Contreras Mónica, Rocca Ana, Benedetti Laura, Kakisu Hisae, Delgado Sabrina, Ruiz José Antonio
Servicio de Gastroenterología, Hospital de Pediatría J.P. Garrahan.
Acta Gastroenterol Latinoam. 2005;35(2):99-103.
Congenital chloride diarrhea (CCD) is a rare hereditary disease, with a prenatal onset, secondary to a deficit in the intestinal chloride transport. In the present study, we describe the clinical characteristics of three patients with congenital watery diarrhea, two of them females, aged between 9 and 14 months at the first visit. All patients presented perinatal antecedents of polyhydramnios and prematurity, watery stools since birth and growth failure. Metabolic alkalosis, hypokalemia and hypochloremia were found. Stool ionogram with elevated doses of chloride, exceeding both sodium and potassium, confirmed the diagnosis of CCD. Substitute treatment with sodium and potassium chloride was started with good results. CCD should be considered as a differential diagnosis to congenital watery diarrhea, since early diagnosis and appropriate treatment are mandatory for the normal development of the child, avoiding severe complications such as neurological sequelae and even death.
先天性氯腹泻(CCD)是一种罕见的遗传性疾病,产前发病,继发于肠道氯转运缺陷。在本研究中,我们描述了3例先天性水样腹泻患者的临床特征,其中2例为女性,初诊时年龄在9至14个月之间。所有患者均有围产期羊水过多和早产史,自出生起即有水样便和生长发育迟缓。发现有代谢性碱中毒、低钾血症和低氯血症。粪便离子图显示氯含量升高,超过钠和钾,确诊为CCD。开始用氯化钠和氯化钾替代治疗,效果良好。应将CCD视为先天性水样腹泻的鉴别诊断,因为早期诊断和适当治疗对儿童的正常发育至关重要,可避免严重并发症,如神经后遗症甚至死亡。