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Tang YJ, Zhang J, Wang J, Tian RD, Zhong WW, Yao BS, Hou BY, Chen YH, He W, He YH. Link between mutations in ACVRL1 and PLA2G4A genes and chronic intestinal ulcers: A case report and review of literature. World J Gastrointest Surg 2024; 16:932-943. [PMID: 38577076 PMCID: PMC10989323 DOI: 10.4240/wjgs.v16.i3.932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/29/2023] [Accepted: 02/23/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Genetic factors of chronic intestinal ulcers are increasingly garnering attention. We present a case of chronic intestinal ulcers and bleeding associated with mutations of the activin A receptor type II-like 1 (ACVRL1) and phospholipase A2 group IVA (PLA2G4A) genes and review the available relevant literature. CASE SUMMARY A 20-year-old man was admitted to our center with a 6-year history of recurrent abdominal pain, diarrhea, and dark stools. At the onset 6 years ago, the patient had received treatment at a local hospital for abdominal pain persisting for 7 d, under the diagnosis of diffuse peritonitis, acute gangrenous appendicitis with perforation, adhesive intestinal obstruction, and pelvic abscess. The surgical treatment included exploratory laparotomy, appendectomy, intestinal adhesiolysis, and pelvic abscess removal. The patient's condition improved and he was discharged. However, the recurrent episodes of abdominal pain and passage of black stools started again one year after discharge. On the basis of these features and results of subsequent colonoscopy, the clinical diagnosis was established as inflammatory bowel disease (IBD). Accordingly, aminosalicylic acid, immunotherapy, and related symptomatic treatment were administered, but the symptoms of the patient did not improve significantly. Further investigations revealed mutations in the ACVRL1 and PLA2G4A genes. ACVRL1 and PLA2G4A are involved in angiogenesis and coagulation, respectively. This suggests that the chronic intestinal ulcers and bleeding in this case may be linked to mutations in the ACVRL1 and PLA2G4A genes. Oral Kangfuxin liquid was administered to promote healing of the intestinal mucosa and effectively manage clinical symptoms. CONCLUSION Mutations in the ACVRL1 and PLA2G4A genes may be one of the causes of chronic intestinal ulcers and bleeding in IBD. Orally administered Kangfuxin liquid may have therapeutic potential.
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Affiliation(s)
- Yong-Jing Tang
- Department of Infectious Diseases, The Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
| | - Jian Zhang
- Department of Gastroenterology, Dafang County People's Hospital, Bijie 551600, Guizhou Province, China
| | - Jie Wang
- Department of Internal Medicine, Puchang Branch, Medical Community, Suiyang County People's Hospital, Zunyi 563300, Guizhou Province, China
| | - Ren-Dong Tian
- Department of Infectious Diseases, The Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
| | - Wei-Wei Zhong
- Department of Infectious Diseases, Jingmen Central Hospital, Jingmen 448000, Hubei Province, China
| | - Ben-Sheng Yao
- Department of Infectious Diseases, Dafang County People's Hospital, Bijie 551600, Guizhou Province, China
| | - Bing-Yu Hou
- Department of Gastroenterology, Dafang County People's Hospital, Bijie 551600, Guizhou Province, China
| | - Ying-Hua Chen
- Department of Infectious Diseases, The Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
| | - Wei He
- Department of Infectious Diseases, The Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
| | - Yi-Huai He
- Department of Infectious Diseases, The Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
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Hudson CJ, Groh AMR, Macciardi F, Hudson RC. Genetic polymorphism data support a relationship between schizophrenia and microsatellite variability in PLA2G4A in Northern Europeans not Han Chinese. Am J Med Genet B Neuropsychiatr Genet 2022; 189:3-5. [PMID: 34889025 PMCID: PMC9300063 DOI: 10.1002/ajmg.b.32881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 11/22/2021] [Indexed: 11/10/2022]
Affiliation(s)
| | - Adam M. R. Groh
- Montreal Neurological Institute‐HospitalMcGill UniversityMontréalQuébecCanada
| | - Fabio Macciardi
- Department of PsychiatryUniversity of California, Irvine (UCI)IrvineCaliforniaUSA
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