Lu You-Ran, Yuan Qing, Liu Jian, Han Xue, Liu Min, Liu Qing-Quan, Wang Yu-Guang
Department of Respiration, Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical University, Beijing 100010, China.
Department of Imaging, Traditional Chinese Medicine Hospital Affiliated to Capital Medical University, Beijing 100010, China.
World J Clin Cases. 2021 Aug 26;9(24):7123-7132. doi: 10.12998/wjcc.v9.i24.7123.
Birt-Hogg-Dubé (BHD) syndrome is a rare autosomal dominant disease caused by germline mutations in the folliculin (FLCN) protein gene, which usually manifests as cutaneous fibrofolliculoma, pulmonary cysts, renal cell carcinoma, and spontaneous pneumothorax.
A 26-year-old woman with no history of smoking was admitted to the Respiratory Department of our hospital due to intermittent wheezing that lasted for 8 mo. She had experienced recurrent spontaneous pneumothorax more than four times during the past 8 mo. After admission, the patient again suffered from left pneumothorax without a clear reason. Lung computed tomography (CT) showed multiple low-density cystic changes in both lungs. Physical examination on admission revealed multiple white dome-shaped papules in the neck, the nape, and behind the ear. In addition, the patient had a family history of spontaneous pneumothorax. Her mother had suffered from pneumothorax four times (at age 36, 37, 42, and 50 years). Her second maternal aunt had suffered from a right pneumothorax at the age of 40. The multidisciplinary diagnosis of BHD, which included the Respiratory Department, Radiology Department, Pathology Department, and Dermatological Department, was BHD and was later confirmed by family genetic testing. The same variation ( gene) was found in the patient's mother and aunt.
This case highlights the importance of multidisciplinary diagnosis and a treatment platform for the diagnosis of BHD.
Birt-Hogg-Dubé(BHD)综合征是一种罕见的常染色体显性疾病,由卵泡抑素(FLCN)蛋白基因的种系突变引起,通常表现为皮肤纤维毛囊瘤、肺囊肿、肾细胞癌和自发性气胸。
一名26岁无吸烟史的女性因间歇性喘息8个月入住我院呼吸科。在过去8个月中,她经历了4次以上复发性自发性气胸。入院后,患者再次无明显原因出现左侧气胸。肺部计算机断层扫描(CT)显示双肺多发低密度囊性改变。入院体格检查发现患者颈部、项部和耳后有多个白色圆顶状丘疹。此外,患者有自发性气胸家族史。她的母亲曾4次患气胸(分别在36岁、37岁、42岁和50岁时)。她的二姨母在40岁时患右侧气胸。呼吸科、放射科、病理科和皮肤科多学科诊断为BHD,后来经家族基因检测得到证实。在患者的母亲和姨母中发现了相同的变异(基因)。
本病例突出了多学科诊断和治疗平台对BHD诊断的重要性。