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Younger DS. Neonatal and infantile hypotonia. HANDBOOK OF CLINICAL NEUROLOGY 2023; 195:401-423. [PMID: 37562880 DOI: 10.1016/b978-0-323-98818-6.00011-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
The underlying etiology of neonatal and infantile hypotonia can be divided into primary peripheral and central nervous system and acquired or genetic disorders. The approach to identifying the likeliest cause of hypotonia begins with a bedside assessment followed by a careful review of the birth history and early development and family pedigree and obtaining available genetic studies and age- and disease-appropriate laboratory investigations. Until about a decade ago, the main goal was to identify the clinical signs and a battery of basic investigations including electrophysiology to confirm or exclude a given neuromuscular disorder, however the availability of whole-exome sequencing and next generation sequencing and transcriptome sequencing has simplified the identification of specific underlying genetic defect and improved the accuracy of diagnosis in many related Mendelian disorders.
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Affiliation(s)
- David S Younger
- Department of Clinical Medicine and Neuroscience, CUNY School of Medicine, New York, NY, United States; Department of Medicine, Section of Internal Medicine and Neurology, White Plains Hospital, White Plains, NY, United States.
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Veiga-Fernández A, Joigneau Prieto L, Álvarez T, Ruiz Y, Pérez R, Gámez F, Ortega Abad V, Yllana F, De León-Luis J. Perinatal diagnosis and management of early-onset Marfan syndrome: case report and systematic review. J Matern Fetal Neonatal Med 2019; 33:2493-2504. [PMID: 30652519 DOI: 10.1080/14767058.2018.1552935] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Early onset Marfan syndrome is the most severe form of Marfan syndrome diagnosed during perinatal period. Early onset Marfan syndrome is associated with high mortality rates, usually within the first 2 years of life. First, we present a case of prenatally diagnosed early onset Marfan syndrome in a dichorionic diamniotic twin pregnancy, where suspicion was raised at 35 weeks of gestation. Ultrasound and fetal magnetic resonance imaging were used to assess prenatal findings in the affected fetus. She presented right diaphragmatic eventration, elongation of humerus and femur and subluxation of the crystalline lens. She died 3 months after birth. Secondly, we present a PubMed-based review of the published articles on early onset Marfan syndrome, with pre- or postnatal suspicion or diagnosis. We found 39 articles published between 1981 and 2017, arising information on 55 cases. Including ours, early onset Marfan syndrome was prenatally diagnosed in 34.54% of the cases. In these cases, the most frequent prenatal findings were cardiomegaly, dilatation of the great vessels and mitral or tricuspid regurgitation. Mortality rate during the first 15 months after birth was 73.68%. In the postnatally diagnosed cases, the most frequent findings were arachnodactyly, dilatation of the great vessels and mitral or tricuspid regurgitation. Mortality rate was 61.11%. Overall genetic confirmation was performed in 67.27% of the cases. Prenatal diagnosis of early onset Marfan syndrome is challenging but of utmost importance, since management should take place in a tertiary care center, by a multidisciplinary team. Differential diagnosis is essential in order to perform an adequate genetic counseling.
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Affiliation(s)
| | | | - Teresa Álvarez
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Yolanda Ruiz
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ricardo Pérez
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Francisco Gámez
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Fátima Yllana
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
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3
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Uriarte JJ, Meirelles T, Gorbenko del Blanco D, Nonaka PN, Campillo N, Sarri E, Navajas D, Egea G, Farré R. Early Impairment of Lung Mechanics in a Murine Model of Marfan Syndrome. PLoS One 2016; 11:e0152124. [PMID: 27003297 PMCID: PMC4803219 DOI: 10.1371/journal.pone.0152124] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 03/09/2016] [Indexed: 01/04/2023] Open
Abstract
Early morbidity and mortality in patients with Marfan syndrome (MFS) -a connective tissue disease caused by mutations in fibrillin-1 gene- are mainly caused by aorta aneurysm and rupture. However, the increase in the life expectancy of MFS patients recently achieved by reparatory surgery promotes clinical manifestations in other organs. Although some studies have reported respiratory alterations in MFS, our knowledge of how this connective tissue disease modifies lung mechanics is scarce. Hence, we assessed whether the stiffness of the whole lung and of its extracellular matrix (ECM) is affected in a well-characterized MFS mouse model (FBN1C1039G/+). The stiffness of the whole lung and of its ECM were measured by conventional mechanical ventilation and atomic force microscopy, respectively. We studied 5-week and 9-month old mice, whose ages are representative of early and late stages of the disease. At both ages, the lungs of MFS mice were significantly more compliant than in wild type (WT) mice. By contrast, no significant differences were found in local lung ECM stiffness. Moreover, histopathological lung evaluation showed a clear emphysematous-like pattern in MFS mice since alveolar space enlargement was significantly increased compared with WT mice. These data suggest that the mechanism explaining the increased lung compliance in MFS is not a direct consequence of reduced ECM stiffness, but an emphysema-like alteration in the 3D structural organization of the lung. Since lung alterations in MFS are almost fully manifested at an early age, it is suggested that respiratory monitoring could provide early biomarkers for diagnosis and/or follow-up of patients with the Marfan syndrome.
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Affiliation(s)
- Juan J. Uriarte
- Unitat Biofísica i Bioenginyeria, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
- CIBER Enfermedades Respiratorias, Madrid, Spain
| | - Thayna Meirelles
- Departament de Biologia Cel·lular, Immunologia i Neurociències, Universitat de Barcelona, Barcelona, Spain
| | - Darya Gorbenko del Blanco
- Departament de Biologia Cel·lular, Immunologia i Neurociències, Universitat de Barcelona, Barcelona, Spain
| | - Paula N. Nonaka
- Unitat Biofísica i Bioenginyeria, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
- Master's and Doctoral Degree Programs in Rehabilitation Sciences, Nove de Julho University, Sao Paulo, Brazil
| | - Noelia Campillo
- Unitat Biofísica i Bioenginyeria, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
- CIBER Enfermedades Respiratorias, Madrid, Spain
- Institut de Bioenginyeria de Catalunya, Barcelona, Spain
| | - Elisabet Sarri
- Departament de Biologia Cel·lular, Immunologia i Neurociències, Universitat de Barcelona, Barcelona, Spain
| | - Daniel Navajas
- Unitat Biofísica i Bioenginyeria, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
- CIBER Enfermedades Respiratorias, Madrid, Spain
- Institut de Bioenginyeria de Catalunya, Barcelona, Spain
| | - Gustavo Egea
- Departament de Biologia Cel·lular, Immunologia i Neurociències, Universitat de Barcelona, Barcelona, Spain
- Institut de Nanociències i Nanotecnologia, Universitat de Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi Sunyer, Barcelona, Spain
| | - Ramon Farré
- Unitat Biofísica i Bioenginyeria, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
- CIBER Enfermedades Respiratorias, Madrid, Spain
- Institut d’Investigacions Biomèdiques August Pi Sunyer, Barcelona, Spain
- * E-mail:
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Zych-Krekora K, Wójtowicz A, Krekora M, Słodki M, Gentillon H, Respondek-Liberska M. Case report. Longitudinal Echo Monitoring in Fetus with Phenotypical Marfan Syndrome, Helpfull for Perinatal Management - Case Presentation and Literature Review. PRENATAL CARDIOLOGY 2016. [DOI: 10.1515/pcard-2016-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
It was the second pregnancy of an otherwise healthy married couple. The fetus (male) had detailed echocardiography monitoring in the second half of the pregnancy due to progression of cardiomegaly, and echocardiographic features of congestive heart failure. Marfan syndrome was suspected based on cardiac anomalies. For the first time, the rupture of aneurysm of aortic sinus Valsalva was documented. Despite transplacental treatment with digoxin there was fetal demise at the 34th week of gestation and postmortem newborn phenotype confirmed prenatal diagnosis.
Marfan Syndrome is a rare genetic anomaly which can be diagnosed prenatally by detailed echocardiography, usually with bad prognosis (just opposite to “benign” case diagnosed later on in life span). The most common prenatal cardiac manifestations are cardiomegaly with signs of cardiac insufficiency. We present the case with new echocardiographic features.
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Affiliation(s)
- Katarzyna Zych-Krekora
- Prenatal Cardiology Department ,Research Institute Polish Mother’s Memorial Hospital in Łódź, Poland Poland
- Pediatrics, Immunology and Nephrology Department, Research Institute Polish Mother’s Memorial Hospital in Łódź, Poland
| | - Anna Wójtowicz
- Department of Clinical Obstetrics and Perinatology ,University Hospital in Krakow, Poland
| | - Michał Krekora
- Obstetrics and Gynecology Department, Research Institute Polish Mother’s Memorial Hospital in Łódź, Poland
| | - Maciej Słodki
- Prenatal Cardiology Department ,Research Institute Polish Mother’s Memorial Hospital in Łódź, Poland Poland
- Faculty of Health Sciences. The State University of Applied Sciences in Plock, Poland
| | - Hugues Gentillon
- Department of Radiology and Diagnostic Imaging, Barlicki University Hospital, Medical University of Łódź, Łódź, Poland
| | - Maria Respondek-Liberska
- Prenatal Cardiology Department ,Research Institute Polish Mother’s Memorial Hospital in Łódź, Poland Poland
- Fetal Malformations Department, Medical University of Lodz, Poland
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Engineered mutations in fibrillin-1 leading to Marfan syndrome act at the protein, cellular and organismal levels. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2015; 765:7-18. [DOI: 10.1016/j.mrrev.2015.04.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 03/22/2015] [Accepted: 04/27/2015] [Indexed: 11/19/2022]
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Anuwutnavin S, Lee L, Silverman N, Sklansky M. Fetal cardiac manifestations of Marfan Syndrome. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2014; 33:2211-2216. [PMID: 25425382 DOI: 10.7863/ultra.33.12.2211] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Sanitra Anuwutnavin
- Division of Maternal-Fetal-Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand (S.A.), Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology (L.L., N.S.), Division of Pediatric Cardiology, Department of Pediatrics (M.S.), David Geffen School of Medicine, Los Angeles, California USA, Center for Fetal Medicine and Women's Ultrasound, Los Angeles, California USA (N.S.)
| | - Lydia Lee
- Division of Maternal-Fetal-Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand (S.A.), Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology (L.L., N.S.), Division of Pediatric Cardiology, Department of Pediatrics (M.S.), David Geffen School of Medicine, Los Angeles, California USA, Center for Fetal Medicine and Women's Ultrasound, Los Angeles, California USA (N.S.)
| | - Neil Silverman
- Division of Maternal-Fetal-Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand (S.A.), Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology (L.L., N.S.), Division of Pediatric Cardiology, Department of Pediatrics (M.S.), David Geffen School of Medicine, Los Angeles, California USA, Center for Fetal Medicine and Women's Ultrasound, Los Angeles, California USA (N.S.)
| | - Mark Sklansky
- Division of Maternal-Fetal-Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand (S.A.), Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology (L.L., N.S.), Division of Pediatric Cardiology, Department of Pediatrics (M.S.), David Geffen School of Medicine, Los Angeles, California USA, Center for Fetal Medicine and Women's Ultrasound, Los Angeles, California USA (N.S.)
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Franken R, Heesterbeek TJ, de Waard V, Zwinderman AH, Pals G, Mulder BJM, Groenink M. Diagnosis and genetics of Marfan syndrome. Expert Opin Orphan Drugs 2014. [DOI: 10.1517/21678707.2014.950223] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Kirschner R, Hubmacher D, Iyengar G, Kaur J, Fagotto-Kaufmann C, Brömme D, Bartels R, Reinhardt DP. Classical and neonatal Marfan syndrome mutations in fibrillin-1 cause differential protease susceptibilities and protein function. J Biol Chem 2011; 286:32810-23. [PMID: 21784848 DOI: 10.1074/jbc.m111.221804] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Mutations in fibrillin-1 give rise to Marfan syndrome (MFS) characterized by vascular, skeletal, and ocular abnormalities. Fibrillins form the backbone of extracellular matrix microfibrils in tissues including blood vessels, bone, and skin. They are crucial for regulating elastic fiber biogenesis and growth factor bioavailability. To compare the molecular consequences of mutations causing the severe neonatal MFS with mutations causing the milder classical MFS, we introduced representative point mutations from each group in a recombinant human fibrillin-1 fragment. Structural effects were analyzed by circular dichroism spectroscopy and analytical gel filtration chromatography. Proteolytic susceptibility was probed with non-physiological and physiological proteases, including plasmin, thrombin, matrix metalloproteinases, and cathepsins. All mutant proteins showed a similar gross secondary structure and no differences in heat stability as compared with the wild-type protein. Proteins harboring neonatal mutations were typically more susceptible to proteolytic cleavage compared with those with classical mutations and the wild-type protein. Proteolytic neo-cleavage sites were found both in close proximity and distant to the mutations, indicating small but significant structural changes exposing cryptic cleavage sites. We also report for the first time that cathepsin K and V cleave non-mutated fibrillin-1 at several domain boundaries. Compared with the classical mutations and the wild type, the group of neonatal mutations more severely affected the ability of fibrillin-1 to interact with heparin/heparan sulfate, which plays a role in microfibril assembly. These results suggest differential molecular pathogenetic concepts for neonatal and classical MFS including enhanced proteolytic susceptibility for physiologically relevant enzymes and loss of function for heparin binding.
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Affiliation(s)
- Ryan Kirschner
- Faculty of Dentistry, Division of Biomedical Sciences, Faculty of Medicine, McGill University, Montreal H3A 2B2, Canada
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Gavilán C, Herraiz I, Granados MA, Moral MT, Gómez-Montes E, Galindo A. Prenatal diagnosis of neonatal Marfan syndrome. Prenat Diagn 2011; 31:610-3. [DOI: 10.1002/pd.2748] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Revised: 02/17/2011] [Accepted: 02/26/2011] [Indexed: 11/07/2022]
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10
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Burkhead A, Poindexter G, Morrell DS. A case of extensive Aplasia Cutis Congenita with underlying skull defect and central nervous system malformation: discussion of large skin defects, complications, treatment and outcome. J Perinatol 2009; 29:582-4. [PMID: 19638992 DOI: 10.1038/jp.2008.250] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Aplasia Cutis Congenita (ACC) is a rare condition characterized by the absence of a portion of skin at birth. Skin defects are usually small (0.5 to 3 cm) and located on the scalp. Although there can be other physical or genetic abnormalities, ACC is most often a benign isolated condition. Rarely is an underlying bony defect present, and this association increases the rate of complications. We report a case of a newborn male with ACC of the entire crown and vertex scalp, non-ossified parietal skull and dysplastic corpus callosum. The patient's skull and skin defects were treated non-surgically, and he recovered well.
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Affiliation(s)
- A Burkhead
- University of North Carolina School of Medicine, Chapel Hill, NC 27599-9535, USA.
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11
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Faivre L, Collod-Beroud G, Callewaert B, Child A, Binquet C, Gautier E, Loeys BL, Arbustini E, Mayer K, Arslan-Kirchner M, Stheneur C, Kiotsekoglou A, Comeglio P, Marziliano N, Wolf JE, Bouchot O, Khau-Van-Kien P, Beroud C, Claustres M, Bonithon-Kopp C, Robinson PN, Adès L, De Backer J, Coucke P, Francke U, De Paepe A, Jondeau G, Boileau C. Clinical and mutation-type analysis from an international series of 198 probands with a pathogenic FBN1 exons 24-32 mutation. Eur J Hum Genet 2008; 17:491-501. [PMID: 19002209 DOI: 10.1038/ejhg.2008.207] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Mutations in the FBN1 gene cause Marfan syndrome (MFS) and a wide range of overlapping phenotypes. The severe end of the spectrum is represented by neonatal MFS, the vast majority of probands carrying a mutation within exons 24-32. We previously showed that a mutation in exons 24-32 is predictive of a severe cardiovascular phenotype even in non-neonatal cases, and that mutations leading to premature truncation codons are under-represented in this region. To describe patients carrying a mutation in this so-called 'neonatal' region, we studied the clinical and molecular characteristics of 198 probands with a mutation in exons 24-32 from a series of 1013 probands with a FBN1 mutation (20%). When comparing patients with mutations leading to a premature termination codon (PTC) within exons 24-32 to patients with an in-frame mutation within the same region, a significantly higher probability of developing ectopia lentis and mitral insufficiency were found in the second group. Patients with a PTC within exons 24-32 rarely displayed a neonatal or severe MFS presentation. We also found a higher probability of neonatal presentations associated with exon 25 mutations, as well as a higher probability of cardiovascular manifestations. A high phenotypic heterogeneity could be described for recurrent mutations, ranging from neonatal to classical MFS phenotype. In conclusion, even if the exons 24-32 location appears as a major cause of the severity of the phenotype in patients with a mutation in this region, other factors such as the type of mutation or modifier genes might also be relevant.
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Affiliation(s)
- L Faivre
- Centre de Génétique, CHU, Dijon, France.
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12
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Stadié R, Geipel A, Heep A, Herberg U, Welker B, Gembruch U, Berg C. Prenatal diagnosis of Marfan syndrome. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2007; 30:119-21. [PMID: 17546605 DOI: 10.1002/uog.4011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
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13
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Ramaswamy P, Lytrivi ID, Nguyen K, Gelb BD. Neonatal Marfan syndrome : in utero presentation with aortic and pulmonary artery dilatation and successful repair of an acute flail mitral valve leaflet in infancy. Pediatr Cardiol 2006; 27:763-5. [PMID: 17091324 DOI: 10.1007/s00246-006-1378-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2006] [Accepted: 07/19/2006] [Indexed: 10/23/2022]
Abstract
Neonatal Marfan syndrome (nMFS) is the rare and severe form of this connective tissue disorder with poor outcome due to progressive valvular insufficiency. We describe a case of nMFS suspected in utero, by fetal echocardiography, due to marked dilatation of both great arteries, which is the first description of fetal pulmonary artery dilatation in this disorder. The patient developed a flail mitral valve leaflet during the first year of life that was successfully repaired with an excellent medium-term result. This is the first report of this type of surgery in infancy.
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Affiliation(s)
- Prema Ramaswamy
- Division of Pediatric Cardiology, Maimonides Medical Center, 4802, 10th Avenue, Brooklyn, NY, 11219, USA.
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Summers KM, Nataatmadja M, Xu D, West MJ, McGill JJ, Whight C, Colley A, Adès LC. Histopathology and fibrillin-1 distribution in severe early onset Marfan syndrome. Am J Med Genet A 2006; 139:2-8. [PMID: 16222666 DOI: 10.1002/ajmg.a.30981] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Marfan syndrome (MFS) is an autosomal dominant condition which may involve the cardiovascular, ocular, skeletal, and other systems. Mutations causing MFS are found in the FBN1 gene, encoding fibrillin-1, an extracellular matrix protein involved in microfibril formation. In the most severe cases, mutations are generally found in exons 24-32, and children with these mutations usually die in the first years of life, of cardiopulmonary failure. We present clinical, molecular and histopathological studies on a patient with severe early onset MFS. He has a mutation in exon 25 of FBN1, a G>A transition at nucleotide position 3131 that converts the codon TGC, coding for cysteine at position 1044, to TAC, coding for tyrosine (C1044Y). This has resulted in abnormalities of the extracellular matrix and a severe clinical phenotype, although he has survived to the age of 14 years.
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Affiliation(s)
- K M Summers
- School of Molecular and Microbial Sciences, The University of Queensland, Queensland, Australia.
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Whitelaw CM, Anwar S, Adès LC, Gole GA, Elder JE, Savarirayan R. Primary trabeculodysgenesis in association with neonatal Marfan syndrome. Am J Med Genet A 2005; 128A:418-21. [PMID: 15264290 DOI: 10.1002/ajmg.a.30139] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We present the clinical and ophthalmological findings in two infants with neonatal Marfan syndrome (nMFS) and primary trabeculodysgenesis (PT). Fibrillin 1 (FBN1) mutations were confirmed in both cases. Numerous eye anomalies have been recognized in infants with nMFS, but PT has not been reported previously. Our report expands the phenotype of nMFS, and highlights the importance of early and careful ophthalmological assessment of these infants.
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Affiliation(s)
- Charlotte M Whitelaw
- Genetic Health Services Victoria, Royal Children's Hospital, Melbourne, Australia
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