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儿童期肝糖原累积症:20例患者的临床及实验室检查结果

[Hepatic glycogenosis in childhood: clinical and laboratory findings in 20 patients].

作者信息

Ferreira A M, Fernandes M I, Galvão L C, Sawamura R, Goldani H A, de Oliveira J A

机构信息

Departamento de Puericultura e Pediatria, Universidade de São Paulo.

出版信息

Arq Gastroenterol. 1995 Jul-Sep;32(3):146-51.

PMID:8728790
Abstract

We studied 20 children with a clinical picture and laboratory study suggestive of hepatic glycogenosis. The age of the beginning of symptoms varied from birth to 24 months and the age at the diagnosis varied from 2 to 81 months. Hepatomegaly was found in all patients, diarrhea in 65% (13/26), "doll-face" in 55% (11/20) and convulsions in 50% (10/20). Nutritional evaluation showed more height deficiency than weight deficiency. Laboratory tests showed elevation of hepatic transaminases (12/19), hypercolesterolemia (8/14), hyperuricemia (6/17) and hypoglycemia (6/20). Liver function was not compromised in most of the cases. The results of glucagon tolerance test were variable. The histoenzymology study performed in 15 patients revealed the following results: Type VI (liver phosphorylase deficiency) in seven, Type I (glucose-6-phosphatase deficiency) in two, Type IV (brancher enzyme) in one and no conclusion could be drawn in five patients. The finding of hypoglycemia in few cases of this study can be justified by the few number of glycogenosis Type I, probably due to the fact that this type is the most easily diagnosed, with less necessity of referring them to specialized centers.

摘要

我们研究了20名临床表现和实验室检查提示肝糖原累积症的儿童。症状开始出现的年龄从出生到24个月不等,诊断时的年龄从2个月到81个月不等。所有患者均有肝肿大,65%(13/26)有腹泻,55%(11/20)有“娃娃脸”,50%(10/20)有惊厥。营养评估显示身高不足比体重不足更为常见。实验室检查显示肝转氨酶升高(12/19)、高胆固醇血症(8/14)、高尿酸血症(6/17)和低血糖(6/20)。大多数病例肝功能未受损害。胰高血糖素耐量试验结果不一。对15名患者进行的组织酶学研究结果如下:7例为VI型(肝磷酸化酶缺乏症),2例为I型(葡萄糖-6-磷酸酶缺乏症),1例为IV型(分支酶缺乏症),5例无法得出结论。本研究中少数病例出现低血糖的情况可通过I型糖原累积症病例数较少来解释,这可能是因为该型最容易诊断,转诊至专科中心的必要性较小。

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