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尿素循环障碍中的高血压:病例报告

High Blood Pressure in a Urea Cycle Disorder: Case Report.

作者信息

Solé Carolina, Arriaga María, Cañedo Elvira

机构信息

Department of Neonatology, Gregorio Marañon Hospital, Madrid, Spain.

Department of Metabolism Diseases and Nutrition, Niño Jesús Hospital, Madrid, Spain.

出版信息

AJP Rep. 2020 Oct;10(4):e347-e351. doi: 10.1055/s-0040-1716733. Epub 2020 Oct 7.

DOI:10.1055/s-0040-1716733
PMID:33133764
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7591362/
Abstract

Urea cycle disorders (UCDs) form a group of metabolic pathological conditions that might develop serious neurological consequences. Early diagnosis, before irreversible damage is established, is the most important prognostic and morbidity factor.  We present the case of a 5-day newborn with high blood pressure and respiratory distress. Diagnosis was type I citrullinemia. With appropriate citrullinemia guided-treatment blood pressure returned to normal.  High blood pressure has been rarely described as a lead symptom for the debut of a UCD. We must take this into consideration as an early recognition and treatment of these disorders are of the utmost importance.

摘要

尿素循环障碍(UCDs)是一组可能导致严重神经后果的代谢性病理状况。在不可逆转的损伤形成之前进行早期诊断,是最重要的预后和发病因素。 我们报告了一例5天大的新生儿,伴有高血压和呼吸窘迫。诊断为I型瓜氨酸血症。通过适当的瓜氨酸血症指导治疗,血压恢复正常。 高血压很少被描述为UCD首次出现的主要症状。我们必须将此考虑在内,因为对这些疾病的早期识别和治疗至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebcd/7591362/f66877926525/10-1055-s-0040-1716733-i200069-7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebcd/7591362/b35ae941239f/10-1055-s-0040-1716733-i200069-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebcd/7591362/54a3f504c4cc/10-1055-s-0040-1716733-i200069-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebcd/7591362/c2a491e13b48/10-1055-s-0040-1716733-i200069-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebcd/7591362/fbd0d52180e6/10-1055-s-0040-1716733-i200069-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebcd/7591362/aa268f39e8a4/10-1055-s-0040-1716733-i200069-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebcd/7591362/8c9fa59fc41b/10-1055-s-0040-1716733-i200069-6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebcd/7591362/f66877926525/10-1055-s-0040-1716733-i200069-7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebcd/7591362/b35ae941239f/10-1055-s-0040-1716733-i200069-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebcd/7591362/54a3f504c4cc/10-1055-s-0040-1716733-i200069-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebcd/7591362/c2a491e13b48/10-1055-s-0040-1716733-i200069-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebcd/7591362/fbd0d52180e6/10-1055-s-0040-1716733-i200069-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebcd/7591362/aa268f39e8a4/10-1055-s-0040-1716733-i200069-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebcd/7591362/8c9fa59fc41b/10-1055-s-0040-1716733-i200069-6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebcd/7591362/f66877926525/10-1055-s-0040-1716733-i200069-7.jpg

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本文引用的文献

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The Effects of Oral l-Arginine and l-Citrulline Supplementation on Blood Pressure.口服 l-精氨酸和 l-瓜氨酸补充对血压的影响。
Nutrients. 2019 Jul 22;11(7):1679. doi: 10.3390/nu11071679.
2
Suggested guidelines for the diagnosis and management of urea cycle disorders: First revision.尿素循环障碍的诊断和管理建议指南:第一版修订。
J Inherit Metab Dis. 2019 Nov;42(6):1192-1230. doi: 10.1002/jimd.12100. Epub 2019 May 15.
3
High blood pressure, a red flag for the neonatal manifestation of urea cycle disorders.高血压,尿素循环障碍新生儿表现的一个警示信号。
Orphanet J Rare Dis. 2019 Apr 8;14(1):80. doi: 10.1186/s13023-019-1055-z.
4
Inborn Errors of Metabolism with Hyperammonemia: Urea Cycle Defects and Related Disorders.伴有高氨血症的先天性代谢缺陷:尿素循环障碍及相关疾病
Pediatr Clin North Am. 2018 Apr;65(2):231-246. doi: 10.1016/j.pcl.2017.11.004. Epub 2018 Feb 2.
5
Systemic hypertension in two patients with ASL deficiency: a result of nitric oxide deficiency?两名患有亚硫酸盐氧化酶缺乏症患者的系统性高血压:一氧化氮缺乏的结果?
Mol Genet Metab. 2009 Sep-Oct;98(1-2):195-7. doi: 10.1016/j.ymgme.2009.06.006. Epub 2009 Jun 13.
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Brain MR imaging in neonatal hyperammonemic encephalopathy resulting from proximal urea cycle disorders.近端尿素循环障碍所致新生儿高氨血症性脑病的脑部磁共振成像
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