拉森综合征、抗磷脂综合征、膈疝和结肠息肉的病例报告:隐性关联还是单纯巧合?

Shashwat Mallik, Shahin Khan, Aayushi J Rajani, Juhi Amin, Darshankumar Manubhai Raval
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引用次数: 0

摘要

拉森综合征是一种极为罕见的骨骼疾病,以多发性骨骼畸形和关节挛缩为特征,使人衰弱。一名 47 岁的女性患有这种严重的疾病,包括功能性四肢瘫痪、肢体萎缩和各种骨科手术。这是唯一一例抗磷脂抗体综合征(APLA)和拉森氏综合征同时存在的病例。虽然已知拉森综合征的遗传基础涉及丝胺 B(FLNB)基因突变,但该患者的独特表现和复杂的临床病史更增加了几分耐人寻味。耐人寻味的是,APLA 易导致血栓事件,但该患者表现为直肠出血且凝血指标正常,这又是一个意想不到的转折。尽管没有明确的因果关系,但这一病例凸显了拉森综合征和 APLA 同时存在的罕见性。它们之间可能存在的相互作用和相互影响在很大程度上仍未得到探讨,这也凸显了在这一领域开展更多研究的必要性。在外科手术中处理 APLA 时也出现了错综复杂的情况。在多种抗凝药物之间转换的决定强调了为患有多种并发症的患者提供个体化综合治疗的必要性。该病例提出了拉森综合征与马凡氏综合征等结缔组织疾病之间可能存在重叠的问题,值得进一步探讨。该病例还强调了加强患者活动以预防卧床或坐轮椅患者血栓事件的重要性。这个病例极为特殊,具有遗传性骨骼疾病、自身免疫性疾病、复发性膈疝和结肠息肉引起的出血等特点,需要进一步研究和分析,以揭示这些疾病之间的潜在关联。
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A Case Report of Larsen's Syndrome, Antiphospholipid Syndrome, Diaphragmatic Hernia, and a Colon Polyp: A Hidden Association or a Mere Coincidence.

Larsen's syndrome is an exceedingly rare and debilitating skeletal disorder characterized by multiple bony deformities and joint contractures. A 47-year-old female grappled with its severe manifestations, including functional quadriplegia, limb atrophy, and various orthopedic surgeries. This is the only reported case of the concurrent presence of antiphospholipid antibody syndrome (APLA) and Larsen's syndrome. While Larsen's syndrome's genetic underpinnings are known to involve filamin B (FLNB) gene mutations, this patient's distinct presentation and complex clinical history added layers of intrigue. Intriguingly, APLA predisposes individuals to thrombotic events, but the patient's manifestation with rectal bleeding with normal coagulation parameters introduced an unexpected twist. Despite the absence of clear causative links, this case highlights the rarity of encountering Larsen's syndrome and APLA concurrently. Their potential interactions and mutual influence remain largely unexplored, underscoring the need for more research in this domain. Intricacies also emerged in the management of APLA within a surgical context. The decision to transition between anticoagulants underscores the necessity of individualized and comprehensive care for patients grappling with multiple comorbidities. It raises questions about the potential overlap between Larsen's syndrome and connective tissue diseases, like Marfan's syndrome, that warrant further exploration. The case also emphasizes the significance of increased patient mobilization to prevent thrombotic events in those who are bedridden or wheelchair-bound. This extremely unique presentation, featuring a genetic skeletal disorder, an autoimmune condition, recurrent diaphragmatic hernias, and a colon polyp-induced hemorrhage, beckons further research and analysis to unravel any potential associations between these conditions.

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