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布朗-维阿莱托-范莱尔综合征伪装成神经免疫疾病:3例临床病例及文献综述

Brown-Vialetto-Van Laere Syndrome as a Mimic of Neuroimmune Disorders: 3 Cases From the Clinic and Review of the Literature.

作者信息

Allison Tyler, Roncero Inés, Forsyth Rob, Coffman Keith, Pichon Jean-Baptiste Le

机构信息

1 Division of Neurology, Children's Mercy Hospital, Kansas City, MO, USA.

2 Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom.

出版信息

J Child Neurol. 2017 May;32(6):528-532. doi: 10.1177/0883073816689517. Epub 2017 Jan 24.

DOI:10.1177/0883073816689517
PMID:28116953
Abstract

We present 3 patients identified at 2 different institutions with Brown-Vialetto-Van Laere syndrome. Each patient was initially diagnosed with a neuroimmune disorder for a period of a few weeks to a few months. In each case, genetic analysis revealed mutations in one of the riboflavin transporters, confirming Brown-Vialetto-Van Laere syndrome. It is likely that Brown-Vialetto-Van Laere syndrome is more common than previously reported, and because it mimics neuroimmune disorders, it may be misdiagnosed as such. It shares many features with diseases such as chronic inflammatory demyelinating neuropathy, may present with positive cerebrospinal fluid antibody titers, and may transiently respond to intravenous immunoglobulin. We review the literature on Brown-Vialetto-Van Laere syndrome and Fazio-Londe syndrome, 2 riboflavin transporter disorders, looking for clinical presentations that may lead to confusion with neuroimmune disorders. We emphasize the importance of correctly diagnosing the disease, as its treatment is relatively benign and will stop progression of the disease and may even reverse it.

摘要

我们报告了在两家不同机构确诊的3例患有布朗 - 维亚莱托 - 范拉尔综合征(Brown-Vialetto-Van Laere syndrome)的患者。每位患者最初都被诊断为神经免疫性疾病,持续了数周至数月不等。在每例病例中,基因分析均显示核黄素转运蛋白之一存在突变,从而确诊为布朗 - 维亚莱托 - 范拉尔综合征。布朗 - 维亚莱托 - 范拉尔综合征可能比之前报道的更为常见,并且由于它与神经免疫性疾病相似,可能会被误诊为此类疾病。它与慢性炎症性脱髓鞘性多发性神经病等疾病有许多共同特征,可能出现脑脊液抗体滴度阳性,并且可能对静脉注射免疫球蛋白产生短暂反应。我们回顾了关于布朗 - 维亚莱托 - 范拉尔综合征和法齐奥 - 隆德综合征(Fazio-Londe syndrome)这两种核黄素转运蛋白疾病的文献,寻找可能导致与神经免疫性疾病混淆的临床表现。我们强调正确诊断该疾病的重要性,因为其治疗相对温和,能够阻止疾病进展,甚至可能使其逆转。

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