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先天性白内障与先天性氯腹泻——一种独特的组合及产前诊断

Congenital cataract and congenital chloride diarrhoea-a unique combination and antenatal diagnosis.

作者信息

Wani Abdul Majid, Janhan Noor, Hussain Waleed Mohd, Fatani Mohamad Ibrahim, Hemdi Mohannad, Imam Ahmed, Khoujah Amer Mohd, Akhtar Mubeena, Shiekh Firdous

机构信息

Hera General Hospital, Medicine, 4a/201, Hera General, Hospital, MAKKAH, Western, 21955, Saudi Arabia.

出版信息

BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.04.2009.1775. Epub 2009 Aug 17.

Abstract

Congenital chloride diarrhoea (CCD) is a serious inherited defect of intestinal electrolyte absorption transmitted in an autosomal recessive way. The molecular pathology involves an epithelial Cl(-)/HCO(3)(-) exchanger protein, encoded by the solute carrier family 26 member 3 gene (SLC26A3) and known DRA (down regulated in adenomas) in the distal ileum and colon. Polyhydramnios, premature birth, ileus without meconium passage, hypochloremia, and hyponatremia are typical features of CCD in the neonate followed by chronic metabolic alkalosis, hypokalemia, hypochloremia, retarded growth and renal impairment in older children and adults if the disease is not adequately treated. Antenatal diagnosis if made on the basis of findings on ultrasonography-a non-invasive diagnostic test-can help in early management of the disorder immediately after birth and, thus, prevent the sequelae. We present an interesting case of CCD diagnosed antenatally and found to have congenital cataract, which is a unique occurrence not reported in literature so far.

摘要

先天性氯腹泻(CCD)是一种严重的遗传性肠道电解质吸收缺陷病,以常染色体隐性方式遗传。分子病理学涉及一种上皮性Cl(-)/HCO(3)(-)交换蛋白,由溶质载体家族26成员3基因(SLC26A3)编码,在回肠末端和结肠中称为DRA(腺瘤下调基因)。羊水过多、早产、无胎粪排出的肠梗阻、低氯血症和低钠血症是新生儿CCD的典型特征,如果疾病未得到充分治疗,大龄儿童和成人会出现慢性代谢性碱中毒、低钾血症、低氯血症、生长发育迟缓及肾功能损害。基于超声检查(一种非侵入性诊断测试)结果进行的产前诊断有助于在出生后立即对该疾病进行早期管理,从而预防后遗症。我们报告了一例产前诊断为CCD且伴有先天性白内障的有趣病例,这是迄今为止文献中未报道过的独特病例。

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本文引用的文献

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Celiac disease in a girl with congenital chloride diarrhea: coincidence of 2 diarrheal disorders.
J Pediatr Gastroenterol Nutr. 2008 Oct;47(4):504-6. doi: 10.1097/MPG.0b013e318174e843.
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Genetic origins of cataract.白内障的遗传起源
Arch Ophthalmol. 2007 Feb;125(2):165-73. doi: 10.1001/archopht.125.2.165.
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[Congenital chloride diarrhea].[先天性氯腹泻]
Acta Gastroenterol Latinoam. 2005;35(2):99-103.
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Congenital chloride diarrhea: antenatal ultrasonographic findings in siblings.
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