Vuotto F, Chevrier E, Bourgeois E, Cambier N, Chevalier J, Rose C
Service d'hématologie, université catholique de Lille, boulevard de Belfort, 59020 Lille, France.
Rev Med Interne. 2008 Apr;29(4):315-8. doi: 10.1016/j.revmed.2007.10.006. Epub 2007 Oct 30.
We report a case of hemoglobinopathy which could be associated with a pseudoxanthoma elastic-like syndrome.
We report the case of a 26-year-old male patient with sickle cell anemia for which the supra-aortic-doppler ultrasonography suggested an asymptomatic left carotid artery of 70% stenosis. The magnetic resonance imaging and angiography showed a left megadolichocarotid with plicature suggestive of pseudoxanthoma elastic or a dilatation relative to a high rate of blood explaining the acceleration speed. There was a cutaneous infiltration but other vasculopathies of neither carotide, nor cerebral, nor ocular have been discovered while they were sometimes found in pseudoxanthoma elastic-like syndrome. This acquired form is different of rare hereditary disease by a later diagnosis, a clinical expression often very incomplete and a frequent association with hemoglobinopathies.
This observation shows that RMA could be necessary to perform in adults, when cervical and transcranial Doppler ultrasonography is abnormal, particularly before deciding to start long term blood transfusions. The hemoglobinopathy and pseudoxanthoma elastic-like syndrome must not be ignored because the control of cardiovascular factors reduce the risks of arterial complications.
我们报告一例血红蛋白病,其可能与弹性假黄瘤样综合征相关。
我们报告一名26岁男性镰状细胞贫血患者的病例,经主动脉弓多普勒超声检查显示左侧颈动脉无症状性狭窄70%。磁共振成像和血管造影显示左侧颈动脉迂曲延长并伴有褶皱,提示弹性假黄瘤或因血流速度加快导致的扩张。存在皮肤浸润,但未发现颈动脉、脑或眼部的其他血管病变,而这些病变在弹性假黄瘤样综合征中有时会出现。这种后天获得性形式与罕见的遗传性疾病不同,其诊断较晚,临床表型通常非常不完整,且常与血红蛋白病相关。
该病例表明,当颈部和经颅多普勒超声检查异常时,尤其是在决定开始长期输血之前,成人可能需要进行磁共振血管造影。血红蛋白病和弹性假黄瘤样综合征不容忽视,因为控制心血管因素可降低动脉并发症的风险。