Crouzon 증후군 환자의 증례보고

CROUZON SYNDROME : CASE REPORT

  • 이수진 (서울대학교 치과대학 소아치과학교실) ;
  • 김영재 (서울대학교 치과대학 소아치과학교실) ;
  • 장기택 (서울대학교 치과대학 소아치과학교실) ;
  • 이상훈 (서울대학교 치과대학 소아치과학교실) ;
  • 김종철 (서울대학교 치과대학 소아치과학교실) ;
  • 한세현 (서울대학교 치과대학 소아치과학교실) ;
  • 김정욱 (서울대학교 치과대학 소아치과학교실)
  • Lee, Su-Jin (Department of Pediatric Dentistry, College of Dentistry and Dental Research Institute, Seoul National University) ;
  • Kim, Young-Jae (Department of Pediatric Dentistry, College of Dentistry and Dental Research Institute, Seoul National University) ;
  • Jang, Ki-Taek (Department of Pediatric Dentistry, College of Dentistry and Dental Research Institute, Seoul National University) ;
  • Lee, Sang-Hoon (Department of Pediatric Dentistry, College of Dentistry and Dental Research Institute, Seoul National University) ;
  • Kim, Chong-Chul (Department of Pediatric Dentistry, College of Dentistry and Dental Research Institute, Seoul National University) ;
  • Hahn, Se-Hyun (Department of Pediatric Dentistry, College of Dentistry and Dental Research Institute, Seoul National University) ;
  • Kim, Jung-Wook (Department of Pediatric Dentistry, College of Dentistry and Dental Research Institute, Seoul National University)
  • 발행 : 2009.02.27

초록

Crouzon 증후군은 1912년 프랑스의 신경학자 Crouzon에 의해 처음 알려진 질환으로 10q25-10q26 염색체에 위치한 FGFR2 유전자의 돌연변이에 의해 발생되며 발생률은 25,000명당 1명 꼴로 상염색체 우성 유전 경향을 보이는 유전적 질환이다. 본 증례는 서울대학교 치과병원 소아치과에 내원한 9세의 Crouzon 증후군 환아에 대한 것으로 특징적으로 두개봉합이 조기에 폐쇄되는 두개골유합증(craniosynostosis)으로 인한 두개안면골 이상, 안구돌출증, 상악골 저성장 및 상대적인 하악전 돌증을 나타내었다. 이에 Crouzon 증후군의 의과 및 치과적 소견을 살펴보고, 이에 대해 과거의 문헌을 고찰하여 다소의 지견을 얻었기에 보고하는 바이다.

Crouzon syndrome is a rare disease, first decribed by Crouzon in 1912. This syndrome is cuased by mutations in the FGFR2 gene, which is mapped to chromosome locus 10q25-10q26. The condition occurs in about 1 of every 25,000 birth and is inherited as an autosomal dominant trait. We experienced a case of Crouzon's disease in a 9-year-old-female child. Physical examination revealed craniosynostosis, hypertelorism, exophthalmos, hypoplastic maxilla and a relative mandibular prognathism. The purpose of this study is to report the dental and medical characteristics of the patient and review the literatures of Crouzon syndrome.

키워드

참고문헌

  1. 대한소아치과학회 : 소아∙청소년 치과학 4판, 신흥인터내셔날, 서울, 4-5, 2007.
  2. 차대우, 안효숙 : Crouzon씨 병 1예. 대한안과학회지, 32:694-697, 1991.
  3. 손흥규, 김순주, 최병재 등 : Crouzon's disease의 증례. 대한소아치과학회지, 11:249-254, 1984.
  4. Singer SL, Walpole I, Brogan WF, et al. : Dentofacial features of a family with Crouzon syndrome; case reports. Aust Dent J, 42:11-17, 1997. https://doi.org/10.1111/j.1834-7819.1997.tb00089.x
  5. Horbelt CV : Physical and oral characteristics of Crouzon syndrome, Apert syndrome and Pierre Robin sequence. Gen Dent, 56:132-134, 2008.
  6. Carinci F, Pezzetti F, Locci P, et al. : Apert and Crouzon syndromes; clinical findings, genes and extracellular matrix. J Craniofac Surg, 16:361-368, 2005. https://doi.org/10.1097/01.SCS.0000157078.53871.11
  7. Crouzon O : Dysostosis carnio-faciale hereditaire. Bull Mem Soc Med Hop Paris, 33:545, 1912.
  8. 김송태, 유용상, 최용균 : 두개안면이골증 1례. 대한소아과학회지, 28:75-79, 1985.
  9. Hehr U, Muenke M : Craniosynostosis syndromes; from genes to premature fusion of skull bones. Mol Genet Metab, 68:139-151, 1999. https://doi.org/10.1006/mgme.1999.2915
  10. De Ravel TJ, Taylor IB, Van Oostveldt AJ : A further mutation of the FGFR2 tyrosine kinase domain in mild Crouzon syndrome. Eur J Hum Genet, 13:503-505, 2005. https://doi.org/10.1038/sj.ejhg.5201325
  11. 김남기, 박선규, 조수철 등 : 두개안면이골증(Crouzon씨 병) 1례. 전북의대논문집, 16:151-155, 1992.
  12. 류수경, 강기현, 고광준 : 두개안면이골증의 두 증례. 대한구강악안면방사선학회지, 34:165-169, 2004.
  13. Maeda T, Hatakenaka M, Muta H, et al. : Clinically mild, atypical, and aged craniofacial syndrome is diagnosed as Crouzon syndrome by identification of a point mutation in the fibroblast growth factor receptor 2 gene (FGFR2). Intern Med, 43:432-435, 2004. https://doi.org/10.2169/internalmedicine.43.432
  14. Kreiborg S : Crouzon Syndrome; a clinical and roentgencephalometric study. Scand J Plast Reconstr Surg Suppl, 18:1-198, 1981.
  15. Posnick JC, Ruiz RL : The craniofacial dysostosis syndromes; current surgical thinking and future directions. Cleft Palate Craniofac J, 37:433, 2000. https://doi.org/10.1597/1545-1569(2000)037<0433:TCDSCS>2.0.CO;2
  16. 양규호, 오희수 : 상악골 저상장을 동반한 Crouzon syndrome에 관한 증례. 대한소아치과학회지, 18:106-116, 1991.
  17. Gorlin R, Cohen M, Levin L : Syndromes with craniostenosinostopsys; general aspects and well-known syndromes. Oxford: Oxford University Press, 520- 526, 1990.
  18. Carinci F, Avantaggiato A, Curioni C : Crouzon syndrome: cephalometric analysis and evaluation of pathogenesis. Cleft Palate Craniofac J, 31:201-209, 1994. https://doi.org/10.1597/1545-1569(1994)031<0201:CSCAAE>2.3.CO;2
  19. Sharma A, Dang N, Gupta S : Crouzon disease-a case report. J Indian Soc Pedod Prev Dent, 16:134-137, 1998.
  20. Boutros S, Shetye PR, Ghali S, et al. : Morphology and growth of the mandible in Crouzon, Apert, and Pfeiffer syndromes. J Craniofac Surg, 18:146-150, 2007. https://doi.org/10.1097/01.scs.0000248655.53405.a7
  21. Dalben Gda S, Costa B, Gomide MR : Oral health status of children with syndromic craniosynostosis. Oral Health Prev Dent, 4:173-179, 2006.
  22. Pijpers M, Poels PJ, Vaandrager JM, et al. : Undiagnosed obstructive sleep apnea syndrome in children with syndromal craniofacial synostosis. J Craniofac Surg, 15:670-674, 2004. https://doi.org/10.1097/00001665-200407000-00026
  23. Iannetti G, Fadda T, Agrillo A, et al. : Lefort III advancement with and without osteogenesis distraction. J Craniofac Surg, 17:536-543, 2006. https://doi.org/10.1097/00001665-200605000-00025
  24. Lowe LH, Booth TN, Joglar JM, et al. : Midface anomalies in children. Radiographics, 20:907-922, 2000.
  25. Kreiborg S, Cohen MM Jr : Is craniofacial morphology in Apert and Crouzon syndromes the same? Acta Odontol Scand, 56:339-341, 1998. https://doi.org/10.1080/000163598428275
  26. 윤재강, 김진철, 임풍 등 : Crouzon씨 병의 치험례. 대한성형외과학회지, 14:243-250, 1987.
  27. 박선재, 박철규 : Lefort III advancement를 이용한 Crouzon씨 병 교정. 대한성형외과학회지, 26:590-596, 1999.