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一例新生儿马凡综合征:管理难题与多学科团队的作用

A Case of Neonatal Marfan Syndrome: A Management Conundrum and the Role of a Multidisciplinary Team.

作者信息

Carande Elliott J, Bilton Samuel J, Adwani Satish

机构信息

Department of Medical Sciences, University of Oxford, Level 3, John Radcliffe Hospital, Oxford OX3 9DU, UK.

Department of Paediatric Cardiology, John Radcliffe Hospital, Oxford OX3 9DU, UK.

出版信息

Case Rep Pediatr. 2017;2017:8952428. doi: 10.1155/2017/8952428. Epub 2017 Jan 11.

Abstract

Neonatal Marfan syndrome (nMFS) is a rare condition with a poor prognosis. It is genotypically and phenotypically distinct from the typical Marfan syndrome and carries a poorer prognosis. This case report describes the progression of a 14-month-old girl diagnosed with nMFS at 5 months of age. Her diagnosis followed the identification of a fibrillin-1 mutation ( gene, exon 26, chromosome 15), which is a common locus of nMFS. This patient developed severe cardiac complications resulting in congestive cardiac failure in early life and required major cardiac surgery. Since surgical intervention, our patient is still reliant on a degree of ventilator support, but the patient has gained weight and echocardiography has demonstrated improved left ventricular function and improved tricuspid and mitral valve regurgitation. Therefore, we argue the importance of a cautious multidisciplinary approach to early surgical intervention in cases of nMFS.

摘要

新生儿马方综合征(nMFS)是一种罕见疾病,预后较差。它在基因型和表型上与典型马方综合征不同,预后更差。本病例报告描述了一名14个月大女童的病情进展,该女童在5个月大时被诊断为nMFS。她的诊断是在发现原纤蛋白-1突变(基因,第26外显子,15号染色体)后做出的,这是nMFS的常见位点。该患者出现了严重的心脏并发症,在生命早期导致充血性心力衰竭,需要进行大型心脏手术。自手术干预以来,我们的患者仍在一定程度上依赖呼吸机支持,但患者体重增加,超声心动图显示左心室功能改善,三尖瓣和二尖瓣反流情况好转。因此,我们认为对于nMFS病例,谨慎的多学科方法进行早期手术干预非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd23/5266800/4123ddd94dad/CRIPE2017-8952428.001.jpg

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