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[乔伯特综合征:7例基因分型病例系列的发病率及临床放射学描述]

[Joubert syndrome: incidence and clinicoradiological description of a genotyped series of seven cases].

作者信息

Ramos-Fernández J M, Extraviz-Moreno A, Calvo-Medina R, Ruiz-García C, Mora-Ramírez M D

机构信息

Hospital Regional Universitario Materno Infantil Málaga, Málaga, España.

出版信息

Rev Neurol. 2021 Aug 15;73(4):115-120. doi: 10.33588/rn.7304.2021066.

Abstract

INTRODUCTION

Joubert syndrome is produced by an alteration of the ciliary proteins essential for the structure and function of neurons and organs such as the kidneys, liver, sight, and hearing. Some 34 mutations are currently known.

OBJECTIVE

Calculate the incidence / prevalence, describe the phenotype / genotype and radiological alterations of this ciliopathy in our health area.

PATIENTS AND METHODS

We reviewed the medical records with a diagnosis of Joubert Syndrome in the last 10 years to collect phenotype, radiological characteristics, and extra-neurological manifestations in relation to the genetic alteration detected.

RESULTS

7 cases were included: 5 children (6 -17 years). They had 6 different mutations. Hypotonia, thin / long fingers and delayed psychomotor development were constant. They presented dysmorphic features, mental retardation, ocular apraxia, and nystagmus indistinctly in 3/7; Neonatal apnea/hyperpnea 2/7; hypoplasia of vermis 7/7; Molar syndrome was evident in 6/7 and in 2/7 there was elongation-thinning of cerebellar peduncles. Pontomesencephalic junction tightness 6/7; fastigium of the IV ventricle high in 4/7. Among the somatic complications, retinopathy 2/7, retinal coloboma 1/7, liver fibrosis 1/7, nephronoptysis 1/7 and renal cyst 1/7.

CONCLUSIONS

The incidence of Joubert syndrome was at least 1 / 20,000 newborns / year. The pontomesencephalic and peduncular radiological alterations were constant. Hypotonia, psychomotor retardation, and thin / long fingers affected all cases.

摘要

引言

乔伯特综合征是由对神经元以及肾脏、肝脏、视觉和听觉等器官的结构和功能至关重要的纤毛蛋白改变所引起的。目前已知约34种突变。

目的

计算我们健康区域内这种纤毛病的发病率/患病率,描述其表型/基因型及影像学改变。

患者与方法

我们回顾了过去10年中诊断为乔伯特综合征的病历,以收集与检测到的基因改变相关的表型、影像学特征和神经外表现。

结果

纳入7例患者:5名儿童(6 - 17岁)。他们有6种不同的突变。肌张力减退、手指细长和精神运动发育迟缓是常见症状。3/7的患者出现了畸形特征、智力障碍、眼球失用和眼球震颤;2/7出现新生儿呼吸暂停/呼吸急促;7/7出现小脑蚓部发育不全;6/7有磨牙综合征,2/7有小脑脚延长变细。脑桥中脑交界处狭窄6/7;第四脑室顶在4/7位置较高。在躯体并发症中,视网膜病变2/7,视网膜裂孔1/7,肝纤维化1/7,肾下垂1/7,肾囊肿1/7。

结论

乔伯特综合征的发病率至少为每年1/20000新生儿。脑桥中脑和脑脚的影像学改变是持续存在的。肌张力减退、精神运动发育迟缓以及手指细长影响了所有病例。

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