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一名12岁儿童的进行性家族性肝内胆汁淤积症3伪装成威尔逊病:一段诊断历程。

Progressive familial intrahepatic cholestasis 3 Camouflaging as Wilson disease in a 12-year-old: a diagnostic Odyssey.

作者信息

Panda Kalpana, Pradhan Subhasis, Dash Mrutunjay, Pati Girish Kumar

机构信息

Department of Paediatric Gastroenterology & Hepatology, Institute of Medical Sciences & SUM Hospital, Bhubaneswar, Odisha, India.

Department of Gastroenterology & Hepatology, MKCG Medical College and Hospital, Berhampur, Odisha, India.

出版信息

Gastroenterol Hepatol Bed Bench. 2024;17(3):320-324. doi: 10.22037/ghfbb.v17i3.2999.

Abstract

Primary Familial Intrahepatic Cholestasis type 3 is an exceedingly rare genetic cholestatic disorder characterized by the defective hepatocanaliculr bile acid transport leading to progressive liver disease. In this case report, we describe the course of treatment for a 12-year-old kid diagnosed with Wilson disease based on Leipzig score and copper investigations. The child did not improve with chelation therapy and was subsequently genetically classified as PFIC-3. This case highlighted the caveats in Wilson disease diagnostic scoring system. The diagnostic odyssey, therapeutic interventions, and outcome of this case underscore the intricate interplay between clinical suspicion, investigative strategies, and the pivotal role of genetic testing to elucidate rare liver disorders in children.

摘要

3型原发性家族性肝内胆汁淤积症是一种极其罕见的遗传性胆汁淤积性疾病,其特征是肝小管胆汁酸转运缺陷,导致进行性肝病。在本病例报告中,我们描述了一名12岁儿童基于莱比锡评分和铜检测被诊断为威尔逊病后的治疗过程。该患儿螯合疗法治疗无效,随后经基因检测分类为PFIC-3。本病例突出了威尔逊病诊断评分系统中的注意事项。该病例的诊断历程、治疗干预及结果强调了临床怀疑、检查策略以及基因检测在阐明儿童罕见肝病方面的关键作用之间的复杂相互作用。

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本文引用的文献

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ABCB4 disease mimicking morbus Wilson: A potential diagnostic pitfall.ABCB4 病模仿 Wilson 病:一个潜在的诊断陷阱。
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2020 Mar;164(1):121-125. doi: 10.5507/bp.2019.054. Epub 2019 Nov 15.
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Systematic review of progressive familial intrahepatic cholestasis.进行性家族性肝内胆汁淤积症的系统评价。
Clin Res Hepatol Gastroenterol. 2019 Feb;43(1):20-36. doi: 10.1016/j.clinre.2018.07.010. Epub 2018 Sep 17.
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EASL Clinical Practice Guidelines: Wilson's disease.EASL 临床实践指南:肝豆状核变性。
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