Kolb H J, Guthoff T
Abteilung für Pädiatrische Intensivmedizin und Neonatologie, Städtischen Kinderklinik, Wuppertal.
Monatsschr Kinderheilkd. 1987 Dec;135(12):827-31.
The difficulties of early diagnosis of Menkes' kinky hair syndrome are described guided by the clinical courses of three related patients. One of these children could be observed continuously from birth. Different from other descriptions the diagnostic value of the clinical features observed in our patients is estimated as follows: 1. severe cerebral degeneration with seizures in the first year of life; 2. subdural hygroma; 3. decreased levels of serum copper and serum coeruloplasmin; 4. hair abnormalities; 5. skin abnormalities. The diagnosis is likely, if serum copper and serum coeruloplasmin are decreased. The diagnosis is proved by increased copper uptake into cultured fibroblasts. The prenatal diagnosis is possible by chorionic villus biopsy or amniocentesis. The importance of carrier detection by cultured fibroblasts and subsequent genetic counselling is underlined.
通过3例相关患者的临床病程描述了门克斯卷发综合征早期诊断的困难。其中一名儿童从出生起就得到持续观察。与其他描述不同,我们患者所观察到的临床特征的诊断价值评估如下:1. 出生后第一年出现严重脑变性并伴有癫痫发作;2. 硬膜下积液;3. 血清铜和血清铜蓝蛋白水平降低;4. 毛发异常;5. 皮肤异常。如果血清铜和血清铜蓝蛋白降低,则可能作出诊断。通过培养的成纤维细胞铜摄取增加可证实诊断。通过绒毛取样或羊膜穿刺术可进行产前诊断。强调了通过培养的成纤维细胞检测携带者并随后进行遗传咨询的重要性。