Tsuji A, Yanai J, Miura T, Shirai Y, Osano M, Hosoda Y, Sato M, Asaishi T, Oda Y, Hajikano H
Department of Pediatrics, Yamanashi Medical College, Tokyo.
Acta Paediatr Jpn. 1990 Apr;32(2):155-61. doi: 10.1111/j.1442-200x.1990.tb00802.x.
Two cases of Japanese girls with congenital cutis laxa associated with cardiovascular abnormalities are described. Case 1: A 12-year-old girl has been under our observation from the age of 6 months. Cardioangiogram revealed dilatation of the ascending aorta, meandering of the descending aorta and the coronary arteries, coiling of the carotid and innominate (brachiocephalic) arteries, and hypoplasia of the pulmonary arteries. Case 2: A 2.8/12-year-old girl died after our follow-up from the age of 3 months. The cause of death was congestive heart failure secondary to peripheral stenosis of the pulmonary arteries. In both cases, skin biopsy revealed a decreased number of elastic fibers and an increased amount of acidic mucopolysaccharides. The same histological features were observed in the pulmonary arteries and other arteries as well. Electron microscopic findings were diffuse thinning of elastic fibers and reduced elastic content. The high blood level of elastase (167.8 micrograms/l) in case 1 may cast a light on the unknown etiology of the disease.
本文描述了两例患有先天性皮肤松弛症并伴有心血管异常的日本女孩。病例1:一名12岁女孩从6个月大起就一直在我们的观察之下。心血管造影显示升主动脉扩张、降主动脉和冠状动脉迂曲、颈动脉和无名(头臂)动脉盘绕以及肺动脉发育不全。病例2:一名2.8/12岁女孩在我们从3个月大开始随访后死亡。死因是继发于肺动脉外周狭窄的充血性心力衰竭。在这两个病例中,皮肤活检均显示弹性纤维数量减少且酸性粘多糖量增加。在肺动脉和其他动脉中也观察到了相同的组织学特征。电子显微镜检查结果为弹性纤维弥漫性变薄且弹性成分减少。病例1中弹性蛋白酶的高血水平(167.8微克/升)可能为该疾病未知的病因提供线索。