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Sengers syndrome: a rare case of cardiomyopathy combined with congenital cataracts in an infant: post-mortem case report
Cardiovascular Pathology ( IF 2.3 ) Pub Date : 2021-07-16 , DOI: 10.1016/j.carpath.2021.107371
Nora Fawzy Fnon 1 , Hanan Hosney Hassan 1 , Hazem Mahmoud Ali 1 , Zahraa Khalifa Sobh 2
Affiliation  

Sengers syndrome is a rare autosomal recessive disorder caused by a mutation in the Acylglycerol Kinase (AGK) gene with subsequent mitochondrial dysfunction. It is a combination of cardiomyopathy, skeletal myopathy, congenital bilateral cataracts, and lactic acidosis following exertion. The current study describes an extremely rare case of Sengers syndrome that is diagnosed during post-mortem examination. A four-month-old female child underwent sudden cardiac arrest immediately following the induction of general anesthesia for lens extraction surgery. This infant was the first child born to healthy, non-consanguineous, Egyptian parents. There were unremarkable medical problems either during pregnancy or during delivery. This infant was born at term with a normal APGAR score and weight. She had congenital bilateral cataracts since birth, easily-fatigued, and delayed milestones for her age. A post-mortem examination revealed a hypertrophied heart that weighed 96.6 grams with left ventricular hypertrophy. The left ventricle free wall thickness was 1cm, and an interventricular septum thickness of 1.3 cm. Histopathologically, the myocardium showed myocytes disarray. Also, the myocytes were hypertrophied, and vacuolated. The Gömöri trichrome stain revealed vacuolated cardiomyocytes surrounded by collagenous connective tissue, and the Periodic Acid Schiff (PAS) stain excluded that these vacuolations were related to glycogen storage disease. Focal lymphocytic infiltrations were observed within the myocardium. Thus, Sengers syndrome should be taken into consideration as a possible diagnosis whenever a congenital cataract is present for clinical and medicolegal cases.



中文翻译:

Sengers 综合征:一例罕见的婴儿心肌病合并先天性白内障:验尸报告

Sengers 综合征是一种罕见的常染色体隐性遗传病,由酰基甘油激酶 (AGK) 基因突变导致线粒体功能障碍。它是心肌病、骨骼肌病、先天性双侧白内障和劳累后乳酸性酸中毒的组合。目前的研究描述了一种极为罕见的 Sengers 综合征病例,该病例在尸检期间被诊断出来。一名 4 个月大的女童在为晶状体摘除手术进行全身麻醉后立即发生心脏骤停。这个婴儿是健康的、非近亲的埃及父母所生的第一个孩子。无论是在怀孕期间还是在分娩期间,都出现了不起眼的医疗问题。该婴儿足月出生,APGAR 评分和体重正常。她从出生就患有先天性双侧白内障,容易疲劳,并且延迟了她这个年龄的里程碑。尸检显示心脏肥大,重达 96.6 克,左心室肥大。左心室游离壁厚1cm,室间隔厚1.3cm。组织病理学上,心肌显示肌细胞紊乱。此外,肌细胞肥大和空泡化。Gömöri 三色染色显示空泡化心肌细胞被胶原结缔组织包围,高碘酸希夫 (PAS) 染色排除这些空泡化与糖原贮积病有关。在心肌内观察到局灶性淋巴细胞浸润。因此,当临床和法医病例出现先天性白内障时,应考虑将 Sengers 综合征作为可能的诊断。并推迟了她这个年龄的里程碑。尸检显示心脏肥大,重达 96.6 克,左心室肥大。左心室游离壁厚1cm,室间隔厚1.3cm。组织病理学上,心肌显示肌细胞紊乱。此外,肌细胞肥大和空泡化。Gömöri 三色染色显示空泡化心肌细胞被胶原结缔组织包围,高碘酸希夫 (PAS) 染色排除这些空泡化与糖原贮积病有关。在心肌内观察到局灶性淋巴细胞浸润。因此,当临床和法医病例出现先天性白内障时,应考虑将 Sengers 综合征作为可能的诊断。并推迟了她这个年龄的里程碑。尸检显示心脏肥大,重达 96.6 克,左心室肥大。左心室游离壁厚1cm,室间隔厚1.3cm。组织病理学上,心肌显示肌细胞紊乱。此外,肌细胞肥大和空泡化。Gömöri 三色染色显示空泡化心肌细胞被胶原结缔组织包围,高碘酸希夫 (PAS) 染色排除这些空泡化与糖原贮积病有关。在心肌内观察到局灶性淋巴细胞浸润。因此,当临床和法医病例出现先天性白内障时,应考虑将 Sengers 综合征作为可能的诊断。尸检显示心脏肥大,重达 96.6 克,左心室肥大。左心室游离壁厚1cm,室间隔厚1.3cm。组织病理学上,心肌显示肌细胞紊乱。此外,肌细胞肥大和空泡化。Gömöri 三色染色显示空泡化心肌细胞被胶原结缔组织包围,高碘酸希夫 (PAS) 染色排除这些空泡化与糖原贮积病有关。在心肌内观察到局灶性淋巴细胞浸润。因此,当临床和法医病例出现先天性白内障时,应考虑将 Sengers 综合征作为可能的诊断。尸检显示心脏肥大,重达 96.6 克,左心室肥大。左心室游离壁厚1cm,室间隔厚1.3cm。组织病理学上,心肌显示肌细胞紊乱。此外,肌细胞肥大和空泡化。Gömöri 三色染色显示空泡化心肌细胞被胶原结缔组织包围,高碘酸希夫 (PAS) 染色排除这些空泡化与糖原贮积病有关。在心肌内观察到局灶性淋巴细胞浸润。因此,当临床和法医病例出现先天性白内障时,应考虑将 Sengers 综合征作为可能的诊断。6克伴左心室肥厚。左心室游离壁厚1cm,室间隔厚1.3cm。组织病理学上,心肌显示肌细胞紊乱。此外,肌细胞肥大和空泡化。Gömöri 三色染色显示空泡化心肌细胞被胶原结缔组织包围,高碘酸希夫 (PAS) 染色排除这些空泡化与糖原贮积病有关。在心肌内观察到局灶性淋巴细胞浸润。因此,当临床和法医病例出现先天性白内障时,应考虑将 Sengers 综合征作为可能的诊断。6克伴左心室肥厚。左心室游离壁厚1cm,室间隔厚1.3cm。组织病理学上,心肌显示肌细胞紊乱。此外,肌细胞肥大和空泡化。Gömöri 三色染色显示空泡化心肌细胞被胶原结缔组织包围,高碘酸希夫 (PAS) 染色排除这些空泡化与糖原贮积病有关。在心肌内观察到局灶性淋巴细胞浸润。因此,当临床和法医病例出现先天性白内障时,应考虑将 Sengers 综合征作为可能的诊断。心肌显示肌细胞紊乱。此外,肌细胞肥大和空泡化。Gömöri 三色染色显示空泡化心肌细胞被胶原结缔组织包围,高碘酸希夫 (PAS) 染色排除这些空泡化与糖原贮积病有关。在心肌内观察到局灶性淋巴细胞浸润。因此,当临床和法医病例出现先天性白内障时,应考虑将 Sengers 综合征作为可能的诊断。心肌显示肌细胞紊乱。此外,肌细胞肥大和空泡化。Gömöri 三色染色显示空泡化心肌细胞被胶原结缔组织包围,高碘酸希夫 (PAS) 染色排除这些空泡化与糖原贮积病有关。在心肌内观察到局灶性淋巴细胞浸润。因此,当临床和法医病例出现先天性白内障时,应考虑将 Sengers 综合征作为可能的诊断。在心肌内观察到局灶性淋巴细胞浸润。因此,当临床和法医病例出现先天性白内障时,应考虑将 Sengers 综合征作为可能的诊断。在心肌内观察到局灶性淋巴细胞浸润。因此,当临床和法医病例出现先天性白内障时,应考虑将 Sengers 综合征作为可能的诊断。

更新日期:2021-08-24
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