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[黑尿症:尿液变色的罕见原因。1例新生儿病例报告]

[Alkaptonuria: a rare cause of urine discoloration. Report of a case in a newborn].

作者信息

Adonis-Koffy L, Gonzalès E, Nathanson S, Spodek C, Bensman A

出版信息

Arch Pediatr. 2000 Aug;7(8):844-6. doi: 10.1016/s0929-693x(00)80194-3.

Abstract

UNLABELLED

Alcaptonuria is a rare hereditary disease, characterized by an abnormal blackish coloration of the urine and dark pigmentation of the conjunctive tissue which is due to a deficiency in homogentisate 1,2-dioxygenase (HGO), a phenylalanine catabolizing enzyme. An accumulation of homogentisate (HGA) is then formed, and is responsible for the dark coloration which only occurs after the urine has been exposed to air over a period of time. Signs of this disorder therefore frequently remain unnoticed during childhood, because the urine requires a relatively long exposure to air before it changes color. Diagnosis is generally made at a later date, during adulthood, following complications such as ochronosis, inflammatory arthritis, or urinary calculi.

CASE REPORT

In this study, the case has been described of alcaptonuria diagnosed in a five-month old infant. No efficient cure has yet been found, although certain treatments, including high doses of vitamin C, do seem to have a beneficial effect on limiting the complications associated with this disorder. Early diagnosis whenever possible is therefore important.

CONCLUSION

This case report is interesting because of the early diagnosis involved. In the event of any abnormal coloration of the urine, diagnosis may be established via the addition of an alkylating agent, and the levels of HGA determined by chromatography.

摘要

未标注

黑尿症是一种罕见的遗传性疾病,其特征是尿液异常变黑以及结膜组织色素沉着,这是由于苯丙氨酸分解代谢酶尿黑酸1,2 -双加氧酶(HGO)缺乏所致。随后形成尿黑酸(HGA)积聚,这导致尿液在暴露于空气中一段时间后才会出现的深色。因此,这种疾病的症状在儿童期常常未被注意到,因为尿液需要较长时间暴露于空气中才会变色。诊断通常在成年期后期,在出现如褐黄病、炎性关节炎或尿路结石等并发症之后进行。

病例报告

在本研究中,描述了一名5个月大婴儿被诊断为黑尿症的病例。尽管包括高剂量维生素C在内的某些治疗方法似乎确实对限制与此疾病相关的并发症有有益效果,但尚未找到有效的治愈方法。因此,尽可能早期诊断很重要。

结论

该病例报告因其涉及早期诊断而有趣。如果尿液出现任何异常颜色,可通过添加烷基化剂来进行诊断,并通过色谱法测定HGA水平。

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