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Bhalla D, Sati S, Basel D, Karody V. A novel termination site in a case of Stüve-Wiedemann syndrome: case report and review of literature. Front Pediatr 2024; 12:1341841. [PMID: 38628360 PMCID: PMC11018973 DOI: 10.3389/fped.2024.1341841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
Stüve-Wiedemann syndrome (SWS) is a rare autosomal recessive disorder that is characterized by bowing of long bones, dysautonomia, temperature dysregulation, swallowing and feeding difficulties, and frequent respiratory infections. Respiratory distress and hyperthermic events are the leading causes of early neonatal death, and most patients are not expected to survive past infancy. Here, we report on the survival of a 5-year-old male with SWS, discussing his case presentation, providing a brief clinical course, and discussing the outcome. This case adds to the literature surrounding rare instances of childhood survivors of SWS and raises awareness for this syndrome to facilitate an earlier recognition, intervention, and genetic counseling for the families, thereby improving understanding of this disease and the health outcomes for the children affected by this condition.
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Affiliation(s)
- Deepali Bhalla
- Medical College of Wisconsin, Milwaukee, WI, United States
| | - Sunil Sati
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Donald Basel
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Vijender Karody
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States
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Jin J, Rothämel P, Büchel J, Kammer B, Brunet T, Pattathu J, Flemmer AW, Nussbaum C, Schroepf S. Case Report: Stüve-Wiedemann syndrome-a rare cause of persistent pulmonary hypertension of the newborn. Front Pediatr 2024; 11:1329404. [PMID: 38239591 PMCID: PMC10794634 DOI: 10.3389/fped.2023.1329404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 12/11/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction Persistent pulmonary hypertension of the newborn (PPHN) is a life-threatening condition characterized by hypoxemia due to elevated pulmonary vascular resistance. PPHN commonly arises secondary to various underlying conditions, including infection, meconium aspiration, and respiratory distress syndrome. Management includes pulmonary vasodilators, mechanical ventilation, oxygen supplementation, vasopressors, and volume replacement. Stüve-Wiedemann syndrome (SWS), a rare genetic disorder characterized by bone dysplasia, respiratory distress, hyperthermia, and swallowing difficulties, may present with pulmonary hypertension, indicating a poor prognosis. Case description A term female neonate presented with secondary respiratory failure and severe PPHN of unknown etiology on the second day of life, necessitating intubation. Clinical findings included facial dysmorphia, camptodactyly, skeletal anomalies, and generalized muscular hypotonia. High-frequency oscillation ventilation and surfactant administration yielded marginal improvement. On the third day of life, a severe pulmonary hypertensive crisis necessitated inhaled and systemic pulmonary vasodilators along with volume and catecholamine therapy. Whole exome sequencing revealed a homozygous mutation in the leukemia inhibitory factor receptor (LIFR) gene, consistent with Stüve-Wiedemann syndrome. Discussion/conclusion The case underscores the importance of considering and prompting evaluation of rare genetic causes in the differential diagnosis of PPHN, especially when other abnormalities are present and conventional therapies prove inadequate. Therapeutic strategies must account for the different pathophysiology of primary PPHN including vascular remodeling, as seen in SWS, which may not respond to pulmonary vasodilators typically employed in secondary PPHN due to vasoconstriction. In this case, the patient responded well to treatment for primary PPHN, but the use of high-frequency oscillation ventilation and surfactant was not helpful.
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Affiliation(s)
- Jessica Jin
- Division of Neonatology, Department of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Paula Rothämel
- Division of Neonatology, Department of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Johanna Büchel
- Clinic and Outpatient Clinic for Obstetrics and Gynecology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Birgit Kammer
- Department of Pediatric Radiology, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Theresa Brunet
- Institute of Human Genetics, Klinikum Rechts der Isar, University Hospital, Technical University of Munich, Munich, Germany
| | - Joseph Pattathu
- Department of Pediatric Cardiology and Pediatric Intensive Care, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Andreas W. Flemmer
- Division of Neonatology, Department of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Claudia Nussbaum
- Division of Neonatology, Department of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Sebastian Schroepf
- Division of Neonatology, Department of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
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McDermott H, Simmonds J, Thyagarajan M, Islam L, Naik S, Titheradge H. Paediatric survivors beyond infancy with Stüve-Wiedemann syndrome - A case series from the West Midlands, UK. Eur J Med Genet 2023:104788. [PMID: 37295610 DOI: 10.1016/j.ejmg.2023.104788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 03/23/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
Stüve-Wiedemann Syndrome (STWS) is an autosomal recessive condition caused by variants in the LIFR gene, presenting with respiratory failure, hyperthermia and skeletal dysplasia in the neonatal period. Historically identified as a lethal condition, more children are now managed holistically from early in life with multidisciplinary team involvement with improved outcomes. This stems from early diagnosis, supported by molecular testing in the pre and postnatal periods. This report includes five such cases with survival in childhood to 10 years old in the UK affected by skeletal abnormalities, hyperthermia, respiratory distress and their diagnostic odyssey. All cases have a molecular diagnosis; two patients (family 1) were found to be homozygous for a novel pathogenic LIFR variant NM_002310.5:c.704G > A, p.(Trp235Ter). One patient (family 2) is compound heterozygous with the previously reported LIFR variant NM_002310.5:c.756dup p.(Lys253Ter), and a second novel variant NM_002310.5:c.397+5G > A. Two patients (family 3) are homozygous for one of the same LIFR variants NM_002310.5:c.756dup p.(Lys253Ter) as in family 2. This report discusses genotypic and phenotypic data for five patients with STWS, as well as the need for multi-disciplinary, proactive management and genetic counselling.
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Affiliation(s)
- Helen McDermott
- Birmingham Women's and Children's NHS Foundation Trust, Clinical Genetics Department, Birmingham, Birmingham, UK.
| | - Jennifer Simmonds
- Leeds Teaching Hospitals NHS Trust, North East and Yorkshire Genomic Laboratory Hub Central Laboratory, Ashley Wing, St James's University Hospital, Leeds, UK
| | - Mani Thyagarajan
- Birmingham Women's and Children's NHS Foundation Trust, Radiology Department, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, UK
| | - Lily Islam
- Birmingham Women's and Children's NHS Foundation Trust, Clinical Genetics Department, Birmingham, Birmingham, UK
| | - Swati Naik
- Birmingham Women's and Children's NHS Foundation Trust, Clinical Genetics Department, Birmingham, Birmingham, UK
| | - Hannah Titheradge
- Birmingham Women's and Children's NHS Foundation Trust, Clinical Genetics Department, Birmingham, Birmingham, UK
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Warnier H, Barrea C, Bethlen S, Schrouff I, Harvengt J. Clinical overview and outcome of the Stuve-Wiedemann syndrome: a systematic review. Orphanet J Rare Dis 2022; 17:174. [PMID: 35461249 PMCID: PMC9034487 DOI: 10.1186/s13023-022-02323-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stuve-Wiedemann syndrome (SWS) is a rare and severe genetic disease characterized by skeletal anomalies and dysautonomic disturbances requiring appropriate care. Peer support is mandatory to fill the lack of clinical recommendations in such rare diseases. We report a new case and provide the first systematic review of all previous published cases. OBJECTIVE To better describe the timeline of SWS and to improve paediatric management. DATA SOURCES SWS English publications available on Pubmed until 31/03/2021. STUDY SELECTION Case description combining typical osteo-articular and dysautonomic involvement (with 2 items by categories required for children < 2 years and 3 items > 2 years). DATA EXTRACTION Demographic, clinical, genetics and outcome data. RESULTS In our cohort of 69 patients, the median age at report was 32 months. Only 46% presented antenatal signs. Mortality rate is higher during the first 2 years (42% < 2 years; 10% > 2 years) mainly due to respiratory failure, pulmonary arterial hypertension appearing to be a poor prognosis factor (mortality rate 63%). After 2 years, orthopaedic symptoms significantly increase including joint mobility restriction (81%), spinal deformations (77%) and fractures (61%). CONCLUSIONS Natural history of SWS is marked by a high mortality rate before 2 years due to dysautonomic disturbances. A specialized multidisciplinary approach is needed to address these early mortality risks and then adapt to the specific, mainly orthopaedic, needs of patients after 2 years of age. Further research is required to provide clinical guidelines and improve pre-natal counselling.
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Affiliation(s)
| | - Christophe Barrea
- Department of Paediatrics, Neuropeadiatrics, CHU of Liège, Liège, Belgium
| | - Sarah Bethlen
- Department of Physical Medicine, CHU of Liège, Liège, Belgium
| | | | - Julie Harvengt
- Department of Human Genetics, CHU of Liège, Avenue de l'Hôpital 1, Sart-Tilman, 4000, Liège, Belgium.
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