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非致死性多发性翼状胬肉综合征:埃斯科瓦尔综合征。

Nonlethal multiple pterygium syndrome: Escobar syndrome.

作者信息

Bissinger Robin L, Koch Frances R

机构信息

College of Nursing (Dr Bissinger) and Division of Neonatology, Department of Pediatrics (Dr Koch), Medical University of South Carolina, Charleston.

出版信息

Adv Neonatal Care. 2014 Feb;14(1):24-9. doi: 10.1097/ANC.0000000000000039.

Abstract

Nonlethal Escobar is a rare disorder that is a variant of multiple pterygium syndromes. It is a form of arthrogryposis multiplex congenita characterized by excessive webbing (pterygia), congenital contractures (arthrogryposis), and scoliosis. It is usually diagnosed in utero on fetal ultrasound and then confirmed in the neonatal period. A case of nonlethal neonatal Escobar is reported in a 35-week-and-6-day old infant who presented in utero with decreased fetal movement, oligohydramnios, and arthrogryposis. The etiologies from maternal causes were excluded prior to birth. Subsequent workup after birth led to a highly suspected diagnosis of nonlethal Escobar by the geneticist. The diagnosis was confirmed by a positive CHRNG gene sequence analysis after discharge. The infant demonstrated contractures and bilateral hip subluxation but was feeding well and was discharged home with outpatient follow-up. Treatment after discharge has been extensive secondary to difficulties associated with this disease. The clinical presentation of nonlethal Escobar, as well as diagnosis and treatment strategies, is provided with caregiving strategies.

摘要

非致死性埃斯科瓦尔综合征是一种罕见疾病,是多种翼状胬肉综合征的一种变体。它是先天性多发性关节挛缩症的一种形式,其特征为过多的蹼状组织(翼状胬肉)、先天性挛缩(关节挛缩症)和脊柱侧弯。通常在胎儿超声检查时于子宫内诊断出来,然后在新生儿期得到确认。本文报道了一例35周零6天的非致死性新生儿埃斯科瓦尔综合征病例,该婴儿在子宫内时出现胎动减少、羊水过少和关节挛缩症。在出生前排除了由母体原因导致的病因。出生后的后续检查使遗传学家高度怀疑该病例为非致死性埃斯科瓦尔综合征。出院后通过CHRNG基因序列分析呈阳性得以确诊。该婴儿表现出挛缩和双侧髋关节半脱位,但喂养良好,出院后接受门诊随访。由于与该疾病相关的困难,出院后的治疗范围广泛。本文提供了非致死性埃斯科瓦尔综合征的临床表现以及诊断和治疗策略,并给出了护理策略。

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