作者: Andreas R. Janecke , Peter Heinz-Erian , Thomas Müller
DOI: 10.1097/MPG.0000000000001139
关键词: Genetic heterogeneity 、 Pathology 、 Enteroendocrine cell differentiation 、 Intestinal mucosa 、 Differential diagnosis 、 Dysplasia 、 Pathophysiology 、 Medicine 、 Immunology 、 Inflammatory bowel disease 、 Diarrhea
摘要: Congenital diarrheal disorders (CDDs) represent a group of challenging clinical conditions for pediatricians because the severity presentation and broad range possible differential diagnoses. CDDs arise from alterations in transport nutrients electrolytes across intestinal mucosa, enterocyte enteroendocrine cell differentiation and/or polarization defects, modulation immune response. Advances were made recently deciphering etiology pathophysiology one these disorders, congenital sodium diarrhea (CSD). CSD refers to an intractable intrauterine onset with high fecal loss. is clinically genetically heterogeneous. A syndromic form features choanal atresias as well recurrent corneal erosions. Small bowel histology frequently detects epithelial "tufting" dysplasia. It autosomal recessively inherited, caused by SPINT2 mutations. The nonsyndromic can be dominant activating mutations GUCY2C, encoding receptor guanylate cyclase C (GC-C), recessive SLC9A3 loss-of-function encodes Na/H antiporter 3, major brush border exchanger, downstream target GC-C. number patients GUCY2C developed inflammatory disease. Both recognized CDD forms underlying disease genes are gradually increasing. Knowledge enables noninvasive, next-generation gene panel-based testing facilitate early diagnosis CDD. Primary 3 GC-C malfunction implicated predisposition subset patients.