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Birt-Hogg-Dubé 综合征。

Birt-Hogg-Dubé syndrome.

机构信息

Respiratory Medicine Dept, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Division of Genetic Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

出版信息

Eur Respir Rev. 2020 Sep 17;29(157). doi: 10.1183/16000617.0042-2020. Print 2020 Sep 30.

Abstract

Birt-Hogg-Dubé syndrome (BHD) is a rare inherited autosomal dominant disorder caused by germline mutations in the tumour suppressor gene , encoding the protein folliculin. Its clinical expression typically includes multiple pulmonary cysts, recurrent spontaneous pneumothoraces, cutaneous fibrofolliculomas and renal tumours of various histological types. BHD has no sex predilection and tends to manifest in the third or fourth decade of life. Multiple bilateral pulmonary cysts are found on chest computed tomography in >80% of patients and more than half experience one or more episodes of pneumothorax. A family history of pneumothorax is an important clue, which suggests the diagnosis of BHD. Unlike other cystic lung diseases such as lymphangioleiomyomatosis and pulmonary Langerhans cell histiocytosis, BHD does not lead to progressive loss of lung function and chronic respiratory insufficiency. Renal tumours affect about 30% of patients during their lifetime, and can be multiple and recurrent. The diagnosis of BHD is based on a combination of genetic, clinical and/or skin histopathological criteria. Management mainly consists of early pleurodesis in the case of pneumothorax, periodic renal imaging for tumour detection, and diagnostic work-up in search of BHD in relatives of the index patient.

摘要

Birt-Hogg-Dubé 综合征(BHD)是一种罕见的遗传性常染色体显性疾病,由肿瘤抑制基因的种系突变引起,该基因编码蛋白滤泡素。其临床表型通常包括多发性肺囊肿、复发性自发性气胸、皮肤纤维毛囊瘤和各种组织学类型的肾肿瘤。BHD 无性别倾向,倾向于在第三或第四十年发病。>80%的患者在胸部计算机断层扫描中发现多发性双侧肺囊肿,超过一半的患者经历过一次或多次气胸。气胸的家族史是一个重要的线索,提示 BHD 的诊断。与其他囊性肺疾病(如淋巴管平滑肌瘤病和肺朗格汉斯细胞组织细胞增生症)不同,BHD 不会导致肺功能进行性丧失和慢性呼吸功能不全。肾肿瘤在患者一生中影响约 30%,且可能为多发性和复发性。BHD 的诊断基于遗传、临床和/或皮肤组织病理学标准的综合判断。治疗主要包括气胸时的早期胸膜固定术、定期进行肾成像以检测肿瘤,以及对索引患者的亲属进行 BHD 的诊断性检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b506/9489184/cdf33eed7056/ERR-0042-2020.01.jpg

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