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NEJM:遗传性出血性毛细血管扩张-病例报道

2019-12-26 xing.T MedSci原创

遗传性出血性毛细血管扩张(或Rendu–Osler–Weber综合征)是一种常染色体显性遗传疾病,导致血管畸形。在以下任何三种情况下进行临床诊断:复发性鼻出血、粘膜皮肤毛细血管扩张、内脏动静脉病变或有遗传性出血性毛细血管扩张的一级亲属。肺动静脉畸形可因栓塞导致卒中。

患者为一名74岁的妇女,因右侧大脑中动脉急性梗塞而住院,突发左侧无力。她的病史中主要有间歇性鼻出血、黑便和慢性贫血。家族史包括多名症状相似的一级亲属。

除了扁平化的鼻唇沟皱纹,偏瘫和左侧反射亢进外,体检还发现口腔粘膜和手指的毛细血管扩张(如图A和B所示)。胸部X光片显示右半胸腔有一个圆形密度影(如图C所示),血管造影证实为大的肺动静脉畸形(如图D所示)。



遗传性出血性毛细血管扩张(或Rendu–Osler–Weber综合征)是一种常染色体显性遗传疾病,导致血管畸形。在以下任何三种情况下进行临床诊断:复发性鼻出血、粘膜皮肤毛细血管扩张、内脏动静脉病变或有遗传性出血性毛细血管扩张的一级亲属。肺动静脉畸形可因栓塞导致卒中

该患者成功进行了动静脉畸形线圈栓塞术,以防止将来发生缺血性事件,但后来失访。 
 
原始出处:

Helena Schotland.et al.Hereditary Hemorrhagic Telangiectasia.N Engl J Med 2019;https://www.nejm.org/doi/full/10.1056/NEJMicm1905896

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    2020-01-07 lsj637
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    2019-12-26 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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