在被诊断为小纤维神经病变的儿科患者中观察到的胃肠道表现
Shruti Nabar1, Jenelle Fernandez2, Vikram Prakash3
1Center for Digestive Health and Nutrition, Orlando Health Arnold Palmer Hospital for Children, Orlando, Florida, USA.
Journal of pediatric gastroenterology and nutrition
|March 20, 2024
概括
儿科小纤维神经病变 (SFN) 通常会出现胃肠道症状,如便秘. 对于患有无法解释的胃肠道疾病的儿童来说,识别SFN至关重要,因为它可以解释多系统性投诉.
科学领域:
- 神经学 神经学
- 胃肠病学 胃肠病学
- 自主医学是一种自主医学.
背景情况:
- 小纤维神经病变 (SFN) 影响感觉和自主神经纤维,导致潜在的胃肠 (GI) 功能障碍.
- 自主功能障碍和自身免疫受体抗体越来越多地与SFN相关,表现为胃肠道问题,如便秘,恶心和腹.
- 肠道神经系统参与SFN可能解释了在受影响的儿童中观察到的异常的肠道运动模式.
研究的目的:
- 调查诊断为小纤维神经病变 (SFN) 的儿科患者胃肠道 (GI) 症状的患病率和临床特征.
- 为了确定胃肠道症状是否是儿童SFN的主要表现特征.
- 强调在患有耐火性胃肠道症状的儿科病例中考虑SFN的重要性.
主要方法:
- 通过皮肤活检对26名通过皮肤活检诊断出SFN的儿科患者进行了回顾性图表审查.
- 通过表皮神经纤维密度低于距离腿部第五百分位,证实了SFN的诊断.
- 收集的数据包括人口统计信息,临床特征以及自主和体感症状的评估.
主要成果:
- 85%的患有SFN的儿科患者经历了体感症状 (疼痛,麻木),85%报告了GI症状.
- 便秘是最常见的胃肠道症状,影响了50%的患者,与运动性测试相关.
- 在61.5%的患者中观察到自主功能障碍,包括静止和温度失调.
结论:
- 胃肠道症状在患有小纤维神经病变 (SFN) 的儿科患者中很常见,并且可能是主要的投诉.
- 在患有难治性胃肠道症状的儿童中识别SFN对于理解多系统性投诉至关重要.
- 早期识别和评估SFN可以导致更好地管理复杂的儿科病例.
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