Jain Gunjan, Jain Vaibhav Kumar, Sharma Indra Kumar, Sharma Reena, Saraswat Neeraj
Senior Resident, Department of Paediatrics, Uttar Pradesh University of Medical Sciences , Etawah, Uttar Pradesh, India .
Assistant Professor, Department of Ophthalmology, Uttar Pradesh University of Medical Sciences , Etawah, Uttar Pradesh, India .
J Clin Diagn Res. 2016 Nov;10(11):SR01-SR03. doi: 10.7860/JCDR/2016/21041.8780. Epub 2016 Nov 1.
Neurofibromatosis type 1 (NF-1) is an autosomal dominant disorder involving multiple systems and affects approximately 1 out of 3000 persons. Ocular manifestations are lisch nodules, plexiform neurofibroma, optic pathway gliomas. The proper diagnosis of NF-1 is a crucial task for a clinician due to the various clinical manifestations including vision and life threatening malignancies in few patients, which may arise in the different phases of life. The authors report three cases of NF-1, presenting with ophthalmic symptoms in teenager boys. On further ophthalmic and paediatric evaluation the diagnosis of NF-1 was confirmed on the basis of clinical criteria. This series also describe the abnormal facial features like telecanthus and broad nose which has been reported rarely. Case 1 was kept under regular follow-up and Case 2 and Case 3 were planned for the debulking surgery for plexiform neurofibroma of upper eye lid. A multidisciplinary approach is required to diagnose and treat such patients keeping in mind the myriad of clinical manifestations and life-long follow-up is required.
1型神经纤维瘤病(NF-1)是一种涉及多个系统的常染色体显性疾病,每3000人中约有1人受其影响。眼部表现包括Lisch结节、丛状神经纤维瘤、视神经通路胶质瘤。由于少数患者存在包括视力问题和危及生命的恶性肿瘤等各种临床表现,且这些表现可能出现在生命的不同阶段,因此对临床医生来说,正确诊断NF-1是一项至关重要的任务。作者报告了3例NF-1病例,均为青少年男性,表现为眼部症状。经过进一步的眼科和儿科评估,根据临床标准确诊为NF-1。该系列病例还描述了内眦距增宽和宽鼻等异常面部特征,此类报道较为罕见。病例1接受定期随访,病例2和病例3计划对上眼睑丛状神经纤维瘤进行减瘤手术。鉴于临床表现多样,诊断和治疗此类患者需要多学科方法,且需进行终身随访。