1
|
Pirot N, Crahes M, Adle-Biassette H, Soares A, Bucourt M, Boutron A, Carbillon L, Mignot C, Trestard L, Bekri S, Laquerrière A. Phenotypic and Neuropathological Characterization of Fetal Pyruvate Dehydrogenase Deficiency. J Neuropathol Exp Neurol 2016; 75:227-38. [PMID: 26865159 DOI: 10.1093/jnen/nlv022] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
To distinguish pyruvate dehydrogenase deficiency (PDH) from other antenatal neurometabolic disorders thereby improving prenatal diagnosis, we describe imaging findings, clinical phenotype, and brain lesions in fetuses from 3 families with molecular characterization of this condition. Neuropathological analysis was performed in 4 autopsy cases from 3 unrelated families with subsequent biochemical and molecular confirmation of PDH complex deficiency. In 2 families there were mutations in the PDHA1 gene; in the third family there was a mutation in the PDHB gene. All fetuses displayed characteristic craniofacial dysmorphism of varying severity, absence of visceral lesions, and associated encephaloclastic and developmental supra- and infratentorial lesions. Neurodevelopmental abnormalities included microcephaly, migration abnormalities (pachygyria, polymicrogyria, periventricular nodular heterotopias), and cerebellar and brainstem hypoplasia with hypoplastic dentate nuclei and pyramidal tracts. Associated clastic lesions included asymmetric leukomalacia, reactive gliosis, large pseudocysts of germinolysis, and basal ganglia calcifications. The diagnosis of PDH deficiency should be suspected antenatally with the presence of clastic and neurodevelopmental lesions and a relatively characteristic craniofacial dysmorphism. Postmortem examination is essential for excluding other closely related entities, thereby allowing for biochemical and molecular confirmation.
Collapse
Affiliation(s)
- Nathalie Pirot
- From the Department of Radiology (NP), Pathology Laboratory (MC, AL), and Department of Metabolic Biochemistry (AS, SB), Rouen University Hospital, Rouen, France; Pathology Department (HAB), Lariboisière University Hospital, Rouen, France; Pathology Laboratory (MB), Jean Verdier University Hospital, Paris-Bondy, Rouen, France; Biochemistry and Genetics Laboratory (AB), Bicêtre University Hospital, Paris-le Kremlin Bicêtre, Paris, France; Department of Obstetrics and Gynecology (LC), Jean Verdier University Hospital, Paris-Bondy, France; Intensive Care Unit (CM), Trousseau University Hospital, Paris, France; Belvédère Maternity Hospital (LT), Mont Saint Aignan, France; and NeoVasc Region-Inserm Team ERI28, Laboratory of Microvascular Endothelium and Neonate Brain Lesions (SB, AL), Institute for Research and Innovation in Biomedicine, University of Rouen, Rouen, France
| | - Marie Crahes
- From the Department of Radiology (NP), Pathology Laboratory (MC, AL), and Department of Metabolic Biochemistry (AS, SB), Rouen University Hospital, Rouen, France; Pathology Department (HAB), Lariboisière University Hospital, Rouen, France; Pathology Laboratory (MB), Jean Verdier University Hospital, Paris-Bondy, Rouen, France; Biochemistry and Genetics Laboratory (AB), Bicêtre University Hospital, Paris-le Kremlin Bicêtre, Paris, France; Department of Obstetrics and Gynecology (LC), Jean Verdier University Hospital, Paris-Bondy, France; Intensive Care Unit (CM), Trousseau University Hospital, Paris, France; Belvédère Maternity Hospital (LT), Mont Saint Aignan, France; and NeoVasc Region-Inserm Team ERI28, Laboratory of Microvascular Endothelium and Neonate Brain Lesions (SB, AL), Institute for Research and Innovation in Biomedicine, University of Rouen, Rouen, France
| | - Homa Adle-Biassette
- From the Department of Radiology (NP), Pathology Laboratory (MC, AL), and Department of Metabolic Biochemistry (AS, SB), Rouen University Hospital, Rouen, France; Pathology Department (HAB), Lariboisière University Hospital, Rouen, France; Pathology Laboratory (MB), Jean Verdier University Hospital, Paris-Bondy, Rouen, France; Biochemistry and Genetics Laboratory (AB), Bicêtre University Hospital, Paris-le Kremlin Bicêtre, Paris, France; Department of Obstetrics and Gynecology (LC), Jean Verdier University Hospital, Paris-Bondy, France; Intensive Care Unit (CM), Trousseau University Hospital, Paris, France; Belvédère Maternity Hospital (LT), Mont Saint Aignan, France; and NeoVasc Region-Inserm Team ERI28, Laboratory of Microvascular Endothelium and Neonate Brain Lesions (SB, AL), Institute for Research and Innovation in Biomedicine, University of Rouen, Rouen, France
| | - Anais Soares
- From the Department of Radiology (NP), Pathology Laboratory (MC, AL), and Department of Metabolic Biochemistry (AS, SB), Rouen University Hospital, Rouen, France; Pathology Department (HAB), Lariboisière University Hospital, Rouen, France; Pathology Laboratory (MB), Jean Verdier University Hospital, Paris-Bondy, Rouen, France; Biochemistry and Genetics Laboratory (AB), Bicêtre University Hospital, Paris-le Kremlin Bicêtre, Paris, France; Department of Obstetrics and Gynecology (LC), Jean Verdier University Hospital, Paris-Bondy, France; Intensive Care Unit (CM), Trousseau University Hospital, Paris, France; Belvédère Maternity Hospital (LT), Mont Saint Aignan, France; and NeoVasc Region-Inserm Team ERI28, Laboratory of Microvascular Endothelium and Neonate Brain Lesions (SB, AL), Institute for Research and Innovation in Biomedicine, University of Rouen, Rouen, France
| | - Martine Bucourt
- From the Department of Radiology (NP), Pathology Laboratory (MC, AL), and Department of Metabolic Biochemistry (AS, SB), Rouen University Hospital, Rouen, France; Pathology Department (HAB), Lariboisière University Hospital, Rouen, France; Pathology Laboratory (MB), Jean Verdier University Hospital, Paris-Bondy, Rouen, France; Biochemistry and Genetics Laboratory (AB), Bicêtre University Hospital, Paris-le Kremlin Bicêtre, Paris, France; Department of Obstetrics and Gynecology (LC), Jean Verdier University Hospital, Paris-Bondy, France; Intensive Care Unit (CM), Trousseau University Hospital, Paris, France; Belvédère Maternity Hospital (LT), Mont Saint Aignan, France; and NeoVasc Region-Inserm Team ERI28, Laboratory of Microvascular Endothelium and Neonate Brain Lesions (SB, AL), Institute for Research and Innovation in Biomedicine, University of Rouen, Rouen, France
| | - Audrey Boutron
- From the Department of Radiology (NP), Pathology Laboratory (MC, AL), and Department of Metabolic Biochemistry (AS, SB), Rouen University Hospital, Rouen, France; Pathology Department (HAB), Lariboisière University Hospital, Rouen, France; Pathology Laboratory (MB), Jean Verdier University Hospital, Paris-Bondy, Rouen, France; Biochemistry and Genetics Laboratory (AB), Bicêtre University Hospital, Paris-le Kremlin Bicêtre, Paris, France; Department of Obstetrics and Gynecology (LC), Jean Verdier University Hospital, Paris-Bondy, France; Intensive Care Unit (CM), Trousseau University Hospital, Paris, France; Belvédère Maternity Hospital (LT), Mont Saint Aignan, France; and NeoVasc Region-Inserm Team ERI28, Laboratory of Microvascular Endothelium and Neonate Brain Lesions (SB, AL), Institute for Research and Innovation in Biomedicine, University of Rouen, Rouen, France
| | - Lionel Carbillon
- From the Department of Radiology (NP), Pathology Laboratory (MC, AL), and Department of Metabolic Biochemistry (AS, SB), Rouen University Hospital, Rouen, France; Pathology Department (HAB), Lariboisière University Hospital, Rouen, France; Pathology Laboratory (MB), Jean Verdier University Hospital, Paris-Bondy, Rouen, France; Biochemistry and Genetics Laboratory (AB), Bicêtre University Hospital, Paris-le Kremlin Bicêtre, Paris, France; Department of Obstetrics and Gynecology (LC), Jean Verdier University Hospital, Paris-Bondy, France; Intensive Care Unit (CM), Trousseau University Hospital, Paris, France; Belvédère Maternity Hospital (LT), Mont Saint Aignan, France; and NeoVasc Region-Inserm Team ERI28, Laboratory of Microvascular Endothelium and Neonate Brain Lesions (SB, AL), Institute for Research and Innovation in Biomedicine, University of Rouen, Rouen, France
| | - Cyril Mignot
- From the Department of Radiology (NP), Pathology Laboratory (MC, AL), and Department of Metabolic Biochemistry (AS, SB), Rouen University Hospital, Rouen, France; Pathology Department (HAB), Lariboisière University Hospital, Rouen, France; Pathology Laboratory (MB), Jean Verdier University Hospital, Paris-Bondy, Rouen, France; Biochemistry and Genetics Laboratory (AB), Bicêtre University Hospital, Paris-le Kremlin Bicêtre, Paris, France; Department of Obstetrics and Gynecology (LC), Jean Verdier University Hospital, Paris-Bondy, France; Intensive Care Unit (CM), Trousseau University Hospital, Paris, France; Belvédère Maternity Hospital (LT), Mont Saint Aignan, France; and NeoVasc Region-Inserm Team ERI28, Laboratory of Microvascular Endothelium and Neonate Brain Lesions (SB, AL), Institute for Research and Innovation in Biomedicine, University of Rouen, Rouen, France
| | - Laetitia Trestard
- From the Department of Radiology (NP), Pathology Laboratory (MC, AL), and Department of Metabolic Biochemistry (AS, SB), Rouen University Hospital, Rouen, France; Pathology Department (HAB), Lariboisière University Hospital, Rouen, France; Pathology Laboratory (MB), Jean Verdier University Hospital, Paris-Bondy, Rouen, France; Biochemistry and Genetics Laboratory (AB), Bicêtre University Hospital, Paris-le Kremlin Bicêtre, Paris, France; Department of Obstetrics and Gynecology (LC), Jean Verdier University Hospital, Paris-Bondy, France; Intensive Care Unit (CM), Trousseau University Hospital, Paris, France; Belvédère Maternity Hospital (LT), Mont Saint Aignan, France; and NeoVasc Region-Inserm Team ERI28, Laboratory of Microvascular Endothelium and Neonate Brain Lesions (SB, AL), Institute for Research and Innovation in Biomedicine, University of Rouen, Rouen, France
| | - Soumeya Bekri
- From the Department of Radiology (NP), Pathology Laboratory (MC, AL), and Department of Metabolic Biochemistry (AS, SB), Rouen University Hospital, Rouen, France; Pathology Department (HAB), Lariboisière University Hospital, Rouen, France; Pathology Laboratory (MB), Jean Verdier University Hospital, Paris-Bondy, Rouen, France; Biochemistry and Genetics Laboratory (AB), Bicêtre University Hospital, Paris-le Kremlin Bicêtre, Paris, France; Department of Obstetrics and Gynecology (LC), Jean Verdier University Hospital, Paris-Bondy, France; Intensive Care Unit (CM), Trousseau University Hospital, Paris, France; Belvédère Maternity Hospital (LT), Mont Saint Aignan, France; and NeoVasc Region-Inserm Team ERI28, Laboratory of Microvascular Endothelium and Neonate Brain Lesions (SB, AL), Institute for Research and Innovation in Biomedicine, University of Rouen, Rouen, France
| | - Annie Laquerrière
- From the Department of Radiology (NP), Pathology Laboratory (MC, AL), and Department of Metabolic Biochemistry (AS, SB), Rouen University Hospital, Rouen, France; Pathology Department (HAB), Lariboisière University Hospital, Rouen, France; Pathology Laboratory (MB), Jean Verdier University Hospital, Paris-Bondy, Rouen, France; Biochemistry and Genetics Laboratory (AB), Bicêtre University Hospital, Paris-le Kremlin Bicêtre, Paris, France; Department of Obstetrics and Gynecology (LC), Jean Verdier University Hospital, Paris-Bondy, France; Intensive Care Unit (CM), Trousseau University Hospital, Paris, France; Belvédère Maternity Hospital (LT), Mont Saint Aignan, France; and NeoVasc Region-Inserm Team ERI28, Laboratory of Microvascular Endothelium and Neonate Brain Lesions (SB, AL), Institute for Research and Innovation in Biomedicine, University of Rouen, Rouen, France.
| |
Collapse
|