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具有不寻常临床特征的神经棘红细胞增多症:一例报告。

Neuroacanthocytosis with unusual clinical features: A case report.

作者信息

Zhu Hui, Feng Xue-Min, Zhao Teng, Liu Jing-Yao

机构信息

Department of Neurology, The First Hospital, Jilin University, Changchun, China.

出版信息

Medicine (Baltimore). 2019 Jan;98(2):e14050. doi: 10.1097/MD.0000000000014050.

Abstract

RATIONALE

Neuroacanthocytosis (NA) is a heterogeneous group of inherited neurodegenerative disorders characterized by misshapen spiculated erythorcytes and symptoms that resemble Huntington's disease.

PATIENT CONCERNS

A 59-year-old female who developed hyperkinetic involuntary movements that became progressively more obvious during the course of a year.

DIAGNOSES

Acanthocytes were observed in a peripheral blood smear. The patient had elevated levels of serum creatine kinase (CK). Gene sequencing did not reveal a genetic mutation.

INTERVENTIONS

The patient was administered oral tiapride, alprazolam, B1 and B12 Vitamins.

OUTCOMES

After 2 months of treatment the patient's symptoms were obviously alleviated. At the 6 month follow-up, the patient could feed herself and walk without assistance.

LESSONS

The NA syndrome is extremely rare. It may be identified in the clinic based on abnormal orofacial movement, chorea, cognitive decline, elevated CK levels, and acanthocytosis. If available, protein- or genetic-based testing may provide a confirmatory diagnosis.

摘要

理论依据

神经棘红细胞增多症(NA)是一组异质性遗传性神经退行性疾病,其特征为异形棘状红细胞以及类似亨廷顿舞蹈病的症状。

患者情况

一名59岁女性,出现运动亢进性不自主运动,并在一年病程中逐渐加重。

诊断

外周血涂片观察到棘红细胞。患者血清肌酸激酶(CK)水平升高。基因测序未发现基因突变。

干预措施

给予患者口服硫必利、阿普唑仑、维生素B1和维生素B12。

结果

治疗2个月后患者症状明显缓解。在6个月随访时,患者能够自理进食且无需辅助即可行走。

经验教训

NA综合征极为罕见。临床上可根据异常的口面部运动、舞蹈症、认知衰退、CK水平升高和棘红细胞增多症进行识别。如有条件,基于蛋白质或基因的检测可提供确诊依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acdb/6336636/5548de0952ec/medi-98-e14050-g001.jpg

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