2019, Number 4
<< Back Next >>
Rev Cubana Pediatr 2019; 91 (4)
Proteus syndrome and West syndrome in female infant
Portuondo BE, Acuña GPM, Morales PE, Gonzales AY, Caridad RM
Language: Spanish
References: 16
Page: 1-13
PDF size: 397.50 Kb.
ABSTRACT
Introduction: Proteus syndrome is a rare congenital hamartoma syndrome with neuroectodermal manifestations of progressive kind and a degree of variable severity.
Objective: To present a clinical case where facial diysmorphias, the excessive growth of a hemicara, a macro-skull, and neurological manifestations are combined.
Case presentation: A 10-month-old female infant with a history of risky pregnancy, daughter of a teenage mother, with fetal exposure to tobacco, marijuana and alcohol. She was born with macrocephaly, facial dysmorphia with right hemihypertrophy, hyperpigmented nevus that started with infantile spasms from the first month of life; and West syndrome of structural etiology with right hemimegalencephaly was diagnosed. The patient meets the clinical criteria of Proteus syndrome and she had a favorable response to the combined treatment of adrenocorticotropic hormone and Vigabatrin with control of spasms, improvement of hypsarrhythmia and psychomotor development.
Conclusions: Proteus syndrome is characterized by exaggerated growth in various tissues (epidermal, connective, bone, adipose and endothelial) during embryogenesis, so that clinical manifestations are usually evident from birth or in the first years of life. It is related with a group of cases with malformations of the central nervous system and West syndrome.
REFERENCES
Copetalo Rocha RC, Mechereffe do Amaral D, Milanez Morgado de Abreu MA, Soriano Estrella MP, Marques Barbosa A. Proteus Síndrome. Case Report. An Bras Dermatol. 2017; 92(5):717-20. doi: http://dx.doi.org/10.1590/abd1806-4841.20174496
Sene LS, Sales PO, Chojniak R. Síndrome de Proteus: relato de caso. Rev Assoc Med Bras. 2013;59:318-20.
Biesecker L. The challenges of Proteus syndrome: diagnosis and management. Eur J Hum Genet. 2006;14:1151-7.
Fernández Mayoralas M, Fernández Jaén A, Calleja Pérez B, Muñoz Jareño N. Enfermedades neurocutáneas. JANO. 2007;1. Acceso: 02/09/2018. Disponible en: http://www.jano.es/ficheros/sumarios/1/0/1667/87/00870091-LR.pdf
Pérez-Salomón E, Concepción N, Terrero-Mora M, Rodríguez-Navarro Z, Torres-Molina A. Síndrome de Proteo. Presentación de un caso. Medisur. 2013;11(5):563-8. Acceso: 02/09/2018. Disponible en: http://medisur.sld.cu/index.php/medisur/article/view/1849
De Souza RA. Hotspots. Origins of the elephant man: mosaic somatic mutations cause Proteus syndrome. Clin Genet. 2012;81:123-4.
Hotamisligil GS. Proteus syndrome and hamartoses with overgrowth. Dysmorphol Clin Genet. 1990;4:87-102.
Thomason JL, Abramowsky CR, Rickets RR, Culbertson JH, Clifton MS, Shehata BM. Proteus syndrome: three case reports with a review of the literature. Fetal Pediatr Pathol. 2012; 31:145-53.
Velázquez Fragua R, Pascual-Castroviejo I. Síndrome de Proteus. An Pediatr .2003; 58(5):496-501
Guerrini R, William B. Malformations of cortical development: clinical features and genetic causes. Lancet Neurol. 2014;13:710-16.
Urbach H, Greschus S. Malformations of cortical development. MRI in Epilepsy. 2013;1:125-63.
Barkovich AJ, Guerrini R, Kuzniecky RI, Jackson GD, Dobyns WB. A developmental and genetic classification for malformations of cortical development. Brain. 2012;135:1348-69.
Olmos- López A, Von son-de Fernex F. Síndrome de West y epilepsia refractaria, asociada a hemimegalencefalia aislada. Reporte de caso. Rev Mex Neuroc. 2016;17(3):120-8.
Wirrell EC, Shellhaas RA, Joshi C, Keator C, Kumar S, Mitchell WG. How should children with West syndrome be efficiently and accurately investigated? Results from the National Infantile Spasms Consortium. Epilepsia. 2015;56:617-25.
Scheffer IE, French J, Hirsch E, Satish J, Mathern GW, Salomon LM, et al. Classification of the epilepsies: new concepts for discussion and debate. Special report of the ILAE Classification Task Force of the Commission for Classification and Terminology. Epilep Open. 2016;1:37-44
O' Callaghan FJ, Edwards SW. Alber FD, Hacock E, Johnson AL, Kennedy CR, et al. Safety and effectiveness of hormonal treatment versus hormonal treatment with vigabatrin for infantile spasms (ICISS): a randomised, multicentre, open-label trial.. Lancet Neurol. 2017;16(1):33-42. doi: 10.1016/S1474-4422(16)30294-0.