Bardet-Biedl综合征患者的克罗恩病:随机异常还是罕见的表型特征?

Margot L Zuidhof, Tim G J de Meij, Sietse Q Nagelkerke, Anne M Smets, Ilan J N Koppen
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摘要

Bardet-Biedl综合征(BBS)是一种常染色体隐性多系统非运动性纤毛病。有关于BBS和自身免疫性疾病(包括炎症性肠病(IBD))共同发生的轶事报道。我们提出了首个BBS7患儿发展为克罗恩病的病例报告,增加了关于BBS和IBD之间关联的证据。一名13岁的女孩患有BBS7,表现为腹痛和明显的体重减轻(-13%),但没有其他IBD的典型症状,如腹泻和失血。粪钙保护蛋白升高,但胃镜和结肠镜检查未见宏观异常。超声和核磁共振显示肠狭窄,手术治疗。组织病理学检查证实为克罗恩病。总之,报告的BSS和自身免疫性疾病的共同发生以及该患者IBD的非典型表现,使得对有BBS和胃肠道症状的患者进行IBD诊断测试的门槛较低。
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Crohn's Disease in a Patient With Bardet-Biedl Syndrome: Random Anomaly or Rare Phenotypic Trait?

Bardet-Biedl syndrome (BBS) is an autosomal recessive multisystem nonmotile ciliopathy. There are anecdotal reports of the co-occurrence of BBS and autoimmune diseases, including inflammatory bowel disease (IBD). We present the first case report of a child with BBS7 who developed Crohn disease, adding to the evidence on the association between BBS and IBD. A 13-year-old girl with BBS7 presented with abdominal pain and significant weight loss (-13%), but without other classical symptoms of IBD, such as diarrhea and blood loss. Fecal calprotectin was elevated, but on gastroscopy and colonoscopy, no macroscopic abnormalities were found. Ultrasound and MRI revealed an intestinal stenosis which was treated surgically. Histopathological examination confirmed the diagnosis Crohn disease. In conclusion, the reported co-occurrence of BSS and autoimmune diseases and the atypical presentation of IBD in this patient warrant a low threshold to perform diagnostic tests for IBD in patients with BBS and gastrointestinal symptoms.

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