Voluminoso hamartoma hipotalámico en un nixo de 5 meses

9ROXPLQRVRKDPDUWRPDKLSRWDOiPLFRHQXQQLxRGHPHVHV(SLOHSVLD\FLUXJtD
($UiQ-3HUHLUD/&DVWUR\59D]
6HUYLFLRGH1HXURFLUXJtD6HUYLFLRGH$QDWRPtD3DWROyJLFD+RVSLWDO6mR-RmR2SRUWR3RUWXJDO
5HVXPHQ
/RVDXWRUHVSUHVHQWDQHOFDVRFOtQLFRGHXQQLxRGH
PHVHVGHHGDGFRQXQKDPDUWRPDKLSRWDOiPLFRFRQ
FULVLVJHOiVWLFDVSHUVLVWHQWHV\UHIUDFWDULDVDXQDDPSOLD
FRPELQDFLyQGHGLIHUHQWHVDQWLHSLOpSWLFRV
6H GHFLGLy UHDOL]DU XQD UHPRFLyQ SDUFLDO GH OD OHVLyQ
WXPRUDOSDUDGHVFRPSUHVLyQ\GLVPLQXFLyQGHOHVWtPXORHSL
OHSWRJpQLFRHQXQLQWHQWRGHFRQWUROTXLU~UJLFRGHODVFULVLV
/DWHUDSpXWLFDTXLU~UJLFDVHUHYHOyFRPRXQDRSFLyQ
YiOLGDHQHOWUDWDPLHQWRGHODVFULVLVJHOiVWLFDVLQFRQWUR
ODEOHVFRQODWHUDSpXWLFDPpGLFD
3$/$%5$6 &/$9( +DPDUWRPD KLSRWDOiPLFR +DPDU
WRPDGHOVLVWHPDQHUYLRVRFHQWUDO&ULVLVJHOiVWLFDV
9ROXPLQRXVK\SRWKDODPLFKDPDUWRPDLQDPRQWKROG
ER\(SLOHSV\DQGVXUJHU\
6XPPDU\
7KHDXWKRUVUHSRUWWKHFDVHRIPRQWKROGER\ZLWKD
K\SRWKDODPLFKDPDUWRPDDQGSHUVLVWHQWJHODVWLFVHL]XUHVLQ
VSLWHRIDZLGHFRPELQDWLRQRIGLIIHUHQWDQWLHSLOHSWLFGUXJV
,WZDVGHFLGHGWRFDUU\RXWRQO\SDUWLDOUHPRYDORI
WKHWXPRUIRUGHFRPSUHVVLRQDQGWRGHFUHDVLQJWKHDFWL
YLW\RIWKHHSLOHSWRJHQLFIRFXV
6XUJLFDO WKHUDS\ UHYHDOHG DV D YDOLG RSWLRQ LQ WKH
WUHDWPHQWRIWKHXQFRQWUROODEOHJHODVWLFVHL]XUHV
.(<:25'6+\SRWKDODPLFKDPDUWRPD&HQWUDOQHUYRXV
V\VWHPKDPDUWRPD*HODVWLFFULVHV
,QWURGXFFLyQ
/RV KDPDUWRPDV KLSRWDOiPLFRV VRQ HO SURGXFWR GH
XQD DQRPDOtD HQ HO GHVDUUROOR HPEULRQDULR TXH FDXVD OD
IRUPDFLyQGHXQDPDVDFRPSXHVWDGHWHMLGRTXHHVWiKDEL
WXDOPHQWHHQHVHiUHDDXQTXHHQSURSRUFLyQ\GLVWULEXFLyQ
1HXURFLUXJtD 5HFLELGR$FHSWDGR
LQDGpFXDGDFRQSUHGRPLQLRGHXQWLSRFHOXODU
(O SULPHU FDVR GHVFULWR HQ OD OLWHUDWXUD VH UHPRQWD D
$XQTXHHVWDHQWLGDGHVELHQFRQRFLGDVLJXHVLHQGR
XQDPDOIRUPDFLyQFRQJpQLWDSRFRIUHFXHQWHTXHVHGHVDUUR
OODHQWUHODyVHPDQDGHJHVWDFLyQ(VWiFDUDFWHUL]DGD
SRUVXHVWDELOLGDGORFDO\SRUVHUSRFRLQYDVLYDGXUDQWHVX
FUHFLPLHQWRDORODUJRGHOWLHPSR
/RV KDPDUWRPDV SXHGHQ FODVL¿FDUVH PRUIROyJLFDPHQWH
FRPRSHGLFXODGRVRVpVLOHV&XDQGRSUHVHQWDQHSLOHSVLDODV
FULVLVJHOiVWLFDVVRQODVPiVWtSLFDVHQHVWDVOHVLRQHV\FXUVDQ
FRQHSLVRGLRVGHDSQHDFULVLVIDFLDOHVFOyQLFDV\JHPLGRV
6H KDQ GHVFULWR GLIHUHQWHV WLSRV GH WUDWDPLHQWRV FRQ
PD\RURPHQRUp[LWRFRPRODFLUXJtDODWHUPRFRDJXODFLyQ
FRQUDGLRIUHFXHQFLDJXLDGDSRUHVWHUHRWD[LD\PiVUHFLHQ
WHPHQWHODUDGLRFLUXJtD
&DVRFOtQLFR
/RV DXWRUHV SUHVHQWDQ HO FDVR FOtQLFR GH XQ QLxR GH
PHVHV GH HGDG TXH GHVGH HO QDFLPLHQWR HVWDED VLHQGR
WUDWDGRFRQIHQREDUELWDOPJGtDSRUFULVLVIUHFXHQWHV
GH KLSHUWRQtD D[LDO FRQ PRYLPLHQWRV GH YHUVLyQ RFXODU
VHJXLGRVGHJHPLGR\SRVWUDFLyQ$OWHUFHUGtDGHYLGDOH
IXH UHDOL]DGD XQD SULPHUD HFRJUDItD WUDQVIRQWDQHODU TXH
IXHLQIRUPDGDFRPRQRUPDO$OPHV\PHGLRGHHGDGVHOH
UHDOL]yXQHOHFWURHQFHIDORJUDPDWDPELpQLQIRUPDGRFRPR
QRUPDOSRUORTXHVXVSHQGLyODWHUDSLDDQWLFRQYXOVLYD$O
UHLQLFLDUVHODVFULVLVVHOHWUDWyFRQIHQREDUELWDOHQGRVLVGH
PJFDGDKRUDV
$ ORV GRV PHVHV GH YLGD OH IXH UHDOL]DGD XQD QXHYD
HFRJUDItD WUDQVIRQWDQHODU TXH PRVWUy XQD PDOIRUPDFLyQ
FHUHEUDOKLSHUFRJpQLFDHQODUHJLyQVXEWDOiPLFDHKLSRWD
OiPLFD )LJXUDV $ \ % TXH KDFtDQ LQGLVWLQJXLEOHV SRU
FRPSOHWRODVHVWUXFWXUDVDQDWyPLFDVGHHVWDUHJLyQ1RVH
LGHQWL¿FDEDHOWHUFHUYHQWUtFXOR\SUHVHQWDEDXQHMHPD\RU
GH DSUR[LPDGDPHQWH FP QR VLHQGR SRVLEOH HYDOXDU VX
H[WHQVLyQDQWHURSRVWHULRU/DVHVWUXFWXUDVGHOWURQFRFHUH
EUDOHVWDEDQWDPELpQERUUDGDVSRUODOHVLyQPDQWHQLpQGRVH
OD LQWHJULGDG GH ORV GRV WiODPRV YHQWUtFXORV ODWHUDOHV \
GHO FXHUSR FDOORVR 3RVWHULRUPHQWH HVWD LPDJHQ IXH FRQ
¿UPDGDFRQWRPRJUDItDFRPSXWDUL]DGD7&\UHVRQDQFLD
$UiQ\FROV
)LJXUD $ (FRJUDItD WUDQVIRQWDQHODU HQ FRUWH FRURQDO
UHDOL]DGDDORVGRVPHVHVGHYLGDHQODTXHVHSXHGHYHU
XQDLPDJHQKLSHUFRJpQLFDFRUUHVSRQGLHQWHDOKDPDUWRPD
ORFDOL]DGDSRUGHEDMRGHORVYHQWUtFXORVODWHUDOHV\HQOD
OtQHDPHGLD
1HXURFLUXJtD
)LJXUD%(FRJUDItDWUDQVIRQWDQHODUHQFRUWHVDJLWDOHQOD
TXHHVLQGLVWLQJXLEOHHOWHUFHUYHQWUtFXORDVtFRPRHOWURQFR
FHUHEUDO GHIRUPDGRV SRU OD FRPSUHVLyQ UHDOL]DGD SRU OD
OHVLyQWXPRUDO
)LJXUD$,PDJHQGH50HQFRUWHVDJLWDO7VLQJDGROLQLR
HQ OD FXDO VH REVHUYDQ ODV GLPHQVLRQHV GH OD OHVLyQ \ HO
PDUFDGRHIHFWRGHPDVDVREUHHOWURQFRFHUHEUDO
PDJQpWLFD 50 (Q ODV LPiJHQHV VH UHYHODED FRPR XQD
HVLyQ KRPRJpQHD FRQ GHQVLGDG H LQWHQVLGDG LGpQWLFD DO
SDUpQTXLPD HQFHIiOLFR GH DSUR[LPDGDPHQWH FP GH
HMHPD\RUORFDOL]DGDHQODUHJLyQVXSUDVHODUFRQLQYDJLQD
FLyQDORODUJRGHOFOLYXV\H[WHQVLyQVXEWHPSRUDOELODWHUDO
OOHJDQGRKDVWDORVDJXMHURVGH0RQUR\RFXSDQGRORVGRV
WHUFLRVDQWHULRUHVGHOWHUFHUYHQWUtFXOR6XHMHDQWHURSRV
WHULRU PHGtD FP \ HQ VX ORQJLWXG Pi[LPD FDXVDED
GHVSOD]DPLHQWR\FRPSUHVLyQFRQVLGHUDEOHGHOWURQFRFHUH
EUDO VLQ SURGXFLU LQYDVLyQ GHO SDUpQTXLPD SHULWXPRUDO
)LJXUD%&RUWHD[LDO7VLHQGRPX\HYLGHQWHVXDVSHFWR
UHGRQGHDGRFRQOtPLWHVELHQGH¿QLGRV\VXUHODFLyQFRQODV
HVWUXFWXUDVVXSUD\SHULVHODUHV
VLHQGRVXFRQ¿JXUDFLyQUHGRQGHDGD\VXGLiPHWURFRURQDO
GHFP)LJXUDV$\%
(QXQLQWHQWRGHFRQWUROPpGLFRGHOFXDGURFRQYXOVLYR
IXHWUDWDGRFRQXQDGRVLVFUHFLHQWHGHIHQREDUELWDOKDVWD
PJFK\YDOSURDWRGHVRGLRHQGRVLVGHPJFK
3RVWHULRUPHQWHHVWD~OWLPDGRVLVVHDXPHQWyDPJFK
\VHDVRFLyYLJDEDWULPHQXQDGRVLVGHPJFK
9ROXPLQRVRKDPDUWRPDKLSRWDOiPLFRHQXQQLxRGHPHVHV(SLOHSVLD\FLUXJtD
1HXURFLUXJtD
)LJXUD+HPDWR[LOLQD(RVLQD[iUHDGHKDPDU
WRPD KLSRWDOiPLFR FRQ QHXURQDV GH YDULRV WDPDxRV
DVWURFLWRV\XQSHTXHxRYDVR
)LJXUD50SRVWRSHUDWRULDHQODTXHHVPX\HYLGHQWHOD
GHVFRPSUHVLyQ GHO WURQFR FHUHEUDO HIHFWXDGD SRU OD FLWR
UUHGXFFLRQTXLUXUJLFD
$O DJUDYDUVH OD VLQWRPDWRORJtD FRQ DXPHQWR GHO
Q~PHUR \ GXUDFLyQ GH ODV FULVLV VH GHFLGLy UHDOL]DU XQD
GHVFRPSUHVLyQ PLFURTXLU~UJLFD FLWRUUHGXFFLyQ GLDJQyV
WLFRWHUDSpXWLFD 'XUDQWH OD FLUXJtD VH SXGR REVHUYDU XQD
OHVLyQ KRPRJpQHD GH DVSHFWR \ FRQVLVWHQFLD LGpQWLFD D OD
GH OD VXVWDQFLD EODQFD \ SRFR KHPRUUiJLFD TXH LQYDGtD HO
TXLDVPDySWLFR6HOOHYyDFDERXQDPD\RUGHVFRPSUHVLyQ
DQLYHOVXSUDVHODUSUHySWLFR\UHWURFOLYDOREVHUYiQGRVHXQD
PD\RUUHFWL¿FDFLyQSRVWRSHUDWRULDGHOWURQFRFHUHEUDOORTXH
SURGXMRXQDFODUDGHVFRPSUHVLyQTXLU~UJLFD)LJXUD
$OH[DPHQDQDWRPRSDWROyJLFR)LJXUDVHREVHUYyXQ
WHMLGRQHUYLRVRGHGHQVLGDGFHOXODUOLJHUDPHQWHDXPHQWDGD
DFRVWDGHIUHFXHQWHVDJUHJDGRVGHQHXURQDVGHPRUIRORJtD
QRUPDO1RVHREVHUYDURQDWLSLDVGHODVFpOXODVJOLDOHVQL
¿JXUDVGHPLWRVLV
(QHOHVWXGLRLQPXQRFLWRTXtPLFRFRQDQWLFXHUSRVSDUD
16(VLQDSWR¿VLQDQHXUR¿ODPHQWRVFURPRJUDQLQD*)$3
\SURWHtQD6VHREVHUYyLQPXQRUUHDFWLYLGDGSDUDWRGRV
ORVDQWLFXHUSRVH[FHSWRSDUDODFURPRJUDQLQDTXHQRSUH
VHQWyQLQJXQDH[SUHVLyQHQHOWHMLGRSRUORTXHODOHVLyQ
IXHGLDJQRVWLFDGDGHKDPDUWRPDKLSRWDOiPLFR
'XUDQWH HO SRVWRSHUDWRULR QR VH SURGXMHURQ LQFLGHQWHV
GLJQRVGHPHQFLyQDQRVHUXQGHVHTXLOLEULRKLGURHOHFWUROtWLFR
WUDQVLWRULRTXHIXHFRUUHJLGRVLQPD\RUHVFRQVHFXHQFLDV
6H REVHUYy XQD PHMRUtD SRVTXLU~UJLFD HYLGHQWH GH OD
VLQWRPDWRORJtD HQFRQWUiQGRVH DFWXDOPHQWH FRQ WDQ VyOR
XQRRGRVHSLVRGLRVGHFULVLVSRUGtDGHGXUDFLyQLQIHULRU
DOPLQXWR\GHPXFKDPHQRULQWHQVLGDGPDQWHQLpQGRVHOD
PHGLFDFLyQ DQWLFRQYXOVLYD FRQ IHQREDUELWDO YDOSURDWR GH
VRGLR\YLJDEDWULPHQGRVLVGH\PJSRUGtD
UHVSHFWLYDPHQWH
'LVFXVLyQ
(OKDPDUWRPDKLSRWDOiPLFRHVXQDKHWHURWRSLDFRQJp
QLWDFRPSXHVWDSRUQHXURQDVJOtD\¿EUDVPLHOtQLFDV/D
OHVLyQVHSXHGHFODVL¿FDUHQGRVJUXSRVFOtQLFRVGLIHUHQWHV
(O SULPHUR VH FDUDFWHUL]DSRU SXEHUWDG SUHFR] HQ HO TXH
ORVVtQWRPDVFRPLHQ]DQHQWUHHOQDFLPLHQWR\ORVWUHVDxRV
GHHGDG(QHOVHJXQGRSXHGHQRKDEHUSXEHUWDGSUHFR]\
VtFRQYXOVLRQHVJHOiVWLFDVGHOWLSRFULVLVSDUFLDOHVFRPSOH
MDVUHWUDVRPHQWDO\WUDVWRUQRVVLTXLiWULFRV
0DFURVFySLFDPHQWHHVWDVOHVLRQHVVHORFDOL]DQHQWUHHO
WDOORKLSR¿VDULR\ORVWXEpUFXORVPDPLODUHV6RQOHVLRQHV
JHQHUDOPHQWH LVRLQWHQVDV FRQ UHVSHFWR D OD VXVWDQFLD JULV
QRUPDO HQ 7 \ 75 ODUJR 7( FRUWR \ IUHFXHQWHPHQWH
KLSHULQWHQVDVHQ,37QRPRVWUDQGRUHDOFHWUDVODDGPLQLV
WUDFLyQGHFRQWUDVWHQLIRFRVGHFDOFL¿FDFLyQ
/D WRPRJUDÀD SRU HPLVLyQ GH SRVLWURQHV 3(7 FRQ
OD DGPLQLVWUDFLyQ GH WUD]DGRUHV PHWDEyOLFRV FRPR HO
)ÀXRUXURGHVKLGURJHQDVD \ FRQ PHGLFLRQHV GH OD XWL
OL]DFLyQ GH JOXFRVD FHUHEUDO SXHGH GHPRVWUDU XQ iUHD
GH KLSRPHWDEROLVPR HQ ORV SHUtRGRV GH LQWHUFULVLV HQ
SDFLHQWHV HQ ORV TXH ORV H[iPHQHV GH 7& \ 50 QR VRQ
WDQHYLGHQWHV(VWHPLVPRiUHDVHYXHOYHKLSHUPHWDEyOLFD
GXUDQWHODVFULVLV
(OGLDJQyVWLFRGLIHUHQFLDOGHEHUHDOL]DUVHFRQHOJOLRPD
KLSRWDOiPLFRFUDQHRIDULQJLRPDJOLRPDySWLFRJHUPLQRPD
\JDQJOLRJOLRPD&DGDXQRGHHOORVFRQFDUDFWHUtVWLFDVGH
QHXURLPDJHQTXHWUDVXQHVWXGLRDGHFXDGRODVKDFHQGLV
WLQJXLEOHVHQWUHVtHQODPD\RUtDGHORVFDVRV
(O WUDWDPLHQWR TXLU~UJLFR HV GLVFXWLEOH HQ HVWH WLSR GH
OHVLRQHV ([LVWHQ GLIHUHQWHV WUDWDPLHQWRV SRVLEOHV SDUD
HVWDHQWLGDGFOtQLFD'HVGHHOWUDWDPLHQWRFRQVHUYDGRUFRQ
WHUDSpXWLFDPpGLFDDQWLFRPLFLDOKDVWDODUHPRFLyQTXLU~U
JLFD FRPSOHWD R SDUFLDO FOiVLFD \ \D PiV UHFLHQWHPHQWH
$UiQ\FROV
FRQ OD WHUPRFRDJXODFLyQ FRQ UDGLRIUHFXHQFLD JXLDGD SRU
HVWHUHRWD[LD\FRQODUDGLRFLUXJtD
'HVGH KHPRV HQFRQWUDGR SXEOLFDGRV FDVRV
WRGRVHOORVFRQFULVLVJHOiVWLFDV'HpVWRVIXHURQWUDWD
GRVTXLU~UJLFDPHQWHHIHFWXiQGRVHHQUHPRFLRQHVWRWDOHV
\HQXQDUHPRFLyQSDUFLDO0HMRUDURQGHODVFULVLVGH
HVWRV SDFLHQWHV 'HO PLVPR PRGR HQ ORV WUDWDGRV FRQ
WHUPRFRDJXODFLyQ \ WHUDSpXWLFD PpGLFD FRQVHUYDGRUD VH
REWXYLHURQPHMRUtDVGHODVLQWRPDWRORJtDFRPLFLDO
QRHQFRQWUiQGRVHSRUORWDQWRGLIHUHQFLDVHYLGHQWHVHQWUH
HVWRVWLSRVGHWUDWDPLHQWR
5HFLHQWHPHQWH 8QJHU \ FROV UH¿HUHQ TXH OD
UDGLRFLUXJtDHQGRVLVEDMDVGH*\VHKDPRVWUDGR
H¿FD]HQODVXSUHVLyQGHODDFWLYLGDGHSLOHSWRJpQLFDQR
VXEVWLWX\HQGRDODFLUXJtD\HQFRQWUiQGRVHWRGDYtDHQXQD
IDVH LQLFLDO GH E~VTXHGD GH SDUiPHWURV /D UDGLRFLUXJtD
UHSUHVHQWD XQD DOWHUQDWLYD YiOLGD SDUD DTXHOORV FDVRV HQ
RVTXHH[LVWHXQDFRQWUDLQGLFDFLyQTXLU~UJLFDIRUPDORQR
KD\ FRQVHQWLPLHQWR IDPLOLDU SDUD OD FLUXJtD /D UDGLDFLyQ
FHUHEUDO SUHVHQWD PXFKRV HIHFWRV VHFXQGDULRV HVSHFLDO
PHQWHHQQLxRVGHFRUWDHGDGSRUORTXHGHEHVHUSRQGHUDGD
FDXWHORVDPHQWH
(VHYLGHQWHTXHFXDQGRH[LVWHXQYROXPHQWXPRUDOTXH
SURGXFHXQHIHFWRGHPDVDVLJQL¿FDWLYRFRQFRPSUHVLyQ\
GHVSOD]DPLHQWRGHHVWUXFWXUDVDG\DFHQWHVODFLUXJtDWLHQH
YDULRVREMHWLYRVODFRQ¿UPDFLyQKLVWROyJLFDGHOGLDJQyV
WLFRODFLWRUUHGXFFLyQGHVFRPSUHVLYD\ODUHGXFFLyQGHODV
FULVLV /D GLVSDULGDG GH OD H[WHQVLyQ GH HVWDV OHVLRQHV QR
SHUPLWH FRPSDUDU UHVXOWDGRV HQWUH HVWUDWHJLDV TXLU~UJLFDV
PiVRPHQRVDJUHVLYDV6LQHPEDUJRQRVSDUHFHOyJLFRTXH
ODQHXURQDYHJDFLyQSXHGDVHUXQLQVWUXPHQWRPX\~WLOHQ
ODFLUXJtDGHHVWDVOHVLRQHV9DOGXH]D\FROVUHFRPLHQGDQ
OD FLUXJtD FRPR WHUDSpXWLFD GH HOHFFLyQ HQ ORV FDVRV GH
GHWHULRURYLVXDOSURJUHVLYR\IDOORGHOWUDWDPLHQWRPpGLFR
7DPELpQHQORVFDVRVGHFULVLVGHGLItFLOFRQWURO\DQRUPD
OLGDGHVGHOGHVDUUROORODFLUXJtDHVHOHFWLYD
&RQFOXVLyQ
$~QHQFDVRVFRPRHOQXHVWURHQTXHSRUODVFDUDFWH
UtVWLFDVGHOSURFHVRWXPRUDOVHHIHFW~HVyORXQDUHVHFFLyQ
PX\SHTXHxDpVWDSXHGHVHU~WLOSDUDHOFRQWUROGHODVFULVLV
FRQYXOVLYDV
%LEOLRJUDItD
O $OEULJKW $/ /HH 3$ 1HXURVXUJLFDO WUHDWPHQW RI
K\SRWKDODPLFKDPDUWRPDVFDXVLQJSUHFRFLRXVSXEHUW\-1HX
URVXUJ
$ULWD..XULVX.,LGD.HWDO6XEVLGHQFHRIVHL]XUH
LQGXFHGE\VWHUHRWDWLFUDGLDWLRQLQDSDWLHQWZLWKK\SRWKDODPLF
KDPDUWRPD&DVHUHSRUW-1HXURVXUJ
%R\NR 2% &XUYHV -7 2DNHV :- %XUJHU 3&
1HXURFLUXJtD
+DPDUWRPDV RI WKH WXEHU FPHUHXP &7 05 DQG SDWKRORJLF
¿QGLQJV$-15
&KHQJ . 6DZDPXUD < <DPDXFKL 7 $EH +
$V\PSWRPDWLFODUJHK\SRWKDODPLFKDPDUWRPDDVVRFLDWHGZLWK
SRO\GDFW\O\LQDQDGXOW1HXURVXUJ
&KHQ 7& *RQ]iOH]*yPH] , 0F&RPE -*
8QFRPPRQ JOLDO WXPRUV (Q .D\H $+ /DZV (5 -U HGV
%UDLQ 7XPRXUV $Q (QF\FORSHGLD $SSURDFK (GLQEXUJK
&KXUFKLOO/LYLQJVWRQHSS
(QJHO - -U .XKO '( 3KHOSV 0( 3DWWHUQV RI
KXPDQ ORFDO FHUHEUDO JOXFRVH PHWDEROLVP GXULQJ HSLOHSWLF
VHL]XUHV6FLHQFH
)XNXGD0.DPH\DPD6:DFKL0HWDO6WHUHRWD[\
IRU K\SRWKDODPLF KDPDUWRPD ZLWK LQWUDFWDEOH JHODVWLF VHL]X
UHVWHFKQLFDOFDVHUHSRUW1HXURVXUJHU\
.X]QLHFN\5*XWKULH%0RXQW]-HWDO,QWULQVLF
HSLOHSWRJHQHVLVRIK\SRWKDODPLFKDPDUWRPDVLQJHODVWLFHSL
OHSV\$QQ1HXURO
0DFKDGR+5+RIIPDQQ+-+ZDQJ3$*HODVWLF
VHL]XUHV WUHDWHG E\ UHVHFWLRQ RI D K\SRWKDODPLF KDPDUWRPD
&KLOGV1HUY6\VW
0XQDUL & .DKDQH 3 )UDQFLRQH 6 HW DO 5ROH RI
WKHK\SRWKDODPLFKDPDUWRPDLQWKHJHQHVLVRIJHODVWLF¿WVD
YLGHRVWHUHR((* VWXG\ (OHFWURHQFHSKDORJU &OLQ 1HXURSKL
VLRO
2VERUQ $* 7XPRUHV FHUHEUDOHV \ PDVDV GH WLSR
WXPRUDO &ODVL¿FDFLyQ \ GLDJQyVWLFR GLIHUHQFLDO (Q $QQH
* 2VERUQ 1HXURUUDGLRORJtD 'LDJQyVWLFD 0DGULG 0RVE\
'R\PD/LEURV6$SS
3DLOODV-(5RJHU-7RJD06RXOD\URO56DOD
PRQ*'UDYHW&%XUHDX0+DPDUWRPDRIWKHK\SRWKD
ODPXV&OLQLFDOUDGLRORJLFDODQGKLVWRORJLFDOVWXG\UHVXOWVRI
VXUJLFDOH[FLVLRQ5HY1HXURO3DULV
6FKLIIHU ' %UDLQ 7XPRUV %LRORJ\ 3DWKRORJ\ DQG
&OLQLFDO 5HIHUHQFHV HG %HUOLQ 6SULQJHU9HUODJ S
8QJHU ) 6FKU|WWQHU 2 +DVHOEHUJHU . HW DO
*DPPD NQLIH UDGLRVXUJHU\ IRU K\SRWKDODPLF KDPDUWRPDV LQ
SDWLHQWV ZLWK PHGLFDOO\ LQWUDFWDEOH HSLOHSV\ DQG SUHFRFLRXV
SXEHUW\-1HXURVXUJ
9DOGXH]D -0 &ULVWDQWH / 'DPPDQQ 2 HW DO
+\SRWKDODPLFKDPDUWRPDVZLWKVSHFLDOUHIHUHQFHWRJHODVWLF
HSLOHSV\DQGVXUJHU\1HXURVXUJHU\
9DTXHUR-&RFD6$WODVGH3DWRORJtD7XPRUDOGHO
6LVWHPD1HUYLRVR0DGULG0LQLVWHULRGH'HIHQVD6HFUHWDUtD
*HQHUDO7pFQLFDSS
$UiQ ( 3HUHLUD - &DVWUR / 9D] 5 9ROXPLQRVR
KDPDUWRPDKLSRWDOiPLFRHQXQQLxRGHPHVHV(SLOHSVLD
\FLUXJtD1HXURFLUXJtD
&RUUHVSRQGHQFLDSRVWDO(GXDUGR$UiQ(FKDEH5HSGHO6DOYD
GRUž'6DQWLDJRGH&RPSRVWHOD$&RUXxD(VSDxD