粒線體被稱爲細胞的發電廠,它提供細胞組織、器官及全身活動時所需約百分之九十的能量,因此影響著我們平日的活力與精神。 Kearns-Sayre Syndrome (KSS)是導因於粒線體DNA (mtDNA)的多器官病變,其主要特徵爲1.二十歲前發病2.漸進性的眼外肌麻痺3.視網膜色素變化;此外,Kearns-Sayre氏症候群也至少包括一種下列疾病:1.心臟傳導缺損2.小腦症狀(如步態不穩及共濟失調)3.腦脊髓液蛋白質含量異常;另外病人也可能出現內分泌異常(如糖尿病、生長遲緩、身材矮小、副甲狀腺功能不足)、聽力障礙(如雙耳感音神經性聽力損失)、精神疾病(如癡呆)、眼睛疾病(如白內障)、腎臟疾病(如遠端腎小管酸血症)及肌肉張力不全等。目前已知粒線體基因的突變是由母系遺傳而來。粒線體病變的診斷主要靠臨床症狀,加上一些輔助檢查,如:測定血中乳酸值、眼底檢查、腦部核磁共振、肌肉切片等,最後的確認可作粒線體酵素定量分析及粒線體基因檢查。由於此類病患在耳鼻喉科門診相當罕見,特提出最近本院經歷之一病例,該個案爲10歲女童,表現出個子矮小,眼皮無力,學業上的表現逐年退步,並有答非所問及好動的情形,經本院詳細檢查後,最後診斷爲KS氏症候群,本文並探討個案疾病發生的原因、歷程及臨床相關領域。
Mitochondrial disorders are responsible for a variety of neurological syndromes. Clinical symptoms may occur in different organs to various extents; often they are associate with progressive hearing loss. The diagnostic criteria for KSS include a triad of: 1) onset before 20 years-old, 2) progressive external ophthaemoplegia (PEO) with ptosis, 3) pigmentary retinopathy. Other associated symptoms such as cardiac conduction on block, cerebellar syndrome, elevated cerebrospinal fluid protein (>100mg/dL), dementia, sensorineural hearing loss, multiple endocrine abnormalities, or short stature are frequently seen. Since progressive, bilateral sensorineural hearing loss is a major symptom for many mitochodrial anomalies, it is worthwhile for practicing audiologists to be aware of this rare disease.