Peutz-Jeghers综合征:一种罕见的肠梗阻遗传原因

A. M. M. Rana, Taufiqul Haque, Kallol Chandra Dew
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摘要

Peutz-Jeghers综合征(PJS)是一种罕见的常染色体显性遗传病。突变发生在19号染色体上的丝氨酸苏氨酸激酶(STK11)/肝激酶B1 (LKB1)基因上。每5万到20万人中就有1人受到影响。临床表现为口腔、唇部、指尖及肛周色素沉着。腹痛、贫血、胃肠道出血、胃肠道息肉、肠梗阻(多由肠套叠引起)及恶性肿瘤与本病密切相关。我们报告了一位21岁的女性,她的嘴唇和指尖有特征性的色素沉着病变,并伴有消化道的多发息肉。病人以腹痛和呕吐在普通急诊科就诊。详细检查显示诊断为PJS。由于缺乏遗传分析设备,我们已根据世界卫生组织的标准绘制诊断图。PJS患者发生肠道和肠外恶性肿瘤的风险较高。早期诊断和息肉切除术以及监测复发可以延长癌症的生存期。中华医学杂志2023年1月12期01号P: 115- 120
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Peutz–Jeghers Syndrome: A Rare Genetic Cause of Intestinal Obstruction
Peutz–Jeghers syndrome (PJS) is a rare autosomal dominant disorder. The mutation is found in the serine threonine kinase (STK11)/ liver kinase B1 (LKB1) gene on chromosome 19. It impacts 1 out of 50000–200000 individuals. Clinical menifestations include hyperpigmented lesion in oral cavity, lips, fingertips and perianal region. Abdominal pain, Anaemia, Gastrointestinal (GI) bleeding, GI polyp, Intestinal obstruction (mostly due to intussusception) and malignancy are closely interlinked with the disease. We present a 21 years old lady with characteristic hyperpigmented lesions in lips and fingertips with multiple polyps in the GI tract. The patient was presented in general emergency department with abdominal pain and vomiting. Detail workout revealed the diagnosis as PJS. We have plotted the diagnosis according to the WHO criteria due to the lacking of genetic analysis facility. Patients with PJS are at high risk of intestinal and extraintestinal malignancy. Early diagnosis and polypectomy along with surveillance for recurrence may prolong cancer free lifetime. CBMJ 2023 January: Vol. 12 No. 01 P: 115- 120
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