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病例报告:血管性埃勒斯-当洛综合征的复杂动脉表现,伴有一种新的变异型且患者年轻时死亡。

Case report: Complex arterial findings in vascular ehlers-danlos syndrome with a novel variant and death at young age.

作者信息

Taurino Jacopo, Micaglio Emanuele, Russo Raucci Annalisa, Zanussi Monica, Chessa Massimo, Udugampolage Nathasha Samali, Carrera Paola, Pappone Carlo, Pini Alessandro

机构信息

Cardiovascular-Genetic Center, IRCCS Policlinico San Donato, Milan, Italy.

Arrhythmology & Electrophysiology, IRCCS Policlinico San Donato, Milan, Italy.

出版信息

Front Cardiovasc Med. 2023 Jun 19;10:1110392. doi: 10.3389/fcvm.2023.1110392. eCollection 2023.

DOI:10.3389/fcvm.2023.1110392
PMID:37404745
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10315819/
Abstract

Vascular Ehlers-Danlos syndrome (vEDS) is a genetic disease caused by a pathogenic mutation in the gene. Despite its severe course, the rarity and extreme clinical variability of the disease can pose significant obstacles to a timely diagnosis. Early and accurate diagnosis may lead to improved patient outcomes by providing access to targeted pharmacological treatments like celiprolol and enhancing the management of vEDS-related complications. Herein, we report a patient harboring a novel missense variant, in which the diagnosis was only possible belatedly due to delayed referral for genetic evaluation. The patient developed pulmonary complications, aneurysms, and vascular malformations, and died at the age of 26 years due to massive pulmonary bleeding.

摘要

血管型埃勒斯-当洛综合征(vEDS)是一种由该基因的致病性突变引起的遗传性疾病。尽管其病程严重,但该疾病的罕见性和极端临床变异性可能对及时诊断造成重大障碍。早期准确的诊断可通过提供使用如塞利洛尔等靶向药物治疗的机会以及加强对vEDS相关并发症的管理,从而改善患者的预后。在此,我们报告了一名携带新型错义变异的患者,由于基因评估转诊延迟,诊断只能在很晚的时候才得以进行。该患者出现了肺部并发症、动脉瘤和血管畸形,并于26岁时因大量肺出血死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11cc/10315819/24084b18ec1f/fcvm-10-1110392-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11cc/10315819/1b8c58b86d82/fcvm-10-1110392-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11cc/10315819/a80d33d74d0d/fcvm-10-1110392-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11cc/10315819/24084b18ec1f/fcvm-10-1110392-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11cc/10315819/1b8c58b86d82/fcvm-10-1110392-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11cc/10315819/a80d33d74d0d/fcvm-10-1110392-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11cc/10315819/24084b18ec1f/fcvm-10-1110392-g003.jpg

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Retrograde Type A Aortic Dissection 48 Hours after TEVAR in a Patient with a Delayed Diagnosis of Vascular Ehlers-Danlos Syndrome.血管性埃勒斯-当洛综合征延迟诊断患者行胸主动脉腔内修复术后48小时发生逆行A型主动脉夹层。
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A 19-year-old man with relapsing bilateral pneumothorax, hemoptysis, and intrapulmonary cavitary lesions diagnosed with vascular Ehlers-Danlos syndrome and a novel missense mutation in COL3A1.一名 19 岁男性,反复发作性双侧气胸、咯血和肺内空洞性病变,诊断为血管型 Ehlers-Danlos 综合征,COL3A1 基因存在新的错义突变。
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Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology.序列变异解读的标准与指南:美国医学遗传学与基因组学学会和分子病理学协会的联合共识推荐
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Survival is affected by mutation type and molecular mechanism in vascular Ehlers-Danlos syndrome (EDS type IV).在血管型埃勒斯-当洛综合征(IV型EDS)中,生存受突变类型和分子机制的影响。
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