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病例报告:一例新生儿杜宾-约翰逊综合征病例。

Case Report: A case of Dubin-Johnson syndrome in a newborn.

作者信息

Long Junshan, Qiu Baowei, Su Xiaoxia, Zhang Jing, Dong Qi

机构信息

Department of General Surgery, Hainan Women and Children's Medical Center, Hainan Women and Children's Medical Center, Haikou, Hainan, China.

出版信息

Front Pediatr. 2024 Jul 19;12:1417649. doi: 10.3389/fped.2024.1417649. eCollection 2024.

Abstract

BACKGROUND

Dubin-Johnson Syndrome (DJS) is a rare autosomal recessive genetic disorder, with most cases presenting in adolescence, but rare in newborns.

OBJECTIVE

To investigate the clinical characteristics and treatment outcomes of DJS in a newborn.

METHODS

We present the clinical features of a newborn diagnosed with DJS through molecular genetic testing.

RESULTS

The patient was a male newborn who developed jaundice and scleral icterus on the 6th day of life. Both direct and indirect bilirubin levels were elevated. After treatment with phototherapy, indirect bilirubin levels decreased, but direct bilirubin remained unchanged, and the stool color gradually lightened. At 56 days of age, the patient underwent laparoscopic cholecystostomy, which revealed viscous bile plugs in the bile ducts. Following the surgery, the patient received oral ursodeoxycholic acid, compound glycyrrhizin, and methylprednisolone. Follow-up until one year post-surgery showed a gradual reduction in direct bilirubin levels to the normal range. Molecular genetic testing revealed three heterozygous mutations in the gene on chromosome 10, with one pathogenic variant inherited from the father and two from the mother, confirming the diagnosis of DJS.

CONCLUSION

DJS is a benign condition with a favorable prognosis. In newborns, it should be differentiated from other causes of cholestasis, and compared to cholestasis, jaundice in newborns with DJS responds more slowly to treatment.

摘要

背景

杜宾-约翰逊综合征(DJS)是一种罕见的常染色体隐性遗传病,多数病例在青春期发病,但新生儿罕见。

目的

探讨1例新生儿杜宾-约翰逊综合征的临床特征及治疗效果。

方法

我们报告1例经分子遗传学检测确诊为杜宾-约翰逊综合征的新生儿的临床特征。

结果

该患者为男性新生儿,出生后第6天出现黄疸和巩膜黄染。直接胆红素和间接胆红素水平均升高。经光疗后,间接胆红素水平下降,但直接胆红素水平未变,且大便颜色逐渐变浅。56日龄时,患者接受腹腔镜胆囊造瘘术,术中见胆管内有黏稠胆汁栓。术后,患者接受口服熊去氧胆酸、复方甘草酸苷和甲泼尼龙治疗。术后1年随访显示直接胆红素水平逐渐降至正常范围。分子遗传学检测显示10号染色体上该基因有3个杂合突变,其中1个致病变异来自父亲,2个来自母亲,确诊为杜宾-约翰逊综合征。

结论

杜宾-约翰逊综合征为良性疾病,预后良好。在新生儿中,应与其他胆汁淤积原因相鉴别,与胆汁淤积相比,杜宾-约翰逊综合征新生儿的黄疸对治疗反应较慢。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd88/11294160/b168c09ece71/fped-12-1417649-g001.jpg

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