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[微绒毛包涵体病作为严重先天性腹泻的病因。病例报告]

[Microvillous inclusion disease as a cause of severe congenital diarrhea. Case report].

作者信息

Schoen Kathrin, Puchi Alexa, González Ilse, Torres María Teresa, Espinosa Roberto, González Raúl

机构信息

Unidad de Gastroenterología y Nutrición infantil, Hospital Dr. Gustavo Fricke, Viña del Mar, Chile.

Facultad de Medicina, Universidad de Valparaíso, Chile.

出版信息

Rev Chil Pediatr. 2017;88(5):662-667. doi: 10.4067/S0370-41062017000500015.

Abstract

UNLABELLED

Congenital diarrheas correspond to a severe and low frequency digestive disease, with a high mortality. They start a few days or months after birth, leading to intestinal insufficiency and dependence on parenteral nutrition. It must be highly suspected in newborns or infants with diarrhea and severe electrolyte disorders. The diagnosis is based on clinical, endoscopic, histologic and eventually genetic findings. Treatment is supportive with intensive correction of electrolyte imbalances as well as parenteral nutrition.

OBJECTIVE

To present a case report of congenital diarrhea identified as microvillous inclusion disease presenting in the neonatal period.

CASE REPORT

Male patient currently 3 years of age, son of consanguineous parents. At 10 days of age presents a severe secretory diarrhea, requiring treatment in a critical care unit and parenteral nutrition. Initially he also presented with Fanconi syndrome, which improved afterwards. The suspicion of congenital microvillous inclusion was confirmed later by optic and electronic microscopy, and inmunohistochemistry. A succesful evolution was later achieved maintaining home parenteral nutrition after discharge.

CONCLUSION

We present the first known case in Chile of congenital diarrhea due to microvillous inclusión disease and his evolution.

摘要

未标注

先天性腹泻是一种严重且发病率低的消化系统疾病,死亡率高。它在出生后几天或几个月开始出现,导致肠道功能不全并依赖肠外营养。对于患有腹泻和严重电解质紊乱的新生儿或婴儿,必须高度怀疑此病。诊断基于临床、内镜、组织学检查,最终还需依据基因检测结果。治疗以积极纠正电解质失衡以及肠外营养支持为主。

目的

报告一例在新生儿期被诊断为微绒毛包涵体病的先天性腹泻病例。

病例报告

现3岁男性患者,父母为近亲结婚。出生10天时出现严重分泌性腹泻,需在重症监护病房接受治疗并进行肠外营养。最初他还出现了范科尼综合征,后来病情有所改善。随后通过光学和电子显微镜检查以及免疫组织化学检查,确诊为先天性微绒毛包涵体病。出院后通过维持家庭肠外营养,病情得到了成功控制。

结论

我们报告了智利首例因微绒毛包涵体病导致的先天性腹泻病例及其病情发展情况。

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