• 临床论丛 • 上一篇    下一篇

婴儿泛发性动脉钙化一例

宋莉莉1,邢轶维1,张芳2,胡坚1,王丹1,郭静1   

  1. 1. 天津市儿童医院
    2. 天津市儿童医院新生儿科
  • 收稿日期:2013-01-14 修回日期:2013-01-18 出版日期:2013-02-15 发布日期:2013-02-15
  • 通讯作者: 宋莉莉

Generalized Arterial Calcification in Infancy:A Case Report and Review of the Literature

  • Received:2013-01-14 Revised:2013-01-18 Published:2013-02-15 Online:2013-02-15
  • Contact: SONG Li Li

摘要: 摘要:目的 报道罕见婴儿泛发性动脉钙化(Generalized arterial calcification in infancy,GACI)的临床特点及诊疗经验,提高对该病的认识。方法 对1例GACI患儿的临床表现、辅助检查、诊疗过程进行分析,并对国内及国外相关文献进行回顾。结果 患儿生后两次住院,反复呼吸困难、心力衰竭、休克,经治疗后临床症状好转,之后出现高血压表现,进一步CT检查可见心脏及胸腹大血管管壁多发钙化,诊断GACI。结论 GACI是一种罕见的常染色体隐性遗传疾病,包括弥漫性动脉钙化和血管内膜增生,并逐步导致动脉狭窄,常在六个月内因心肌缺血而死亡。多数患儿在产前已经发病,或在新生儿期出现充血性心力衰竭的症状。GACI可以依靠病理组织活检或影像学来诊断。双膦酸盐已被用于治疗,但疗效尚不明确。在大多数情况下,该疾病与ENPP1基因突变有关。

关键词: 婴儿泛发性动脉钙化, 小儿特发性动脉钙化, ENPP1, 基因

Abstract: Abstract: Objective To report a case of rare generalized artery calcification in infant (GACI) with the clinical characteristics and diagnostic experience, and to enhance the understanding of the disease accordingly. Methods A case of a neonate, boy, with GACI was analyzed in clinical manifestation, auxiliary examination and process of treatment. We have also reviewed the relevant literature. Results The affected infant hospitalized for twice, performing for the dyspnea frequently, heart failure, and shock. The clinical symptoms improved after treatment, accompanying with the syndrome of hypertension, and then for the further CT examination showed generalized calcifications of the cardiac and thoracoabdominal aorta wall, finally the patient was diagnosed GACI. Conclusion GACI is a rare genetic disorder consisting of diffuse arterial calcification and intimal proliferation. The disease typically results in progressive arterial stenosis and frequently leads to death from myocardial ischemia within 6 months of life. Affected infants are usually diagnosed before birth or in the neonatal period with symptoms of congestive heart failure. GACI can be diagnosis by the pathologic biopsy or imaging. Therapy with bisphosphonate has been used to treat the condition, but with inconsistent results. The disease is associated with mutations in ENPP1 gene in the majority of the cases.

Key words: Generalized arterial calcification in infancy, Idiopathic infantile arterial calcification, ENPP1 gene