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Liang Y, He S, Yang L, Li T, Zhao L, Sun C. CHARGE syndrome with early fetal ear abnormalities: A case report. Clin Case Rep 2024; 12:e8670. [PMID: 38505478 PMCID: PMC10948373 DOI: 10.1002/ccr3.8670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/06/2024] [Accepted: 03/07/2024] [Indexed: 03/21/2024] Open
Abstract
Key Clinical Message CHARGE syndrome is a rare genetic disorder characterized by several distinct features. The presence of fetal ear abnormalities could be the early indicator of CHARGE syndrome. Subsequent prenatal diagnosis is essential to confirm the disorder. This is significant because the patient may receive genetic counseling and appropriate disposal based on the accurate diagnosis. Abstract CHARGE syndrome is a rare genetic disorder with multiple specific clinical features. The prenatal diagnosis is crucial but rarely achieved. We report a fetus with fetal external ear abnormality detected by ultrasound at 22nd week of gestation. Postnatal examination revealed an external ear abnormality, a mild atrial septal defect, and other clinical signs of CHARGE syndrome. A de novo pathogenic nonsense mutation in the CHD7 gene (c.406C > T, p.Q136X in exon 2) was identified to cause the disorder. Our study demonstrated that prenatal diagnosis and genetic testing were recommended to obtain a solid diagnosis of CHARGE syndrome when fetal external ear abnormality was detected by ultrasound examination.
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Affiliation(s)
- Yu Liang
- Department of UltrasoundShijiazhuang Fourth Hospital, Hebei Key Laboratory of Maternal and Fetal MedicineShijiazhuangChina
| | - Sijie He
- Hebei Industrial Technology Research Institute of Genomics in Maternal & Child Health, Clin Lab, BGI GenomicsShijiazhuangChina
| | - Liuqiao Yang
- BGI ResearchShenzhenChina
- College of Life SciencesUniversity of Chinese Academy of SciencesBeijingChina
| | - Tao Li
- BGI ResearchShenzhenChina
| | | | - Cong‐xin Sun
- Department of UltrasoundShijiazhuang Fourth Hospital, Hebei Key Laboratory of Maternal and Fetal MedicineShijiazhuangChina
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Polito MV, Ferraioli M, Nocilla A, Coppola G, D'Auria F, Marzano A, Barnabei L, Malinconico M, Bossone E, Ferrara F. CHARGE syndrome and congenital heart diseases: systematic review of literature. Monaldi Arch Chest Dis 2023. [PMID: 37675914 DOI: 10.4081/monaldi.2023.2661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 08/18/2023] [Indexed: 09/08/2023] Open
Abstract
CHARGE syndrome (CS) is a rare genetic disease that affects many areas of the body. The aim of the present systematic review was to evaluate the prevalence and types of congenital heart diseases (CHDs) in CS and their impact on clinical outcome. A systematic review from 1981 to September 2022 was conducted. Clinical studies that reported the association between CS and CHDs were identified, including a case report of a rare congenital anomaly of the aortic arch (AA) with persistent fifth aortic arch (PFAA). Demographic, clinical and outcome data were extracted and analyzed. Sixty-eight studies (44 case reports and 24 case series; n=943 CS patients) were included. The prevalence of CHDs was 76.6%, patent ductus arteriosus (PDA) 26%, ventricular (VSD) 21%, atrial septal defects (ASD) 18%, tetralogy of Fallot 11%, aortic abnormalities 24%. PFAA has not been previously reported in CS. Cardiac surgery was performed in more than half of CS patients (150/242, 62%). In-hospital mortality rate was about 9.5% (n=86/900) in case series studies and 12% (n=5/43) in case reports, including cardiovascular (CV) and non-CV causes. CHDs and feeding disorders associated with CS may have a substantial impact on prognosis. CHDs were usually associated with CS and represent important causes of morbidity and mortality. PFAA, although rare, may also be present. The prognosis is highly dependent on the presence of cardiac and non-cardiac developmental abnormalities. Further studies are needed to better identify the main causes of the long-term outcome of CS patients.
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Affiliation(s)
- Maria Vincenza Polito
- Division of Cardiology, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University Hospital of Salerno.
| | - Mario Ferraioli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA).
| | - Alessandra Nocilla
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA).
| | - Guido Coppola
- Division of Cardiology, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University Hospital of Salerno.
| | - Federica D'Auria
- Division of Cardiology, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University Hospital of Salerno.
| | - Antonio Marzano
- Division of Cardiology, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University Hospital of Salerno.
| | - Luca Barnabei
- Division of Cardiology, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University Hospital of Salerno.
| | - Marisa Malinconico
- Division of Cardiology, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University Hospital of Salerno.
| | - Eduardo Bossone
- Department of Public Health, Federico II University of Naples.
| | - Francesco Ferrara
- Division of Cardiology, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University Hospital of Salerno.
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3
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Onesimo R, Sforza E, Giorgio V, Rigante D, Kuczynska E, Leoni C, Proli F, Agazzi C, Limongelli D, Cerchiari A, Tartaglia M, Zampino G. Predicting the clinical trajectory of feeding and swallowing abilities in CHARGE syndrome. Eur J Pediatr 2023; 182:1869-1877. [PMID: 36800035 PMCID: PMC10167171 DOI: 10.1007/s00431-023-04841-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 01/11/2023] [Accepted: 01/21/2023] [Indexed: 02/18/2023]
Abstract
UNLABELLED To date, the feeding and oral-motor abilities of patients with CHARGE syndrome (CS) have not been longitudinally assessed. This study aims to investigate the level of these abilities at different ages and evaluate how they evolve during growth. We retrospectively analysed oral-motor features of 16 patients with molecularly confirmed CS (age range 4-21 years old; mean 11 years; SD 6 years; median 10 years). Nearly 100% of CS new-borns had weak sucking at birth, and half of them demonstrated poor coordination between breathing and swallowing. Over time, the percentages of children with tube feeding dependence (60% at birth) faced a slow but steady decrease (from 33% at 6 months, 25% at 12 months, to 13% at school age) in tandem with the decreasing risk of aspiration. The ability of eating foods requiring chewing was achieved at school age, after the acquisition of an adequate oral sensory processing. A mature chewing pattern with a variety of food textures was not achieved by more than half of patients, including those requiring artificial enteral nutrition. Most patients started prolonged oral-motor treatments with speech language therapists in early childhood. CONCLUSIONS Although feeding and swallowing disorders are constant features in CS patients, a slow and gradual development of feeding abilities occurs in most cases. Rehabilitation plays a key role in overcoming structural and functional difficulties and attaining appropriate eating skills. WHAT IS KNOWN • Feeding problems and swallowing dysfunction have been noted in CHARGE syndrome. • The involvement of multiple factors, including structural problems in the mouth, throat, or esophagus, and neurological impairment, make feeding a complicated task in CHARGE individuals. WHAT IS NEW • Dysphagia gradually improves in most CHARGE children over time, though with a wide interindividual variability. • The percentages of children with tube feeding dependence decrease over time from 60% at birth to 33% at 6 months and 13% at school age.
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Affiliation(s)
- R Onesimo
- Center for Rare Diseases, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A, Gemelli-IRCCS, 00168, Rome, Italy.,Università Cattolica del Sacro Cuore, Largo Vito 1, 00168, Rome, Italy.,Pediatric Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, 00168, Rome, Italy
| | - E Sforza
- Università Cattolica del Sacro Cuore, Largo Vito 1, 00168, Rome, Italy.
| | - V Giorgio
- Center for Rare Diseases, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A, Gemelli-IRCCS, 00168, Rome, Italy.,Università Cattolica del Sacro Cuore, Largo Vito 1, 00168, Rome, Italy.,Pediatric Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, 00168, Rome, Italy
| | - D Rigante
- Center for Rare Diseases, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A, Gemelli-IRCCS, 00168, Rome, Italy.,Università Cattolica del Sacro Cuore, Largo Vito 1, 00168, Rome, Italy.,Pediatric Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, 00168, Rome, Italy
| | - E Kuczynska
- Center for Rare Diseases, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A, Gemelli-IRCCS, 00168, Rome, Italy
| | - C Leoni
- Center for Rare Diseases, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A, Gemelli-IRCCS, 00168, Rome, Italy.,Pediatric Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, 00168, Rome, Italy
| | - F Proli
- Pediatric Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, 00168, Rome, Italy
| | - C Agazzi
- Pediatric Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, 00168, Rome, Italy
| | - D Limongelli
- Pediatric Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, 00168, Rome, Italy
| | - A Cerchiari
- Feeding and Swallowing Services Unit, Dept. Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital-IRCCS, 00168, Rome, Italy
| | - M Tartaglia
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù IRCCS, 00168, Rome, Italy
| | - G Zampino
- Center for Rare Diseases, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A, Gemelli-IRCCS, 00168, Rome, Italy.,Università Cattolica del Sacro Cuore, Largo Vito 1, 00168, Rome, Italy.,Pediatric Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, 00168, Rome, Italy
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Thomas AT, Waite J, Williams CA, Kirk J, Oliver C, Richards C. Phenotypic characteristics and variability in CHARGE syndrome: a PRISMA compliant systematic review and meta-analysis. J Neurodev Disord 2022; 14:49. [PMID: 36045324 PMCID: PMC9429597 DOI: 10.1186/s11689-022-09459-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 08/15/2022] [Indexed: 12/01/2022] Open
Abstract
Background CHARGE syndrome (OMIM #214800) is a phenotypically complex genetic condition characterised by multi-system, multi-sensory impairments. Behavioural, psychological, cognitive and sleep difficulties are not well delineated and are likely associated with biopsychosocial factors. Methods This meta-analysis investigated the prevalence of clinical features, physical characteristics and conditions, behavioural, psychological, cognitive and sleep characteristics in CHARGE syndrome, and statistically evaluated directional associations between these characteristics. Pooled prevalence estimates were calculated using reliable, prespecified quality weighting criteria, and meta-regression was conducted to identify associations between characteristics. Results Of the 42 eligible studies, data could be extracted for 1675 participants. Prevalence estimates were highest for developmental delay (84%), intellectual disability (64%), aggressive behaviour (48%), self-injurious behaviour (44%) and sleep difficulties (45%). Meta-regression indicated significant associations between intellectual disability and choanal atresia, intellectual disability and inner ear anomalies, sleep difficulties and growth deficiency, and sleep difficulties and gross motor difficulties. Conclusions Our comprehensive review of clinical features, behavioural, psychological, cognitive and physical characteristics, conditions and comorbidities in CHARGE syndrome provides an empirically based foundation to further research and practice. Supplementary Information The online version contains supplementary material available at 10.1186/s11689-022-09459-5.
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Affiliation(s)
- Andrea T Thomas
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK. .,Cerebra Network for Neurodevelopmental Disorders, Birmingham, UK.
| | - Jane Waite
- Cerebra Network for Neurodevelopmental Disorders, Birmingham, UK.,Aston University, Birmingham, UK
| | - Caitlin A Williams
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, UK
| | - Jeremy Kirk
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Chris Oliver
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Caroline Richards
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK.,Cerebra Network for Neurodevelopmental Disorders, Birmingham, UK
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Wei H, Tan ES, Jamuar S, Lai AHM, Ng I, Tan EC. Additional individuals with CHD7 variants in Chinese and other southeast Asian patients. Am J Med Genet A 2020; 182:2461-2465. [PMID: 32804436 DOI: 10.1002/ajmg.a.61798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/17/2020] [Accepted: 07/11/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Heming Wei
- Research Laboratory, KK Women's and Children's Hospital, Singapore, Singapore
| | - Ee-Shien Tan
- Genetics Service, KK Women's and Children's Hospital, Singapore, Singapore.,Pediatrics Academic Clinical Programme, SingHealth Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Saumya Jamuar
- Genetics Service, KK Women's and Children's Hospital, Singapore, Singapore.,Pediatrics Academic Clinical Programme, SingHealth Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Angeline H M Lai
- Genetics Service, KK Women's and Children's Hospital, Singapore, Singapore.,Pediatrics Academic Clinical Programme, SingHealth Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Ivy Ng
- Genetics Service, KK Women's and Children's Hospital, Singapore, Singapore.,Pediatrics Academic Clinical Programme, SingHealth Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Ene-Choo Tan
- Research Laboratory, KK Women's and Children's Hospital, Singapore, Singapore.,Pediatrics Academic Clinical Programme, SingHealth Duke-NUS Graduate Medical School, Singapore, Singapore
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