Squarcia U, Agnetti A, Caffarra A, Cavalli C, Marbini A
Pediatr Med Chir. 1986 Mar-Apr;8(2):157-61.
A case of a 3 and a half years old girl with severe congestive heart failure, and typical picture of dilated cardiomyopathy is presented. The serum level of carnitine (17.2 micromoles/l, versus 44.1 +/- 12.2 micromoles/l, normal value for age) and the histologic and biochemical evaluation of quadriceps muscle tissue confirmed the diagnosis of primary deficit of carnitine. L-carnitine (2 gr. three times a day p.o.) was added to anti-congestive therapy. After 8 weeks of therapy, the general and cardiocirculatory conditions are much improved. The physiopathology of dilated cardiomyopathy due to deficit of carnitine are discussed. An early diagnosis, and an early substitutive therapy with L-carnitine dramatically improve the outcome of the disease.
本文报告了一例3岁半患有严重充血性心力衰竭且有典型扩张型心肌病表现的女童。血清肉碱水平(17.2微摩尔/升,而该年龄的正常数值为44.1±12.2微摩尔/升)以及股四头肌组织的组织学和生化评估证实了原发性肉碱缺乏症的诊断。在抗充血治疗中添加了左旋肉碱(口服,每日三次,每次2克)。治疗8周后,一般状况和心脏循环状况有了很大改善。文中讨论了因肉碱缺乏导致扩张型心肌病的病理生理学。早期诊断以及早期使用左旋肉碱替代疗法可显著改善疾病的预后。