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NEJM:一例遗传性毛细血管扩张症(Osler-Weber-Rendu综合征)案例报道

2015-09-26 MedSci MedSci原创

女性,58岁,因出现直肠间歇性排出鲜红血液,疲乏和进行性呼吸困难而来院就诊。据其主诉,她从小便有自发性鼻出血反复发作病史,但她从来没有去做过全面的检查。此外,她称其母亲也出现过跟她类似的频繁性鼻出血和皮肤病变。体格检查发现其唇黏膜毛细血管扩张(如图A所示)和有甲襞(如图B所示)。实验室检查结果显示,该患者有重度缺铁性贫血(血红蛋白水平为8.1g/dl,平均红细胞体积为72fl), 下消化道内窥镜检

女性,58岁,因出现直肠间歇性排出鲜红血液,疲乏和进行性呼吸困难而来院就诊。


据其主诉,她从小便有自发性鼻出血反复发作病史,但她从来没有去做过全面的检查。此外,她称其母亲也出现过跟她类似的频繁性鼻出血和皮肤病变。


体格检查发现其唇黏膜毛细血管扩张(如图A所示)和有甲襞(如图B所示)。

实验室检查结果显示,该患者有重度缺铁性贫血(血红蛋白水平为8.1g/dl,平均红细胞体积为72fl), 下消化道内窥镜检查发现动静脉畸形和结肠毛细血管扩张(图C)。影像学检查结果显示,肺和脑部的血管未见异常。

根据以上所述的临床表现及检查结果,可以诊断该患者患上的是一种遗传性出血性毛细血管扩张症,或称Osler-Weber-Rendu综合征。

为了进一步明确她的诊断,对其进行了基因测试,发现Endoglin基因突变,该结果更加肯定了该患者与其母亲的诊断。

原始出处:
Pérez-Belmonte LM, Gomez-Moyano E.Images in Clinical Medicine: Osler-Weber-Rendu Syndrome. N Engl J Med. 2015 Sep 24;373(13):e15

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    2016-01-11 lsj637
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  5. 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  7. 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