Department of Pediatrics, University of Naples, Federico II, Italy.
Acta Paediatr. 2010 Apr;99(4):632-5. doi: 10.1111/j.1651-2227.2009.01608.x. Epub 2009 Nov 27.
Blue Rubber Bleb Nevus Syndrome (BRBNS) is a rare condition characterized by multiple venous malformations involving the skin and internal organs. The gastrointestinal tract is always involved and intestinal haemorrhage is the most frequent clinical manifestation associated with iron deficiency anaemia. We describe a 10-year-old girl who, since birth, presented numerous venous malformations all over her body and a lymphangioma in the right leg. At the age of 5 years, she also had a severe episode of gastric bleeding requiring a blood transfusion. From this episode, she is suffering from chronic anaemia and this is the reason for admission into our hospital. The endoscopic examination of the gastrointestinal tract revealed multiple giant venous malformations in the oesophagus, stomach, duodenum and in all visible sections of the colon. Endoscopy is the gold standard technique for the diagnosis of BRBNS with GI lesions and also allows immediate therapeutic measures such as argon plasma coagulation, laser photocoagulation, sclerotherapy or band ligation. In addition, pharmacological treatments based on corticosteroids, interferon alfa, vincristine or octreotide have been described for BRBNS.
Blue Rubber Bleb Nevus Syndrome is a congenital cutaneous and gastrointestinal haemangiomatosis. Its morbidity and mortality depends on involvement of visceral organs and particularly on GI bleeding. The treatment is based on pharmacological or surgical therapy. Overall, the most important step is the follow-up to the presence and the evolution of GI lesions and the possible bleeding.
描述一种罕见的先天性皮肤和胃肠道血管畸形疾病——蓝色橡皮疱痣样静脉畸形综合征(BRBNS),其特征为皮肤和内脏器官存在多处静脉畸形,胃肠道始终受累,最常见的临床表现为肠道出血和缺铁性贫血。
我们报告了一位 10 岁女孩,从出生起全身就出现了多处静脉畸形,右腿还有一处淋巴管瘤。5 岁时,她曾因严重的胃出血而接受输血治疗。从那时起,她就一直患有慢性贫血,这也是她入院的原因。胃肠道内镜检查显示食管、胃、十二指肠和所有可见结肠段均存在多发性巨大静脉畸形。内镜检查是诊断胃肠道 BRBNS 的金标准技术,还可以立即采取氩等离子凝固、激光光凝、硬化治疗或套扎等治疗措施。此外,还描述了基于皮质类固醇、干扰素-α、长春新碱或奥曲肽的 BRBNS 药物治疗。
BRBNS 是一种先天性皮肤和胃肠道血管畸形病,其发病率和死亡率取决于内脏器官受累情况,尤其是胃肠道出血情况。治疗基于药物或手术治疗。最重要的是要密切监测胃肠道病变的存在和进展,以及可能发生的出血。