Meléndez-Montañez Jesús M, De Jesús-Rojas Wilfredo
Department of Pediatrics and Basic Science, Ponce Health Sciences University, Ponce, PR 00716, USA.
Children (Basel). 2023 Jan 31;10(2):280. doi: 10.3390/children10020280.
-related metabolic syndrome (CRMS) is a novel diagnosis due to widespread use of and advances in the newborn screening (NBS) process for cystic fibrosis (CF) in the United States of America, allowing for the diagnosis of asymptomatic children with CF. Before 2015, a large Puerto Rican pediatric population was not screened for CF in the NBS test. Studies have shown that patients presenting with idiopathic recurrent or chronic pancreatitis have an increased frequency of cystic fibrosis transmembrane conductance regulator () gene mutations. We present a retrospective chart review of 12 pediatric cases ( = 12) that were presented to an outpatient community clinic with clinical manifestations associated with CF. The pancreatic insufficiency prevalence (PIP) score was calculated on mutations. The mutations considered for the calculation of the PIP score were: F508del (c.1521_1523del), V201M (c.601G > A), I507del (c.1519_1521del), and L1335P (c.4004T > C). V201M mutation was classified as mild in both PIP scores, and a correlation with pancreatitis was noted. Clinical manifestations vary in cases with the V201M variant (c.601G > A). One case was diagnosed with -related disorder (CRD) and recurrent pancreatitis. It is important to consider CRMS or CRD as a differential diagnosis in the pediatric population of Puerto Rico due to the implications and increased risk of pancreatitis and other CF-related complications.
与囊性纤维化相关的代谢综合征(CRMS)是一种新的诊断,这归因于美国囊性纤维化(CF)新生儿筛查(NBS)流程的广泛应用和进展,使得能够诊断出无症状的CF患儿。2015年之前,大量波多黎各儿科人群未在NBS检测中接受CF筛查。研究表明,表现为特发性复发性或慢性胰腺炎的患者囊性纤维化跨膜传导调节因子()基因突变频率增加。我们对12例儿科病例(n = 12)进行了回顾性病历审查,这些病例因与CF相关的临床表现就诊于门诊社区诊所。根据突变情况计算胰腺功能不全患病率(PIP)评分。计算PIP评分时考虑的突变包括:F508del(c.1521_1523del)、V201M(c.601G > A)、I507del(c.1519_1521del)和L1335P(c.4004T > C)。在两个PIP评分中,V201M突变均被归类为轻度,并注意到其与胰腺炎的相关性。V201M变异体(c.601G > A)的病例临床表现各异。1例被诊断为与囊性纤维化相关的疾病(CRD)和复发性胰腺炎。由于胰腺炎及其他与CF相关并发症的影响和风险增加,在波多黎各儿科人群中将CRMS或CRD作为鉴别诊断很重要。