Latour H, Ferrière M, Baissus C, Renevier D, Martin O, Rebuffat G, Chaptal P A
Arch Mal Coeur Vaiss. 1981 Jul;74(7):871-6.
The case of a patient with Von Recklinghausen's disease with multiple localisations, cardiac, aortic, pulmonary and renal artery is reported. Neurofibromatosis was confirmed by the presence of a "royal" tumour on the left elbow and of many "café au lait" spots of over 15 mm diameter. There was no craniofacial dysmorphism or intellectual impairment. The karyotype was normal. The cardiovascular lesions comprised: - stenosis of the left renal artery resulting in renovascular hypertension. This was due to pure intimal hyperplasia; - supravalvular aortic stenosis with hypoplasia of the ascending aorta. There was no craniofacial dysmorphism or intellectual impairment. The karyotype was normal. The cardiovascular lesions comprised: - stenosis of the left renal artery resulting in renovascular hypertension. This was due to pure intimal hyperplasia; - supravalvular aortic stenosis with hypoplasia of the ascending aorta. There was no craniofacial dysmorphism or intellectual impairment. The karyotype was normal. The cardiovascular lesions comprised: - stenosis of the left renal artery resulting in renovascular hypertension. This was due to pure intimal hyperplasia; - supravalvular aortic stenosis with hypoplasia of the ascending aorta, severe aortic regurgitation with dilatation of the aortic ring without rheumatic valvular thickening; - supra valvular pulmonary stenosis which was atypical in site, extension and in the absence of post stenotic dilatation. The pressure gradient was mild (22 mm Hg). There was a striking similarity between the pulmonary and aortic lesions. This new syndrome may be classified amongst the genetic cardiocutaneous syndromes such as the Gorlin or "leopard" syndrome, Watson's syndrome and Noonan's syndrome. Unusual features are the absence of craniofacial abnormalities, normal intelligence, and the left-sided dominance aggravated by hypertension due to curable intimal stenosis of the renal artery.
报告了1例患有冯·雷克林霍增氏病(神经纤维瘤病)的患者,病变累及心脏、主动脉、肺和肾动脉等多个部位。左肘部出现“典型”肿瘤以及多个直径超过15毫米的“牛奶咖啡斑”,证实为神经纤维瘤病。患者无颅面畸形或智力障碍。核型正常。心血管病变包括:- 左肾动脉狭窄导致肾血管性高血压,原因是单纯内膜增生;- 主动脉瓣上狭窄伴升主动脉发育不全。无颅面畸形或智力障碍。核型正常。心血管病变包括:- 左肾动脉狭窄导致肾血管性高血压,原因是单纯内膜增生;- 主动脉瓣上狭窄伴升主动脉发育不全,严重主动脉瓣反流伴主动脉环扩张,无风湿性瓣膜增厚;- 肺动脉瓣上狭窄,其部位、范围不典型,且无狭窄后扩张。压力阶差较小(22毫米汞柱)。肺和主动脉病变之间存在显著相似性。这种新综合征可归类于遗传性心脏皮肤综合征,如戈林综合征或“豹皮综合征”、沃森综合征和努南综合征。不寻常的特征是无颅面异常、智力正常,以及由于可治愈的肾动脉内膜狭窄导致的高血压加重了左侧优势。