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伴有胃腺癌的IV型埃勒斯-当洛综合征

Ehlers-Danlos syndrome type IV with gastric adenocarcinoma.

作者信息

Kanechorn Na Ayuthaya Rajyani, Patthamapasphong Nonthaya, Sura Thanyachai, Niumpradit Nucha, Trachoo Objoon

机构信息

Department ofDermatology, Phramongkutklao Hospital, Thailand.

出版信息

J Med Assoc Thai. 2008;91 Suppl 1:S166-71.

Abstract

BACKGROUND

Ehlers-Danlos syndrome has many subtypes. The vascular type (type IV) is characterized by thin, translucent skin, easy bruising, characteristic facial appearance, and arterial, intestinal, and/or uterine fragility.

OBJECTIVES

To encourage a better understanding of vascular EDS as a basis for early diagnosis, prevention, and management of complications. A first case of EDS type IV with adeno-carcinoma of the stomach in Thailand was reported and literature was reviewed.

RESULT

A 62-year-old Thai priest was admitted in Priest Hospital because of progressive muscle weakness of both legs with neurogenic claudication from compression fracture of L1-2. Abdominal aortic aneurysm were detected with upper gastrointestinal hemorrhage, esophagogastroduodenoscopy showed diffuse gastric body swelling and erythema resulting in chronic gastritis. Gastric biopsy was indicative of adenocarcinoma of the stomach and gastrectomy was done. Dermatologists were consulted due to generalized cutaneous pain, easy bruising following venepuncture, and EKG padding. A vascular EDS type IV was diagnosed.

CONCLUSION

After gastrectomy, the patient became drowsy and unconscious from profuse recurrent cerebral hemorrhage and expired.

摘要

背景

埃勒斯-当洛综合征有多种亚型。血管型(IV型)的特征为皮肤薄且半透明、易出现瘀伤、具有特征性面容以及动脉、肠道和/或子宫脆弱。

目的

促进对血管型埃勒斯-当洛综合征的更好理解,作为早期诊断、预防和处理并发症的基础。报告了泰国首例IV型埃勒斯-当洛综合征合并胃癌的病例并对文献进行了回顾。

结果

一名62岁的泰国牧师因L1-2压缩性骨折导致双下肢进行性肌无力伴神经源性间歇性跛行入住牧师医院。检测发现腹主动脉瘤并伴有上消化道出血,食管胃十二指肠镜检查显示胃体弥漫性肿胀和红斑,诊断为慢性胃炎。胃活检提示胃癌,遂行胃切除术。因全身皮肤疼痛、静脉穿刺后易出现瘀伤以及心电图电极片接触部位皮肤表现,咨询了皮肤科医生。诊断为IV型血管型埃勒斯-当洛综合征。

结论

胃切除术后,患者因大量反复脑出血而变得嗜睡和昏迷,最终死亡。

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