Department of Neurology, Harrison International Peace Hospital, Hengshui, Hebei, China.
Nurse in Charge of Nephrology, Harrison International Peace Hospital, Hengshui, Hebei, China.
Int J Neurosci. 2020 May;130(5):438-442. doi: 10.1080/00207454.2019.1691204. Epub 2019 Dec 17.
: To our knowledge, this is the first report of patient with BHD syndrome caused by a novel mutation in the FLCN gene who developed a cerebral venous sinus thrombosis(CVST).: A 62-year-old male patient with a history of hypertension and two case of spontaneous pneumothorax. He had a 1-month history of headache and was admitted to the hospital one day after the headache aggravated. The patient had a family history of BHD syndrome which was confirmed by FLCN gene sequencing. Sequencing analysis revealed a novel nonsense mutation (NM_144997; c.607A > T; p.Lys203Ter) in the FLCN gene exon 6 of the patient, which was proved to be a pathogenetic mutation by pedigree verification. BHD syndrome was finally definitive diagnosis. Low molecular weight heparin (21 days) was given for anticoagulant therapy before and after resection of renal tumor which is confirmed to be clear cell carcinoma in the kidney. After discharge, warfarin was given for anticoagulant therapy (6 months).: There was no recurrence of CVST. And no recurrence of tumor and new renal tumor were found in renal MRI examination after 6 months.
据我们所知,这是首例由 FLCN 基因突变引起的 BHD 综合征患者并发脑静脉窦血栓形成(CVST)的报告。
患者为 62 岁男性,有高血压病史和 2 次自发性气胸病史。头痛病史 1 个月,头痛加重 1 天后入院。患者有 BHD 综合征家族史,FLCN 基因测序证实。测序分析显示患者第 6 外显子中存在一种新的无义突变(NM_144997;c.607A>T;p.Lys203Ter),经家系验证证实为致病性突变。最终明确诊断为 BHD 综合征。在肾肿瘤切除前后给予低分子肝素(21 天)抗凝治疗,肾肿瘤病理证实为肾透明细胞癌。出院后给予华法林抗凝治疗(6 个月)。
患者未再发 CVST。6 个月后肾 MRI 检查未见肿瘤复发和新的肾肿瘤。