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甲状旁腺功能减退症与 DiGeorge 样综合征中的良性甲状腺结节相关:一例罕见病例报告及文献复习。

Hypoparathyroidism Associated with Benign Thyroid Nodules in DiGeorge-like Syndrome: A Rare Case Report and Literature Review.

机构信息

Department of Surgery, Division of Pediatric and Adolescent Surgery, University of Pisa, Pisa, Italy.

Department of Clinical and Experimental Medicine, Pediatric Unit, University of Pisa, Pisa, Italy.

出版信息

Endocr Metab Immune Disord Drug Targets. 2024;24(7):850-856. doi: 10.2174/0118715303274582231102094440.

Abstract

BACKGROUND

DiGeorge-like syndrome (DGLS) is a rare genetic disorder due to the presence of the same classical clinical manifestations of DiGeorge syndrome (DGS) without its typical deletion. In the DGLS phenotype, hypoparathyroidism seldom occurs and is considered rare. In DGS, hypocalcemia affects up to 70% of patients, and a considerable share often has asymptomatic thyroid abnormalities.

CASE PRESENTATION

In this study, we describe an unusual case of a 16-year-old patient with DGLS due to a duplication of 365 kb in the 20p11.22 region, affected by hypoparathyroidism associated with thyroid nodule. The intraoperative parathyroid evaluation ruled out agenesis as a cause of hypoparathyroidism. In addition, we carried out a thorough literature review from 2010 to 2023 of DGLS cases using specific keywords, such as "22q11.2 deletion syndrome", "Di- George-like Syndrome", "hypoparathyroidism", "thyroid", and "children", analyzing 119 patients with DGLS.

CONCLUSION

Interestingly enough, the present case represents, to our knowledge, the first report of a patient with DGLS associated with hypoparathyroidism and the presence of thyroid nodules where an intraoperative observation reported a non-functional parathyroid gland.

摘要

背景

DiGeorge 样综合征(DGLS)是一种罕见的遗传性疾病,由于存在与 DiGeorge 综合征(DGS)相同的典型临床表现,但没有其典型的缺失。在 DGLS 表型中,甲状旁腺功能减退症很少发生,被认为较为罕见。在 DGS 中,低钙血症影响多达 70%的患者,相当一部分患者常常存在无症状的甲状腺异常。

病例介绍

在本研究中,我们描述了一例不寻常的 16 岁 DGLS 患者,其病因是 20p11.22 区域的 365 kb 重复,患有与甲状腺结节相关的甲状旁腺功能减退症。术中甲状旁腺评估排除了甲状旁腺发育不全作为甲状旁腺功能减退症的原因。此外,我们从 2010 年至 2023 年使用特定关键字(如“22q11.2 缺失综合征”、“DiGeorge 样综合征”、“甲状旁腺功能减退症”、“甲状腺”和“儿童”)对 DGLS 病例进行了全面的文献回顾,分析了 119 例 DGLS 患者。

结论

有趣的是,本病例代表了我们所知的首例与甲状旁腺功能减退症和甲状腺结节相关的 DGLS 患者,术中观察报告一个无功能的甲状旁腺。

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