親結(jié)婚并不常見(3/29,10.3%)。結(jié)論JBS是一種罕見的、伴有獨(dú)特先天性多發(fā)畸形的遺傳性疾病,其特征表現(xiàn)是先天性胰腺外分泌不足伴有鼻翼發(fā)育不全或缺失,可以通過典型臨床表現(xiàn)及UBRl基因檢測
3、加以明確?!娟P(guān)鍵詞】Johanson.Blizzard綜合征;胰腺外分泌功能不全ReportofaeasewithJohanson-BlizzardsyndromeandliteraturesreviewuUzhi垂ng,ZHANGz饑-hua,1_1Mei,JINYu,LIANMin,mⅣG耽凡-weLDepartmentofDigestiveDiseases,NanjingChildren7sHospital,Nqnji鴨MedicalUniversity.Nanjing210008.ChinaCorrespondingauthor:finYu(Email:jinyu@如ue比
4、cn)【Abstract】ObjectiveTostudytheclinicalcharacteristicsanddiagnosisoftheJohansou.Blizzardsyndrome.Method,nleclinicalcharacteristicsanddiagnosingprocedureoflca.sewithJobalison.Blizzardsyndromewereanalyzed.a(chǎn)ndgeneticanalysisWaSmadeindiagnosingprocedure,and28casesofJohanson—Blizzardsyndromewithde
5、tailedclinicaldatawerereviewedandanalized.ResultAoneyearandninemonthsoldgirl,whowasinitiallyadmittedtothehospitalbecauseoffattydiarrheaandincreasedfrequencyofdefecation.ImperforateanUS。andaplasticalaenabiwasnoticedafterbirth.Onphysicalexamination.shortstature,mentalretardation。toothabnormaliti
6、esandscalpdefectswereobserved.Fat只lobuleWaSfoundbyroutinestooltesLSerumbiochemistryshowed8.11exocrineandendocrinepancreaticinsufficiency。CTscanoftheabdomendemonstratedfattyreplacementofthepancre.8s。UBRJgeneanalysisshowedheterozygousfortwomissenscchanges.Inall29cases,exocrinepancreaticinsuffici
7、ency(72.4%)andhypoplasiaofthealacnasi(93%)werethemostconlInonclinicalmanifestations,andsensorineuralhearingloss(59%),scalpdefects(69%)andhairthinningorupsweepofthehair(44.8%)。hypothyroidism(44.8%),absenceofpermanentteeth(44.8%)andimperf