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共济失调毛细血管扩张症:一例报告及简要综述

Ataxia-Telangiectasia: A Case Report and a Brief Review.

作者信息

Sirajwala Abulkalam A, Khan Shahin, Rathod Vaishnavi M, Gevariya Vishwa C, Jansari Jay R, Patel Yash M

机构信息

Department of General Medicine, Sir Sayajirao General Hospital and Medical College Baroda, Vadodara, IND.

出版信息

Cureus. 2023 May 22;15(5):e39346. doi: 10.7759/cureus.39346. eCollection 2023 May.

Abstract

Ataxia-telangiectasia (A-T) is a rare inherited syndrome that primarily presents as ataxia due to cerebellar involvement and dilated capillaries in the oculocutaneous region. But many more serious complications of the condition exist, due to which both the quality and length of life are severely affected. Some of these include opportunistic infections due to an abnormal immune system, various malignancies, and an increased sensitivity to ionizing radiation. Due to the involvement of multiple systems in the body, diagnosis of this condition could be tricky as it may manifest with uncommon signs like dystonic head movements seen in our case. We have presented the case of a 16-year-old male born out of a consanguineous marriage, with the major symptoms of walking difficulties, frequent falls, and jerky movements of the head. Similar or related complaints had been noted in the past in his siblings. Laboratory investigations revealed elevated levels of serum alpha-fetoprotein, while the confirmatory diagnosis was made by genetic testing of the ataxia-telangiectasia mutated (ATM) gene. The patient was treated with amantadine and clonazepam, along with speech therapy, but the prognosis remained poor due to the lack of curative treatment for A-T.

摘要

共济失调毛细血管扩张症(A-T)是一种罕见的遗传性综合征,主要表现为由于小脑受累导致的共济失调以及眼皮肤区域毛细血管扩张。但该病症还存在许多更严重的并发症,因此生活质量和寿命均受到严重影响。其中一些并发症包括免疫系统异常导致的机会性感染、各种恶性肿瘤以及对电离辐射的敏感性增加。由于身体多个系统受累,这种病症的诊断可能很棘手,因为它可能表现出一些不常见的症状,如我们病例中所见的张力障碍性头部运动。我们报告了一例16岁男性病例,该男性为近亲结婚所生,主要症状为行走困难、频繁跌倒和头部抽搐运动。过去在他的兄弟姐妹中也注意到了类似或相关的症状。实验室检查显示血清甲胎蛋白水平升高,而通过共济失调毛细血管扩张症突变(ATM)基因的基因检测做出了确诊。该患者接受了金刚烷胺和氯硝西泮治疗,并接受了言语治疗,但由于缺乏针对A-T的治愈性治疗,预后仍然很差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ef/10284443/7acac070e12d/cureus-0015-00000039346-i01.jpg

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