Extremely young case of small bowel intussusception due to Peutz-Jeghers syndrome with nonsense mutation of STK11

Clin J Gastroenterol. 2019 Oct;12(5):429-433. doi: 10.1007/s12328-019-00964-0. Epub 2019 Mar 19.

Abstract

Intussusception is a frequent and severe complication of Peutz-Jeghers syndrome (PJS). We herein present the case of a 3-year-old girl who experienced jejuno-jejunal intussusception due to PJS polyps. Despite no apparent family history of PJS, she had exhibited mucocutaneous pigmentation since infancy and recurrent abdominal pain and vomiting from 2 years of age. Segmental resection of the jejunum during emergency laparotomy for the intussusception revealed multiple hamartomatous polyps. Genetic analysis uncovered a germline nonsense mutation of c.247A>T in exon 1 of serine/threonine kinase 11 (STK11). Biannual follow-up surveillance for polyps by esophagogastroduodenoscopy, colonoscopy, and small bowel capsule endoscopy is ongoing. Reports describing the clinical and genetic features of extremely young PJS with intussusceptions are rare, although a literature review of STK11 germline mutations revealed several other pediatric cases of complicating intussusception at ≤ 8 years old. Considering the recent advances in surveillance and treatment options for the small bowel, earlier management of symptomatic children with PJS may be warranted to avoid surgical emergency.

Keywords: Child; Intussusception; Peutz–Jeghers syndrome; STK11.

Publication types

  • Case Reports
  • Review

MeSH terms

  • AMP-Activated Protein Kinase Kinases
  • Child, Preschool
  • Codon, Nonsense*
  • Female
  • Humans
  • Intussusception / diagnostic imaging
  • Intussusception / etiology*
  • Jejunal Diseases / diagnostic imaging
  • Jejunal Diseases / etiology*
  • Peutz-Jeghers Syndrome / complications*
  • Peutz-Jeghers Syndrome / genetics
  • Protein Serine-Threonine Kinases / genetics*
  • Ultrasonography

Substances

  • Codon, Nonsense
  • Protein Serine-Threonine Kinases
  • STK11 protein, human
  • AMP-Activated Protein Kinase Kinases