先天性肝纤维化伴多囊肾1例报告并文献复习
2020-07-04王亚平杜忠彩刘培牛庆慧梁坤边城
王亚平 杜忠彩 刘培 牛庆慧 梁坤 边城

[摘要] 目的 探讨先天性肝纤维化(CHF)的诊断及治疗。
方法 对我科收治的1例CHF病人的临床资料进行回顾性分析并复习相关文献。
结果 该病人以不明原因肝硬化为首发表现就诊,辗转多家医院,最终通过肝脏穿刺活检病理及基因检测确诊为CHF伴多囊肾。
结论 CHF是一种少见的累及肝脏和肾脏的疾病,临床上主要以门静脉高压和肝功能正常为主要特点,肝脏穿刺活检病理为其诊断金标准,肝移植为最佳根治性方法。
[关键词] 肝硬化;遗传疾病,先天性;多囊肾疾病
[中图分类号] R575.2
[文献标志码] A
[文章编号] 2096-5532(2020)03-0370-03
doi:10.11712/jms.2096-5532.2020.56.047
[开放科学(资源服务)标识码(OSID)]
[网络出版] http://kns.cnki.net/kcms/detail/37.1517.R.20200320.1535.011.html;2020-03-23 15:30:53
CONGENITAL HEPATIC FIBROSIS AND POLYCYSTIC KIDNEY: A CASE REPORT AND LITERATURE REVIEW
WANG Yaping, DU Zhongcai, LIU Pei, NIU Qinghui, LIANG Kun, BIAN Cheng
(Department of Infectious Diseases, The Affiliated Hospital of Qingdao University, Qingdao 266003, China)
[ABSTRACT]ObjectiveTo investigate the diagnosis and treatment of congenital hepatic fibrosis (CHF).
MethodsA retrospective analysis was performed for the clinical data of one patient with CHF who was treated in our department, and related articles were reviewed.
ResultsThe patient attended a hospital due to the initial manifestation of unexplained liver cirrhosis and was examined in several hospitals, and finally he was diagnosed with CHF and polycystic kidney by liver biopsy and gene detection.
ConclusionCHF is a rare disease involving the liver and the kidney, with the main features of portal hypertension and normal li-
ver function. Liver biopsy is the gold standard for diagnosis and liver transplantation is the optimal radical method.
[KEY WORDS]liver cirrhosis; genetic diseases, inborn; polycystic kidney diseases
先天性肝纖维化(CHF)是一种少见的与胆管板畸形(DPM)相关的常染色体隐性遗传性疾病。CHF常合并肾脏疾病[1],且其中一半以上病人合并常染色体隐性遗传性多囊肾(ARPKD),但合并常染色体显性遗传性多囊肾(ADPKD)者少见。CHF病人发病年龄差异较大,但多以青少年为主,临床表现不一,出血风险较高。由于该病临床少见,极容易漏诊、误诊,影响其治疗及预后。本文病人以不明原因肝硬化为首发表现,病程较长,最终通过病理及基因检测确诊为CHF合并ADPKD。现报告如下。
1 病例报告
病人,女,35岁,因“发现脾大、肝硬化10年,肝区疼痛加重1月”于2017-03-14入院。病人10年前因肝区不适于当地医院查体时发现肝硬化,当时上腹部CT示:肝硬化、脾大,脾内低密度,少量腹水;双肾多发囊肿;胆囊结石。胃镜检查示食管静脉曲张。肝脏穿刺活检病理示肝细胞不典型增生,不明原因肝硬化。……
