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[达农病:一例病例报告及文献综述]

[Danon disease: a case report and literature overview].

作者信息

Catović Suad, Otasević Petar

出版信息

Srp Arh Celok Lek. 2007 Mar-Apr;135(3-4):197-200. doi: 10.2298/sarh0704197c.

Abstract

Danon disease, a rare glycogen storage disease, is a dominant X-linked disorder. It is due to mutation in gene for lysosome-associated membrane protein 2 (LAMP 2). The LAMP 2 gene is located on Xq24, and its mutation causes primary deficiency of LAMP 2 and myocyte hypertrophy by accumulations of vacuoles containing glycogen. Danon disease is clinically characterized by the triad of hypertrophic cardiomyopathy (HCM), proximal myopathy and mental retardation. Myopathy and mental retardation can be absent, and cardiomyopathy is usually hypertrophic. This is a case report of the patient with genetically confirmed Danon disease and mixed cardiomyopathy, but without myopathy and mental retardation. ECG showed typical Wolff-Parkinson-White (WPW) pattern while echocardiography demonstrated hypertrophy and dilatation of all cardiac chambers with impaired systolic and diastolic function. Male sex, early onset of symptoms, massive hypertrophy of the myocardium and ventricular preexcitation indicate a genetic basis for HCM. Therapeutic measures, except heart transplantation, do not improve prognosis substantially. Only an accurate diagnosis in patients with unexplained HCM helps in establishing of the appropriate treatment strategies and adequate genetic consultation.

摘要

丹农病是一种罕见的糖原贮积病,是一种X连锁显性疾病。它是由于溶酶体相关膜蛋白2(LAMP 2)基因发生突变所致。LAMP 2基因位于Xq24,其突变导致LAMP 2原发性缺乏以及含有糖原的空泡积聚引起心肌细胞肥大。丹农病的临床特征为肥厚型心肌病(HCM)、近端肌病和智力发育迟缓三联征。肌病和智力发育迟缓可能不存在,心肌病通常为肥厚型。本文报告一例经基因确诊为丹农病且合并心肌病,但无肌病和智力发育迟缓的患者。心电图显示典型的预激综合征(WPW)图形,而超声心动图显示所有心腔肥厚和扩张,收缩和舒张功能受损。男性、症状早发、心肌大量肥厚和心室预激提示HCM存在遗传基础。除心脏移植外,治疗措施并不能显著改善预后。只有对不明原因的HCM患者进行准确诊断,有助于制定合适的治疗策略和进行充分的遗传咨询。

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