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H 综合征肾脏受累致糖尿病:病例报告

Renal Involvement in H Syndrome, A Rare Cause of Diabetes Mellitus: Case Report.

机构信息

Department of Pediatric Endocrinology, Sakarya Training and Research Hospital Sakarya, Sakarya University, Ministry of Health, Turkey.

Department of Pediatric Endocrinology, Sanlıurfa Training and Research Hospital, Ministry of Health, Şanlıurfa, Turkey.

出版信息

Endocr Metab Immune Disord Drug Targets. 2023;23(5):727-731. doi: 10.2174/1871530323666221111151455.

Abstract

BACKGROUND

H syndrome is a rare genodermatosis deriving from a mutation in the SLC29A3 gene and affecting numerous systems, particularly the skin. The syndrome exhibits different clinical characteristics involving several systems, most beginning with the letter "H." The most common clinical findings are cutaneous hyperpigmentation, flexion contracture in the fingers, hearing loss, short stature, insulin-dependent diabetes mellitus, heart anomalies, hepatosplenomegaly, and hypogonadism. Fewer than 150 cases have been reported so far and vast majority of them consisted with patients with Arab ethnicity.

CASE PRESENTATION

We describe a patient presenting with short stature, developing diabetes mellitus at follow-ups, with homozygous deletion determined in exon 3 of the SLC29A3 gene, and diagnosed with H syndrome, reported due to the presence and rarity of renal involvement (hematuria and proteinuria).

CONCLUSION

In conclusion, despite its rarity, endocrinologists, rheumatologists/nephrologists, and dermatologists need to be aware of H syndrome as a pleiotropic syndrome. H syndrome should be considered in the differential diagnosis of patients with cutaneous hyperpigmentation (particularly in the bilateral thigh and calf region) together with proteinuria/hematuria. In addition, periodic urine analysis should be performed in patients with H syndrome.

摘要

背景

H 综合征是一种罕见的遗传性皮肤病,源自 SLC29A3 基因突变,影响多个系统,特别是皮肤。该综合征表现出不同的临床特征,涉及多个系统,大多数以字母“H”开头。最常见的临床发现是皮肤色素沉着过度、手指弯曲挛缩、听力损失、身材矮小、胰岛素依赖型糖尿病、心脏异常、肝脾肿大和性腺功能减退。迄今为止,报告的病例少于 150 例,其中绝大多数为阿拉伯裔患者。

病例介绍

我们描述了一名患者,表现为身材矮小,随访中出现糖尿病,SLC29A3 基因第 3 外显子纯合缺失,诊断为 H 综合征,报告该病例是因为存在且罕见肾脏受累(血尿和蛋白尿)。

结论

尽管罕见,但内分泌学家、风湿病学家/肾病学家和皮肤科医生需要意识到 H 综合征是一种多效性综合征。在伴有蛋白尿/血尿的皮肤色素沉着过度(特别是双侧大腿和小腿区域)患者的鉴别诊断中应考虑 H 综合征。此外,应在 H 综合征患者中定期进行尿液分析。

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