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[胎儿期致命性佝偻病与未诊断出的母体乳糜泻]

[Fatal rickets in the fetus and undiagnosed maternal celiac disease].

作者信息

Soler-Bel Josep, Veganzones Irene, Navarro Alexandra, Ramos Fernando, Serra-Buxeda Elena, Ferreres Joan Carles

机构信息

Servicio de Medicina Interna, Hospital Sant Joan de Déu de Manresa, Althaia, Xarxa Assistencial de Manresa, Barcelona, España.

出版信息

Gastroenterol Hepatol. 2011 Dec;34(10):678-82. doi: 10.1016/j.gastrohep.2011.05.006. Epub 2011 Jul 14.

Abstract

Celiac disease is a relatively frequent enteropathy associated with a wide range of clinical manifestations, due in part to malabsorption. In women, it has been associated with obstetric and gynecological alterations such as repeated miscarriages, intrauterine growth delay, premature delivery, and low birth weight. We present the case of a woman with undiagnosed celiac disease who gave birth to a stillborn foetus via normal delivery after 34 weeks of gestation. The foetus presented severe morphological alterations due to hypomineralization which were compatible with rickets. In the medical literature congenital rickets secondary to maternal celiac disease due to malabsorption is rare. We discuss the current knowledge on maternofoetal phospho-calcium metabolism and relate active celiac disease with severe hypocalcaemia during pregnancy and fatal rickets in the foetus. We recommend screening for celiac disease in pregnant women with signs of malabsorption or impaired fetal development.

摘要

乳糜泻是一种相对常见的肠病,部分由于吸收不良而伴有广泛的临床表现。在女性中,它与产科和妇科改变有关,如反复流产、宫内生长迟缓、早产和低出生体重。我们报告一例未确诊乳糜泻的女性病例,该女性在妊娠34周后经正常分娩产下一名死胎。由于矿化不足,胎儿出现了严重的形态学改变,符合佝偻病表现。在医学文献中,由于吸收不良继发于母亲乳糜泻的先天性佝偻病很罕见。我们讨论了目前关于母婴磷钙代谢的知识,并将活跃期乳糜泻与孕期严重低钙血症及胎儿致命性佝偻病联系起来。我们建议对有吸收不良迹象或胎儿发育受损迹象的孕妇进行乳糜泻筛查。

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