Xu Wenrui, Zhao Jiuliang, Zhu Yicheng, Zhang Weihong
Department of Radiology Department of Rheumatology Department of Neurology, Peking Union Medical College Hospital (PUMCH), Peking Union Medical College and Chinese Academy of Medical Sciences (PUMC&CAMS), Beijing, People's Republic of China.
Medicine (Baltimore). 2017 Jan;96(1):e5545. doi: 10.1097/MD.0000000000005545.
Cerebroretinal microangiopathy with calcifications and cysts (CRMCC) is believed to be an autosomal recessive genetic disease, with disorders in multisystem organs. Its characteristic neurological disorders manifested on neuroimaging are a triad of leukoencephalopathy, intracranial calcifications, and parenchymal cysts. In this paper, we report a CRMCC patient with multisystem involvement, focusing on the neuroimaging features, to get a better understanding of the rare disease and improve our diagnostic ability.
The 23-year-old female patient firstly presented with an adolescence onset of ophthalmological manifestations. Four years later, hematological and neurological disorders occurred, the latter of which demonstrated a relatively slow progression in the following 7 years preceding her presentation to our hospital.
During hospitalization, disorders involving digestive, cardiovascular and respiratory systems were also detected. In addition, a more comprehensive depiction of neurological disorders on neuroimaging was also obtained.
On the basis of multiple system disorders and the detection of mutations in conserved telomere maintenance component 1(CTC1) gene, a diagnosis of CRMCC was made.
After supportive therapy during her 4-week hospitalization, the patient's general condition improved and was released from the hospital.
CRMCC could be primarily diagnosed with the aid of its multiple system disorders and remarkable neuroimaging features. Cerebral micro hemorrhages determined by the combination of CT and T2-weighted magnetic resonance images in our case could provide some additional information for diagnosis. Furthermore, several other associated disorders were depicted for the first time in our case, expanding the clinical spectrum of CRMCC.
脑视网膜微血管病变伴钙化和囊肿(CRMCC)被认为是一种常染色体隐性遗传病,累及多系统器官。其在神经影像学上表现出的特征性神经障碍为白质脑病、颅内钙化和实质囊肿三联征。在本文中,我们报告了一名多系统受累的CRMCC患者,重点关注其神经影像学特征,以更好地了解这种罕见疾病并提高我们的诊断能力。
该23岁女性患者最初出现青春期眼部表现。4年后出现血液学和神经学障碍,在她到我院就诊前的7年里,后者进展相对缓慢。
住院期间,还发现了涉及消化、心血管和呼吸系统的障碍。此外,还获得了神经影像学上对神经障碍更全面的描述。
基于多系统障碍以及保守端粒维持成分1(CTC1)基因突变的检测,诊断为CRMCC。
在4周的住院期间进行支持治疗后,患者的一般状况有所改善并出院。
CRMCC可主要借助其多系统障碍和显著的神经影像学特征进行诊断。我们病例中通过CT和T2加权磁共振图像联合确定的脑微出血可为诊断提供一些额外信息。此外,我们的病例首次描述了其他几种相关障碍,扩展了CRMCC的临床谱。