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Managing Follicular Lymphoma in the Elderly Population. 老年人群滤泡性淋巴瘤的管理。
IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.1155/2023/1038934
Jiao Jie Cherie Tan, Yuen Lei Sze, Clarice Choong Shi Hui

Follicular lymphoma (FL) is one of the most commonly diagnosed types of indolent non-Hodgkin lymphoma (NHL). The median age of diagnosis for FL is 65 years old. Although the median life expectancy after diagnosis is approximately 10 years, the incurable disease has a high risk of transformation. This case report focuses on an 80-year-old patient diagnosed with low-grade follicular lymphoma which subsequently transformed leading to the patient's eventual demise as the patient took on the palliative intent. This case report aims to highlight the importance of clinical markers or prognostic factors to identify patients, specifically the elderly population who are at risk of transformation to aggressive forms when their FL remains at stage I-II phases. Currently, elderly patients with FL tend to be quickly dismissed with curative intent with chemotherapy, given their age and comorbidities, despite forming the majority of the population with follicular lymphoma. Age more than 60 years old has been shown to be one of the most powerful yet poor prognostic features in follicular lymphoma international prognostic index (FLIPI)-the main scoring system used for FL. Hence, further studies are required to look into the tailoring treatment for elderly patients with follicular lymphoma after risk stratifying them with appropriate clinical and prognostic markers.

滤泡性淋巴瘤(FL)是一种最常见的诊断类型的惰性非霍奇金淋巴瘤(NHL)。FL的中位诊断年龄为65岁。虽然诊断后的平均预期寿命约为10年,但这种无法治愈的疾病有很高的转化风险。本病例报告的重点是一位80岁的低级别滤泡性淋巴瘤患者,随着患者接受姑息治疗,该患者随后发生转变,导致患者最终死亡。本病例报告旨在强调临床标志物或预后因素对识别患者的重要性,特别是老年人群,当他们的FL仍处于I-II期时,他们有转变为侵袭性形式的风险。目前,尽管在滤泡性淋巴瘤患者中占多数,但考虑到年龄和合并症,老年FL患者往往很快被排除在化疗的治疗目的之外。年龄超过60岁已被证明是滤泡性淋巴瘤国际预后指数(FLIPI)中最重要但预后较差的特征之一,这是滤泡性淋巴瘤的主要评分系统。因此,需要进一步的研究,在使用适当的临床和预后标志物对老年滤泡性淋巴瘤患者进行风险分层后,对其进行定制治疗。
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引用次数: 0
Pathological Correlation of a Cardiac Mass with Multimodality Imaging. 心脏肿块与多模态影像的病理相关性。
IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.1155/2023/7352934
Sumit Sohal, Farida A Tanko, Esad Vucic, Sergio Waxman, Suresh Gupta, Billie Fyfe-Kirschner

Cardiac masses are rarely encountered in clinical practice and can lead to severe hemodynamic consequences. In addition to clinical cues, noninvasive modalities can play an important role in characterization of these masses and therefore their diagnosis and management planning. Here in this case report, we describe the use of various forms of noninvasive imaging techniques to narrow the differential diagnosis and form an operative plan for a cardiac mass later identified as a benign myxoma originating from the right ventricle on histological examination.

心脏肿块在临床实践中很少遇到,可导致严重的血流动力学后果。除了临床提示外,非侵入性模式可以在这些肿块的特征和诊断和管理计划中发挥重要作用。在此病例报告中,我们描述了使用各种形式的无创成像技术来缩小鉴别诊断范围,并形成一个心脏肿块的手术计划,后来在组织学检查中确定为起源于右心室的良性黏液瘤。
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引用次数: 0
DNAH11 and a Novel Genetic Variant Associated with Situs Inversus: A Case Report and Review of the Literature. DNAH11和一种与位置反向相关的新遗传变异:一个病例报告和文献综述。
IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.1155/2023/8436715
Fatemeh Sodeifian, Noosha Samieefar, Sepideh Shahkarami, Elham Rayzan, Simin Seyedpour, Meino Rohlfs, Christoph Klein, Delara Babaie, Nima Rezaei

Background: Primary ciliary dyskinesia (PCD), also known as the immotile-cilia syndrome, is a clinically and genetically heterogeneous syndrome. Improper function of the cilia causes impaired mucociliary clearance. Neonatal respiratory distress, rhinosinusitis, recurrent chest infections, wet cough, and otitis media are respiratory presentations of this disease. It could also manifest as infertility in males as well as laterality defects in both sexes, such as situs abnormalities (Kartagener syndrome). During the past decade, numerous pathogenic variants in 40 genes have been identified as the causatives of primary ciliary dyskinesia. DNAH11 (dynein axonemal heavy chain 11) is a gene that is responsible for the production of cilia's protein and encodes the outer dynein arm. Dynein heavy chains are motor proteins of the outer dynein arms and play an essential role in ciliary motility. Case Presentation. A 3-year-old boy, the offspring of consanguineous parents, was referred to the pediatric clinical immunology outpatient department with a history of recurrent respiratory tract infections and periodic fever. Furthermore, on medical examination, situs inversus was recognized. His lab results revealed elevated levels of erythrocyte sedimentation rate (ESR) and C reactive protein (CRP). Serum IgG, IgM, and IgA levels were normal, while IgE levels were elevated. Whole exome sequencing (WES) was performed for the patient. WES demonstrated a novel homozygous nonsense variant in DNAH11 (c.5247G > A; p. Trp1749Ter).

Conclusion: We reported a novel homozygous nonsense variant in DNAH11 in a 3-year-old boy with primary ciliary dyskinesia. Biallelic pathogenic variants in one of the many coding genes involved in the process of ciliogenesis lead to PCD.

背景:原发性纤毛运动障碍(PCD),也被称为不动纤毛综合征,是一种临床和遗传异质性综合征。纤毛功能不正常导致纤毛黏液清除受损。新生儿呼吸窘迫、鼻窦炎、复发性胸部感染、湿咳和中耳炎是本病的呼吸道表现。它也可能表现为男性不育,以及两性的侧性缺陷,如部位异常(Kartagener综合征)。在过去的十年中,40个基因中的许多致病变异已被确定为原发性纤毛运动障碍的病因。DNAH11(动力蛋白轴突重链11)是一种基因,负责产生纤毛蛋白并编码外动力蛋白臂。动力蛋白重链是动力蛋白外臂的运动蛋白,在纤毛运动中起重要作用。案例演示。1例3岁男童,系近亲父母所生,以反复呼吸道感染及周期性发热病史转介至儿科临床免疫门诊。此外,在医学检查中,确认了倒位。他的实验室结果显示红细胞沉降率(ESR)和C反应蛋白(CRP)水平升高。血清IgG、IgM、IgA水平正常,IgE水平升高。对患者进行全外显子组测序。WES在DNAH11中发现了一个新的纯合无义变异(c.5247G > a;Trp1749Ter页)。结论:我们报道了一个3岁男孩原发性纤毛运动障碍DNAH11的新纯合无义变异。参与纤毛发生过程的许多编码基因之一的双等位致病变异导致PCD。
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引用次数: 0
Association of CYP2C9∗3 and CYP2C8∗3 Non-Functional Alleles with Ibuprofen-Induced Upper Gastrointestinal Toxicity in a Saudi Patient. CYP2C9∗3和CYP2C8∗3非功能等位基因与布洛芬诱导的沙特患者上胃肠道毒性的关系。
IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.1155/2023/6623269
Amina M Bagher

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) widely used to alleviate pain and inflammation. Although it is generally considered safe, common adverse drug reactions of ibuprofen include stomach pain, nausea, and heartburn. It can also cause gastrointestinal (GI) bleeding, especially in individuals with a history of GI ulcers or bleeding disorders. Ibuprofen is predominantly metabolized by the cytochrome P450 (CYP) enzymes CYP2C9 and CYP2C8. Individuals carrying the CYP2C93 or CYP2C83 non-functional alleles have reduced enzyme activities resulting in elevated ibuprofen plasma concentrations and half-life. We presented a case of a 31-year-old Saudi female patient with a history of rheumatoid arthritis (RA) who had taken ibuprofen at 600 mg twice daily for eight weeks. The patient presented to the emergency department with symptoms including nausea, vomiting, severe abdominal pain, and black tarry stools. An emergency esophagogastroduodenoscopy was performed on the patient, which revealed a deep bleeding ulcer measuring 1 × 1 cm in the antrum of the stomach. Laboratory investigations indicated anemia (hemoglobin: 7.21 g/dL and hematocrit: 22.40 g/dl). The patient received intravenous proton pump inhibitors and a packed red blood cell transfusion. Genetic analysis revealed that the patient was a carrier of CYP2C93 and CYP2C83 variant alleles, indicating that the patient is a poor metabolizer for both enzymes. The patient's symptoms improved over the subsequent days, and she was discharged with instructions to avoid NSAIDs. This is the first reported Saudi patient homozygous for CYP2C93 and CYP2C83 variant alleles, which led to ibuprofen-induced upper GI toxicity. This case demonstrates the importance of contemplating CYP2C9 and CYP2C8 genetic variations when administrating NSAIDs like ibuprofen. Careful assessment of the risks and benefits of NSAID therapy in each patient and consideration of alternative pain management strategies must be conducted when appropriate.

布洛芬是一种非甾体抗炎药(NSAID),广泛用于减轻疼痛和炎症。尽管布洛芬通常被认为是安全的,但常见的不良药物反应包括胃痛、恶心和胃灼热。它还可以引起胃肠道出血,特别是有胃肠道溃疡或出血性疾病史的个体。布洛芬主要由细胞色素P450 (CYP)酶CYP2C9和CYP2C8代谢。携带CYP2C9 * 3或CYP2C8 * 3非功能等位基因的个体酶活性降低,导致布洛芬血药浓度和半衰期升高。我们报告了一例31岁的沙特女性患者,有类风湿关节炎(RA)病史,服用布洛芬600毫克,每日两次,持续8周。患者以恶心、呕吐、剧烈腹痛和黑焦油样便等症状就诊于急诊科。对患者进行了紧急食管胃十二指肠镜检查,发现胃窦处有1 × 1 cm的深出血溃疡。实验室检查显示贫血(血红蛋白:7.21 g/dL,红细胞压积:22.40 g/dL)。患者接受静脉注射质子泵抑制剂和填充红细胞输注。遗传分析显示患者是CYP2C9∗3和CYP2C8∗3变异等位基因的携带者,表明患者是两种酶的不良代谢者。在随后的几天里,病人的症状有所改善,她出院时被告知要避免使用非甾体抗炎药。这是首次报道的沙特患者CYP2C9∗3和CYP2C8∗3变异等位基因纯合,导致布洛芬诱导的上消化道毒性。本病例表明,在给药布洛芬等非甾体抗炎药时,考虑CYP2C9和CYP2C8基因变异的重要性。在适当的时候,必须仔细评估每位患者使用非甾体抗炎药治疗的风险和益处,并考虑其他疼痛管理策略。
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引用次数: 2
Recurrent Strokes in a Woman with a History of Thrombotic Thrombocytopenic Purpura. 有血栓性血小板减少性紫癜病史的女性复发性中风。
IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.1155/2023/7070189
Ijele Adimora, Bingnan Zhang, Modupe Idowu

Thrombotic thrombocytopenic purpura (TTP) is a microangiopathy characterized by mechanical hemolytic anemia, resulting in end-organ damage. We describe a case of TTP which presented as an ischemic stroke. The patient presented with stroke as the primary manifestation of TTP despite a normal platelet count and mildly elevated lactate dehydrogenase level (LDH). The patient underwent two transfusions of fresh frozen plasma (FFP), and ADAMTS13 levels confirmed the diagnosis of TTP after discharge. This case demonstrates the importance of maintaining a high index of suspicion for TTP in the setting of normal laboratory values and reveals the many atypical manifestations of TTP.

血栓性血小板减少性紫癜(TTP)是一种以机械性溶血性贫血为特征的微血管疾病,导致终末器官损伤。我们描述了一例TTP的表现为缺血性中风。尽管患者血小板计数正常,乳酸脱氢酶(LDH)水平轻度升高,但TTP的主要表现为卒中。患者接受了两次新鲜冷冻血浆(FFP)输注,出院后ADAMTS13水平证实TTP的诊断。该病例显示了在正常实验室值的情况下,对TTP保持高度怀疑的重要性,并揭示了TTP的许多非典型表现。
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引用次数: 0
Antithrombin Deficiency Is Associated with a Novel Homozygous Detrimental Mutation in SERPINC1 Gene in a Saudi Female. 在沙特女性中,抗凝血酶缺乏与serpin1基因的一种新的纯合有害突变有关。
IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.1155/2023/8872346
Sana Alqarni, Baraah Alqarni, Abdulrahman Alsultan

Antithrombin (AT) deficiency is a blood disorder associated with an increased tendency to form thrombosis. Hereditary AT deficiency is frequently caused by mutations in SERPINC1 gene. It is usually inherited as an autosomal dominant with variable penetrance. Homozygous pathogenic mutations in this gene are extremely rare. We present a case of a 7-year-old female who presented at age of 4 years with massive cerebral sinus venous thrombosis. Thrombophilia workup showed a low AT level of 30%. Targeted genetic sequencing of SERPINC1 revealed a novel pathogenic homozygous mutation c.1320C>G p. (Phe440Leu). The patient was managed initially with unfractionated heparin with AT replacement using fresh frozen plasma and was later switched to only low-molecular-weight heparin. There was no recurrence or new thrombosis with 3 years of follow-up.

抗凝血酶(AT)缺乏症是一种与血栓形成倾向增加相关的血液疾病。遗传性AT缺乏症通常由serpin1基因突变引起。它通常作为常染色体显性遗传,具有可变外显率。这种基因的纯合子致病性突变极为罕见。我们提出的情况下,一个7岁的女性谁在4岁时提出了大量的脑窦静脉血栓形成。血栓形成检查显示AT水平低至30%。serpin1基因测序发现了一个新的致病纯合突变c.1320C>G . p. (Phe440Leu)。患者最初使用未分离肝素,并用新鲜冷冻血浆替代AT,后来改用低分子量肝素。随访3年,无复发及新的血栓形成。
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引用次数: 0
Splenic Lymphangioma Mimicking Lymphomatous Involvement: A Case Report with Review of the Literature. 模拟淋巴瘤累及的脾淋巴管瘤1例并文献复习。
IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.1155/2023/9969213
Neda Soleimani, Fatemeh Pouraminaee, Mohammad Hossein Anbardar, Ali Bahador, Benyamin Rahimi, Sahand Mohammadzadeh, Fatemeh Aghakhaninejad, Mohammad Farahmand, Mahsa Hasani

Lymphangioma is a benign malformation of lymphatic vessels usually found in the head and neck areas or axilla. They may involve visceral organs with a lower percentage. Splenic lymphangioma is a rare tumor. This disease is often seen in children but may be diagnosed incidentally in adults. Most patients are asymptomatic, but in large and multifocal lesions, the patient may have some nonspecific symptoms such as abdominal pain, abdominal distention, nausea, vomiting, and loss of appetite. Physical examination may show no specific findings or detect palpable masses. The preoperative diagnosis of splenic lymphangioma is challenging. Histopathological evaluation and sometimes immunohistochemistry tests can result in a definitive diagnosis. In this study, we present an 18-year-old man, with Burkitt's lymphoma who underwent laparotomy and total splenectomy as a result of cystic lesions discovered accidentally during imaging with the final diagnosis of splenic lymphangioma after histopathological evaluation.

淋巴管瘤是一种良性的淋巴管畸形,常见于头颈部或腋窝。它们可能涉及比例较低的内脏器官。脾淋巴管瘤是一种罕见的肿瘤。这种疾病常见于儿童,但也可能在成人中偶然诊断出来。大多数患者无症状,但在大面积和多灶性病变中,患者可能有一些非特异性症状,如腹痛、腹胀、恶心、呕吐和食欲不振。体格检查可能没有特别的发现或发现可触及的肿块。脾淋巴管瘤的术前诊断具有挑战性。组织病理学评估和有时免疫组织化学测试可导致明确的诊断。在这项研究中,我们报告了一名18岁的伯基特淋巴瘤患者,由于在影像学中意外发现囊性病变,接受了剖腹手术和全脾切除术,经组织病理学评估后最终诊断为脾淋巴管瘤。
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引用次数: 0
Neurologic and Thrombotic Complications in the Setting of Chronic Nitrous Oxide Abuse. 慢性一氧化二氮滥用的神经系统和血栓并发症。
IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.1155/2023/5058771
Erin Meier, Monica Malviya, Sukhdeep Kaur, Jacklynn Ibrahim, Andrew Corrigan, Andrew Moawad, Sathya Alekhya Bukkuri, Joshua Trebach, Mark K Su, Manju Pillai

Nitrous oxide is a commonly used inhaled anesthetic for medical procedures, as well as a drug of abuse throughout the world. Excessive nitrous oxide inhalation has been shown to cause a functional vitamin B12 deficiency and hyperhomocysteinemia, which can lead to peripheral neuropathy and hypercoagulability, respectively. While the development of neurologic toxicity from chronic nitrous oxide abuse (i.e., encephalopathy, myelopathy, and neuropathy) has been previously described, the thrombotic potential of chronic nitrous oxide abuse is less known. The authors report two cases of nitrous oxide abuse leading to both neurologic and thrombotic complications.

一氧化二氮是医疗过程中常用的吸入麻醉剂,也是世界各地滥用的药物。过量吸入一氧化二氮已被证明会导致功能性维生素B12缺乏症和高同型半胱氨酸血症,这两种疾病分别会导致周围神经病变和高凝血症。虽然慢性一氧化二氮滥用的神经毒性(即脑病、脊髓病和神经病)的发展已经被描述过,但慢性一氧化二氮滥用的血栓形成潜力却鲜为人知。作者报告了两例一氧化氮滥用导致神经系统和血栓并发症。
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引用次数: 0
Restenosis of Coronary Arteries in Patients with Coronavirus Infection: Case Series. 冠状病毒感染患者冠状动脉再狭窄:病例系列。
IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.1155/2023/3000420
Gulnara Batenova, Lyudmila Pivina, Evgeny Dedov, Altay Dyussupov, Zhanar Zhumanbayeva, Yerbol Smail, Tatyana Belikhina, Laura Pak, Diana Ygiyeva

Introduction: Coronavirus infection is a risk factor for vascular thrombosis. This is of particular importance for patients undergoing myocardial revascularization since this infection can be a trigger for the formation of restenosis in the area of a previously implanted coronary stent. Understanding the risk factors for stent thrombosis and restenosis is of particular importance in individuals at risk for adverse outcomes. The rarity of such situations makes the present study unique.

Objective: Studying the peculiarities of restenosis and thrombosis of the coronary arteries in patients after coronavirus infection.

Methods: The study was performed in the Department of Cardiovascular Surgery of Emergency Hospital, Semey City, in 2021. We have examined the medical records of 10 consecutive patients with restenosis of coronary arteries after coronavirus infection and 10 matched-by-age patients with similar restenosis of coronary arteries who did not have coronavirus infection as a comparison group. To determine statistically significant differences between independent samples, we calculated the Mann-Whitney U test.

Results: The average age of patients was 65.7 years. Only one case was classified as early restenosis (within 8 days of previous revascularization), two cases represented late restenosis, and seven cases were very late restenoses. In 70% of cases, restenosis was localized in the left anterior descending artery, in 30% of cases, it was in the right coronary artery, and in 40% of cases, it was in the left circumflex artery. In comparison with patients who did not have a coronavirus infection, there were statistically significant differences regarding IgG (P < 0.001) and fibrinogen (P=0.019).

Conclusion: Patients with myocardial revascularization in the past have a higher risk of stent restenosis against the background of coronavirus infection due to excessive neointimal hyperplasia, hypercoagulability, increased inflammatory response, and endothelial dysfunction.

冠状病毒感染是血管血栓形成的危险因素。这对于接受心肌血运重建术的患者尤其重要,因为这种感染可能会触发先前植入的冠状动脉支架区域形成再狭窄。了解支架血栓形成和再狭窄的危险因素对有不良后果风险的个体尤为重要。这种情况的罕见性使得本研究是独一无二的。目的:探讨冠状病毒感染后冠状动脉再狭窄和血栓形成的特点。方法:研究于2021年在塞米市急诊医院心血管外科进行。我们检查了连续10例冠状病毒感染后冠状动脉再狭窄患者的医疗记录,以及10例相似冠状动脉再狭窄但未感染冠状病毒的按年龄匹配的患者作为对照组。为了确定独立样本之间的统计显著性差异,我们计算了Mann-Whitney U检验。结果:患者平均年龄65.7岁。仅1例为早期再狭窄(先前血运重建术后8天内),2例为晚期再狭窄,7例为极晚期再狭窄。70%的病例发生在左前降支,30%的病例发生在右冠状动脉,40%的病例发生在左旋动脉。与未感染冠状病毒的患者相比,IgG (P < 0.001)和纤维蛋白原(P=0.019)差异有统计学意义。结论:在冠状病毒感染背景下,既往行心肌血运重建术的患者由于内膜过度增生、高凝、炎症反应增高、内皮功能障碍等因素,发生支架再狭窄的风险较高。
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引用次数: 0
The First Registered Type 0 Spinal Muscular Atrophy Patient in Latvia: Call for Change in Prenatal Diagnostic Procedures. 拉脱维亚第一个登记的0型脊髓性肌萎缩症患者:呼吁改变产前诊断程序。
IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.1155/2023/3480298
Tīna Luīze Čupāne, Mikus Dīriks, Gita Tauriņa, Liene Korņejeva, Linda Gailīte, Ieva Mālniece, Madara Auzenbaha

This case report presents the first registered patient in Latvia with type 0 spinal muscular atrophy (SMA). During the first-trimester ultrasonography of the unborn patient, an increased thickness of the nuchal fold was detected. The mother reported decreased foetal movements during the pregnancy. After the boy was born, his general condition was extremely severe. The clinical signs indicated a suspected neuromuscular disorder. A precise diagnosis, type 0 SMA, was determined 7 days after birth through a newborn pilot-screening for SMA, which was conducted for all newborns whose parents consented to participate. The condition of the infant deteriorated. He had severe respiratory distress followed by multiple events leading to his death. Currently, there are only a few published case reports detailing an increased nuchal translucency (NT) measurement in association with a diagnosis of SMA in the foetus. However, an increased NT measurement is a clinically relevant sign as it can be related to genetic syndromes, foetal malformations, disruptions, and dysplasias. Since there is no cure for infants with type 0 SMA at present, it is crucial to be able to detect this disease prenatally in order to provide the best possible care for the patient and parents. This includes the provision of palliative care for the patient, among other measures. This case report highlights the prenatal signs and symptoms in relation to type 0 SMA.

本病例报告介绍了拉脱维亚第一例0型脊髓性肌萎缩症(SMA)的注册患者。在未出生患者的妊娠早期超声检查中,发现颈褶厚度增加。这位母亲报告说,怀孕期间胎动减少。这个男孩出生后,他的一般情况非常严重。临床症状显示疑似神经肌肉紊乱。出生后7天,通过对所有父母同意参加的新生儿进行SMA试点筛查,确定了精确的诊断,即0型SMA。婴儿的情况恶化了。他有严重的呼吸窘迫,随后发生了多种事件导致他死亡。目前,只有少数已发表的病例报告详细介绍了增加的颈部透明度(NT)测量与胎儿SMA诊断的关系。然而,增加的NT测量是一个临床相关的迹象,因为它可能与遗传综合征,胎儿畸形,中断和发育不良有关。由于目前没有治愈0型SMA婴儿的方法,因此能够在产前检测出这种疾病,以便为患者和父母提供最好的护理是至关重要的。除其他措施外,这包括为患者提供姑息治疗。本病例报告强调了与0型SMA相关的产前体征和症状。
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引用次数: 0
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Case Reports in Medicine
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