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先天性脑积水:戈麦斯 - 洛佩斯 - 埃尔南德斯综合征。一种诊断不足的综合征。一例临床病例。

Congenital Hydrocephalus: Gómez-López-Hernández syndrome. An underdiagnosed Syndrome. A clinical case.

作者信息

Gálvez V Camila, Huete Isidro, Hernández Marta

机构信息

División de Pediatría, Unidad de Neurología Pediátrica, Chile.

Departamento de Radiología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Chile.

出版信息

Rev Chil Pediatr. 2018 Feb;89(1):92-97. doi: 10.4067/S0370-41062018000100092.

Abstract

INTRODUCTION

Hydrocephalus is defined as complex conditions influenced by genetic and environmental factors. Excluding hydrocephalus acquired from infection or brain tumors, congenital hydrocephalus with a genetic cause may occur isolated (hydrocephalus isolated, pure or non-syndromatic) or as a component of a genetic syndrome (syndromic hydrocephalus).

OBJECTIVE

To present a syndromic congenital hydrocephalus with a known diagnosis, in order to be considered in the study of this pathology and to perform a review of hydrocephaly with a genetic cause.

CLINICAL CASE

Preschool with a prenatal diagnosis of hydrocephalus and rhombencephalosynapsis, karyotype and study of TORCH was normal. At the moment of birth, the prenatal diagnoses were confirmed and a malformation of cerebral cortical development was excluded. During the first week of life, perito neal ventricle shunt was performed. A reevaluation at age 4, the absence of corneal reflexes bilate ral parietal and congenital focal alopecia associated with rhombencephalosynapsis, meet definitive criteria for cerebello-trigeminal-dermal displasia or Gómez-López-Hernández syndrome (GLHS).

CONCLUSIONS

GLHS is an uncommon neurocutaneous syndrome, possibly a sporadic condition that is underdiagnosed. Due to the new imaging and genetic technologies pre and post-natal, today it is possible to achieve a better and more accurate diagnosis of hydrocephalus with a genetic origin, in which the high suspicion of teams of clinical specialists is essential. Without accurate diagnosis, we can not access to a long-term prognosis, prevention of aggregate morbidity or an adequate genetic counseling, which are required in today's pediatrics.

摘要

引言

脑积水被定义为受遗传和环境因素影响的复杂病症。排除由感染或脑肿瘤引起的脑积水,具有遗传病因的先天性脑积水可能单独出现(孤立性脑积水、单纯性或非综合征性脑积水),也可能作为遗传综合征的一部分出现(综合征性脑积水)。

目的

介绍一例已确诊的综合征性先天性脑积水病例,以便在对该病症的研究中予以考虑,并对具有遗传病因的脑积水进行综述。

临床病例

一名学龄前儿童,产前诊断为脑积水和菱形脑联合,核型及TORCH检查正常。出生时,产前诊断得到证实,排除了大脑皮质发育畸形。在出生后的第一周,进行了腹膜脑室分流术。4岁时复查,双侧顶叶角膜反射缺失以及与菱形脑联合相关的先天性局限性脱发,符合小脑 - 三叉 - 皮肤发育异常或戈麦斯 - 洛佩斯 - 埃尔南德斯综合征(GLHS)的明确标准。

结论

GLHS是一种罕见的神经皮肤综合征,可能是一种诊断不足的散发性病症。由于产前和产后新的影像学和基因技术,如今有可能对具有遗传起源的脑积水做出更好、更准确的诊断,其中临床专家团队的高度怀疑至关重要。没有准确的诊断,我们就无法获得长期预后、预防合并症或进行充分的遗传咨询,而这些在当今儿科中是必需的。

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