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Coetzer KC, Zöllner E, Moosa S. Genetic basis of osteogenesis imperfecta from a single tertiary centre in South Africa. Eur J Hum Genet 2023:10.1038/s41431-023-01509-3. [PMID: 38102329 DOI: 10.1038/s41431-023-01509-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/23/2023] [Accepted: 11/22/2023] [Indexed: 12/17/2023] Open
Abstract
Osteogenesis imperfecta (OI) is a clinically heterogeneous disorder characterised by skeletal fragility and an increased fracture incidence. It occurs in approximately one in every 15-20,000 births and is known to vary considerably in its severity. This report aimed to use next-generation sequencing (NGS) technology to identify disease genes and causal variants in South African patients with clinical-radiological features of OI. A total of 50 affected individuals were recruited at Tygerberg Hospital's Medical Genetics clinic. Patients were selected for a gene panel test (n = 39), a single variant test (n = 1) or exome sequencing (ES) (n = 12, 7 singletons, 1 affected duo, and 1 trio), depending on funding eligibility. An in-house genomic bioinformatics pipeline was developed for the ES samples using open-source software and tools. This study's 100% diagnostic yield was largely attributable to an accurate clinical diagnosis. A causal variant in COL1A1 or COL1A2 was identified in 94% of this patient cohort, which is in line with previous studies. Interestingly, this study was the first to identify the common South African pathogenic FKBP10 variant in a patient of mixed ancestry, adding to what was previously known about this variant in our population. Additionally, a recurrent variant in COL1A2: c.1892G>T was discovered in 27 individuals (25 from three large unrelated families and two further individuals), facilitating the establishment of local testing for this variant in South African patients.
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Affiliation(s)
- Kimberly Christine Coetzer
- Division of Molecular Biology and Human Genetics, Stellenbosch University Faculty of Medicine, and Health Sciences, Tygerberg, 7505, Cape Town, South Africa
| | - Ekkehard Zöllner
- Department of Paediatrics, Stellenbosch University Faculty of Medicine, and Health Sciences, Tygerberg, 7505, Cape Town, South Africa
| | - Shahida Moosa
- Division of Molecular Biology and Human Genetics, Stellenbosch University Faculty of Medicine, and Health Sciences, Tygerberg, 7505, Cape Town, South Africa.
- Medical Genetics, Tygerberg Hospital, Tygerberg, 7505, Cape Town, South Africa.
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Peláez Chomba MS, Vásquez Gómez GR, Sullcahuaman Allende YC, Mendoza Fernández JC, Purizaca Rosillo ND, Zevallos A, Cruzate Cabrejos VL. Case Report: A prenatal diagnosis of osteogenesis imperfecta in a patient with a novel pathogenic variant in COL1A2. F1000Res 2023; 12:603. [PMID: 37829592 PMCID: PMC10565417 DOI: 10.12688/f1000research.131094.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 10/14/2023] Open
Abstract
Osteogenesis imperfecta is considered a rare genetic condition which is characterized by bone fragility. In 85% of cases, it is caused by mutations in COL1A1 and COL1A2 genes which are essential to produce type I collagen. We report the case of a female neonate delivered to a 27-year-old women at San Bartolomé Teaching Hospital with a family history of clavicle fracture. A prenatal control with ultrasound was performed to the mother at 29 weeks. A fetus with altered morphology and multiple fractures was found. Therefore, a prenatal diagnosis of osteogenesis imperfecta was performed. The neonate was born with a respiratory distress syndrome and an acyanotic congenital heart disease. Therefore, she remained in NICU until her death. We highlight the importance of prenatal diagnosis, genetic counseling and a multidisciplinary evaluation in this type of pathologies and report a new probably pathogenic variant in the COL1A2 gene detected by exomic sequencing in amniotic fluid.
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Affiliation(s)
- Melissa Sindy Peláez Chomba
- Departamento de Gineco Obstetricia, Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Lima, Cercado de Lima 15001, Peru
| | - Guillermo Raúl Vásquez Gómez
- Departamento de Gineco Obstetricia, Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Lima, Cercado de Lima 15001, Peru
| | - Yasser Ciro Sullcahuaman Allende
- Instituto de Investigación Genómica, IGENOMICA, Lima, Lima, San Borja 15037, Peru
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Lima, San Martin de Porres 15102, Peru
| | - Julio Cesar Mendoza Fernández
- Unidad Funcional de Genética y Biología Molecular, Instituto Nacional de Enfermedades Neoplásicas, Lima, Lima, Surquillo 15038, Peru
| | | | - Alejandra Zevallos
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Lima, Chorrillos 15067, Peru
| | - Vicente Leandro Cruzate Cabrejos
- Departamento de Gineco Obstetricia, Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Lima, Cercado de Lima 15001, Peru
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Lima, Chorrillos 15067, Peru
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Muacevic A, Adler JR, Cardona JD, Bendeck JL, Cifuentes Gaitan K, Ferrer Valencia V, Domínguez MT, Quevedo ML, Fernández I, Celis Regalado LG. Osteogenesis Imperfecta: A Case Series and Literature Review. Cureus 2023; 15:e33864. [PMID: 36819366 PMCID: PMC9935240 DOI: 10.7759/cureus.33864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2023] [Indexed: 01/18/2023] Open
Abstract
Osteogenesis imperfecta (OI) is a hereditary disease of connective tissue characterized by the loss of bone density and mass, which increases the fragility of the bones, thus presenting multiple fractures throughout the years followed by bone deformity and articular instability. This condition has various clinical presentations. We present four cases of OI, one case with type I, two cases with type II, and one case with type III. The clinical diagnosis in most of the cases was clinical; only one of them was confirmed with genomic sequence. The treatment of these cases was based on medication, orthopedic surgery, and recovery and physical therapy. The evolution was torpid in these cases but with prolonged life expectancy despite the severity and type of OI. It is important to highlight that the patients did not have a neurocognitive compromise. Early diagnosis and multidisciplinary medical management are crucial in obtaining better outcomes for this disease, improving the quality of life, and avoiding complications.
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An Unusual Diagnosis of Sporadic Type III Osteogenesis Imperfecta in the First Day of Life. Case Rep Pediatr 2022; 2022:3251980. [PMID: 35706981 PMCID: PMC9192219 DOI: 10.1155/2022/3251980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 04/30/2022] [Accepted: 05/26/2022] [Indexed: 11/17/2022] Open
Abstract
Osteogenesis imperfecta (OI) is a group of rare, permanent genetic bone disorders resulting from the mutations in genes encoding type 1 collagen. It usually is inherited by an autosomal dominant pattern, but it can sometimes occur sporadically. Among the four main types, type III is the most severe type which presents with multiple bone fractures, skeletal deformities, blue sclera, hearing, and dental abnormalities. It is estimated that only 1 in 20,000 cases of OI are detected during infancy, and the diagnosis carries a poor prognosis. This case is reported for the rarity of sporadic OI diagnosis in neonates. We present a case of a 1-day-old neonate following a normal vaginal delivery referred to our center in the view of low birth weight and multiple bony deformities. Physical examination revealed an ill-looking child with poor suckling, gross bony deformities in upper and lower limbs, and blue sclera. X-ray showed thin gracile bones with multiple bone fractures. Echocardiography revealed a 4 mm patent ductus arteriosus. The patient was diagnosed with type III OI with patent ductus arteriosus. Though OI is rare in neonates and infants, it should be considered in the differentials in a newborn presenting with multiple bony deformities regardless of family history, history of trauma, or physical abuse. OI is also associated with cardiac anomalies such as the atrial septal defect and patent ductus arteriosus for which echocardiography is recommended routinely.
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Augustin D, Augustin DH, David D, Théodas JA, Derisier AF. Osteogenesis Imperfecta Type 3 in a 10-Year-Old Child With Acute Respiratory Distress Syndrome. Cureus 2022; 14:e22198. [PMID: 35308738 PMCID: PMC8925934 DOI: 10.7759/cureus.22198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Osteogenesis imperfecta (OI) represents a group of rare connective tissue disorders characterized by excessive bone fragility. Type 3 is a rare form with new mutations; osteopenia and bone fragility are significant with numerous fractures, continuous and severe deformity of the spine, and long bones. Our case study concerns a 10-year-old male child admitted to the pediatric department of the State University of Haiti Hospital. OI type 3 was diagnosed based on both clinical and radiological assessments. Multidisciplinary care was initiated. Although the evolution was still unsatisfactory, characterized by intermittent episodes of dyspnea and left lung hypoplasia, he was stabilized after 28 days of hospitalization and referred to the orthopedics department for follow-up care.
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Sepehri A, Sidhu A, Masri BA. Total Hip Replacements in Patients with Rare Pathologic Conditions Affecting Bone. J Bone Joint Surg Am 2021; 103:1355-1362. [PMID: 33780390 DOI: 10.2106/jbjs.20.01398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
➤ As a result of the advances in surgical technique and implant design, total hip arthroplasty (THA) is increasingly offered for the management of osteoarthritis of the hip in patients with fragile or pathologic bone. ➤ Posttraumatic or congenital deformities associated with fragile or pathologic bone are frequently encountered and necessitate diligent preoperative planning. ➤ Surgeons should be prepared to evaluate and manage intraoperative iatrogenic fracture. ➤ While there is limited evidence to date, components made with computer-assisted design can be considered, given the unique and highly variable patient population.
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Affiliation(s)
- Aresh Sepehri
- Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
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Almidani E, Elsidawi W, Almohamedi A, Bin Ahmed I, Alfadhel A. Case Report of Transient Neonatal Hyperparathyroidism: Medically Free Mother. Cureus 2020; 12:e7000. [PMID: 32206464 PMCID: PMC7077087 DOI: 10.7759/cureus.7000] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Transit neonatal hyperparathyroidism (TNHP) is a very rare recessive mutation in the calcium channel transporter. TNHP is defined as an impairment of calcium transportation from the mother to the fetus prenatally and mainly in the third trimester. TNHP classically presents with skeletal deformities and subsequently affects multiple systems. TNHP has been linked to a mutation in the transient receptor potential cation channel, subfamily V, member 6 (TRPV6). We report a case of a full-term male infant diagnosed with TNHP prenatally from a medically free mother. The patient was discharged home at the age of 28 days after an excellent response to the trial of calcium infusion.
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Affiliation(s)
- Eyad Almidani
- Pediatrics, King Faisal Specialist Hospital and Research Center, Riyadh, SAU
| | - Weam Elsidawi
- Pediatrics: Newborn Intensive Care Unit, King Faisal Specialist Hospital and Research Center, Riyadh, SAU
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Chamunyonga F, Masendeke KL, Mateveke B. Osteogenesis imperfecta and pregnancy: a case report. J Med Case Rep 2019; 13:363. [PMID: 31822291 PMCID: PMC6905103 DOI: 10.1186/s13256-019-2296-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 10/16/2019] [Indexed: 11/18/2022] Open
Abstract
Background Osteogenesis imperfecta is a rare connective tissue disorder of varying phenotypic presentations. In pregnancies complicated by osteogenesis imperfecta, there is an increased risk to both the mother and fetus. Case presentation We present a case of a 34-year-old, wheelchair-bound, primigravid African (Zimbabwean) patient with short stature and skeletal deformities. Her care, requiring a multidisciplinary team approach, resulted in the delivery of a live baby girl with a birth weight of 2100 g, also with osteogenesis imperfecta. Conclusion Good outcomes are reported when a multidisciplinary team is involved in the care of patients with osteogenesis imperfecta. Pregnancies can be carried to term but require close antenatal surveillance. Prenatal diagnosis is possible with ultrasound and genetic testing. Delivery should be carefully planned by a multidisciplinary team. Decisions on delivery mode should be made on a case-by-case basis.
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Affiliation(s)
- Felix Chamunyonga
- Department of Obstetrics and Gynecology, University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe.
| | - Kudzaishe Lloyd Masendeke
- Department of Obstetrics and Gynecology, University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe
| | - Bismark Mateveke
- Department of Obstetrics and Gynecology, University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe
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Qadar LT, Ochani RK, Shaikh A, Arsalan Q, Ali R. A Unique Association of Osteogenesis Imperfecta with Bilateral Renal Osteodystrophy and Gastroenteritis in a Three-year-old Boy. Cureus 2019; 11:e4467. [PMID: 31249745 PMCID: PMC6579323 DOI: 10.7759/cureus.4467] [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] [Indexed: 11/24/2022] Open
Abstract
We describe a three-year-old male child who presented to the pediatrics out-patient department with a history of decrease in appetite, generalized weakness, on and off loose motions for one year, inability to walk and sit for eight months with a loss of neck holding for 14 days. On examination, the patient had a classic frog-shaped leg posture. X-rays of chest, skull, pelvis and long bones were performed which showed osteopenic bones, frontal bossing and multiple microfractures, which were classic for osteogenesis Imperfecta but the child did not have other salient features such as blue sclera, otosclerosis, and respiratory difficulty. The patient also had urinary complaints due to which ultrasound of kidney ureters and bladder (KUB) was performed, which showed bilateral renal calculi and grade 2 renal parenchymal changes. This case report illustrates the evaluation of the child with osteogenesis imperfecta, as well as the unique association of renal osteodystrophy and gastroenteritis with it.
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Affiliation(s)
- Laila Tul Qadar
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | | | - Asim Shaikh
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Qazi Arsalan
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Ramsha Ali
- Pediatrics, Dow University of Health Sciences, Karachi, PAK
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