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Late diagnosis of tuberous sclerosis: a case report
Luis F Domínguez-Valdez1, Jaime E Hernández-Utrera1, Iliana N Chávez-Sánchez1
1Departamento de Medicina Interna, UMAE Hospital de Especialidades 'Dr. Antonio Fraga Mouret', Centro Médico Nacional 'La Raza', Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Abstract:
Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disorder characterized by the formation of hamartomas in organ systems such as the brain, skin, kidneys and lungs. Patients with TSC are usually diagnosed early in life. However, in some cases, the diagnosis is delayed until adulthood because various manifestations occur at various times throughout an individual's life. In this regard, we present the case of a female patient diagnosed at the beginning of the seventh decade of life. The patient had a history of seizures and showed clinical findings on the skin (facial angiofibromas, ungual fibromas, 'Confetti-like' skin lesions, shagreen patch), brain (cortical tubers), heart (cardiac rhabdomyomas), kidneys (angiomyolipomas) and a positive genetic test for mutations in TSC2, fulfilling the diagnostic criteria. We compared the differences between manifestations in patients diagnosed during childhood and adulthood. Knowledge of the clinical spectrum of TSC allows early identification.
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