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科茨加综合征:小儿胃肠道出血的诊断与治疗挑战

Coats Plus syndrome: a diagnostic and therapeutic challenge in pediatric gastrointestinal hemorrhage.

作者信息

Hoşnut Ferda Özbay, Şahin Gülseren, Akçaboy Meltem

机构信息

Division of Pediatric Gastroenterology, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, Turkey.

Department of Pediatrics, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, Turkey.

出版信息

Turk J Pediatr. 2022;64(1):166-170. doi: 10.24953/turkjped.2020.3315.

Abstract

BACKGROUND

Cerebroretinal microangiopathy with calcifications and cysts formerly known as Coats plus syndrome is a rare multisystemic autosomal recessive disease that affects the eyes, brain, bone, and gastrointestinal system. Intestinal telangiectasia are components of vascular malformations characterized by gastrointestinal system bleedings. Recurrent gastrointestinal system bleedings have been reported as being due to hepatic failure or vascular malformations of the gastrointestinal system tract.

CASE

Here we report a patient who presented with recurrent gastrointestinal system bleeding episodes, bilateral exudative retinopathy, intracranial calcification and was diagnosed with Coats plus syndrome. Recurrent gastrointestinal system bleeding was controlled by monthly octreotide treatment.

CONCLUSIONS

Coats plus syndrome presenting with vascular malformations should always be kept in mind in a patient with recurrent gastrointestinal bleeding and accompanying systemic physical findings. Octreotide treatment is an important option for patients with life threatening gastrointestinal system bleeding. Long term use of octreotide treatment can be used successfully in selected pediatric cases.

摘要

背景

伴有钙化和囊肿的脑视网膜微血管病变,以前称为科茨加综合征,是一种罕见的多系统常染色体隐性疾病,会影响眼睛、大脑、骨骼和胃肠道系统。肠道毛细血管扩张是血管畸形的组成部分,其特征是胃肠道出血。据报道,反复出现的胃肠道出血是由于肝功能衰竭或胃肠道系统的血管畸形所致。

病例

在此,我们报告一名患者,该患者反复出现胃肠道出血、双侧渗出性视网膜病变、颅内钙化,并被诊断为科茨加综合征。每月使用奥曲肽治疗可控制反复出现的胃肠道出血。

结论

对于反复出现胃肠道出血并伴有全身体征的患者,应始终考虑到伴有血管畸形的科茨加综合征。奥曲肽治疗是危及生命的胃肠道出血患者的重要选择。在选定的儿科病例中,长期使用奥曲肽治疗可取得成功。

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