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Saliani P, Epstein S, Cohen D. The Role of Ultrasound in the Diagnosis of Fryns Syndrome. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2016. [DOI: 10.1177/8756479303261409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Fryns syndrome is an autosomal recessive genetic disorder characterized by craniofacial, thoracic, limb, genitourinary, gastrointestinal, and central nervous system abnormalities. This case demonstrates the role of sonography in detecting this entity in a fetus that demonstrated normal maternal serum screening and amniocentesis. In this case, there was no family history of this defect, the parents were not consanguineous, and an autopsy was unavailable.
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Peron A, Bedeschi MF, Fabietti I, Baffero GM, Fogliani R, Ciralli F, Mosca F, Rizzuti T, Leva E, Lalatta F. Prenatal and postnatal findings in five cases of Fryns syndrome. Prenat Diagn 2014; 34:1227-30. [DOI: 10.1002/pd.4447] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 06/26/2014] [Accepted: 06/27/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Angela Peron
- Clinical Genetics Unit; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico; Milano Italy
| | | | - Isabella Fabietti
- Obstetrics and Gynecology Unit; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Giulia Maria Baffero
- Obstetrics and Gynecology Unit; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Roberto Fogliani
- Obstetrics and Gynecology Unit; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Fabrizio Ciralli
- Neonatal Intensive Care Unit, Department of Clinical Science and Community Health; Università degli Studi di Milano and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Fabio Mosca
- Neonatal Intensive Care Unit, Department of Clinical Science and Community Health; Università degli Studi di Milano and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Tommaso Rizzuti
- Pathology Unit; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Ernesto Leva
- Department of Pediatric Surgery; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Faustina Lalatta
- Clinical Genetics Unit; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico; Milano Italy
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Arora K, Thukral A, Das RR, Gupta N, Kabra M, Agarwal R. Fryns syndrome: a lethal birth defect with variable phenotypic expressions in siblings. Indian J Pediatr 2014; 81:614-6. [PMID: 23604607 DOI: 10.1007/s12098-013-1011-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 03/13/2013] [Indexed: 11/24/2022]
Abstract
Fryns syndrome (FS) is a multiple congenital anomaly syndrome, inherited as an autosomal recessive defect with variable expression. The authors report a newborn with FS, whose mother had two previous affected pregnancies with the infants having variable phenotypic expression. FS is characterized by craniofacial dysmorphism, diaphragmatic hernia and distal limb hypoplasia. This is the first published report from India describing a case of FS with familial recurrence, which would serve further to illustrate the clinical variability of this disorder.
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Affiliation(s)
- Kamaldeep Arora
- Division of Neonatology, Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India
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Chen CP, Wang TH, Chen YJ, Chang TY, Liu YP, Tzen CY, Chern SR, Wang W. Prenatal diagnosis of Fryns syndrome associated with a microdeletion at 8p23.1. Prenat Diagn 2008; 27:967-9. [PMID: 17602449 DOI: 10.1002/pd.1797] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Chih-Ping Chen
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan, Republic of China.
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Lin AE, Pober BR, Mullen MP, Slavotinek AM. Cardiovascular malformations in Fryns syndrome: is there a pathogenic role for neural crest cells? Am J Med Genet A 2006; 139:186-93. [PMID: 16283673 DOI: 10.1002/ajmg.a.31023] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We performed a comprehensive literature and case report review to characterize the cardiovascular malformations (CVMs) associated with Fryns syndrome (OMIM #229850), a multiple congenital anomaly/mental retardation syndrome consisting of diaphragmatic defects, significant pulmonary hypoplasia, distinctive facial appearance, distal digital hypoplasia, and numerous other external and internal anomalies. A total of 112 patients meeting diagnostic guidelines for Fryns syndrome were identified, of whom 82 met narrowly defined criteria (Group I) and 30 met broader diagnostic criteria (Group II). Twelve patients reported as having Fryns syndrome with atypical features (Group III) were also analyzed. A CVM was reported in 51% (42 of 82) of Group I patients, most commonly an atrial or ventricular septal defect (VSD) (23 of 42, 55%). Conotruncal and aortic arch CVMs were common (11 of 42, 26%), but not significantly so compared to the general population of infants to age 1 year [Ferencz et al., 1997]. Recognizing that minor septal defects associated with congenital diaphragmatic hernia (CDH) may occur in response to altered hemodynamics (instead of being a bonafide CVM), we excluded four patients reported as having hemodynamically insignificant VSDs. Following these exclusions, conotruncal CVMs were found more commonly than in the general population (11 of 38, 29%, P < or = 0.025). In Group II, 9 of 30 (30%) had a CVM with no predominant type among the small number of cases reviewed. Among the atypical Fryns syndrome patients in Group III, half (6 of 12, 50%) had a CVM; most (4 of 6, 67%) were conotruncal, in particular, type B interrupted aortic arch (3 of 4). Patients with Fryns syndrome have a high rate of CVMs, warranting thorough cardiac evaluation including echocardiogram (fetal and/or postnatal) in all patients, similar to the evaluation for other patients with diaphragmatic hernia. The possible association between conotruncal CVMs and Fryns syndrome may provide additional support for an etiologic role of genes related to neural crest cell development in the pathogenesis of Fryns syndrome and hence, congenital diaphragmatic hernia.
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Affiliation(s)
- Angela E Lin
- Teratology Unit, Pediatric Service, MassGeneral Hospital for Children, Boston, Massachusetts 02115, USA.
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MESH Headings
- Abnormalities, Multiple/diagnosis
- Abnormalities, Multiple/etiology
- Bone and Bones/abnormalities
- Craniofacial Abnormalities/diagnosis
- Craniofacial Abnormalities/genetics
- Female
- Hernia, Diaphragmatic/diagnosis
- Hernia, Diaphragmatic/genetics
- Hernias, Diaphragmatic, Congenital
- Humans
- Infant, Newborn
- Karyotyping
- Limb Deformities, Congenital/diagnosis
- Limb Deformities, Congenital/genetics
- Lung/abnormalities
- Magnetic Resonance Imaging
- Nails, Malformed
- Syndrome
- Turner Syndrome/complications
- Turner Syndrome/diagnosis
- Ultrasonography, Interventional
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Slavotinek AM. Fryns syndrome: A review of the phenotype and diagnostic guidelines. ACTA ACUST UNITED AC 2004; 124A:427-33. [PMID: 14735597 DOI: 10.1002/ajmg.a.20381] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Fryns syndrome (FS) is the commonest autosomal recessive syndrome associated with congenital diaphragmatic hernia (CDH) and comprises CDH, pulmonary hypoplasia, craniofacial anomalies, distal limb hypoplasia, and internal malformations. Although there have been more than 50 case reports on probands with FS, the diagnostic guidelines were formulated from a review of eight patients and modifications to the guidelines have only once been suggested. Recently, several case reports have described new anomalies in FS and other papers have highlighted the variation in expressivity found in FS. This paper examines the medical literature on FS to define the phenotype and to review the diagnostic guidelines. We conclude that CDH with brachytelephalangy and/or nail hypoplasia is strongly suggestive of the diagnosis and that pulmonary hypoplasia, craniofacial dysmorphism, orofacial clefting, and polyhydramnios are sufficiently frequent to be diagnostically useful. Other distinctive malformations that are consistent with FS include ventricular dilatation or hydrocephalus, agenesis of the corpus callosum, neuronal or cerebellar heterotopias, abnormalities of the aorta, renal cysts, dilatation of the ureters, bicornuate uterus, renal dysplasia, proximal thumbs, and broad clavicles.
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Affiliation(s)
- Anne M Slavotinek
- Division of Genetics, Department of Pediatrics, University of California-San Francisco, 533 Parnassus Street, San Francisco, CA 94143-0748, USA.
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Mengshol SC, Ornvold K. Pathologic Quiz Case: Hypoplastic Digit, Diaphragmatic Hernia, and Agenesis of the Corpus Callosum in a 215⁄7-Week Fetus. Arch Pathol Lab Med 2003; 127:e425-6. [PMID: 14567736 DOI: 10.5858/2003-127-e425-pqchdd] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Sarah C Mengshol
- Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, USA.
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Jaeger A, Kapur R, Whelan M, Leung E, Cunningham M. Cleft-palate lateral synechia syndrome: insight into the phenotypic spectrum of Fryns syndrome? BIRTH DEFECTS RESEARCH. PART A, CLINICAL AND MOLECULAR TERATOLOGY 2003; 67:460-6. [PMID: 12962292 DOI: 10.1002/bdra.10048] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND In 1972, Fuhrmann et al. (Humangenetik 1972;14:196-203) described a novel syndrome consisting of cleft palate (CP) and lateral synechiae (LS) between the palate and the floor of the mouth. This constellation of malformations, since denoted as cleft-palate lateral synechiae syndrome (CPLS), is a rare syndrome; only five cases have been reported since the original description. Because of the paucity of recognized cases, little is known regarding the phenotypic spectrum of this presumably autosomal dominant condition. CASES We report two unrelated patients who presented with remarkably similar phenotypic features, including multiple intraoral synechiae (filiforme intraalveolar bands), cleft palate, micrognathia, and redundant lower lip tissue. Their phenotypic findings indicate a diagnosis of CPLS; however, case 3 (the monozygotic twin of case 2) had classic phenotypic features of Fryns syndrome. CONCLUSIONS This report presents two new cases of CPLS, and suggests that the CPLS phenotype may represent the mild end of the Fryns syndrome phenotypic spectrum. Supplementary material for this article can be found on the Birth Defects Research (Part A) website (http://www.interscience.wiley.com/ jpages/1542-0752/suppmat/67/fig5.xls).
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Affiliation(s)
- April Jaeger
- University of Vermont College of Medicine, Burlington, Vermont, USA
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Arnold SR, Debich-Spicer D D, Opitz JM, Gilbert-Barness E. Documentation of anomalies not previously described in Fryns syndrome. Am J Med Genet A 2003; 116A:179-82; discussion 183. [PMID: 12494439 DOI: 10.1002/ajmg.a.10763] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We report on a case of Fryns syndrome with microcephaly, multiple facial anomalies, hypoplasia of distal phalanges, diaphragmatic defect with a thin, translucent diaphragm, microphthalmia (right), anophthalmia (left), and multiple midline developmental defects including gastroschisis, central nervous system defects including left arrhinencephaly and cerebellar hypoplasia, midline cleft of the upper lip, alveolar ridge and maxillary bone, and cleft nose with bilateral choanal atresia. These defects add to our knowledge of the phenotype of Fryns syndrome.
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Affiliation(s)
- Sonya Rae Arnold
- Department of Pathology, University of South Florida, and Tampa General Hospital, 33601, USA
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Pierson DM, Subtil A, Taboada E, Butler MG. Newborn with anophthalmia and features of Fryns syndrome. Pediatr Dev Pathol 2002; 5:592-6. [PMID: 12375132 PMCID: PMC6800080 DOI: 10.1007/s10024-002-2106-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2001] [Accepted: 07/24/2002] [Indexed: 11/27/2022]
Abstract
We report a newborn female with craniofacial malformations, bilateral anophthalmia, large abnormally shaped ears, short neck, small distal phalanges and nails, left diaphragmatic hernia, hypoplastic optic nerves, severe pulmonary hypoplasia, and an accessory spleen, and describe the autopsy findings. The infant expired at 18 h of life. The features were most consistent with Fryns syndrome although other conditions were considered including Matthew Wood syndrome. Anophthalmia, to our knowledge, has not been reported previously in Fryns syndrome; however, eye findings are common, particularly microphthalmia and cloudy cornea.
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Affiliation(s)
- Diane M. Pierson
- Department of Pathology, Truman Medical Center, Kansas City, MO, USA
- School of Medicine, University of Missouri—Kansas City, Kansas City, MO, USA
| | - Antonio Subtil
- Department of Pathology, Truman Medical Center, Kansas City, MO, USA
- School of Medicine, University of Missouri—Kansas City, Kansas City, MO, USA
| | - Eugenio Taboada
- Department of Pathology, Children’s Mercy Hospitals and Clinics, Kansas City, MO, USA
- School of Medicine, University of Missouri—Kansas City, Kansas City, MO, USA
| | - Merlin G. Butler
- Department of Pediatrics, Children’s Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64108-9898, USA
- School of Medicine, University of Missouri—Kansas City, Kansas City, MO, USA
- Corresponding author, at Department of Pediatrics, Section of Medical Genetics and Molecular Medicine, Children’s Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64108-9898, USA,
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