Publicado

2017-10-01

Neurofibromatosis tipo 1 y sangrado de intestino delgado. Reporte de caso

Neurofibromatosis type 1 and small bowel bleeding: Case report and literature review

Palabras clave:

Neurofibromatosis 1, Hemorragia gastrointestinal, Melena, Yeyuno (es)
Neurofibromatosis 1, Gastrointestinal Hemorrhage, Melena, Jejunum (en)

Autores/as

  • Martín Alonso Gómez-Zuleta Hospital El Tunal - Unidad de Gastroenterología y Ecoendoscopia - Bogotá D.C. - Colombia. Universidad Nacional de Colombia - Sede Bogotá - Hospital Universitario Nacional de Colombia - Bogotá D.C. - Colombia. Universidad Nacional de Colombia - Sede Bogotá - Facultad de Medicina - Departamento de Medicina Interna - Bogotá D.C. - Colombia.
  • Adán José Lúquez-Mindiola Universidad Nacional de Colombia - Sede Bogotá - Hospital Universitario Nacional de Colombia - Bogotá D.C. - Colombia. Universidad Nacional de Colombia - Sede Bogotá - Facultad de Medicina - Departamento de Medicina Interna - Bogotá D.C. - Colombia.

La neurofibromatosis tipo 1, o enfermedad de von Recklinghausen, es un desorden neurocutáneo hereditario con compromiso gastrointestinal en el 5-25% de los pacientes, siendo sintomático solo el 5%; se presenta posterior a las manifestaciones cutáneas y afecta en su mayoría el yeyuno. Los síntomas de esta enfermedad son dolor abdominal, obstrucción intestinal, perforación, diarrea, masa palpable y sangrado gastrointestinal alto o bajo.

A continuación se reporta el caso de una mujer con sangrado gastrointestinal manifiesto secundario a neurofibromas plexiformes en yeyuno y se realiza una breve revisión de la literatura sobre compromiso gastrointestinal.

Neurofibromatosis type 1, also known as von Recklinghausen disease, is an inherited neurocutaneous disorder with gastrointestinal involvement in 5-25% of patients, with only 5% being symptomatic; it develops following cutaneous manifestations and mostly affects the jejunum. The symptoms include abdominal pain, intestinal obstruction, perforation, diarrhea, palpable mass and high or low gastrointestinal bleeding.

The following report presents the case of a woman with manifest gastrointestinal bleeding secondary to plexiform neurofibromas in the jejunum, as well as a brief review of the literature on gastrointestinal involvement.

Descargas

Los datos de descargas todavía no están disponibles.

Citas

Hirbe AC, Gutmann DH. Neurofibromatosis type 1: a multidisciplinary approach to care. Lancet Neurol. 2014;13(8):834-43. http://doi.org/f2s3hf.

Friedman JM. Epidemiology of neurofibromatosis type 1. Am J Med Genet. 1999;89(1):1-6.

Gottfried ON, Viskochil DH, Couldwell WT. Neurofibromatosis type 1 and tumorigenesis: molecular mechanisms and therapeutic implications. Neurosurg Focus. 2010;28(1):E8. http://doi.org/cbwsxt.

National Institutes of Health Consensus Development Conference Statement: neurofibromatosis. Bethesda, Md., USA, July 13-15, 1987. Neurofibromatosis. 1988;1(3):172-8.

Tadini G, Milani D, Menni F, Pezzani L, Sabatini C, Esposito S. Is it time to change the neurofibromatosis 1 diagnostic criteria? Eur J Intern Med. 2014;25(6):506-10. http://doi.org/f2ww3f.

Agaimy A, Vassos N, Croner RS. Gastrointestinal manifestations of neurofibromatosis type 1 (Recklinghausen´s disease): Clinicopathological spectrum with pathogenetic considerations. Int J Clin Exp Pathol. 2012;5(9):852-62.

Ferner RE, Huson SM, Thomas N, Moss C, Willshaw H, Evans DG, et al. Guidelines for the diagnosis and management of individuals with neurofibromatosis 1. J Med Genet. 2007;44(2):81-8. http://doi.org/dwg3k9.

Ohmiya N, Nakagawa Y, Nagasaka M, Tahara T, Shibata T, Nakamura M, et, al. Obscure gastrointestinal bleeding: Diagnosis and treatment. Dig Endosc. 2015;27(3):285-94. http://doi.org/cdf2.

Gerson LB, Fidler JL, Cave DR, Leighton JA. ACG Clinical Guideline: Diagnosis and management of small bowel bleeding. Am J Gastroenterol. 2015;110(9):1265-87. http://doi.org/f7wjzd.

Rastogi R. Intra-abdominal manifestations of von Recklinghausen´s neurofibromatosis. Saudi J Gastroenterol. 2008;14(2):80-2. http://doi.org/dmpk2k.

Kramer K, Hasel C, Aschoff AJ, Henne-Bruns D, Wuerl P. Multiple gastrointestinal stromal tumors and bilateral pheochromocytoma in neurofibromatosis. World J Gastroenterol. 2007;13(24):3384-7. http://doi.org/cdf3.

Perea VD, Gregaory LJ. Neurofibromas of the stomach. Report of a case associated with von Recklinghausen´s disease and review of the literature. JAMA. 1962;182(3):259-63. http://doi.org/dwqb3n.

Hochberg FH, Dasilva AB, Galdabini J, Richardson EP. Gastrointestinal envolvement in von Recklinghausen´s neurofibromatosis. Neurology. 1974;24(12):1144-51.

Koşucu P, Ahmetoĝlu A, Cobanoĝlu U, Dinç H, Ozdemir O, Gümele HR. Mesenteric involvement in neurofibromatosis type 1: CT and MRI findings in two cases. Abdom Imaging. 2003;28(6):822-6.

Reynolds RM, Browning GG, Nawroz I, Campbell IW. Von Recklinghausen´s neurofibromatosis: neurofibromatosis type 1. Lancet. 2003;361(9368):1552-4. http://doi.org/bqszsp.

Rutgeerts P, Hendrickx H, Geboes K, Ponette E, Broeckaert L, Vantrappen G. Involvement of the upper digestive tract by systemic neurofibromatosis. Gastrointest Endosc. 1981;27(1):22-5. http://doi.org/cprm43.

Selfa-Muñoz A, Ruiz-Escolano E, Martínez-Tirado P, López-Segura R del P, Sáez-Zafra A, Salmerón-Escobar FJ. Gastrointestinal bleeding secondary to intestinal neurofibromatosis. Rev Esp Enferm Dig. 2012;104(2):99-100.

Westmoreland T, Williams PW, Brown KB, Sawaya DE, Nowicki MJ. Endoscopic-assisted laparoscopic surgical removal of a gastric neurofibroma in a child. J Pediatr Surg Case Rep. 2013;1(10):333-6. http://doi.org/cdf5.

Martínez-Ordaz JL, Esmer-Sánchez DD, Suárez-Moreno R, Ruiz-Roque R, Blanco-Benavides R. Neurofibromatosis gastrointestinal. Una causa poco frecuente de cirugía abdominal. Rev Gastroenterol Mex. 2000;65(1):34-6.

Gupta A, Cohen BH, Ruggieri P, Packer RJ, Phillips PC. Phase I study of thalidomide for the treatment of plexiform neurofibroma in neurofibromatosis 1. Neurology. 2003;60(1):130-2.

Widemann BC, Babovic-Vuksanovic D, Dombi E, Wolters PL, Goldman S, Martin S, et al. Phase II trial of pirfenidone in children and young adults with neurofibromatosis type 1 and progressive plexiform neurofibromas. Pediatr Blood Cancer. 2014;61(9):1598-602. http://doi.org/f6dxvc.

Robertson KA, Nalepa G, Yang FC, Bowers DC, Ho CY, Hutchins GD, et al. Imatinib mesylate for plexiform neurofibromas in patients with neurofibromatosis type 1: a phase 2 trial. Lancet Oncol. 2012;13(12):1218-24. http://doi.org/f2f6zg.

Widemann BC, Dombi E, Gillespie A, Wolters PL, Belasco J, Goldman S, et al. Phase 2 randomized, flexible crossover, double-blinded, placebo controlled trial of the farnesyltransferase inhibitor tipifarnib in children and young adults with neurofibromatosis 1 and progressive plexiform neurofibromas. Neuro Oncol. 2014;16(5):707-18. http://doi.org/f5x3ch.