Abi Radi Abou Jaoudeh Rasha, McCleary Brendan, Radhakrishnan Kadakkal
Division of Pediatrics and Adolescent Medicine, Cleveland Clinic Children's Center, Cleveland, OH.
Division of Diagnostic Radiology, Cleveland Clinic Children's Center, Cleveland, OH.
ACG Case Rep J. 2024 Jan 22;11(1):e01240. doi: 10.14309/crj.0000000000001240. eCollection 2024 Jan.
X-linked myotubular myopathy (XLMTM) is a neuromuscular disorder manifesting at birth with hypotonia and respiratory distress. We describe the XLMTM case presenting at birth who developed normal gamma-glutamyl transferase cholestasis at 1 year of age. He was also diagnosed with Crohn's disease 4 years later. His cholestasis could be attributed to progressive familial intrahepatic cholestasis (PFIC) or primary sclerosing cholangitis in the setting of Crohn's disease. However, genetic testing ruled-out PFIC, and his radiographic and liver biopsy findings were not suggestive of primary sclerosing cholangitis. We believe that this cholestasis is related to XLMTM leading to a PFIC-like state.
X连锁肌管性肌病(XLMTM)是一种神经肌肉疾病,出生时表现为肌张力减退和呼吸窘迫。我们描述了1例出生时即患有XLMTM的病例,该患儿在1岁时出现了γ-谷氨酰转移酶正常的胆汁淤积。4年后他还被诊断为克罗恩病。他的胆汁淤积可能归因于进行性家族性肝内胆汁淤积症(PFIC)或克罗恩病背景下的原发性硬化性胆管炎。然而,基因检测排除了PFIC,其影像学和肝脏活检结果也不提示原发性硬化性胆管炎。我们认为这种胆汁淤积与XLMTM有关,导致了类似PFIC的状态。