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巴林一名儿童的肠病性肢端皮炎:病例报告及文献综述

Acrodermatitis Enteropathica in a Child in Bahrain: A Case Report and Literature Review.

作者信息

Isa Hasan M, Ali Zainab H, Abdulla Kawthar M, Alshaikh Zainab J, Busehail Maryam Y

机构信息

Department of Pediatrics, Arabian Gulf University, Manama, BHR.

Department of Pediatrics, Salmaniya Medical Complex, Manama, BHR.

出版信息

Cureus. 2025 Feb 5;17(2):e78545. doi: 10.7759/cureus.78545. eCollection 2025 Feb.

Abstract

Acrodermatitis enteropathica (AE) is a rare autosomal recessive disorder caused by a mutation in the zinc transporter gene, leading to impaired zinc absorption. A triad of periorificial dermatitis, alopecia, and diarrhea is the characteristic clinical presentation, although symptoms may vary with age. This disease typically manifests during infancy, particularly during the weaning process. The diagnosis can be confirmed through a thorough history, clinical findings, and laboratory investigations, mainly plasma zinc level assessment with or without genetic testing. Lifelong zinc supplementation is the standard treatment. This case report describes a 19-month-old Yemeni girl residing in Bahrain who was diagnosed with AE. The patient's main presentation was periorificial dermatitis involving the eyes, nose, mouth, ears, nape, and more extensively around the diaper area. The diagnosis was confirmed by clinical exome sequencing, which demonstrated a homozygous missense variant in exon 3 of the solute carrier family 39 member 4 (SLC39A4) gene. Accordingly, zinc replacement therapy was started, resulting in an improvement in the patient's condition. This case report highlights the clinical characteristics and genetic features of this disease.

摘要

肠病性肢端皮炎(AE)是一种罕见的常染色体隐性疾病,由锌转运蛋白基因突变引起,导致锌吸收受损。口周皮炎、脱发和腹泻三联征是其典型的临床表现,不过症状可能因年龄而异。这种疾病通常在婴儿期出现,尤其是在断奶过程中。通过详细的病史、临床表现和实验室检查,主要是血浆锌水平评估(无论是否进行基因检测),可以确诊。终身补充锌是标准治疗方法。本病例报告描述了一名居住在巴林的19个月大也门女孩,她被诊断为AE。患者的主要表现为口周皮炎,累及眼睛、鼻子、嘴巴、耳朵、颈部,且在尿布区周围更为广泛。通过临床外显子测序确诊,该测序显示溶质载体家族39成员4(SLC39A4)基因第3外显子存在纯合错义变异。据此,开始进行锌替代治疗,患者病情有所改善。本病例报告突出了这种疾病的临床特征和遗传特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b82/11888357/27031c177163/cureus-0017-00000078545-i01.jpg

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