Younes Mohamed, Mansour A, Neffati F, Zrour Saoussen, Bejia Ismail, Ben Amor A, Touzi Mongi, Najjar M F, Bergaoui Naceur
University of Monastir, Tunisie.
Tunis Med. 2011 Feb;89(2):188-91.
Ochronosis of alkaptonuria is a rare hereditary autosomal recessive disease in which there is an absence of homogentisic acid oxidase resulting in accumulation of homogentisic acid in tissues.
To report a new case of alkaptonuria
A 49-year-old man had been followed for 4 years for chronic lombalgia and arthropaty of two knees. He is married to his cousin and father of 4 girls. His parents are also cousins. The clinical examination has found a cutaneuous pigmentation and a lumbar stiffness. At biological checking, creatininemia was at 190 μmol/L and there are not inflammatory indicators. The radiography have shown a discal dorsolumbar calcifications, anterior inter somatic bridges and bilateral arthritis of knees without articular chondrocalcinosis. The diagnosis of ochronosis have been suspected and confirmed by the blackness of urine and the dosage of alkaptonuria. The patient has been treated symptomatiquely. Familial investigation have revealed that his daughter suffered from the same disease with the notion of blackness of urine. She is 12 year old and she's asymptomatic on the osteoarticular level.
Alkaptonuria causes a degenerative arthropaty which can endanger functional prognosis. Early diagnosis and scanning of this innate error of metabolism by genetic study play a fundamental interest, especially for molecular and genetic advisement.
尿黑酸尿症性褐黄病是一种罕见的常染色体隐性遗传病,因缺乏尿黑酸氧化酶导致尿黑酸在组织中蓄积。
报告一例尿黑酸尿症新病例。
一名49岁男性因慢性腰痛和双膝关节炎接受了4年随访。他与表妹结婚,育有4个女儿。他的父母也是近亲。临床检查发现皮肤色素沉着和腰部僵硬。实验室检查显示,血肌酐水平为190μmol/L,且无炎症指标。影像学检查显示胸腰椎间盘钙化、椎体间前桥形成以及双膝双侧关节炎,无关节软骨钙质沉着。根据尿液变黑及尿黑酸尿症检测,怀疑并确诊为褐黄病。对该患者进行了对症治疗。家族调查发现,他的女儿患有同样的疾病,尿液呈黑色。她12岁,骨关节方面无症状。
尿黑酸尿症可导致退行性关节炎,可能危及功能预后。通过基因研究对这种先天性代谢错误进行早期诊断和筛查至关重要,特别是对于分子和遗传咨询。