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[普拉德-威利综合征的诊断。关于一例误诊病例的思考]

[Diagnosis of Prader-Willi syndrome. Considerations on a case of erroneous diagnosis].

作者信息

Scommegna S, Zollino M, Paolone G

机构信息

Azienda Ospedaliera S. Camillo, Forlanini, Circ.ne Gianicolense, 87, 00149 Roma, Italia.

出版信息

Pediatr Med Chir. 2001 May-Aug;23(3-4):191-6.

Abstract

Prader-Willi syndrome is a genetic disease, which is clinically characterized by neonatal hypotonia, feeding problems in the first year of life, excessive eating with severe obesity from the second year of life, developmental delay, hypogonadism, typical facial features, short stature, behaviour problems, mental retardation. It is caused by a genomic imprinting disorder, i.e., lacking expression of paternally derived genes located on the long arm of chromosome 15. We present a case of a child with a neonatal diagnosis of Prader-Willi syndrome, founded on some facial dysmorphic features and a partial deletion of 15q, which we belied thanks to an anamnestic and clinical revaluation, and a metilation test. We also present main topics about Prader-Willi syndrome diagnosis, including clinical and endocrinological features, scoring system, and genetics.

摘要

普拉德-威利综合征是一种遗传性疾病,其临床特征为新生儿肌张力减退、出生后第一年出现喂养问题、从第二年起过度进食且严重肥胖、发育迟缓、性腺功能减退、典型面部特征、身材矮小、行为问题、智力障碍。它由一种基因组印记紊乱引起,即位于15号染色体长臂上的父源基因缺乏表达。我们报告一例新生儿期诊断为普拉德-威利综合征的患儿病例,诊断依据是一些面部畸形特征和15q部分缺失,但通过病史及临床重新评估和甲基化检测,我们推翻了该诊断。我们还介绍了普拉德-威利综合征诊断的主要内容,包括临床和内分泌特征、评分系统及遗传学。

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