Szepetowski S, Lacoste C, Mallet S, Roquelaure B, Badens C, Fabre A
Service de gastropédiatrie, Assistance publique-Hôpitaux de Marseille (AP-HM), hôpital de La Timone, 264, rue Saint-Pierre, 13385 Marseille, France.
Service de gastropédiatrie, Assistance publique-Hôpitaux de Marseille (AP-HM), hôpital de La Timone, 264, rue Saint-Pierre, 13385 Marseille, France.
Arch Pediatr. 2017 Dec;24(12):1228-1234. doi: 10.1016/j.arcped.2017.09.016. Epub 2017 Nov 13.
NISCH syndrome is a rare autosomal recessive disease. It is characterized by scalp hypotrichosis, scarring alopecia, ichthyosis, and neonatal sclerosing cholangitis. It is caused by mutations in the CLDN1 gene encoding the claudin-1 protein, which is located at tight junctions. Fifteen cases have been reported to date and three different mutations have been identified. We report on the case of a 2-year-old boy from a consanguineous Moroccan family, presenting with NISCH syndrome and carrying the so-called Moroccan homozygous mutation (c.200-201delTT). The patient presented with the characteristic symptoms of the syndrome and a favorable progression with normalization of hepatic analyses under symptomatic treatment (vitamin supplementation and ursodeoxycholic acid). The currently limited availability of clinical and therapeutic data does not allow accurate prediction of the course of the disease and short- and long-term prognosis. Moreover, substantial interindividual variability has been reported. Description of new cases will provide new insights into the understanding and the overall management of this syndrome, the course of which remains elusive.
NISCH综合征是一种罕见的常染色体隐性疾病。其特征为头皮毛发稀少、瘢痕性脱发、鱼鳞病和新生儿硬化性胆管炎。它是由位于紧密连接的编码claudin-1蛋白的CLDN1基因突变引起的。迄今为止已报道了15例病例,并鉴定出三种不同的突变。我们报告了一名来自摩洛哥近亲家庭的2岁男孩的病例,该男孩患有NISCH综合征并携带所谓的摩洛哥纯合突变(c.200-201delTT)。该患者表现出该综合征的特征性症状,在对症治疗(补充维生素和熊去氧胆酸)下肝脏分析结果正常,病情进展良好。目前临床和治疗数据有限,无法准确预测疾病进程以及短期和长期预后。此外,已有报道称个体间存在显著差异。新病例的描述将为理解和全面管理该综合征提供新的见解,其病程仍不明确。