在一个患有古典性先天性上腺增生症的患者身上连续四次虚假阴性新生儿查:一个案例报告
Patrick Rizzuto1, Mariam Gangat1, Ahmed Khattab1
1Rutgers Robert Wood Johnson Medical School, Division of Pediatric Endocrinology, New Jersey, United States.
Journal of clinical research in pediatric endocrinology
|March 9, 2026
概括
新生儿对先天性上腺增生症 (CAH) 的查可以错过病例. 这项研究突出了一个患有经典CAH的患者,尽管多次阴性新生儿查结果,但诊断迟到,强调对电解质失衡的警.
科学领域:
- 儿科 儿科 儿科
- 内分泌学 在内分泌学.
- 遗传学 是一个遗传学.
背景情况:
- 先天性上腺增生 (CAH) 是由21-基酶缺乏引起的内分泌疾病.
- 浪费盐的CAH需要及时诊断和管理,以防止危及生命的危机.
- 新生儿查 (NBS) 对于早期发现CAH至关重要.
研究的目的:
- 报告一种经典CAH病例,尽管多次新生儿查结果呈阴性,但仍被诊断为CAH.
- 强调在持续电解质障碍的婴儿中考虑CAH的重要性.
主要方法:
- 一个男性婴儿被怀疑患有CAH的案例报告.
- 连续新生儿查 (NBS) 测试和生物化学分析,包括电解质和17-基孕.
- 对CYP21A2基因突变进行遗传检测.
主要成果:
- 该患者在38天内获得了四次负NBS结果.
- 发生了低血和高血症,需要补充化.
- 升高的17-基孕水平证实了经典的CAH,并确定了CYP21A2基因变异.
结论:
- 新生儿查可能无法检测出所有经典CAH病例.
- 婴儿持续存在的电解质异常要求对CAH的怀疑指数很高.
- 先进的测试,如LC-MS/MS和基因分析对于确诊至关重要.
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