Al-Qattan Mohammad M, AlMarshad Felwa A, Ijaz Attiya, Shah Mardan Qutaiba
King Saud University, Riyadh, Saudi Arabia; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Int J Surg Case Rep. 2020;71:70-72. doi: 10.1016/j.ijscr.2020.04.020. Epub 2020 May 7.
Triggering of the fingers in children is an uncommon entity. A review of the literature on the topic did not reveal any reports of multiple triggering in patients with neurofibromatosis.
Our patient is a known case of neurofibromatosis type I (NF 1). At the age of 4 years, the child required chemotherapy to treat symptomatic bilateral optic glioma. Chemotherapy was complicated by severe viral upper respiratory tract infection with concurrent multi-joint synovitis and mild triggering of the fingers. A second course of chemotherapy was required 2 years later. This was also complicated by a viral infection, joint synovitis, and worsening of the triggering. Surgical release of the A1 and part of the A2 pulleys was curative.
Two factors contributed to the development of multiple triggering in our pediatric patient. The NF 1 itself predisposes to fibrosis. The second factor is the synovitis that accompanied the acute viral infection.
We report on a case of multiple bilateral trigger fingers in a child with NF 1 following an acute viral infection and discuss the pathogenesis.
儿童扳机指是一种罕见的病症。对该主题的文献回顾未发现神经纤维瘤病患者出现多发扳机指的任何报道。
我们的患者是一名已知的Ⅰ型神经纤维瘤病（NF 1）患者。4岁时，该患儿因有症状的双侧视神经胶质瘤需要化疗。化疗出现严重的病毒性上呼吸道感染并发症，同时伴有多关节滑膜炎和轻度扳机指。2年后需要进行第二个疗程的化疗。此次化疗也出现病毒感染、关节滑膜炎并发症，且扳机指病情加重。对A1和部分A2滑车进行手术松解后治愈。
两个因素导致了我们这位儿科患者出现多发扳机指。一是NF 1本身易引发纤维化。二是急性病毒感染伴随的滑膜炎。
我们报告了1例急性病毒感染后患有NF 1的儿童出现双侧多发扳机指的病例，并讨论了其发病机制。
