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- W2465279910 abstract "La galactosémie est une affection héréditaire due à un déficit de l’une des trois enzymes du métabolisme du lactose en glucose : la galactose 1 phosphate uridyltransférase. Présente dans le foie normal dès la dixième semaine de gestation, son déficit peut entraîner des manifestations congénitales par accumulation de galactose dès lors que la mère a une alimentation lactée pendant la grossesse. Il s’agit principalement de la survenue d’une insuffisance hépatique néonatale alors que la cataracte fœtale est rare. Celle-ci est habituellement considérée comme la seule manifestation ophtalmologique, mais d’exceptionnelles complications hémorragiques intra-oculaires ont été décrites. Nous rapportons le cas d’un nouveau-né atteint de galactosémie ne présentant pas de cataracte fœtale, mais une hémorragie intra-vitréenne unilatérale. Les anomalies rétiniennes mises en évidence après la vitrectomie expliqueraient la survenue d’hémorragies dont la diffusion intra-vitréenne serait favorisée par les troubles de la coagulation de la maladie néonatale. Chez l’enfant, les causes des hémorragies intra-vitréennes sont sujet à controverse et leurs complications, dont l’installation rapide d’une amblyopie, justifient une vitrectomie dans le mois qui suit leur apparition. La prévention du risque d’hémorragie intra-oculaire compliquant une galactosémie dépend de la précocité du diagnostic étiologique de l’insuffisance hépatique et de sa prise en charge thérapeutique. Galactosemia is an inherited metabolic disorder due to a defect in one of the three enzymes required to fully metabolize the galactose in glucose: the galactose 1-phosphate uridyltransferase. Because this enzyme is present in the normal foetal liver since the tenth week of gestation, its defect cause congenital abnormality due to galactose accumulation, when the mother had taken milk during the pregnancy. It is mainly a liver pathology whereas the foetal cataract is rare. This latter is usually considered as the sole ophthalmic consequence of this disorder but exceptional ocular haemorrhages have also been described. We report the case of a neonate with galactosemia free from fœtal cataract but presenting an unilateral vitreous haemorrhage. Retinal anomalies seen after vitrectomy are probably the source of the vitreous blood favoured by the coagulopathy associated with the neonatal disease. The causes of infant vitreous haemorrhages are often debated and their complications, especially severe amblyopia, require vitrectomy within the month following their discovery. In galactosemia, vitreous haemorrhage can be prevented by an early diagnosis and an appropriate treatment of the liver pathology." @default.
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- W2465279910 date "2005-05-01" @default.
- W2465279910 modified "2023-10-14" @default.
- W2465279910 title "Hémorragie intra-vitréenne du nouveau-né et galactosémie" @default.
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- W2465279910 doi "https://doi.org/10.1016/s0181-5512(05)81085-x" @default.
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