RESUMO
Introducción. Las atrofias musculares espinales de la infancia son enfermedades neuromusculares hereditarias, autosómicas, recesivas, caracterizadas por la degeneración de las neuronas motoras del asta anterior de la médula espinal. La atrofia muscular espinal tipo I (enfermedad de Werdnig-Hoffmann) es la forma más severa. Se inicia in útero o durante los primeros meses de vida. La muerte suele ocurrir antes de los dos años de edad. Caso clínico. Lactante de 6 meses de edad que ingresa al Servicio de Urgencias por dificultad respiratoria severa. Presenta marcada hipotonía muscular, debilidad de musculatura intercostal y fasciculaciones de la lengua. La electromiografía es compatible con polineuropatía motora con daño mielínico y axonal. El análisis molecular reportó un estado homocigoto para la deleción de los exones 7 y 8 del gen SMN-1 . Con estos dos estudios se integra el diagnóstico de atrofia muscular espinal tipo 1 (enfermedad de Werdnig-Hoffmann). Conclusiones. Es importante conocer y diagnosticar esta entidad para brindar consejo genético a la familia, así como asesoramiento y apoyo en el manejo del paciente.
Background. Childhood spinal muscular atrophy is an autosomal recessive neuromuscular disease characterized by degeneration of the anterior horn cells of the spinal cord. SMA type I, the most severe form (Werdnig-Hoffmann disease) can be detected in utero or during the first months of life. Death typically occurs within the first 2 years of life. Case report. A 6-month-old female was admitted to the emergency room for severe respiratory distress. She had muscular hypotonia, intercostal muscle weakness and tongue fasciculations. Electromyography was compatible with motor polyneuropathy with axonal and myelin damage. Molecular analysis of SMN-1 gene reported homozygous for deletion of exons 7 and 8 of SMN-1 gene. Conclusions. It is imperative to recognize and diagnose this entity in order to provide genetic counseling to the family as well as to offer support and advice in the care of the patient.
RESUMO
OBJECTIVE: The purpose of this study was to identify the relationship of neurotoxic inorganic elements in the hair of patients with the diagnosis of Neural Tube Defects. Our initial hypothesis was that neurotoxic inorganic elements were associated with Neural Tube Defects. METHODS: Twenty-three samples of hair from newborns were obtained from the General Hospital, "Aurelio Valdivieso" in the city of Oaxaca, Mexico. The study group included 8 newborn infants with neural tube pathology. The control group was composed of 15 newborns without this pathology. The presence of inorganic elements in the hair samples was determined by inductively-coupled plasma spectroscopy (spectroscopic emission of the plasma). FINDINGS: THE POPULATION OF NEWBORNS WITH NEURAL TUBE DEFECTS SHOWED SIGNIFICANTLY HIGHER VALUES OF THE FOLLOWING ELEMENTS THAN THE CONTROL GROUP: Aluminium, Neural Tube Defects 152.77±51.06 µg/g, control group 76.24±27.89 µg/g; Silver, Neural Tube Defects 1.45±0.76, control group 0.25±0.53 µg/g; Potassium, Neural Tube Defects 553.87±77.91 µg/g, control group 341.13±205.90 µg/g. Association was found at 75 percentile between aluminium plus silver, aluminium plus potassium, silver plus potassium, and potassium plus sodium. CONCLUSION: IN THE HAIR OF NEWBORNS WITH NEURAL TUBE DEFECTS, THE FOLLOWING METALS WERE INCREASED: aluminium, silver. Given the neurotoxicity of the same, and association of Neural Tube Defects with aluminum and silver, one may infer that they may be participating as factors in the development of Neural Tube Defects.
RESUMO
El síndrome de Goltz, llamado también hipoplasia dérmica focal (HDF), es un raro desorden hereditario que fue reportado primero en mujeres, descubriéndose más tarde que era letal en los varones. Este síndrome se caracteriza por hipoplasia lineal de la dermis y neoformaciones grasas, asociado con efectos oculares, dentales, esqueléticos, neurológicos, en tejidos blandos, en la piel y raramente trastornos cardiacos y renales. Se describe un paciente masculino de trece años de edad, quien es el primer caso presentado dentro de su familia
