延迟诊断的并发症和挑战:成功治疗SPTB基因变异遗传性球形细胞增多症伴肝细胞黄疸1例报告。

IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL
Sintayehu Mekonnen, Dereje Adefris, Belete Shikuro, Abdi Bati, Daniel Azmeraw, Temesegen Kassa, Eliud Teshome, Hawi Farris
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引用次数: 0

摘要

背景:遗传性球形红细胞增多症是一种罕见的遗传性红细胞膜疾病,以贫血、黄疸和脾肿大为特征;然而,在没有家族史和临床表现不寻常的情况下,诊断可能要到晚年才能做出。病例介绍:在这里,我们提出了一个具有挑战性的病例,遗传学证明遗传性球形细胞增多症涉及SPTB基因,患者是一名来自埃塞俄比亚的23岁女性患者,她因偶发性黄疸和肝脾肿大而多次就诊,具有罕见的结合性高胆红素血症、全血细胞减少症、网状红细胞计数正常和缺乏家族史,诊断延误导致了几种并发症。同时行脾切除和胆囊切除术,治疗成功。结论:该病例强调了彻底临床检查的重要性,在不假设初始诊断正确的情况下定期花时间回顾病例,并对不一致的数据保持健康的怀疑态度,以防止误诊和虐待。诊断延迟强调需要提高认识和熟悉的诊断方式遗传性球形红细胞增多症在埃塞俄比亚的医疗保健提供者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Complications of delayed diagnosis and challenges: successfully managed SPTB gene variant hereditary spherocytosis with hepatocellular jaundice-a case report.

Background: Hereditary spherocytosis is a rare genetic disorder of the red blood cell membrane that is characterized by anemia, jaundice, and splenomegaly; however, in the absence of family history and with unusual clinical presentation, the diagnosis might not be made until later in life.

Case presentation: Here, we present a challenging case of genetically proven hereditary spherocytosis that involves the SPTB gene in a 23-year-old female patient from Ethiopia who had repeated medical visits for episodic jaundice and hepatosplenomegaly, with unusual features of conjugated hyperbilirubinemia, pancytopenia, normal reticulocyte count, and lack of family history, where the delay in diagnosis led to several complications. The patient was successfully managed with simultaneous splenectomy and cholecystectomy.

Conclusion: This case underscores the importance of a thorough clinical examination, spending the time to review a case periodically without assuming the initial diagnosis is correct, and maintaining a healthy skepticism of inconsistent data to prevent misdiagnosis and mistreatment. The diagnostic delay highlights the need for increased awareness and familiarity with diagnostic modalities of hereditary spherocytosis among healthcare providers in Ethiopia.

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来源期刊
Journal of Medical Case Reports
Journal of Medical Case Reports Medicine-Medicine (all)
CiteScore
1.50
自引率
0.00%
发文量
436
期刊介绍: JMCR is an open access, peer-reviewed online journal that will consider any original case report that expands the field of general medical knowledge. Reports should show one of the following: 1. Unreported or unusual side effects or adverse interactions involving medications 2. Unexpected or unusual presentations of a disease 3. New associations or variations in disease processes 4. Presentations, diagnoses and/or management of new and emerging diseases 5. An unexpected association between diseases or symptoms 6. An unexpected event in the course of observing or treating a patient 7. Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
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