Aicardi-Goutières syndrome presenting with haematemesis in infancy.
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.


CONCLUSIONS
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.
Paediatric Neurology Department, Evelina Children's Hospital at Guys and St Thomas' Hospitals NHS Foundation Trust, London, UK.
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D
Hall
G I
GI
Rice
N
N
Akbar
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A
Meager
Y J
YJ
Crow
M J
MJ
Lim
D000015:Abnormalities, Multiple / Q000175:diagnosis* / Q000235:genetics; D020274:Autoimmune Diseases of the Nervous System / Q000235:genetics; D001927:Brain Diseases / Q000150:complications / Q000175:diagnosis* / Q000235:genetics; D005260:Female; D041981:Gastrointestinal Tract / Q000473:pathology; D006396:Hematemesis / Q000209:etiology*; D006801:Humans; D007223:Infant; D007249:Inflammation; D008279:Magnetic Resonance Imaging; D012640:Seizures / Q000209:etiology; D013577:Syndrome; D014057:Tomography, X-Ray Computed