马凡氏病:临床治疗综述和随访指南

Rosario Sánchez Martínez
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引用次数: 5

摘要

马凡氏病是由编码纤维蛋白1基因的杂合子突变引起的,并以常染色体显性形式传播。发病率为1 / 10 000活产,是最常见的遗传性结缔组织疾病之一。自Antoine-Bernard-Jean Marfan于1986年首次描述该综合征以来,对该实体的了解逐渐增加。受影响的区域包括眼睛、骨骼和心血管系统、肺、皮肤和覆盖脊髓的组织,这些已在根特标准中描述,目前是诊断的基础。马凡氏病的诊断可能很困难,因为临床表现与年龄有关,有时会导致诊断儿童和年轻患者的困难。其中一些发现在没有患病的普通人群中也很常见。此外,该疾病具有高渗透性,但存在广泛的表型变异性和与不同胶原蛋白疾病的大量重叠,妨碍了鉴别诊断。近年来,由于发现了其他具有类马凡氏症表型和纤维蛋白-1基因突变的疾病,以及积极的医学和外科治疗的发展,从根本上改变了预后,人们对马凡氏综合征的兴趣日益浓厚。由于马凡氏病是多系统的,需要多学科的管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Enfermedad de Marfan: revisión clinicoterapéutica y guías de seguimiento

Marfan's disease is provoked by a heterozygotic mutation in the gene codifying fibrillin-1 and is transmitted in an autosomic dominant form. The incidence is 1 out of every 10,000 live births, making it one of the most frequent hereditary connective tissue diseases.

Since Antoine-Bernard-Jean Marfan first described the syndrome in 1986, knowledge of this entity has progressively increased. Affected areas include the eyes, skeletal and cardiovascular systems, the lung, skin and the tissue covering the spinal cord, which have been described in the Ghent criteria, currently the basis for diagnosis.

Diagnosis of Marfan's disease can be difficult because the clinical findings are age-dependent, sometimes leading to difficulties in diagnosing children and young patients. Some of these findings are also frequent in the general population without the disease. Furthermore, the disease has high penetration but there is wide phenotypic variability and substantial overlap with the distinct collagen diseases, hampering differential diagnosis.

In recent years, interest in Marfan's syndrome has grown due to the detection of other diseases with marfanoid phenotype and mutations in the fibrillin-1 gene and the development of aggressive medical and surgical treatment that has radically changed prognosis. Because Marfan's disease is multisystemic, multidisciplinary management is required.

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