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一例土耳其患者,患有皮质下/室管膜下异位,伴有胼胝体发育不全、颅面畸形、严重眼部异常以及生长发育和智力迟缓。

A Turkish case of subcortical/subependymal heterotopia associated with corpus callosum dysgenesis, craniofacial dysmorphism, severe eye abnormalities, and growth-mental retardation.

作者信息

Caksen H, Tuncer O, Ataş B, Demirok A, Unal O, Ikbal M, Odabaş D

机构信息

Department of Pediatrics, Yüzüncü Yil University, Faculty of Medicine, Van, Turkey.

出版信息

Genet Couns. 2003;14(3):343-8.

Abstract

The patient is a 12-year-old boy with a history of learning disability, growth retardation, and strabismus. Weight, height and head circumference were below the 3rd percentile. A café-au-lait spot, 1x1 cm a diameter, on the back region and pectus excavatum deformity were diagnosed. He had facial asymmetry, a broad nose, sparse eyebrows and eyelashes, a rudimentary frontal sinus, deviation of the nasal septum, and bilateral small maxillary bones. The left orbital fossa was also mildly rudimentary. On eye examination the movements of the left globe to the upward and lateral side were limited and internal strabismus was noted at this side. Visual acuity was 1/10, bilaterally. Bilateral choroid coloboma, glaucoma, vertical and horizontal nystagmus were diagnosed. Fundoscopic examination revealed bilateral optic atrophy and macular and paramacular granulation tissues on the left side. Intelligence quotient was 46. Electroencephalography revealed bilateral frontal slow-wave activity. Visual evoked potential revealed prolonged p100 wave latencies bilaterally. Magnetic resonance imaging of the brain demonstrated corpus callosum dysgenesis, bilateral subcortical heterotopia in the frontal lobes and subependymal heterotopia in the posterior horn of the left ventricle. Chromosomal analysis revealed a normal male karyotype, 46, XY. Although several cases of heterotopia in association with mental retardation, craniofacial dysmorphism, cerebral, and eye abnormalities have been described the combination of abnormalities diagnosed in our case has not previously been reported. We hypothesize that the combination of subcortical/subependymal heterotopia, corpus callosum dysgenesis, craniofacial dysmorphism, severe eye abnormalities, and growth-mental retardation may be a new syndrome.

摘要

该患者是一名12岁男孩,有学习障碍、生长发育迟缓及斜视病史。体重、身高和头围均低于第3百分位数。诊断出背部有一个直径1×1厘米的咖啡牛奶斑和漏斗胸畸形。他有面部不对称、宽鼻、眉毛和睫毛稀疏、额窦发育不全、鼻中隔偏曲以及双侧上颌骨较小。左侧眼眶窝也轻度发育不全。眼部检查发现左眼向上和向外侧运动受限,且该侧存在内斜视。双眼视力均为1/10。诊断出双侧脉络膜缺损、青光眼、垂直和水平眼球震颤。眼底检查显示双侧视神经萎缩以及左侧黄斑和黄斑旁颗粒组织。智商为46。脑电图显示双侧额叶慢波活动。视觉诱发电位显示双侧p100波潜伏期延长。脑部磁共振成像显示胼胝体发育不全、双侧额叶皮质下异位以及左侧脑室后角室管膜下异位。染色体分析显示为正常男性核型,46, XY。尽管此前已描述过几例与智力发育迟缓、颅面畸形、脑部和眼部异常相关的异位病例,但我们病例中所诊断出的异常组合此前尚未见报道。我们推测皮质下/室管膜下异位、胼胝体发育不全、颅面畸形、严重眼部异常以及生长 - 智力发育迟缓的组合可能是一种新的综合征。

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