Aicardi-Goutières syndrome presenting with haematemesis in infancy

Acta Paediatr. 2009 Dec;98(12):2005-8. doi: 10.1111/j.1651-2227.2009.01454.x. Epub 2009 Sep 22.

Abstract

Aicardi-Goutières syndrome is a genetic childhood encephalopathy characterized by basal ganglia calcification, chronic cerebrospinal lymphocytosis and elevated cerebrospinal fluid interferon-alpha, mimicking acquired congenital viral infections. As more is discovered about the pathogenesis of Aicardi-Goutières, it is becoming evident that a dysfunction of the immune system is likely to be responsible for the disease phenotype. We describe a previously healthy 2-month-old female infant who presented with haematemesis and seizures and was subsequently diagnosed with Aicardi-Goutières syndrome. To our knowledge, this is the first documented case of Aicardi-Goutières syndrome presenting with haematemesis. The gastrointestinal tract is an area of high cell loss, revealing early signs of systemic inflammation and we postulate that a systemic proinflammatory milieu occurs in Aicardi-Goutières syndrome.

Conclusion: Aicardi-Goutières syndrome can present with haematemesis, adding to the growing evidence that the Aicardi-Goutières syndrome spectrum encompasses an immune-mediated multisystem involvement. Gastrointestinal inflammation should also be considered in these patients and treated appropriately.

Publication types

  • Case Reports

MeSH terms

  • Abnormalities, Multiple / diagnosis*
  • Abnormalities, Multiple / genetics
  • Autoimmune Diseases of the Nervous System / genetics
  • Brain Diseases / complications
  • Brain Diseases / diagnosis*
  • Brain Diseases / genetics
  • Female
  • Gastrointestinal Tract / pathology
  • Hematemesis / etiology*
  • Humans
  • Infant
  • Inflammation
  • Magnetic Resonance Imaging
  • Seizures / etiology
  • Syndrome
  • Tomography, X-Ray Computed