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一例由SLC40A1基因突变引起的遗传性血色素沉着症病例报告。

A case report of hereditary hemochromatosis caused by mutation of SLC40A1 gene.

作者信息

Yin Xin, Zhang Yu, Gao Hui, Jin Qing-Long, Wen Xiao-Yu

机构信息

Department of Hepatology, The First Hospital of Jilin University, Changchun.

Department of Digestive disease, Tai'an Municipal Hospital, Tai'an, China.

出版信息

Medicine (Baltimore). 2019 Nov;98(44):e17526. doi: 10.1097/MD.0000000000017526.

Abstract

RATIONALE

Hereditary hemochromatosis (HH) is a frequent autosomal recessive disease. The pathogenesis of disease is excessive intestinal absorption of dietary iron, resulting in pathologically high iron storage in tissues and organs. As a systemic disease, it has several manifestations including cirrhosis, diabetes mellitus, cardiomyopathy, joint disease. However, a proportion of patients are asymptomatic.

PATIENT CONCERNS

A 34-year-old man who had abnormal liver function for 9 months without specific symptoms. He underwent various tests, including liver biopsy and genetic testing, which eventually ruled out common liver diseases and identified iron metabolic abnormalities. In addition, we confirmed the pathogenic genes by sequencing the genes of him and his families.

DIAGNOSIS

Combined with the symptoms, auxiliary examinations and sequencing results, the patient was diagnosed as HH.

INTERVENTIONS

The patient was given a low iron diet and phlebotomy therapy interval 2 weeks until the ferritin is <100 mg/L.

OUTCOMES

The patient' condition is stable during the follow-up period.

LESSONS

When clinicians are confronted with unexplained liver dysfunction, the possibility of the HH should be considered. Liver biopsy and gene sequencing are helpful in diagnosis. Phlebotomy treatment is the most economical and practical treatment for HH at present, but it should vary from person to person.

摘要

理论依据

遗传性血色素沉着症(HH)是一种常见的常染色体隐性疾病。该病的发病机制是肠道对膳食铁的过度吸收,导致组织和器官中铁储存病理性升高。作为一种全身性疾病,它有多种表现,包括肝硬化、糖尿病、心肌病、关节疾病。然而,一部分患者没有症状。

患者情况

一名34岁男性,肝功能异常9个月,无特定症状。他接受了各种检查,包括肝活检和基因检测,最终排除了常见肝脏疾病,并发现铁代谢异常。此外,我们通过对他及其家人的基因进行测序,确认了致病基因。

诊断

结合症状、辅助检查和测序结果,该患者被诊断为HH。

干预措施

患者接受低铁饮食,并每2周进行一次放血疗法,直至铁蛋白<100mg/L。

结果

患者在随访期间病情稳定。

经验教训

当临床医生面对无法解释的肝功能障碍时,应考虑HH的可能性。肝活检和基因测序有助于诊断。放血疗法是目前治疗HH最经济实用的方法,但应因人而异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2b7/6946363/2bbba6926aab/medi-98-e17526-g001.jpg

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