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Tangier病可能导致动脉粥样硬化性脑梗死的早发:一例报告。

Tangier disease may cause early onset of atherosclerotic cerebral infarction: A case report.

作者信息

Liang Zhigang, Li Wei, Yang Shaowan, Liu Zhuli, Sun Xuwen, Gao Xiaoyu, Yu Guoping

机构信息

Department of Neurology, Yantai YuHuangDing Hospital Affiliated to Qingdao University, Yantai, Shandong.

Department of Neurology, Beijing Tiantan Hospital, Beijing, China.

出版信息

Medicine (Baltimore). 2018 Sep;97(39):e12472. doi: 10.1097/MD.0000000000012472.

Abstract

RATIONALE

The present study explored the relationship between the adenosine triphosphate (ATP)-binding cassette A1 (ABCA1) gene, atherosclerosis, and cerebral infarction. The diagnosis and treatment ideas of stroke caused by Tangier disease via the summary of the diagnosis and treatment process of one case with juvenile stroke were explored. The relevant literature on the clinical manifestations, laboratory examinations, and treatment of Tangier disease was reviewed.

PATIENT CONCERNS

The brain magnetic resonance imaging (MRI) of a juvenile man with acute onset of sudden right limb weakness and speechlessness revealed infarct lesions. The laboratory tests found low serum high-density lipoprotein (HDL), while further genetic testing identified ABCD1 gene mutation. The mother also carried the mutant gene.

DIAGNOSES

Tangier disease was diagnosed.

INTERVENTIONS

Statin treatment was administered for platelet aggregation.

OUTCOMES

After 3 years of follow-up, the patient was declared to be in a stable condition.

LESSONS

ABCA1 gene mutation caused early onset of atherosclerosis, leading to the occurrence of cerebral infarction. The cerebral infarction associated with reduced high-density lipoprotein (HDL), was under intensive focus with respect to ABCA1 gene. Child and Juvenile stroke patients with low HDL should not be excluded from the possibility of Tangier disease.

摘要

原理

本研究探讨了三磷酸腺苷(ATP)结合盒转运体A1(ABCA1)基因、动脉粥样硬化与脑梗死之间的关系。通过对1例青少年卒中病例诊治过程的总结,探讨了丹吉尔病所致卒中的诊断与治疗思路。回顾了有关丹吉尔病临床表现、实验室检查及治疗的相关文献。

患者情况

一名青少年男性突发急性右肢无力和失语,脑部磁共振成像(MRI)显示有梗死灶。实验室检查发现血清高密度脂蛋白(HDL)水平低,进一步基因检测发现ABCD1基因突变。其母亲也携带该突变基因。

诊断

诊断为丹吉尔病。

干预措施

给予他汀类药物治疗以抑制血小板聚集。

结果

经过3年随访,患者病情稳定。

经验教训

ABCA1基因突变导致动脉粥样硬化早发,进而引发脑梗死。与高密度脂蛋白(HDL)降低相关的脑梗死,是ABCA1基因研究的重点。HDL水平低的儿童和青少年卒中患者不应排除患丹吉尔病的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99d2/6181625/a5336eae97f7/medi-97-e12472-g001.jpg

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