Puertas-Bordallo D, De-Domingo-Barón B, Lozano-Vázquez M, Escudero-Díaz C, Ruiz-Falcó Rojas M L, Fernández-Fernández J
Sección de Oftalmología/Estrabología del Hospital Infantil Universitario Niño Jesús de Madrid, España.
Arch Soc Esp Oftalmol. 2007 Oct;82(10):649-52.
Alström-Hallgren syndrome is an inherited condition in which the transmission of a double dose of a mutated gene leads to specific clinical findings. To the present time there has been only one gene detected which leads to this syndrome, the ALMS1 gene. Mutation of this gene leads to progressive blindness due to photoreceptor dystrophy, progressive sensorineural hearing loss, insulin resistant diabetes, morbid obesity and cardiologic abnormalities.
We present the case of a four-year-old male who, after a cardiopulmonary shutdown in the fourth month of life, was diagnosed with a dilated cardiomyopathy. Nystagmus and photophobia followed, and, after ophthalmologic exploration and an electroretinogram, the results were consistent with Alström syndrome. The appropriate genetic studies were then performed.
The diagnosis in this case was considered basically because of its uncommon clinical features, and the fact a multidisciplinary approach was used in its evaluation. We were only able to confirm the diagnosis by molecular biology techniques, with this resulting in the correct diagnosis in 25-40% of cases. Treatment is symptomatic and the prognosis extremely variable.
阿尔斯特伦 - 霍尔格伦综合征是一种遗传性疾病,其中双倍剂量的突变基因传递会导致特定的临床症状。到目前为止,仅检测到一种导致该综合征的基因,即ALMS1基因。该基因的突变会导致由于光感受器营养不良引起的进行性失明、进行性感音神经性听力损失、胰岛素抵抗性糖尿病、病态肥胖和心脏异常。
我们报告一例4岁男性病例,该患儿在出生后第4个月发生心肺骤停,随后被诊断为扩张型心肌病。继而出现眼球震颤和畏光症状,经眼科检查和视网膜电图检查,结果与阿尔斯特伦综合征相符。随后进行了适当的基因研究。
该病例的诊断主要基于其不常见的临床特征以及在评估过程中采用了多学科方法。我们只能通过分子生物学技术来确诊,这在25% - 40%的病例中能得出正确诊断。治疗以对症治疗为主,预后差异极大。