Farahmand Fatemeh, Modaresi Vajiheh, Izadyar Mina, Mahjob Fatemeh
Department of Pediatric, Tehran University of Medical Sciences, Tehran, IR Iran ; Center of Excellence for Pediatrics. Children's Medical Center, Tehran University of Medical Sciences, Tehran, IR Iran.
Iran J Pediatr. 2010 Dec;20(4):483-6.
Niemann-Pick disease and β-thalassemia are distinct conditions with specific clinical and morphological manifestations. β-thalassemia is the most common inherited blood disorder in Iran whereas Niemann-Pick disease, a lysosomal storage disorder, is rarely found in this country.
This 5-month old girl, a known case of β-thalassemia major was hospitalized for failure to thrive and hepathosplenomegaly. Because of unusual splenomegaly and liver enzymes disturbance that was not compatible with the first diagnosis, further evaluation revealed cherry red spot and high lipid profile suggestive of lysosomal storage disease. Foamy cells in the bone marrow and low activity of the specific enzyme led to the diagnosis of Niemann-Pick disease.
This unique case illustrates the importance of looking for a second pathological condition in a patient whose clinical profile does not support the first diagnosis in its entirety.
尼曼-皮克病和β地中海贫血是具有特定临床和形态学表现的不同病症。β地中海贫血是伊朗最常见的遗传性血液疾病,而尼曼-皮克病作为一种溶酶体贮积症,在该国很少见。
这名5个月大的女童是重度β地中海贫血的已知病例,因发育不良和肝脾肿大住院。由于脾肿大异常以及肝酶紊乱与最初诊断不符,进一步检查发现樱桃红斑和高脂血症,提示溶酶体贮积症。骨髓中的泡沫细胞和特定酶的低活性导致尼曼-皮克病的诊断。
这个独特的病例说明了在临床情况不完全支持最初诊断的患者中寻找第二种病理状况的重要性。