临床儿科杂志 ›› 2021, Vol. 39 ›› Issue (12): 944-.doi: 10.3969/j.issn.1000-3606.2021.12.015

• 综合报道 • 上一篇    下一篇

以头痛为主要表现的Ⅰ型神经纤维瘤病1 例报告

徐欢, 汤继宏, 肖潇, 张兵兵, 师晓燕, 邵艺华   

  1. 苏州大学附属儿童医院神经内科(江苏苏州 215025)
  • 发布日期:2021-12-22
  • 通讯作者: 苏州市科技计划(民生科技)项目(No.SS201866);江苏省卫生健康委科研课题面上项目(No.H2018010)
  • 基金资助:
    汤继宏 电子信箱:tjhzsh@ 126 .com

Neurofibromatosis type Ⅰ presenting with recurrent headache: a case report

XU Huan, TANG Jihong, XIAO Xiao, ZHANG Bingbing, SHI Xiaoyan, SHAO Yihua   

  1. Department of Neurology, Children's Hospital of Soochow University, Suzhou 215025 , Jiangsu, China
  • Online:2021-12-22

摘要: 目的 探讨I型神经纤维瘤病(NF 1)的临床特征。方法 回顾分析1例以头痛为主要临床表现的NF 1患儿的 临床资料,并结合文献复习进行讨论。结果 患儿,男,10岁1个月,因反复头痛1年就诊。患儿躯体散在浅褐色斑块及多 发触痛阳性的硬结;头颅及全脊柱磁共振成像示双侧基底节区、臂丛神经走行区及C2 -C 3椎间孔处呈等T 1长T 2、Flair 序列高信号影。基因检测显示患儿有源自父亲的杂合变异c. 6177 _ 6183 del(p.Leu 2060 Alafs* 4),结合患儿临床表现及家 系情况,明确该变异为患儿的致病原因。结论 NF 1临床表现多样,影像学及基因检测有助诊断。

关键词: I型神经纤维瘤病; 头痛; 儿童

Abstract: Objective To explore the clinical characteristics of neurofibromatosis type Ⅰ(NF1). Methods The clinical data of NF 1 in a child with headache as the main clinical presentation were analyzed, and the relevant literatures were reviewed. Results An aged 10 years and 1 month old boy was admitted to the hospital due to intermittent headache for one year. The physical examination showed several café-au-lait macules and tenderness positive multiple sclerosis on the body. MRI of skull and whole spine showed iso-T 1 , long T 2 and FLAIR sequence high signal in bilateral basal ganglia, brachial plexus and C 2 - 3 intervertebral foramen. A novel frameshift variation of NF 1 (c. 6177 _ 6183 del, p.Leu 2060 Alafs* 4 ) was identified by whole exome sequence. This variation was considered possible pathogenic according to the ACMG guidelines, and the child was diagnosed as NF 1 combined with clinical manifestations and his family history. Conclusions NF 1 is autosomal dominant and has various clinical manifestations. Imaging examination and genetic test can help its diagnosis when the clinical symptoms are atypical. The newly discovered gene variation provides more reference for the related gene variation spectrum of NF 1 .

Key words: neurofibromatosis type ; headache; child