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伴有单侧下肢进行性麻痹的变形综合征:1例罕见病例报告及文献复习

Proteus syndrome with progressive paralysis of the unilateral lower limb: A rare case report and literature review.

作者信息

Cai Feng, Liu Zhi, Zou Jun, Liu Yunfeng, Tang Weiming, Zhou Liping, Zhu Xiaojian, Huang Xiaoping, Long Wei, Zhao Shushan

机构信息

Department of Trauma Orthopaedics, Chaling County People's Hospital, Zhuzhou, 412400, Hunan, China.

Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.

出版信息

Heliyon. 2024 Aug 13;10(16):e36190. doi: 10.1016/j.heliyon.2024.e36190. eCollection 2024 Aug 30.

Abstract

OBJECTIVE

Proteus syndrome, a rare disorder with an incidence of one in a million, is characterized by connective tissue nevi, asymmetric limb overgrowth, and abnormal subcutaneous adipose tissue distribution. Limited awareness of this condition often hinders accurate clinical diagnosis. We report a case of Proteus syndrome with concurrent progressive paralysis in the unilateral lower limb, aiming to enhance understanding of the disease and its associated complications.

METHODS

The patient, an 11-year-old male, has been conclusively diagnosed with Proteus Syndrome. This diagnosis was established by analyzing clinical manifestations, imaging studies, and laboratory tests. In addition, a literature review was conducted to systematically elucidate the etiology, diagnosis, treatment, and prognosis of this condition.

RESULTS

According to the clinical manifestations, we confirmed a case of Proteus syndrome. This example exhibits the general characteristics of patients with severe hemihypertrophy of the bilateral lower limbs, anomalies in hypodermic and adipose distribution, and unilateral lower limb progressive paralysis. Pathological biopsy confirmed the right chest wall mass as a lipoma. Notably, the patient experiences lower limb movement disorders caused by intraspinal disease. At the same time, the gene sequencing results of this Proteus syndrome patient showed mutations in the IDUS gene and SPECC1L gene, which have not been reported before.

CONCLUSION

We diagnosed Proteus Syndrome with lower limb sensorimotor abnormalities, which may be caused by mutations in the IDUS gene or SPECC1L gene. This is the first report of these kinds of gene mutations in association with Proteus Syndrome.

摘要

目的

变形综合征是一种罕见疾病,发病率为百万分之一,其特征为结缔组织痣、肢体不对称过度生长以及皮下脂肪组织分布异常。对这种疾病的认识有限常常妨碍准确的临床诊断。我们报告一例伴有单侧下肢进行性麻痹的变形综合征病例,旨在增进对该疾病及其相关并发症的了解。

方法

该患者为一名11岁男性,已被确诊为变形综合征。通过分析临床表现、影像学检查和实验室检查确诊。此外,进行了文献综述以系统阐明该疾病的病因、诊断、治疗和预后。

结果

根据临床表现,我们确诊了一例变形综合征病例。该病例表现出双侧下肢严重半侧肥大、皮下和脂肪分布异常以及单侧下肢进行性麻痹等患者的一般特征。病理活检证实右胸壁肿块为脂肪瘤。值得注意的是,患者因脊髓疾病出现下肢运动障碍。同时,该变形综合征患者的基因测序结果显示IDUS基因和SPECC1L基因发生突变,此前未见报道。

结论

我们诊断出伴有下肢感觉运动异常的变形综合征,这可能由IDUS基因或SPECC1L基因的突变引起。这是此类基因突变与变形综合征相关的首次报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2461/11367504/09e068b14c84/gr1.jpg

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