2019, Number 2
Prenatal suspicion and postnatal diagnosis of a patient with cystic fibrosis
Language: Spanish
References: 11
Page: 272-278
PDF size: 197.62 Kb.
ABSTRACT
Introduction: cystic fibrosis is a genetic disease of autosomal recessive inheritance, characterized by dysfunction of the exocrine secretion glands.Case report: male patient 2 years of age, at term (39 weeks). In the third trimester of pregnancy, polyhydramnios, dilated bowel loops and a possible low bowel atresia is not ruled out at that time. Rest of normal genetic tests. At the month of birth he enters due to malnutrition and liquid diarrhea. After 2 months, she re-entered due to respiratory manifestations, in the nutritional evaluation her height and weight was below the third percentile, she had skin-pale pallor, demonstrating anemia due to iron deficiency and light hair color. Given the prenatal history and the predominance of digestive and respiratory manifestations, it is decided to perform sweat electrolyte examination in 2 moments, which are negative. It is decided to conduct a molecular study for the detection of mutations that results: ΔF508del / R1162X (Heterozygous compound for cystic fibrosis). Dietary and vitamin therapy treatment is applied. He continues his attention in multidisciplinary consultations, Nutrition, Gastroenterology, Genetics and Pediatrics.
Conclusions: the early diagnosis of cystic fibrosis is made by detecting the cardinal signs that involve the respiratory and digestive system; as well as family history. In the prenatal stage, the findings related to the increased amniotic fluid, the alteration of the fetal vesicle should be taken into account, which allows the definitive diagnosis to be made by studying the mutations.
REFERENCES
González Valdés José Antonio, Abreu Suárez Gladys, Rodríguez Cala Fidel. Reseña histórica de la fibrosis quística y su estudio y tratamiento en Cuba. Rev Cubana Pediatr [Internet]. 2014 Dic [citado 2018 Nov 13]; 86(4): 535-540. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-75312014000400015&lng=es.
Azcurra M, Valenzuela A, Ortíz Paranza L. Estrategias implementadas en Paraguay para la detección neonatal, diagnóstico y tratamiento de las personas con fibrosis quística. Rev Salud Pub Paraguay [Internet]. 2019 [Citado 2019 Feb 15]; 9(1): 81-86. Disponible en: http://revistas.ins.gov.py/index.php/rspp/article/view/534
Santana Hernández EE, Tamayo Chang VJ, Collazo Mesa T, López Reyes I, Feria Estrada F, Rodríguez Cala F. Clinical and genetic characterization of cystic fibrosis in Holguin province. Rev Cubana Pediatr [Internet]. 2017 Jun [citado 2018 Nov 15]; 89(2): 136-144. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-75312017000200004&lng=es.
Licourt-Otero D, Travieso-Téllez A, Orraca-Castillo M, Cabrera-Rodríguez N, Sainz-Padrón L. Caracterización clínica, genética y epidemiológica de la fibrosis quística en Pinar del Río. Revista Cubana de Genética Comunitaria [Internet]. 2018 [citado 2019 Ene 15]; 12(2): [aprox. 16 p.]. Disponible en: http://revgenetica.sld.cu/index.php/gen/article/view/69
Dupuis A, Keenan K, Ooi CY, Dorfman R, Sontag MK, Naehrlich L, et al. Prevalence of meconium ileus marks the severity of mutations of the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Genet Med. [Internet]. 2016 [citado 2019 Ene 15]; 18(2016): 333-40. Disponible en: https://www.nature.com/articles/gim201579
Salinas DB, Sosnay PR, Azen C, Young S, Raraigh KS, Keens TG, et al. Benign and deleterious cystic fibrosis transmembrane conductance regulator mutations identified by sequencing in positive cystic fibrosis newborn screen children from California. PLoS ONE [Internet]. 2016 [citado 2018 Dic 13]; 11(5): e0155624. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4877015/
Parra MG, Bozzo R, Palomino MA. Fibrosis quística atípica y enfermedad del CFTR: a propósito de un caso de traqueobroncopatía osteocondroplástica. Neumol Pediatr [Internet]. 2016 [citado 2019 Ene 13]; 11(1): 44-48. Disponible en: https://www.neumologia-pediatrica.cl/wp-content/uploads/2017/07/fq-atipica.pdf
Farrell PM, White TB, Derichs N, Castellani C, Rosenstein BJ. Cystic fibrosis diagnostic challenges over 4 decades: historical perspectives and lessons learned. J Pediatr. [Internet]. 2017 [citado 2019 Ene 13]; 181(S): S16-S26. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0022347616310514
Sosnay PR, White TB, Farrell PM, Ren CL, Derichs N, Howenstine MS, et al. Diagnosis of Cystic Fibrosis in Nonscreened Populations. J Pediatr. [Internet]. 2017 [citado 2018 Dic 13], 181(S). Disponible en: https://www.clinicalkey.es/#!/content/playContent/1-s2.0- S0022347616310526?returnurl=null&referrer=null