Síndrome de Bean y albinismo: reporte del primer caso en Ecuador

Oyuki Ortiz-Culcay, Mónica Hernández-Lojano, Fabián Zurita-Alvarado, Juan Roldan-Crespo, Oswaldo Vásconez-Hatt
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Abstract

Blue Rubber Bleb Nevus syndrome (BRBNS) or its acronym Bean syndrome is characterized by venous malformations (MV) distributed in multiple anatomical areas, predominantly in the skin and gastrointestinal (GI) tract. Symptomatology is commonly manifested with hemorrhagic episodes and consequent chronic secondary anemia due to deficit. We present the clinical case of a female albino patient of 68 years of age, who came for acute abdominal pain to this we add a chronic rectorrhagia, when performing the physical examination, the presence of venous malformations (MV) characterized by bluish, compressible and heterogeneous nodules, located in the lower lip, chin, perianal region and extremities, as well as pain on palpation in the right hypochondrium. The laboratory analysis revealed low hemoglobin and hematocrit values and other parameters suggestive of iron deficiency anemia, in the colonoscopy report multiple venous malformations (MV) were disseminated, disseminated with rectal predominance, the diagnosis was compatible with Bean Syndrome by the association of MV in skin and Gastrointestinal tract and secondary chronic anemia. The management was clinical symptomatic and palliative surgery, with a favorable evolution. The association of albinism and Bean syndrome are not reported in the international medical literature, considering this the first case in Ecuador as a not very frequent pathology but with important secondary complications, this syndrome should be included as a cause of harmless venous malformations, digestive bleeding, chronic anemia and occlusive effects of hollow viscera
Bean综合征和白化病:厄瓜多尔第一例病例报告
蓝色橡胶水泡痣综合征(Blue Rubber Bleb Nevus syndrome,简称BRBNS)或其缩写Bean综合征,其特征是静脉畸形(MV)分布在多个解剖区域,主要发生在皮肤和胃肠道。症状通常表现为出血性发作和随之而来的慢性继发性贫血。我们报告一位68岁的女性白化病患者的临床病例,她因急性腹痛而来,我们增加了慢性直肠出血,在进行体格检查时,存在静脉畸形(MV),其特征是蓝色,可压缩和异质性结节,位于下唇,下巴,肛周区域和四肢,以及右侧胁软骨触诊疼痛。实验室分析显示低血红蛋白和红细胞压积等参数提示缺铁性贫血,结肠镜报告多发性静脉畸形(MV)弥散,以直肠为主,皮肤和胃肠道MV与继发性慢性贫血相关,诊断符合Bean综合征。治疗方法为临床症状和姑息性手术,进展良好。白化病和Bean综合征的关联在国际医学文献中没有报道,考虑到这是厄瓜多尔的第一例病例,是一种不太常见的病理,但具有重要的继发性并发症,该综合征应被包括为无害静脉畸形、消化道出血、慢性贫血和空心脏器闭塞效应的原因
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