Oishi Taku, Sato Tetsuya, Matsushita Kenshi, Takechi Tomoki, Murakami Nobuyuki, Fujieda Mikiya
No To Hattatsu. 2016 Jan;48(1):34-6.
We report a case of X-linked myotubular myopathy with chylothorax. A male infant weighing 2,114 g was born to a mother whose pregnancy was complicated with polyhydramnios from gestational week 32. At gestational week 37, emergent caesarian section was performed due to membrane rupture followed by fetal bradycardia. Ventilatory support was necessary because the neonate showed severe birth asphyxia accompanied by hypotonia and dyspnea. He also showed a respiratory complication of chylothorax at 10 days old; therefore, thoracic drainage was performed. Congenital chylothorax associated with congenital myotonic dystrophy (CMD) has been described in a number of past reports. Specific findings of congenital myotubular myopathy and partial CMD, such as peripheral halo of muscle fibers, were demonstrated in biopsied muscle, and mutation of the myotubularin (MTM1) gene was identified. Tracheostomy was performed at 5 months old because of prolonged ventilatory support and severe dysphagia. The infant was able to be discharged at 17 months old. Congenital chylothorax might be associated with congenital myotubular myopathies such as CMD.
我们报告一例伴有乳糜胸的X连锁性肌管性肌病。一名体重2114克的男婴,其母亲在妊娠32周时出现羊水过多并发症。妊娠37周时,因胎膜破裂伴胎儿心动过缓行急诊剖宫产。由于新生儿出现严重的出生窒息并伴有肌张力减退和呼吸困难,需要进行通气支持。他在10日龄时还出现了乳糜胸这一呼吸系统并发症;因此,进行了胸腔引流。过去已有多篇报道描述了与先天性肌强直性营养不良(CMD)相关的先天性乳糜胸。在活检肌肉中发现了先天性肌管性肌病和部分CMD的特异性表现,如肌纤维外周晕,并鉴定出肌管素(MTM1)基因突变。由于通气支持时间延长和严重吞咽困难,患儿在5月龄时进行了气管切开术。该婴儿17月龄时得以出院。先天性乳糜胸可能与CMD等先天性肌管性肌病有关。