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[儿童分泌血管活性肠肽的神经节神经母细胞瘤所致慢性腹泻。附1例报告并文献复习]

[Chronic diarrhea caused by VIP-secreting ganglioneuroblastoma in children. Apropos of a case with a review of the literature].

作者信息

Attat I, Podvin A, Fromentin C, Rahier J, Creusy C, Ducoulombier H, Bayart M

出版信息

Chirurgie. 1989;115(3):156-61; discussion 161-2.

PMID:2680332
Abstract

A literature review was conducted in relation to a case of chronic diarrhea associated with a VIP (vasoactive intestinal polypeptide) producing ganglioneuroblastoma (GNB), in an 18-month old female baby. This is a rare entity characterized by premonitory, persisting diarrhea, causing fluid and electrolyte changes typical of the WDHA syndrome, associating watery diarrhea, hypokalemia, and achlorhydia. Elevated VIP plasma levels are an indication for an echographic and/or CT-scan search for the causal secreting tumor. Although the prognosis of this condition seems favorable, the recommended treatment is surgery. The VIP substance represents an excellent biological monitoring marker. Ganglioneuroblastomas are tumors of the sympathetic nervous system, which, according to Pearse's cell and embryologic theory (1966), have to be linked to the APUD system tumors (paraneuromas). VIP-producing forms are rare in children, and only 29 case studies have been compiled in the literature since 1970, when the VIP substance was discovered. The case reported in this study illustrates the diagnostic problems raised by such lesions, and allows us to confirm VIP's imputability for the occurrence of the chronic diarrhea condition in this child.

摘要

对一名18个月大的女婴进行了文献综述,该女婴患有与产生血管活性肠肽(VIP)的神经节神经母细胞瘤(GNB)相关的慢性腹泻。这是一种罕见的病症,其特征为前驱性、持续性腹泻,导致典型的WDHA综合征的液体和电解质变化,伴有水样腹泻、低钾血症和无胃酸。血浆VIP水平升高是通过超声和/或CT扫描寻找因果分泌肿瘤的指征。尽管这种病症的预后似乎良好,但推荐的治疗方法是手术。VIP物质是一种出色的生物监测标志物。神经节神经母细胞瘤是交感神经系统的肿瘤,根据皮尔西的细胞和胚胎学理论(1966年),它们必须与APUD系统肿瘤(副神经节瘤)相关联。产生VIP的形式在儿童中很少见,自1970年发现VIP物质以来,文献中仅汇编了29个病例研究。本研究报告的病例说明了此类病变引发的诊断问题,并使我们能够确认VIP与该儿童慢性腹泻病症的发生有关。

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