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罕见综合征性视网膜营养不良病例报告:窒息性胸廓发育不良(热纳综合征)。

Report of a Rare Syndromic Retinal Dystrophy: Asphyxiating Thoracic Dystrophy (Jeune Syndrome).

作者信息

Aksoy Batuhan, Tigrel Gülipek

机构信息

İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Ophthalmology, İstanbul, Türkiye

出版信息

Turk J Ophthalmol. 2025 Feb 27;55(1):53-56. doi: 10.4274/tjo.galenos.2024.76574. Epub 2025 Jan 30.

DOI:10.4274/tjo.galenos.2024.76574
PMID:39881615
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11866991/
Abstract

Jeune syndrome (JS), first described by Jeune as asphyxiating thoracic dystrophy, is an autosomal recessive osteochondrodysplasia with characteristic skeletal abnormalities and variable renal, hepatic, pancreatic, and ocular complications. Approximately 1 in every 100,000 to 130,000 babies is born with JS. Most patients with JS have respiratory distress due to inadequate lung development and many lose their lives due to respiratory failure. Those who survive have serious comorbidities. In terms of ophthalmological diseases, JS is classified among the hereditary syndromic retinopathies. Most, if not all, hereditary syndromic retinopathies can be analyzed in two main groups: inherited metabolic diseases and ciliopathies. The main cause of ocular pathologies in JS is genetic mutations in ciliary proteins that prevent normal function of retinal photoreceptor cells. Here we describe a patient with JS who presented with the complaint of night blindness. Although Snellen visual acuity was 20/20, the patient’s visual function was severely impaired due to photoreceptor dysfunction caused by ciliopathy secondary to the genetic mutation. This case shows that in patients with syndromic comorbidities accompanying nyctalopia, even those with perfect visual acuity, hereditary retinal dystrophies should be considered and asphyxiating thoracic dystrophy (JS) included in the differential diagnosis. Multimodal retinal imaging, including structural and functional assessments, should be used for the diagnosis and genetic counselling should also be provided.

摘要

儒内综合征(JS),最初由儒内描述为窒息性胸廓发育不良,是一种常染色体隐性遗传的骨软骨发育不良,具有特征性骨骼异常以及肾脏、肝脏、胰腺和眼部的各种并发症。每10万至13万新生儿中约有1例患有JS。大多数JS患者因肺部发育不全而出现呼吸窘迫,许多患者因呼吸衰竭而死亡。存活下来的患者有严重的合并症。在眼科疾病方面,JS属于遗传性综合征性视网膜病变。大多数(如果不是全部)遗传性综合征性视网膜病变可分为两大类:遗传性代谢疾病和纤毛病。JS眼部病变主要原因是睫状蛋白基因突变,导致视网膜光感受器细胞功能异常。本文描述了一名以夜盲为主要诉求的JS患者。尽管斯内伦视力为20/20,但由于基因突变继发纤毛病导致光感受器功能障碍该患者的视觉功能严重受损。该病例表明,对于伴有夜盲症状的综合征性合并症患者,即使视力正常,也应考虑遗传性视网膜营养不良,并将窒息性胸廓发育不良(JS)纳入鉴别诊断。应采用包括结构和功能评估在内的多模式视网膜成像进行诊断,同时也应提供遗传咨询。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca3d/11866991/314af9027012/TurkJOphthalmol-55-1-53-figure-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca3d/11866991/008b5689fc85/TurkJOphthalmol-55-1-53-figure-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca3d/11866991/e8a9afa2c41c/TurkJOphthalmol-55-1-53-figure-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca3d/11866991/314af9027012/TurkJOphthalmol-55-1-53-figure-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca3d/11866991/008b5689fc85/TurkJOphthalmol-55-1-53-figure-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca3d/11866991/e8a9afa2c41c/TurkJOphthalmol-55-1-53-figure-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca3d/11866991/314af9027012/TurkJOphthalmol-55-1-53-figure-3.jpg

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本文引用的文献

1
Reassessment of hyperautofluorescent rings in retinitis pigmentosa using novel retinal imaging techniques.使用新型视网膜成像技术对色素性视网膜炎中的高自发荧光环进行重新评估。
Am J Ophthalmol Case Rep. 2023 Jul 6;32:101872. doi: 10.1016/j.ajoc.2023.101872. eCollection 2023 Dec.
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Syndromic Inherited Retinal Diseases: Genetic, Clinical and Diagnostic Aspects.综合征性遗传性视网膜疾病:遗传学、临床及诊断方面
Diagnostics (Basel). 2020 Oct 2;10(10):779. doi: 10.3390/diagnostics10100779.
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DYNC2H1 mutation causes Jeune syndrome and recurrent lung infections associated with ciliopathy.动力蛋白2重链1(DYNC2H1)突变导致约内综合征及与纤毛病相关的复发性肺部感染。
Clin Respir J. 2018 Mar;12(3):1017-1020. doi: 10.1111/crj.12620. Epub 2017 Mar 12.
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