Triple A syndrome with clinical and genetic findings: A case report; [Klinik ve genetik bulgulari ile triple A sendromu: Bir vaka takdimi]
No Thumbnail Available
Date
2014
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Triple A syndrome (Allgrove syndrome) is a rare autosomal recessive disease characterized by achalasia, alacrima, adrenal insufficiency, and progressive neurological syndrome. This syndrome is caused by mutations in the achalasia-addisonianism-alacrima syndrome (AAAS) gene in the chromosome 12q13 region. We present a nine-year-old boy who had vomiting and progressive dysphagia since six years of age. Achalasia was determined with barium esophagography and esophagus manometric investigation. He had positive Schirmer test (<5 mm) and bilateral optic disc atrophy. The patient's serum cortisol levels were normal and cortisol response was low with ACTH stimulation test. Genetic analysis revealed a homozygous mutation (c.1066-1067delCT) in exon 11 of the AAAS gene, and her younger brother and sister were heterozygous carriers of this mutation. For treatment of achalasia, calcium channel blocker therapy was started, and botulinum toxin was applied to the distal esophagus. The patient's vomiting decreased but continued; his symptoms resolved after the implementation balloon dilation of the esophagus. © 2014, Cocuk Sagligi ve Hastaliklan Dergisi. All rights reserved.
Description
Keywords
botulinum toxin , calcium channel blocking agent , hydrocortisone , achalasia addisonianism alacrima syndrome gene , Allgrove syndrome , Article , atrophy , case report , child , corticotropin test , dysphagia , esophagography , esophagus achalasia , esophagus manometry , gene mutation , genetic analysis , heterozygote , homozygote , human , hydrocortisone blood level , male , mutator gene , optic disc atrophy , optic nerve disease , Schirmer test , school child , vomiting