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一种伴有多囊卵巢综合征和多发性皮下囊肿的人类纤毛病:一例罕见病例报告。

A human ciliopathy with polycystic ovarian syndrome and multiple subcutaneous cysts: A rare case report.

作者信息

Tan Kangan, Liu Peng, Pang Lili, Yang Wanna, Hou Fengqin

机构信息

Department of Infectious Diseases and the Center for Liver Diseases, Peking University First Hospital, Beijing.

Department of Cardiology, Ordos Central Hospital, Ordos School of Clinical Medicine, Inner Mongolia Medical University, Inner Mongolia.

出版信息

Medicine (Baltimore). 2018 Dec;97(50):e13531. doi: 10.1097/MD.0000000000013531.

Abstract

RATIONALE

Ciliopathies is a group of clinically and genetically overlapping disorders due to cilia abnormalities and multiple organ systems are involved in.

PATIENT CONCERNS

We present a young female patient who showed renal function impairment, Caroli syndrome (CS), liver cirrhosis, polycystic ovarian syndrome, and multiple subcutaneous cysts.

DIAGNOSES

The patient was diagnosed with ciliopathy according to the clinical manifestations and whole-genome sequencing.

INTERVENTIONS

She received treatment of intravenous albumin, polyene phosphatidyl choline, furosemide, and antisterone.

OUTCOMES

The patient showed clinical improvement in her edema and liver tests, and ultrasonography revealed that the ascites had disappeared. Unfortunately, the edema relapsed a year later. The patient received the same treatment as before, and there was clinical improvement of the edema. Since the family cannot afford liver and kidney transplantation, the patient only accepted symptomatic treatment.

LESSONS

Polycystic ovarian syndrome and multiple subcutaneous cysts have never before been reported to be associated with ciliopathy. This finding could remind doctors to consider the possibility of ciliopathy disease for patients suffering from similar conditions. In addition, the phenotype of the patient differs from those of patients reported with the same mutations, which also reminds doctors that the clinical manifestation of a given mutation may show patient-specific differences. This case report extends the phenotypic spectrum of ciliopathy, and these findings might represent a new ciliopathy syndrome, which could facilitate the diagnosis of ciliopathies.

摘要

理论依据

纤毛病是一组由于纤毛异常导致临床和基因重叠的疾病,多个器官系统受累。

患者情况

我们报告了一名年轻女性患者,她出现肾功能损害、卡罗里综合征(CS)、肝硬化、多囊卵巢综合征和多个皮下囊肿。

诊断

根据临床表现和全基因组测序,该患者被诊断为纤毛病。

干预措施

她接受了静脉输注白蛋白、多烯磷脂酰胆碱、呋塞米和抗醛固酮治疗。

结果

患者的水肿和肝功能检查显示临床改善,超声检查显示腹水消失。不幸的是,一年后水肿复发。患者接受了与之前相同的治疗,水肿有临床改善。由于家庭负担不起肝肾移植费用,患者仅接受了对症治疗。

经验教训

多囊卵巢综合征和多个皮下囊肿此前从未被报道与纤毛病相关。这一发现可能提醒医生,对于患有类似病症的患者要考虑纤毛病的可能性。此外,该患者的表型与报道的具有相同突变的患者不同,这也提醒医生特定突变的临床表现可能存在患者特异性差异。本病例报告扩展了纤毛病的表型谱,这些发现可能代表一种新的纤毛病综合征,有助于纤毛病的诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a533/6320131/5289a035d8d8/medi-97-e13531-g001.jpg

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