Articole semnate de acelasi autor in Revista Romana de Pediatrie:

UN CAZ RAR DE SINDROM HUNTER – PREZENTARE DE CAZ

Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 1, An 2015

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

National Awards “Science and Research”

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Promoting Global Health

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Lorena Elena Melit, Oana Marginean, Duicu Carmen, Cristina Campean and Maria Oana Marginean

REZUMAT

Mucopolizaharidozele (MPZ) sunt un grup de boli genetice rare din marea familie de boli lizozomale. Tulburările (MPZ) sunt cauzate de o defi cienţă în activitatea unei enzime lizozomale specifice necesare pentru degradarea glicozaminoglicanilor (GAG). MPZ tip II, numită şi sindromul Hunter, constă dintr-un defi cit al unei enzime, iduronat-2-sulfataza.

Vă prezentăm un caz rar de sindrom Hunter cu prezentare atipică. Este vorba despre un băiat de 2,7 ani, care s-a prezentat la Clinica Pediatrie I cu simptome de infecţie a tractului respirator, cu antecedente de multiple infecţii aleotice şi respiratorii. Examenul clinice evidenţiat: statură mare, moderat supraponderal, dismorfism facial (caracteristici faciale grosiere, frunte proeminentă, nas lărgit şi deprimat), degete mici butucănoase, cu flexie a articulaţiilor interfalangiene distale, rigiditate articulară, abdomen proeminent cu hernie ombilicală, hepatomegalie şi splenomegalie, precum şi uşor retard mental. Aspectul clinic a fost sugestiv pentru MPZ tip I, II sau VII. Dozarea enzimelor cu rol în metabolismul mucopolizaharidelor lizozomale a relevat un nivel scăzut al iduronat-2-sulfatazei, modificari caracteristice pentru MPZ tip II. Diagnosticul enzimatic a fost confirmat prin analiza ADN-ului molecular care a arătat o mutaţie a genei hemizigote iduronate-2-sulfatazei la nivelul intronului 3 (c.419-2A>G). S-a instituit terapia de substituţie enzimatică genetic recombinată de iduronat-2-sulfatază (Elaprase®).

Evoluţia cazului, după aproape doi ani de tratament cu Elaprase este favorabil, fără pierderi ale achiziţiilor neurologice.

Cuvinte cheie: sindrom Hunter, copil

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Lorena Elena Melit

A RARE CASE OF HUNTER SYNDROME – CASE REPORT

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Lorena Elena Melit, Oana Marginean, Duicu Carmen, Cristina Campean and Maria Oana Marginean

ABSTRACT

Mucopolysaccharidoses (MPSs) are a group of rare genetic disorders within the larger family of lysosomal diseases. MPSs disorders are caused by a defi ciency in the activity of a specific lysosomal enzyme required for the degradation of glycosaminoglycans (GAGs). MPS type II, also called Hunter syndrome consists in a deficiency of an enzyme, iduronate-2-sulphatase.

We present a rare case of Hunter syndrome with atypical presentation. It is a case about a boy of 2.7 year old who presented to the Paediatric Clinic with symptoms of a respiratory tract infection and a history of frequent ear infections and respiratory tract infections. His clinical examination showed the following abnormalities: high stature, moderately overweight, facial dismorphism (coarse facial features, prominent forehead, a depressed nasal bridge), small stubby fingers with flexion of distal interphalangeal joints, joint stiffness, protruding abdomen with umbilical hernia, hepatomegaly and splenomegaly, and also mild mental retardation.

The clinical aspect was suggestive for MPS type I, II or VII. Dosage of enzymes with role in mucopolysaccharide lysosomal metabolism revealed low levels of iduronate-2-sulphatase, changes that bent for MPS type II. Enzymatic diagnosis was confirmed by molecular DNA analysis that showed a hemizygote mutation of iduronate- 2-sulphatase gene in intron 3 (c.419-2A > G). Enzyme replacement therapy with recombinant human iduronate- 2-sulfatase (Elaprase®) was started.

The evolution of the case after almost two years of treatment with Elaprase is favorably, without loss of neurological acquisitions.

Keywords: Hunter syndrome, child

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Lorena Elena Melit