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由罕见突变引起的遗传性慢性肠道假性梗阻:一例报告

Hereditary chronic intestinal pseudo-obstruction caused by a rare mutation: A case report.

作者信息

Jiang Shan, Zhou Ya-Xuan, Sun Xiao-Hong, Chen Pei-Pei, Tang Hao, Chen Yang, Liu Ya-Ping, Li Yi-Xuan, Kang Lin

机构信息

Department of Geriatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.

Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.

出版信息

World J Gastrointest Surg. 2025 Jun 27;17(6):107235. doi: 10.4240/wjgs.v17.i6.107235.

Abstract

BACKGROUND

Chronic intestinal pseudo-obstruction (CIPO) is a rare and debilitating disorder, characterized by severe impairments in gastrointestinal motility. The affected sites include the enteric/intrinsic autonomic nerves (neuropathy), intestinal smooth muscle cells (myopathy), and interstitial cells of Cajal (mesenchymopathy). The etiology can be genetic, idiopathic, or acquired. Owing to its nonspecific clinical presentation and lack of definitive diagnostic methods, misdiagnosis of CIPO is common.

CASE SUMMARY

This case involved an older male with insidious onset in adolescence who presented with postprandial bloating, intermittent diarrhea, and weight loss. During the disease course, the patient experienced two episodes of intestinal obstruction. Imaging revealed multisegmental digestive tract abnormalities (gastric emptying disorder, significant duodenal dilatation, and segmental jejunal dilatation). Whole-exome sequencing revealed a rare mutation [NM_001040113.2: C.5819del (p.Pro1940HisfsTer91)], confirming hereditary myopathic CIPO.

CONCLUSION

This report adds to our current understanding of CIPO etiology by reinforcing the role of variants in the pathogenesis of the CIPO phenotype.

摘要

背景

慢性肠道假性梗阻(CIPO)是一种罕见且使人衰弱的疾病,其特征为胃肠动力严重受损。受累部位包括肠内/固有自主神经(神经病变)、肠平滑肌细胞(肌病)和 Cajal 间质细胞(间充质病)。病因可以是遗传的、特发性的或后天获得的。由于其临床表现不具特异性且缺乏明确的诊断方法,CIPO 的误诊很常见。

病例摘要

该病例为一名老年男性,青春期起病隐匿,表现为餐后腹胀、间歇性腹泻和体重减轻。在病程中,患者经历了两次肠梗阻发作。影像学检查显示多节段消化道异常(胃排空障碍、十二指肠显著扩张和空肠节段性扩张)。全外显子测序发现一个罕见突变[NM_001040113.2: C.5819del(p.Pro1940HisfsTer91)],证实为遗传性肌病性 CIPO。

结论

本报告通过强化变异在 CIPO 表型发病机制中的作用,增进了我们目前对 CIPO 病因的理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/585f/12188580/c98563111052/wjgs-17-6-107235-g003.jpg

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