Noack F, Sayk F, Ressel A, Berg C, Gembruch U, Reusche E
Department of Pathology, Medical University of Lübeck, Germany.
Prenat Diagn. 2002 Nov;22(11):1011-5. doi: 10.1002/pd.458.
Asplenia associated with situs ambiguus, symmetric liver, bilateral trilobulated lungs, and a complex heart defect was diagnosed on autopsy in a 14-day-old infant. Furthermore, examination of the brain displayed agenesis of the corpus callosum (ACC) with pachygyria and hydrocephalus. The characteristic association of asplenia with visceroatrial heterotaxia is traditionally named after the Swedish pediatrician, Ivemark. Although exceptional, association of Ivemark syndrome with callosal agenesis has been reported recently. The concept of 'developmental fields' describes morphogenetically reactive units of the embryo determining and controlling the development of complex structures in a hierarchical manner. Lateralization defects such as situs inversus, asplenia or polysplenia due to defective left-right axis development, as well as decussation defects such as ACC, are considered as defects of the primary developmental field. Therefore, additional callosal agenesis in Ivemark syndrome may be a coherent and synchronic defect in the primary developmental field rather than a causally independent malformation.
一名14天大的婴儿尸检时被诊断为无脾症,伴有内脏位置不明确、肝脏对称、双侧肺叶呈三叶状以及复杂的心脏缺陷。此外,脑部检查显示胼胝体发育不全(ACC)伴巨脑回和脑积水。无脾症与内脏心房异位的特征性关联传统上以瑞典儿科医生伊韦马克(Ivemark)命名。尽管罕见,但最近有报道称伊韦马克综合征与胼胝体发育不全有关。“发育场”的概念描述了胚胎的形态发生反应单位以分层方式决定和控制复杂结构的发育。由于左右轴发育缺陷导致的侧化缺陷,如内脏反位、无脾症或多脾症,以及交叉缺陷,如胼胝体发育不全,都被认为是初级发育场的缺陷。因此,伊韦马克综合征中额外的胼胝体发育不全可能是初级发育场中一种连贯且同步的缺陷,而非因果独立的畸形。