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Lancet:“毛骨悚然”的颅骨——案例报道

2016-10-16 MedSci MedSci原创

患者女,29岁,2014年4月因头痛行了头颅MRI,结果显示板障空间扩大、颅骨外板位移、灰质低信号(T1加权像)。 患者的头颅X片出现“竖毛征”,骨小梁栅栏状改变沿颅底骨垂直排列。 既往有先天性纯红细胞再生障碍性贫血III型史。需要定期输血,直到9岁行了脾切除。此后患者每年随访血红蛋白,稳定在90–100 g/L。 先天性纯红细胞再生障碍性贫血是一种罕见的遗传性疾病,以无

患者女,29岁,2014年4月因头痛行了头颅MRI,结果显示板障空间扩大、颅骨外板位移、灰质低信号(T1加权像)。



患者的头颅X片出现“竖毛征”,骨小梁栅栏状改变沿颅底骨垂直排列。



既往有先天性纯红细胞再生障碍性贫血III型史。需要定期输血,直到9岁行了脾切除。此后患者每年随访血红蛋白,稳定在90–100 g/L。

先天性纯红细胞再生障碍性贫血是一种罕见的遗传性疾病,以无效红细胞生成为特征。

“竖毛征”见于重度贫血患者
。本案例患者的头骨变化是由于因为慢性贫血所致骨髓红细胞生成增加和骨髓增生。

除了上述,患者的MRI没有发现其他异常,诊断为紧张性头痛,使用镇痛药和行为治疗后,完全缓解。

为了加深印象,再给大家看一张其他患者的“竖毛征”CT图像。



原始出处:


María Asunción Pérez-Jacoiste Asín,et al.Skull erythropoiesis in a patient with congenital dyserythropoietic anaemia.Lancet.20 February 2016 

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    2017-04-30 howi
  2. [GetPortalCommentsPageByObjectIdResponse(id=1828653, encodeId=fcd618286532e, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sun Apr 30 02:38:00 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=152923, encodeId=b26c15292345, content=第一次见,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82351961337, createdName=1e137bdcm70(暂无匿称), createdTime=Wed Nov 02 16:09:59 CST 2016, time=2016-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149680, encodeId=8a271496807f, content=真是让我毛骨悚然!, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7c3865018, createdName=cjingjuan, createdTime=Wed Oct 19 09:21:43 CST 2016, time=2016-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148947, encodeId=04a714894eb7, content=分析透彻,讲解到位,学习新知识了……, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/23/8c541a9831aec7026dffdf6bf34ab45d.jpg, createdBy=11371963624, createdName=兰焱雨, createdTime=Mon Oct 17 09:02:56 CST 2016, time=2016-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148935, encodeId=797614893526, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Oct 17 08:22:25 CST 2016, time=2016-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148927, encodeId=a92114892e71, content=很受益,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Mon Oct 17 07:31:59 CST 2016, time=2016-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148897, encodeId=5a5a14889e0f, content=谢谢指点学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K46ZAxBHmHsph32KkfsWGwmickB6RsCUD8KruE4vo5CpvXfdu16GBpp4ibh6WJu1o9iatP1LWKDmvmic/0, createdBy=be6f1940165, createdName=1e0ece0dm09(暂无匿称), createdTime=Mon Oct 17 00:16:09 CST 2016, time=2016-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148860, encodeId=fc1b1488604d, content=天下之大,第一次听说, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Sun Oct 16 19:04:05 CST 2016, time=2016-10-16, status=1, ipAttribution=)]
    2016-11-02 1e137bdcm70(暂无匿称)

    第一次见,学习了

    0

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    2016-10-19 cjingjuan

    真是让我毛骨悚然!

    0

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    2016-10-17 兰焱雨

    分析透彻,讲解到位,学习新知识了……

    0

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    2016-10-17 李东泽

    很好,不错,以后会多学习

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1828653, encodeId=fcd618286532e, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sun Apr 30 02:38:00 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=152923, encodeId=b26c15292345, content=第一次见,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82351961337, createdName=1e137bdcm70(暂无匿称), createdTime=Wed Nov 02 16:09:59 CST 2016, time=2016-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149680, encodeId=8a271496807f, content=真是让我毛骨悚然!, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7c3865018, createdName=cjingjuan, createdTime=Wed Oct 19 09:21:43 CST 2016, time=2016-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148947, encodeId=04a714894eb7, content=分析透彻,讲解到位,学习新知识了……, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/23/8c541a9831aec7026dffdf6bf34ab45d.jpg, createdBy=11371963624, createdName=兰焱雨, createdTime=Mon Oct 17 09:02:56 CST 2016, time=2016-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148935, encodeId=797614893526, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Oct 17 08:22:25 CST 2016, time=2016-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148927, encodeId=a92114892e71, content=很受益,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Mon Oct 17 07:31:59 CST 2016, time=2016-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148897, encodeId=5a5a14889e0f, content=谢谢指点学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K46ZAxBHmHsph32KkfsWGwmickB6RsCUD8KruE4vo5CpvXfdu16GBpp4ibh6WJu1o9iatP1LWKDmvmic/0, createdBy=be6f1940165, createdName=1e0ece0dm09(暂无匿称), createdTime=Mon Oct 17 00:16:09 CST 2016, time=2016-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148860, encodeId=fc1b1488604d, content=天下之大,第一次听说, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Sun Oct 16 19:04:05 CST 2016, time=2016-10-16, status=1, ipAttribution=)]
    2016-10-17 童小孩

    很受益,谢谢

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1828653, encodeId=fcd618286532e, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sun Apr 30 02:38:00 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=152923, encodeId=b26c15292345, content=第一次见,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82351961337, createdName=1e137bdcm70(暂无匿称), createdTime=Wed Nov 02 16:09:59 CST 2016, time=2016-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149680, encodeId=8a271496807f, content=真是让我毛骨悚然!, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7c3865018, createdName=cjingjuan, createdTime=Wed Oct 19 09:21:43 CST 2016, time=2016-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148947, encodeId=04a714894eb7, content=分析透彻,讲解到位,学习新知识了……, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/23/8c541a9831aec7026dffdf6bf34ab45d.jpg, createdBy=11371963624, createdName=兰焱雨, createdTime=Mon Oct 17 09:02:56 CST 2016, time=2016-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148935, encodeId=797614893526, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Oct 17 08:22:25 CST 2016, time=2016-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148927, encodeId=a92114892e71, content=很受益,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Mon Oct 17 07:31:59 CST 2016, time=2016-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148897, encodeId=5a5a14889e0f, content=谢谢指点学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K46ZAxBHmHsph32KkfsWGwmickB6RsCUD8KruE4vo5CpvXfdu16GBpp4ibh6WJu1o9iatP1LWKDmvmic/0, createdBy=be6f1940165, createdName=1e0ece0dm09(暂无匿称), createdTime=Mon Oct 17 00:16:09 CST 2016, time=2016-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148860, encodeId=fc1b1488604d, content=天下之大,第一次听说, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Sun Oct 16 19:04:05 CST 2016, time=2016-10-16, status=1, ipAttribution=)]
    2016-10-17 1e0ece0dm09(暂无匿称)

    谢谢指点学习了

    0

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    2016-10-16 医路开来

    天下之大,第一次听说

    0

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