1
|
Shenno M, Al-Qiami A, Ibrahim IA, Elhaw L, Nashwan AJ. A rare presentation of bilateral periventricular nodular heterotopia with intra-axial pontine Lesion: A case report and treatment approach. INTERDISCIPLINARY NEUROSURGERY 2024; 36:101894. [DOI: 10.1016/j.inat.2023.101894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2025] Open
|
2
|
Yang L, Wu G, Yin H, Pan M, Zhu Y. Periventricular nodular heterotopias is associated with mutation at the FLNA locus-a case history and a literature review. BMC Pediatr 2023; 23:346. [PMID: 37422633 PMCID: PMC10329368 DOI: 10.1186/s12887-023-04161-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 06/27/2023] [Indexed: 07/10/2023] Open
Abstract
BACKGROUND Periventricular nodular heterotopia (PNH), associated with FLNA mutations, is a rare clinical condition potentially associated with multiple systemic conditions, including cardiac, pulmonary, skeletal, and cutaneous diseases. However, due to a paucity of information in the literature, accurate prognostic advice cannot be provided to patients with the disease. CASE PRESENTATION We report a 2-year-old female whose PNH was associated with a nonsense mutation in the q28 region of the X chromosome, in exon 31 of FLNA (c.5159dupA). The patient is currently seizure-free and has no congenital heart disease, lung disease or skeletal or joint issues, and her development is normal. CONCLUSIONS FLNA-associated PNH is a genetically-heterogeneous disease, and the FLNA mutation, c.5159dupA (p.Tyr1720*) is a newly identified pathogenic variant. FLNA characterization will help the clinical diagnosis and treatment of PNH and provide individualized genetic counseling for patients.
Collapse
Affiliation(s)
- Lin Yang
- Pediatric Department, The Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Hangzhou, Zhejiang 310000 China
| | - GuangSheng Wu
- Pediatric Department, The Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Hangzhou, Zhejiang 310000 China
| | - HuiMei Yin
- Pediatric Department, The Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Hangzhou, Zhejiang 310000 China
| | - MengLan Pan
- Pediatric Department, The Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Hangzhou, Zhejiang 310000 China
| | - YaFei Zhu
- Pediatric Department, The Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Hangzhou, Zhejiang 310000 China
| |
Collapse
|
3
|
Improved Outcomes for Infants and Young Children Undergoing Lung Transplantation at Three Years of Age and Younger. Ann Am Thorac Soc 2023; 20:254-261. [PMID: 36260085 DOI: 10.1513/annalsats.202202-093oc] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Rationale: Since its inception, older children and adolescents have predominated in pediatric lung transplantation. Most pediatric lung transplant programs around the world have transplanted few infants and young children. Early mortality after lung transplantation and inadequate donor organs have been perceived as limitations for success in lung transplantation at this age. Objectives: Our aim was to describe our experience in a large pediatric lung transplant program with respect to lung transplantation in infants and young children, focusing on diagnosis, waitlist, and mortality. Methods: We performed a retrospective review of infants and young children under 3 years of age at the time of transplant in our program from 2002 through 2020. Results: The patient cohort represented a severely morbid recipient group, with the majority hospitalized in the intensive care unit on mechanical ventilation just before transplantation. There was a marked heterogeneity of diagnoses distinct from diagnoses in an older cohort. Waitlist time was shorter than in older age cohorts. There was a decrease in early mortality, lower incidence of allograft rejection, and satisfactory long-term survival in this age group compared with the older cohort and published experience. Severe viral infection was an important cause of early mortality after transplant. Nonetheless, survival is comparable to older patients, with better enduring survival in those who survive the early transplant period in more recent years. Conclusions: Carefully selected infants and young children with end-stage lung and pulmonary vascular disease are appropriate candidates for lung transplantation and are likely underserved by current clinical practice.
Collapse
|
4
|
Spielberg DR, Melicoff E, Heinle JS, Hosek K, Mallory GB. Differential donor management of pediatric vs adult organ donors and potential impact on pediatric lung transplantation. J Heart Lung Transplant 2022; 42:522-532. [PMID: 36564335 DOI: 10.1016/j.healun.2022.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 11/08/2022] [Accepted: 11/10/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Despite clinical progress over time, a shortage of suitable donor organs continues to limit solid organ transplantation around the world. Lungs are the organs most likely to be assessed as unsuitable during donor management among all transplantable organs. Although the number of lung transplants performed in children is limited, death on the wait list remains a barrier to transplant success for many potential transplant candidates. Optimizing organ donor management can yield additional organs for transplant candidates. METHODOLOGY We accessed the Donor Management Goal (DMG) Registry to evaluate the efficiency and efficacy of donor management in the procurement of lungs for transplantation. Further, we stratified donors by age and compared pediatric age cohorts to adult cohorts with respect to attainment of donor management target goals and successful pathway to transplantation. We utilized recipient data from the Organ Procurement Transplantation Network (OPTN) to put this data into context. The DMG bundle consists of nine physiologic parameters chosen as end-points guiding donor management for potential organ donors. The number of parameters fulfilled has been regarded as an indication of efficacy of donor management. RESULTS We noted a markedly lower number of organ donors in the pediatric age group compared to adults. On the other hand, the number of donors greatly exceeds the number of infants, children and adolescents who undergo lung transplantation. Organs transplanted per donor peaks in the adolescent age group. At initial donor referral, DMG bundle attainment is lower in all age groups and improves during donor management. With respect to oxygenation, there is less overall improvement in younger donors compared to older donors during donor management. When donors who yield lungs for transplantation are compared to those whose lungs were not transplanted, oxygenation improved more substantially during donor management. Furthermore, improved oxygenation correlated with the total number of organs transplanted per donor. CONCLUSIONS In the face of continued wait list mortality on the pediatric lung transplant wait list, the number of young donors may not be a limiting factor. We believe that this dataset provides evidence that management of young pediatric donors is not as consistent or efficient as the management of older donors, potentially limiting the number of life-saving organs for pediatric lung transplant candidates. Across all ages, optimizing donor lung management may increase the potential to transplant multiple other organs.
Collapse
Affiliation(s)
- David R Spielberg
- Section of Pediatric Pulmonology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas; Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Ernestina Melicoff
- Section of Pediatric Pulmonology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
| | - Jeffrey S Heinle
- Division of Congenital Heart Surgery, Texas Children's Hospital; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Kathleen Hosek
- Department of Quality Assurance, Texas Children's Hospital, Houston, Texas
| | - George B Mallory
- Section of Pediatric Pulmonology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.
| |
Collapse
|
5
|
Billon C, Adham S, Hernandez Poblete N, Legrand A, Frank M, Chiche L, Zuily S, Benistan K, Savale L, Zaafrane-Khachnaoui K, Brehin AC, Bal L, Busa T, Fradin M, Quelin C, Chesneau B, Wahl D, Fergelot P, Goizet C, Mirault T, Jeunemaitre X, Albuisson J. Cardiovascular and connective tissue disorder features in FLNA-related PVNH patients: progress towards a refined delineation of this syndrome. Orphanet J Rare Dis 2021; 16:504. [PMID: 34863227 PMCID: PMC8642866 DOI: 10.1186/s13023-021-02128-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND FLNA Loss-of-Function (LoF) causes periventricular nodular heterotopia type 1 (PVNH1), an acknowledged cause of seizures of various types. Neurological symptoms are inconstant, and cardiovascular (CV) defects or connective tissue disorders (CTD) have regularly been associated. We aimed at refining the description of CV and CTD features in patients with FLNA LoF and depicting the multisystemic nature of this condition. METHODS We retrospectively evaluated FLNA variants and clinical presentations in FLNA LoF patient with at least one CV or CTD feature, from three cohorts: ten patients from the French Reference Center for Rare Vascular Diseases, 23 patients from the national reference diagnostic lab for filaminopathies-A, and 59 patients from literature review. RESULTS Half of patients did not present neurological symptoms. Most patients presented a syndromic association combining CV and CTD features. CV anomalies, mostly aortic aneurysm and/or dilation were present in 75% of patients. CTD features were present in 75%. Variants analysis demonstrated an enrichment of coding variants in the CH1 domain of FLNA protein. CONCLUSION In FLNA LoF patients, the absence of seizures should not be overlooked. When considering a diagnosis of PVNH1, the assessment for CV and CTD anomalies is of major interest as they represent interlinked features. We recommend systematic study of FLNA within CTD genes panels, regardless of the presence of neurological symptoms.
Collapse
Affiliation(s)
- Clarisse Billon
- Département de génétique, Centre national de référence pour les maladies vasculaires rares, centre de référence européen VASCERN MSA, Hôpital Européen Georges Pompidou, AP-HP, 20 rue Leblanc, 75015, Paris, France. .,INSERM, U970 PARCC, Université de Paris, Paris, France.
| | - Salma Adham
- Département de génétique, Centre national de référence pour les maladies vasculaires rares, centre de référence européen VASCERN MSA, Hôpital Européen Georges Pompidou, AP-HP, 20 rue Leblanc, 75015, Paris, France.,Service de Médecine Vasculaire, Hôpital Saint Eloi, CHU Montpellier, Montpellier, France
| | - Natalia Hernandez Poblete
- Département de génétique médicale, Centre national de référence pour les maladies rares Neurogénétiques, Hôpital Pellegrin, CHU Bordeaux, Bordeaux, France.,Laboratoire de maladies rares : Génétique et Metabolisme (MRGM), INSERM U1211, Université de Bordeaux, Bordeaux, France
| | - Anne Legrand
- Département de génétique, Centre national de référence pour les maladies vasculaires rares, centre de référence européen VASCERN MSA, Hôpital Européen Georges Pompidou, AP-HP, 20 rue Leblanc, 75015, Paris, France.,INSERM, U970 PARCC, Université de Paris, Paris, France
| | - Michael Frank
- Département de génétique, Centre national de référence pour les maladies vasculaires rares, centre de référence européen VASCERN MSA, Hôpital Européen Georges Pompidou, AP-HP, 20 rue Leblanc, 75015, Paris, France.,INSERM, U970 PARCC, Université de Paris, Paris, France
| | - Laurent Chiche
- Faculté de médecine, Université de la Sorbonne, Paris, France.,Service de chirurgie vasculaire et endovasculaire, Centre aortique tertiaire, Hôpital universitaire Pitié-Salpêtrière, AP-HP, Paris, France
| | - Stephane Zuily
- Inserm UMRS 1116 DCAC, Université de Lorraine, Nancy, France.,Division de médecine vasculaire et centre de compétence régional pour les maladies vasculaires rares et autoimmunes systémiques, Centre Hospitalier Régional Universitaire de Nancy, Nancy, France
| | - Karelle Benistan
- Centre de Référence des Syndromes d'Ehlers-Danlos non Vasculaires, Hôpital Raymond Poincaré, Assistance Publique Hôpitaux de Paris, Garches, France.,UMR U1179 INSERM, Université Versailles Saint-Quentin, Montigny-le-Bretonneux, France
| | - Laurent Savale
- Université Paris-Saclay, Le Kremlin Bicêtre, France.,UMR_S 999, INSERM, Groupe hospitalier Marie-Lannelongue -Saint Joseph, Université Paris-Sud, Le Plessis-Robinson, France.,Service de Pneumologie, Hôpital Bicêtre, APHP, Le Kremlin-Bicêtre, France
| | | | - Anne-Claire Brehin
- INSERM U1245 , Normandy center for Genomic and Personalized Medicine, Normandie Univ, CHU Rouen, 76000, Rouen, France
| | - Laurence Bal
- Centre de référence régional Marfan et apparentés, Centre aortique, Hôpital La Timone, AP-HM, Marseille, France
| | - Tiffany Busa
- Département de Génétique Médicale, Hôpital La Timone, CHU de Marseille, Marseille, France
| | - Mélanie Fradin
- Service de Génétique Clinique, Centre de Référence Maladies Rares CLAD-Ouest, ERN ITHACA, CHU Rennes, Hôpital Sud, Rennes, France
| | - Chloé Quelin
- Service de Génétique Clinique, Centre de Référence Maladies Rares CLAD-Ouest, ERN ITHACA, CHU Rennes, Hôpital Sud, Rennes, France
| | - Bertrand Chesneau
- Service de génétique médicale, Hôpital Purpan, CHU de Toulouse, Toulouse, France.,Centre de Référence du Syndrome de Marfan et des syndromes apparentés, Hôpital des Enfants, CHU de Toulouse, Toulouse, France
| | - Denis Wahl
- Inserm UMRS 1116 DCAC, Université de Lorraine, Nancy, France.,Division de médecine vasculaire et centre de compétence régional pour les maladies vasculaires rares et autoimmunes systémiques, Centre Hospitalier Régional Universitaire de Nancy, Nancy, France
| | - Patricia Fergelot
- Département de génétique médicale, Centre national de référence pour les maladies rares Neurogénétiques, Hôpital Pellegrin, CHU Bordeaux, Bordeaux, France.,Laboratoire de maladies rares : Génétique et Metabolisme (MRGM), INSERM U1211, Université de Bordeaux, Bordeaux, France
| | - Cyril Goizet
- Département de génétique médicale, Centre national de référence pour les maladies rares Neurogénétiques, Hôpital Pellegrin, CHU Bordeaux, Bordeaux, France.,Faculté de médecine, Université de la Sorbonne, Paris, France
| | - Tristan Mirault
- Département de génétique, Centre national de référence pour les maladies vasculaires rares, centre de référence européen VASCERN MSA, Hôpital Européen Georges Pompidou, AP-HP, 20 rue Leblanc, 75015, Paris, France.,INSERM, U970 PARCC, Université de Paris, Paris, France
| | - Xavier Jeunemaitre
- Département de génétique, Centre national de référence pour les maladies vasculaires rares, centre de référence européen VASCERN MSA, Hôpital Européen Georges Pompidou, AP-HP, 20 rue Leblanc, 75015, Paris, France.,INSERM, U970 PARCC, Université de Paris, Paris, France
| | - Juliette Albuisson
- Département de génétique, Centre national de référence pour les maladies vasculaires rares, centre de référence européen VASCERN MSA, Hôpital Européen Georges Pompidou, AP-HP, 20 rue Leblanc, 75015, Paris, France.,INSERM, U970 PARCC, Université de Paris, Paris, France.,Plateforme de Transfert en Biologie Cancérologique, Centre Georges François Leclerc - UNICANCER- Institut GIMI, Dijon, France
| | | |
Collapse
|
6
|
Shah AS, Black ED, Simon DM, Gambello MJ, Garber KB, Iannucci GJ, Riedesel EL, Kasi AS. Heterogeneous Pulmonary Phenotypes in Filamin A Mutation-Related Lung Disease. PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY 2021; 34:7-14. [PMID: 33734874 DOI: 10.1089/ped.2020.1280] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Interstitial lung disease (ILD) has been recently reported in a few patients with pathogenic variants in the Filamin A (FLNA) gene with variable presentation and prognosis. This study evaluated the respiratory manifestations and clinical features in children with FLNA disease. Methods: We conducted a retrospective review of pediatric patients with variants in FLNA in a tertiary children's hospital. The clinical features, genotype, management, and outcomes were analyzed. Results: We identified 9 patients with variants in FLNA aged 15 months to 24 years, 4 females and 5 males. Six patients had abnormal chest imaging ranging from mild interstitial prominence to atelectasis, interstitial densities, and hyperinflation. Three patients with ILD presented during the neonatal period or early infancy with respiratory distress or respiratory failure requiring supplemental oxygen or assisted ventilation via tracheostomy. We report male twins with the same FLNA variant and lung disease, but different ages and clinical features at presentation eventually culminating in respiratory failure requiring assisted ventilation. All patients had FLNA variants identified by FLNA sequencing, had abnormal echocardiograms, and none of the patients underwent lung biopsy or lung transplantation. The outcomes were variable and could be as severe as chronic respiratory failure. Conclusion: The wide spectrum of respiratory manifestations and abnormal chest imaging in our study highlights the importance of evaluation for lung disease in patients with variants in FLNA. FLNA sequencing in suspected cases with ILD may obviate the need for a lung biopsy, prompt surveillance for progressive lung disease, and evaluation for associated clinical features.
Collapse
Affiliation(s)
- Amit S Shah
- Division of Pediatric Pulmonology, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia, USA
| | - Emily D Black
- Department of Human Genetics, Emory University, Atlanta, Georgia, USA
| | - Dawn M Simon
- Division of Pediatric Pulmonology, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia, USA
| | | | - Kathryn B Garber
- Department of Human Genetics, Emory University, Atlanta, Georgia, USA.,EGL Genetics, Tucker, Georgia, USA
| | - Glen J Iannucci
- Division of Pediatric Cardiology, Department of Pediatrics, Emory University, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Erica L Riedesel
- Department of Radiology, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia, USA
| | - Ajay S Kasi
- Division of Pediatric Pulmonology, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia, USA
| |
Collapse
|
7
|
Genetic Testing for Neonatal Respiratory Disease. CHILDREN-BASEL 2021; 8:children8030216. [PMID: 33799761 PMCID: PMC8001923 DOI: 10.3390/children8030216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 02/27/2021] [Accepted: 03/08/2021] [Indexed: 11/16/2022]
Abstract
Genetic mechanisms are now recognized as rare causes of neonatal lung disease. Genes potentially responsible for neonatal lung disease include those encoding proteins important in surfactant function and metabolism, transcription factors important in lung development, proteins involved in ciliary assembly and function, and various other structural and immune regulation genes. The phenotypes of infants with genetic causes of neonatal lung disease may have some features that are difficult to distinguish clinically from more common, reversible causes of lung disease, and from each other. Multigene panels are now available that can allow for a specific diagnosis, providing important information for treatment and prognosis. This review discusses genes in which abnormalities are known to cause neonatal lung disease and their associated phenotypes, and advantages and limitations of genetic testing.
Collapse
|
8
|
Deng X, Li S, Qiu Q, Jin B, Yan M, Hu Y, Wu Y, Zhou H, Zhang G, Zheng X. Where the congenital heart disease meets the pulmonary arterial hypertension, FLNA matters: a case report and literature review. BMC Pediatr 2020; 20:504. [PMID: 33143682 PMCID: PMC7607646 DOI: 10.1186/s12887-020-02393-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 10/15/2020] [Indexed: 01/08/2023] Open
Abstract
Background Pediatric patients with genetic disorders have a higher incidence of pulmonary arterial hypertension (PAH) regardless of their heart defects. Filamin A (FLNA) mutation is recently recognized to be associated with pediatric pulmonary disorders, however, the clinical courses of PAH related to the mutation were reported in limited cases. Here, we presented a case and pooled data for better understanding of the correlation between FLNA mutation and pediatric PAH. Case presentation The patient was a 8-month-old female with repeated episodes of pneumonia. Physical examination revealed cleft lip, cleft palate and developmental retardation. Imaging examination showed a small atrial septal defect (ASD), central pulmonary artery enlargement, left upper lobe of lung atelectasis, and pulmonary infiltration. Genetic test showed she carried a de novo pathogenic variant of FLNA gene (c.5417-1G > A, p.-). Oral medications didn’t slow the progression of PAH in the patient, and she died two years later. Conclusions FLNA mutation causes rare but progressive PAH in addition to a wide spectrum of congenital heart disease and other comorbidities in pediatric patients. We highly recommend genetic testing for pediatric patients when suspected with PAH. Given the high mortality in this group, lung transplantation may offer a better outcome.
Collapse
Affiliation(s)
- Xiaoxian Deng
- Congenital Heart Disease center, Wuhan Asia Heart hospital, 753 Jinghan Ave, 430022, Wuhan, China
| | - Shanshan Li
- Congenital Heart Disease center, Wuhan Asia Heart hospital, 753 Jinghan Ave, 430022, Wuhan, China
| | - Qiu Qiu
- Congenital Heart Disease center, Wuhan Asia Heart hospital, 753 Jinghan Ave, 430022, Wuhan, China
| | - Bowen Jin
- Congenital Heart Disease center, Wuhan Asia Heart hospital, 753 Jinghan Ave, 430022, Wuhan, China
| | - Menghuan Yan
- Congenital Heart Disease center, Wuhan Asia Heart hospital, 753 Jinghan Ave, 430022, Wuhan, China
| | - Yuanpin Hu
- Laboratory of Molecular Cardiology, Wuhan Asia Heart hospital, 753 Jinghan Avn, 430022, Wuhan, China
| | - Yang Wu
- Imaging center, Wuhan Asia Heart hospital, 753 Jinghan Ave, 430022, Wuhan, China
| | - Hongmei Zhou
- Congenital Heart Disease center, Wuhan Asia Heart hospital, 753 Jinghan Ave, 430022, Wuhan, China
| | - Gangcheng Zhang
- Congenital Heart Disease center, Wuhan Asia Heart hospital, 753 Jinghan Ave, 430022, Wuhan, China
| | - Xuan Zheng
- Congenital Heart Disease center, Wuhan Asia Heart hospital, 753 Jinghan Ave, 430022, Wuhan, China. .,Laboratory of Molecular Cardiology, Wuhan Asia Heart hospital, 753 Jinghan Avn, 430022, Wuhan, China.
| |
Collapse
|
9
|
Wang Y, Chen S, Yan W, Lu L, Tao Y, Xiao Y, Cai W. Congenital Short-Bowel Syndrome: Clinical and Genetic Presentation in China. JPEN J Parenter Enteral Nutr 2020; 45:1009-1015. [PMID: 33464596 DOI: 10.1002/jpen.1974] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/08/2020] [Accepted: 07/20/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Congenital short-bowel syndrome (CSBS) is a rare disorder characterized by retardation of intestinal development. However, it is still not well recognized at present. In this study, the etiological, clinical, and genetic characteristics of CSBS in China were analyzed. METHODS Nine infants with CSBS were recruited. Full-thickness biopsy findings were evaluated by histopathology. Whole-exome sequencing was performed to identify mutations in patients and their family members. All patients were followed up at >1 year of age. RESULTS Six of 9 infants had malrotation, and 2 patients had intestinal atresia. The average total small-bowel length was 51.7 (40-75) cm. Coxsackie and adenovirus receptor-like membrane protein (CLMP) mutations were found in 5 patients and were related to decreases in ileal goblet cells and mucous secretion. Among these 5 patients, 3 shared the same mutation (c. 206G>A p.R69H), 1 patient had an exon 3-5 deletion, and 1 patient had the C.655T>G, p.Cys219Gly, and C.389-2A>C. Another case carried a loss-of-function mutation in filamin A (FLNA). In the other 3 patients, no pathogenic mutations in genes related to intestinal development were found. The rate of catheter-related bloodstream infection was 4.3 per 1000 catheter days, and intestinal failure-associated liver disease (IFALD) was 77.8%. The median follow-up duration was 24.1 months. Eight patients were weaned off parenteral nutrition (PN). Six patients still exhibited malnutrition during follow-up. CONCLUSIONS Infants with CSBS often need long-term PN and remain at risk of SBS-related complications. CLMP and FLNA mutations are associated with CSBS in the Chinese population.
Collapse
Affiliation(s)
- Ying Wang
- Division of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China
| | - Shanshan Chen
- Division of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Weihui Yan
- Division of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China
| | - Lina Lu
- Division of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yijng Tao
- Division of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yongtao Xiao
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China.,Shanghai Institute for Pediatric Research, Shanghai, China
| | - Wei Cai
- Division of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China.,Shanghai Institute for Pediatric Research, Shanghai, China.,Department of Pediatric Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
10
|
Walsh R, Batra D, Dixit A, Bhatt JM. Clues beyond the lung: an unusual diagnosis in an infant with chronic lung disease. Breathe (Sheff) 2020; 16:190319. [PMID: 32494305 PMCID: PMC7249791 DOI: 10.1183/20734735.0319-2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
11
|
Kremer TM, Lindsay ME, Kinane TB, Hawley MH, Little BP, Mino-Kenudson M. Case 28-2019: A 22-Year-Old Woman with Dyspnea and Chest Pain. N Engl J Med 2019; 381:1059-1067. [PMID: 31509678 DOI: 10.1056/nejmcpc1904041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Ted M Kremer
- From the Department of Pediatrics, UMass Memorial Medical Center, and the Department of Pediatrics, University of Massachusetts Medical School, Worcester (T.M.K.), the Departments of Pediatrics (M.E.L., T.B.K.), Radiology (B.P.L.), and Pathology (M.M.-K.), Massachusetts General Hospital, and the Departments of Pediatrics (M.E.L., T.B.K.), Radiology (B.P.L.), and Pathology (M.M.-K.), Harvard Medical School, Boston, and the Laboratory for Molecular Medicine, Partners HealthCare Personalized Medicine, Cambridge (M.H.H.) - all in Massachusetts
| | - Mark E Lindsay
- From the Department of Pediatrics, UMass Memorial Medical Center, and the Department of Pediatrics, University of Massachusetts Medical School, Worcester (T.M.K.), the Departments of Pediatrics (M.E.L., T.B.K.), Radiology (B.P.L.), and Pathology (M.M.-K.), Massachusetts General Hospital, and the Departments of Pediatrics (M.E.L., T.B.K.), Radiology (B.P.L.), and Pathology (M.M.-K.), Harvard Medical School, Boston, and the Laboratory for Molecular Medicine, Partners HealthCare Personalized Medicine, Cambridge (M.H.H.) - all in Massachusetts
| | - T Bernard Kinane
- From the Department of Pediatrics, UMass Memorial Medical Center, and the Department of Pediatrics, University of Massachusetts Medical School, Worcester (T.M.K.), the Departments of Pediatrics (M.E.L., T.B.K.), Radiology (B.P.L.), and Pathology (M.M.-K.), Massachusetts General Hospital, and the Departments of Pediatrics (M.E.L., T.B.K.), Radiology (B.P.L.), and Pathology (M.M.-K.), Harvard Medical School, Boston, and the Laboratory for Molecular Medicine, Partners HealthCare Personalized Medicine, Cambridge (M.H.H.) - all in Massachusetts
| | - Megan H Hawley
- From the Department of Pediatrics, UMass Memorial Medical Center, and the Department of Pediatrics, University of Massachusetts Medical School, Worcester (T.M.K.), the Departments of Pediatrics (M.E.L., T.B.K.), Radiology (B.P.L.), and Pathology (M.M.-K.), Massachusetts General Hospital, and the Departments of Pediatrics (M.E.L., T.B.K.), Radiology (B.P.L.), and Pathology (M.M.-K.), Harvard Medical School, Boston, and the Laboratory for Molecular Medicine, Partners HealthCare Personalized Medicine, Cambridge (M.H.H.) - all in Massachusetts
| | - Brent P Little
- From the Department of Pediatrics, UMass Memorial Medical Center, and the Department of Pediatrics, University of Massachusetts Medical School, Worcester (T.M.K.), the Departments of Pediatrics (M.E.L., T.B.K.), Radiology (B.P.L.), and Pathology (M.M.-K.), Massachusetts General Hospital, and the Departments of Pediatrics (M.E.L., T.B.K.), Radiology (B.P.L.), and Pathology (M.M.-K.), Harvard Medical School, Boston, and the Laboratory for Molecular Medicine, Partners HealthCare Personalized Medicine, Cambridge (M.H.H.) - all in Massachusetts
| | - Mari Mino-Kenudson
- From the Department of Pediatrics, UMass Memorial Medical Center, and the Department of Pediatrics, University of Massachusetts Medical School, Worcester (T.M.K.), the Departments of Pediatrics (M.E.L., T.B.K.), Radiology (B.P.L.), and Pathology (M.M.-K.), Massachusetts General Hospital, and the Departments of Pediatrics (M.E.L., T.B.K.), Radiology (B.P.L.), and Pathology (M.M.-K.), Harvard Medical School, Boston, and the Laboratory for Molecular Medicine, Partners HealthCare Personalized Medicine, Cambridge (M.H.H.) - all in Massachusetts
| |
Collapse
|
12
|
Pelizzo G, Collura M, Puglisi A, Pappalardo MP, Agolini E, Novelli A, Piccione M, Cacace C, Bussani R, Corsello G, Calcaterra V. Congenital emphysematous lung disease associated with a novel Filamin A mutation. Case report and literature review. BMC Pediatr 2019; 19:86. [PMID: 30922288 PMCID: PMC6440113 DOI: 10.1186/s12887-019-1460-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 03/14/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Progressive lung involvement in Filamin A (FLNA)-related cerebral periventricular nodular heterotopia (PVNH) has been reported in a limited number of cases. CASE PRESENTATION We report a new pathogenic FLNA gene variant (c.7391_7403del; p.Val2464Alafs*5) in a male infant who developed progressive lung disease with emphysematous lesions and interstitial involvement. Following lobar resection, chronic respiratory failure ensued necessitating continuous mechanical ventilation and tracheostomy. Cerebral periventricular nodular heterotopia was also present. CONCLUSIONS We report a novel variant of the FLNA gene, associated with a severe lung disorder and PNVH. The lung disorder led to respiratory failure during infancy and these pulmonary complications may be the first sign of this disorder. Early recognition with thoracic imaging is important to guide genetic testing, neuroimaging and to define optimal timing of potential therapies, such as lung transplant in progressive lung disease.
Collapse
Affiliation(s)
- Gloria Pelizzo
- Pediatric Surgery Department, Children's Hospital "G. di Cristina", ARNAS Civico-Di Cristina-Benfratelli, Via dei Benedettini, 1, 90134, Palermo, Italy.
| | - Mirella Collura
- Cystic Fibrosis and Respiratory Pediatric Center, Children's Hospital G. Di Cristina, ARNAS Civico-Di Cristina-Benfratelli, Palermo, Italy
| | - Aurora Puglisi
- Pediatric Anesthesiology and Intensive Care Unit, Children's Hospital G. Di Cristina, ARNAS Civico-Di Cristina-Benfratelli, Palermo, Italy
| | - Maria Pia Pappalardo
- Pediatric Radiology Unit, Children's Hospital G. Di Cristina, ARNAS Civico-Di Cristina-Benfratelli, Palermo, Italy
| | - Emanuele Agolini
- Laboratory of Medical Genetics, Bambino Gesù Children's Hospital, Rome, Italy
| | - Antonio Novelli
- Laboratory of Medical Genetics, Bambino Gesù Children's Hospital, Rome, Italy
| | - Maria Piccione
- Department of Sciences for Health Promotion and Mother and Child Care "Giuseppe D'Alessandro", University of Palermo, Palermo, Italy
| | - Caterina Cacace
- Neonatal Intensive Care Unit, Hospital "Barone Romeo" Patti, ASP Messina, Messina, Italy
| | - Rossana Bussani
- Institute of Pathological Anatomy, Trieste University Hospital, Trieste, Italy
| | - Giovanni Corsello
- Pediatrics and Neonatal Intensive Therapy Unit, Mother and Child Department, University of Palermo, Palermo, Italy
| | - Valeria Calcaterra
- Pediatrics and Adolescentology Unit, Department of Internal Medicine University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| |
Collapse
|
13
|
The Curious Case of "Case Report" of Infections Caused by Human and Animal Fungal Pathogens: An Educational Tool, an Online Archive, or a Format in Need of Retooling. Mycopathologia 2019; 183:879-891. [PMID: 30570717 DOI: 10.1007/s11046-018-0314-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Case reports describe the unusual occurrence and complications of diseases, diagnostic challenges, and notable therapeutic successes. Some journals have discontinued the case reports, while new case report journals have appeared in recent years. During the eightieth anniversary of Mycopathologia, it is fitting to examine the relevance of the case report since the journal continues to traverse the boundaries of basic and clinical sciences. A random sample of recent case reports and other articles were selected from Mycopathologia. Springer Nature individual article download statistics, and Google Scholar and Scopus citations numbers were compared to assess the reader access and bibliometric impact of case reports. Our analysis indicated that the case report format continues to be a vital element of publication in a cross-disciplinary journal such as Mycopathologia. Medical and veterinary case reports covering fungal pathogens are widely read as evident from their download numbers. The download numbers have a positive correlation with the completeness of the report, the topics and geographic origin of reports have a neutral influence, and the recency leads to lower downloads. There is no discernible trend between the download numbers and the citations of case reports as measured by Google Scholar and Scopus. A specially designed checklist for Mycopathologia case reports and new format MycopathologiaIMAGES are being introduced to improve the quality and relevance of case reports further.
Collapse
|
14
|
Sasaki E, Byrne AT, Phelan E, Cox DW, Reardon W. A review of filamin A mutations and associated interstitial lung disease. Eur J Pediatr 2019; 178:121-129. [PMID: 30547349 DOI: 10.1007/s00431-018-3301-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 11/22/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
Abstract
The filamin A gene (FLNA) on Xq28 encodes the filamin A protein. Mutation in FLNA causes a wide spectrum of disease including skeletal dysplasia, neuronal migration abnormality, cardiovascular malformation, intellectual disability and intestinal obstruction. Recently, childhood-onset interstitial lung disease associated with a range of FLNA mutations has been recognised and reported. We document our personal experience of this emerging disorder and compile a comprehensive overview of clinical features and molecular changes in all identifiable published cases. Reviewing the emerging dataset, we underline this unanticipated phenotypic consequence of pathogenic FLNA mutation-associated pulmonary disease.Conclusion: From the emerging data, we suggest that while reviewing complex cases with a sustained oxygen requirement against a clincial background of cardiac concerns or intestinal obstruction to have a high index of suspicion for FLNA related pathology and to instigate early MRI brain scan and FLNA mutation analysis. What is Known: • FLNA gene on Xq28 encodes the filamin A protein and mutation therein is associated with variable phenotypes depending on its nature of mutation. • Loss-of-function mutation of filamin A is associated with X-linked inherited form of periventricular nodular heterotopia with or without epilepsy with most individuals affected being female. There is a recently recognised associated respiratory phenotype. What is New: • The respiratory phenotype in the form of childhood interstitial lung disease is a recently recognised clinical consequence of loss-of-function FLNA mutation. • Rare male patients with loss-of-function FLNA mutation-associated lung disease with residual protein function can survive into infancy with a severe form of the phenotype.
Collapse
Affiliation(s)
- Erina Sasaki
- Clinical Genetics Department, Our Lady's Children's Hospital, Dublin, Ireland.
| | - Angela T Byrne
- Paediatric Radiology Department, Our Lady's Children's Hospital, Dublin, Ireland
| | - Ethna Phelan
- Paediatric Radiology Department, Our Lady's Children's Hospital, Dublin, Ireland
| | - Desmond W Cox
- Paediatric Respiratory Department, Our Lady's Children's Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - William Reardon
- Clinical Genetics Department, Our Lady's Children's Hospital, Dublin, Ireland
| |
Collapse
|