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首例通过菲律宾新生儿筛查项目确诊为囊性纤维化的菲律宾婴儿病例报告。

A Case Report of the First Filipino Infant Diagnosed with Cystic Fibrosis through the Philippine Newborn Screening Program.

作者信息

Almonte Cielito S, Ellong Mirasol S, Macrohon Bernadette C

机构信息

Department of Pediatrics, Zamboanga City Medical Center.

Ateneo de Zamboanga University School of Medicine.

出版信息

Acta Med Philipp. 2024 Apr 15;58(6):69-73. doi: 10.47895/amp.vi0.7570. eCollection 2024.

Abstract

Cystic Fibrosis (CF) is a rare condition among Asians and has not been reported in the Philippines as of this time. The inclusion of this disease in the Philippines' Expanded Newborn Screening Program (ENBS) has provided this Filipino family the opportunity of early detection and appropriate management of this condition that could ensure the survival of the proband and his other surviving siblings. Here we present a case of a 24-month-old male who had a positive Expanded Newborn Screening (ENBS) test for cystic fibrosis and eventually underwent further tests to confirm a homozygous deletion of exons 1 - 2 of the CFTR gene. He subsequently had recurrent pneumonia but is being managed by a team consisting of a pulmonologist, gastroenterologist, and a metabolic dietitian. The proband had an older sibling whose Newborn Screening (NBS) test was normal and who eventually expired from recurrent bouts of pneumonia. This sibling was never managed as a case of cystic fibrosis. Implications on the diagnosis and management of CF in the local setting is also discussed. The importance of an appropriate CF panel customized to the local population should be reiterated and carrier testing should be encouraged to help with proper family counseling for future pregnancies for the family involved.

摘要

囊性纤维化(CF)在亚洲人中较为罕见,截至目前在菲律宾尚未有相关报道。将这种疾病纳入菲律宾扩大新生儿筛查项目(ENBS),为这个菲律宾家庭提供了早期发现并妥善管理该病症的机会,从而确保先证者及其其他存活兄弟姐妹的生存。在此,我们报告一例24个月大的男性患儿,其扩大新生儿筛查(ENBS)囊性纤维化检测呈阳性,最终接受进一步检测以确认CFTR基因第1 - 2外显子纯合缺失。他随后反复出现肺炎,但由包括肺科医生、胃肠病学家和代谢营养师在内的团队进行管理。先证者有一个哥哥/姐姐,其新生儿筛查(NBS)检测结果正常,但最终因反复肺炎发作而死亡。这个哥哥/姐姐从未被当作囊性纤维化病例进行管理。本文还讨论了在当地环境中对CF的诊断和管理的影响。应重申为当地人群定制合适的CF检测组合的重要性,并鼓励进行携带者检测,以帮助为相关家庭未来的怀孕提供适当的遗传咨询。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6980/11151128/106989c0be51/AMP-58-6-7570-g001.jpg

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