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El Demellawy D, Kovesi T, Gowans R, Oltean I, Huang L, White-Brown A, Sawyer SL. Interstitial lung disease in a family with bi-allelic variants in ABCA3: non-specific interstitial pneumonitis pattern of injury. Pathology 2024; 56:104-107. [PMID: 37657992 DOI: 10.1016/j.pathol.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 06/12/2023] [Accepted: 06/16/2023] [Indexed: 09/03/2023]
Affiliation(s)
- Dina El Demellawy
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada; Department of Genetics, Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada.
| | - Thomas Kovesi
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada; Department of Pediatrics, Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - Rachel Gowans
- Faculty of Science, University of Ottawa, Ottawa, ON, Canada
| | - Irina Oltean
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
| | - Lijia Huang
- Department of Pathology, Children's Hospital of Eastern Ontario (CHEO), ON, Canada
| | - Alexandre White-Brown
- Department of Genetics, Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - Sarah L Sawyer
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada; Department of Genetics, Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
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Osborne B, Dancey SR, Mery E, Oltean I, Bijelić V, de Nanassy J, Lawrence SL, Moretti F, El Demellawy D. Impact of villitis of unknown etiology and adverse acute neonatal outcomes in Eastern Ontario. Placenta 2023; 144:23-28. [PMID: 37952366 DOI: 10.1016/j.placenta.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION Villitis of unknown etiology (VUE) is a histopathological lesion associated with adverse neonatal outcomes. We seek to define the obscure relationship between the severity and distribution of VUE and adverse neonatal outcomes. METHODS A retrospective chart review was conducted of pathologic findings from singleton placentas diagnosed with VUE between 2013 and 2019. Control placentas were matched 1:1 for gestational age and presence/absence of fetal IUGR. Neonatal outcomes of interest included: newborn resuscitation, NICU admission, Apgar scores and cord blood acidosis. Odds ratio and 95 % confidence intervals were calculated with controls as the reference. RESULTS 452 placentas were included. 35 % of pregnancies were complicated by IUGR. When analyzed by severity (low-grade: OR = 4.75 [2.86-8.14]; high-grade: OR = 4.76 [2.71-8.79]) and distribution (focal: OR = 5.24 [2.87-10.17]; multifocal: OR = 4.90 [2.90-8.59]), VUE was significantly associated with need for newborn resuscitation. No other neonatal outcomes of interest were significantly associated with VUE diagnosis. DISCUSSION We determined a statistically significant association between VUE severity and distribution and the need for newborn resuscitation. VUE lesions were not associated with any additional neonatal outcomes of interest. Further studies with larger sample sizes are required to confirm these associations for obstetric and neonatal case management.
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Affiliation(s)
- Brenden Osborne
- Department of Pathology, Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada
| | - Sonia R Dancey
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada
| | - Erika Mery
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada
| | - Irina Oltean
- Clinical Research Unit, Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada
| | - Vid Bijelić
- Clinical Research Unit, Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada
| | - Joseph de Nanassy
- Department of Pathology, Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada
| | - Sarah L Lawrence
- Department of Pediatrics, Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada
| | - Felipe Moretti
- Department of Obstetrics and Gynecology, The Ottawa Hospital, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
| | - Dina El Demellawy
- Department of Pathology, Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada.
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Oltean I, Rajaram A, Tang K, MacPherson J, Hondonga T, Rishi A, Toltesi R, Gowans R, Jahangirnia A, Nasr Y, Lawrence SL, El Demellawy D. The Association of Placental Abruption and Pediatric Neurological Outcome: A Systematic Review and Meta-Analysis. J Clin Med 2022; 12:jcm12010205. [PMID: 36615006 PMCID: PMC9821447 DOI: 10.3390/jcm12010205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/17/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022] Open
Abstract
Placental histopathology provides insights, or "snapshots", into relevant antenatal factors that could elevate the risk of perinatal brain injury. We present a systematic review and meta-analysis comparing frequencies of adverse neurological outcomes in infants born to women with placental abruption versus without abruption. Records were sourced from MEDLINE, Embase, and the CENTRAL Trials Registry from 1946 to December 2019. Studies followed the PRISMA guidelines and compared frequencies of neurodevelopmental morbidities in infants born to pregnant women with placental abruption (exposure) versus women without placental abruption (comparator). The primary endpoint was cerebral palsy. Periventricular and intraventricular (both severe and any grades of IVH) and any histopathological neuronal damage were the secondary endpoints. Study methodologic quality was assessed by the Ottawa-Newcastle scale. Estimated odds ratios (OR) and hazards ratio (HR) were derived according to study design. Data were meta-analyzed using a random effects model expressed as pooled effect sizes and 95% confidence intervals. We included eight observational studies in the review, including 1245 infants born to women with placental abruption. Results of the random effects meta-analysis show that the odds of infants born to pregnant women with placental abruption who experience cerebral palsy is higher than in infants born to pregnant women without placental abruption (OR 5.71 95% CI (1.17, 27.91); I2 = 84.0%). There is no statistical difference in the odds of infants born to pregnant women with placental abruption who experience severe IVH (grade 3+) (OR 1.20 95% CI (0.46, 3.11); I2 = 35.8%) and any grade of IVH (OR 1.20 95% CI (0.62, 2.32); I2 = 32.3%) vs. women without placental abruption. There is no statistically significant difference in the odds of infants born to pregnant women with placental abruption who experience PVL vs. pregnant women without placental abruption (OR 6.51 95% CI (0.94, 45.16); I2 = 0.0%). Despite our meta-analysis suggesting increased odds of cerebral palsy in infants born to pregnant women with placental abruption versus without abruption, this finding should be interpreted cautiously, given high heterogeneity and overall poor quality of the included studies.
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Affiliation(s)
- Irina Oltean
- Department of Surgery & Pathology, Children’s Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada; (I.O.); (K.T.)
| | - Ajay Rajaram
- Department of Pathology, McGill University, Montreal, QC H4A 3J1, Canada;
| | - Ken Tang
- Department of Surgery & Pathology, Children’s Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada; (I.O.); (K.T.)
| | - James MacPherson
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (J.M.); (Y.N.)
| | | | - Aanchal Rishi
- Schulich School of Medicine & Dentistry, Western University, London, ON N6A 5C1, Canada;
| | - Regan Toltesi
- Faculty of Science, Engineering and Architecture, Laurentian University, Sudbury, ON P3E 2C6, Canada;
| | - Rachel Gowans
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Ashkan Jahangirnia
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (A.J.); (S.L.L.)
| | - Youssef Nasr
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (J.M.); (Y.N.)
| | - Sarah L. Lawrence
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (A.J.); (S.L.L.)
- Division of Neonatology, Children’s Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada
| | - Dina El Demellawy
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (A.J.); (S.L.L.)
- Department of Pathology and Laboratory Medicine, Children’s Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada
- Correspondence: ; Tel.: +1-613-737-7600
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4
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Cohen JL, Chakraborty P, Fung-Kee-Fung K, Schwab ME, Bali D, Young SP, Gelb MH, Khaledi H, DiBattista A, Smallshaw S, Moretti F, Wong D, Lacroix C, El Demellawy D, Strickland KC, Lougheed J, Moon-Grady A, Lianoglou BR, Harmatz P, Kishnani PS, MacKenzie TC. In Utero Enzyme-Replacement Therapy for Infantile-Onset Pompe's Disease. N Engl J Med 2022; 387:2150-2158. [PMID: 36351280 PMCID: PMC10794051 DOI: 10.1056/nejmoa2200587] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Patients with early-onset lysosomal storage diseases are ideal candidates for prenatal therapy because organ damage starts in utero. We report the safety and efficacy results of in utero enzyme-replacement therapy (ERT) in a fetus with CRIM (cross-reactive immunologic material)-negative infantile-onset Pompe's disease. The family history was positive for infantile-onset Pompe's disease with cardiomyopathy in two previously affected deceased siblings. After receiving in utero ERT and standard postnatal therapy, the current patient had normal cardiac and age-appropriate motor function postnatally, was meeting developmental milestones, had normal biomarker levels, and was feeding and growing well at 13 months of age.
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Affiliation(s)
- Jennifer L Cohen
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
| | - Pranesh Chakraborty
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
| | - Karen Fung-Kee-Fung
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
| | - Marisa E Schwab
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
| | - Deeksha Bali
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
| | - Sarah P Young
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
| | - Michael H Gelb
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
| | - Hamid Khaledi
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
| | - Alicia DiBattista
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
| | - Stacey Smallshaw
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
| | - Felipe Moretti
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
| | - Derek Wong
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
| | - Catherine Lacroix
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
| | - Dina El Demellawy
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
| | - Kyle C Strickland
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
| | - Jane Lougheed
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
| | - Anita Moon-Grady
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
| | - Billie R Lianoglou
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
| | - Paul Harmatz
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
| | - Priya S Kishnani
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
| | - Tippi C MacKenzie
- From the Department of Pediatrics, Division of Medical Genetics (J.L.C., D.B., S.P.Y., P.S.K.), and the Department of Pathology (K.C.S.), Duke University, Durham, NC; the Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa (P.C., S.S., D.W., C.L., D.E.D., J.L.), the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ottawa Hospital, University of Ottawa (K.F.-K.-F., F.M.), and Children's Hospital of Eastern Ontario Research Institute (P.C., A.D.) - all in Ottawa; the University of California, San Francisco (UCSF) Benioff Children's Hospital and the UCSF Center for Maternal-Fetal Precision Medicine, San Francisco (M.E.S., A.M.-G., B.R.L., P.H., T.C.M.); and the Department of Chemistry, University of Washington, Seattle (M.H.G., H.K.)
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5
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Wright JR, Chan S, Morgen EK, Maung RTA, Brundler MA, El Demellawy D, Fraser RB, Kurek KC, Magee F, Nizalik E, Oligny LL, Somers GR, Stefanovici C, Terry J. Workload Measurement in Subspecialty Placental Pathology in Canada. Pediatr Dev Pathol 2022; 25:604-610. [PMID: 36082400 DOI: 10.1177/10935266221118150] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Workload measurement is important to help determine optimal staffing and workload distribution for pathology laboratories. The Level 4 Equivalent (L4E) System is the most widely used Anatomical Pathology (AP) workload measurement tool in Canada. However, it was initially not developed with subspecialties in mind. METHODS In 2016, a Pan-Canadian Pediatric-Perinatal Pathology Workload Committee (PCPPPWC) was organized to adapt the L4E System to assess Pediatric-Perinatal Pathology workload. Four working groups were formed. The Placental Pathology Working Group was tasked to develop a scheme for fair valuation of placental specimens signed out by subspecialists in the context of the L4E System. Previous experience, informal time and motion studies, a survey of Canadian Pediatric-Perinatal Pathologists, and interviews of Pathologists' Assistants (PA) informed the development of such scheme. RESULTS A workload measurement scheme with average L4E workload values for examination and reporting of singleton and multiple gestation placentas was proposed. The proposal was approved by the Canadian Association of Pathologist - Association canadienne des pathologistes Workload and Human Resources Committee for adoption into the L4E System. CONCLUSION The development of a workload measurement model for placental specimens provides an average and fair valuation of these specimen types, enabling its use for resource planning and workload distribution.
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Affiliation(s)
- James R Wright
- Alberta Children's Hospital (University of Calgary), Calgary, AB, Canada
| | - Suzanne Chan
- 37164Royal Alexandra Hospital (University of Alberta), Edmonton, AB, Canada
| | - Eric K Morgen
- Mount Sinai Hospital (University of Toronto), Toronto, ON, Canada
| | | | | | | | - Dina El Demellawy
- Children's Hospital of Eastern Ontario (University of Ottawa), Ottawa, ON, Canada
| | - Robert B Fraser
- 3682IWK Health Centre (Dalhousie University), Halifax, NS, Canada
| | - Kyle C Kurek
- Alberta Children's Hospital (University of Calgary), Calgary, AB, Canada
| | - Fergall Magee
- 7234Saskatoon Health Region (University of Saskatchewan), Saskatoon, SK, Canada
| | - Elizabeth Nizalik
- Children's Hospital of Eastern Ontario (University of Ottawa), Ottawa, ON, Canada
| | - Luc L Oligny
- 25461CHU Sainte-Justine (Université de Montréal), Montreal, QC, Canada
| | - Gino R Somers
- Hospital for Sick Children (University of Toronto), Toronto, ON, Canada
| | | | - Jefferson Terry
- British Columbia Children's & Woman's Hospital (University of British Columbia), Vancouver, BC, Canada *Current address: BioAge Labs, Richmond, CA
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6
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Jahangirnia A, Oltean I, Nasr Y, Islam N, Weir A, de Nanassy J, Nasr A, El Demellawy D. Peri-Operative Liver Fibrosis and Native Liver Survival in Pediatric Patients with Biliary Atresia: A Systematic Review and Meta-Analysis. Pediatr Gastroenterol Hepatol Nutr 2022; 25:353-375. [PMID: 36148293 PMCID: PMC9482824 DOI: 10.5223/pghn.2022.25.5.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/13/2022] [Accepted: 07/14/2022] [Indexed: 11/29/2022] Open
Abstract
No systematic review to date has examined histopathological parameters in relation to native liver survival in children who undergo the Kasai operation for biliary atresia (BA). A systematic review and meta-analysis is presented, comparing the frequency of native liver survival in peri-operative severe vs. non-severe liver fibrosis cases, in addition to other reported histopathology parameters. Records were sourced from MEDLINE, Embase, and CENTRAL databases. Studies followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and compared native liver survival frequencies in pediatric patients with evidence of severe vs. non-severe liver fibrosis, bile duct proliferation, cholestasis, lobular inflammation, portal inflammation, and giant cell transformation on peri-operative biopsies. The primary outcome was the frequency of native liver survival. A random effects meta-analysis was used. Twenty-eight observational studies were included, 1,171 pediatric patients with BA of whom 631 survived with their native liver. Lower odds of native liver survival in the severe liver fibrosis vs. non-severe liver fibrosis groups were reported (odds ratio [OR], 0.16; 95% confidence interval [CI], 0.08-0.33; I2 =46%). No difference in the odds of native liver survival in the severe bile duct destruction vs. non-severe bile duct destruction groups were reported (OR, 0.17; 95% CI, 0.00-63.63; I2 =96%). Lower odds of native liver survival were documented in the severe cholestasis vs. non-severe cholestasis (OR, 0.10; 95% CI, 0.01-0.73; I2 =80%) and severe lobular inflammation vs. non-severe lobular inflammation groups (OR, 0.02; 95% CI, 0.00-0.62; I2 =69%). There was no difference in the odds of native liver survival in the severe portal inflammation vs. non-severe portal inflammation groups (OR, 0.03; 95% CI, 0.00-3.22; I2 =86%) or between the severe giant cell transformation vs. non-severe giant cell transformation groups (OR, 0.15; 95% CI, 0.00-175.21; I2 =94%). The meta-analysis loosely suggests that the presence of severe liver fibrosis, cholestasis, and lobular inflammation are associated with lower odds of native liver survival in pediatric patients after Kasai.
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Affiliation(s)
| | - Irina Oltean
- Clinical Research Unit, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.,Department of Pathology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.,Department of Surgery, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Youssef Nasr
- Department of Pathology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Nayaar Islam
- Department of Pathology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Arielle Weir
- Clinical Research Unit, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Joseph de Nanassy
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,Department of Pathology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Ahmed Nasr
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,Clinical Research Unit, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.,Department of Surgery, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Dina El Demellawy
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,Clinical Research Unit, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.,Department of Pathology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
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7
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Sergi CM, Miller E, Demellawy DE, Shen F, Zhang M. Chronic recurrent multifocal osteomyelitis. A narrative and pictorial review. Front Immunol 2022; 13:959575. [PMID: 36072576 PMCID: PMC9441751 DOI: 10.3389/fimmu.2022.959575] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/27/2022] [Indexed: 11/30/2022] Open
Abstract
Chronic recurrent and multifocal osteomyelitis (CRMO) is a nonsporadic autoinflammatory disorder. Currently, it is diagnosed based on clinical, radiologic, pathological, and longitudinal data. Numerous aspects should be highlighted due to increased knowledge in imaging and immunology. We emphasize the use of whole-body MRI, which is a non-invasive diagnostic strategy. A literature review was carried out on longitudinal studies. Commonly, the mean age at diagnosis is 11 years, ranging between 3 and 17. The most common sites are the long bone metaphysis, particularly femoral and tibial metaphysis. In addition, the pelvis, spine, clavicle, and mandible may be involved. In long bones, the radiologic appearance can show typical structure, mixed lytic and sclerotic, sclerotic or lytic. It is frequently metaphyseal or juxta-physeal, with hyperostosis or periosteal thickening. The involvement of the vertebral skeleton is often multifocal. Therefore, whole-body MRI is essential in identifying subclinical lesions. CRMO is a polymorphic disorder in which whole-body MRI is beneficial to demonstrate subclinical edema. Vertebral collapse requires long-term monitoring.
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Affiliation(s)
- Consolato M. Sergi
- Anatomic Pathology Division, Children’s Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
- Department of Orthopedics, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, China
- *Correspondence: Consolato M. Sergi,
| | - Elka Miller
- Medical Imaging Department, Children’s Hospital of Eastern Ontario (CHEO), University of Ottawa, Ottawa, ON, Canada
| | - Dina El Demellawy
- Anatomic Pathology Division, Children’s Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - Fan Shen
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - Mingyong Zhang
- Department of Orthopedics, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, China
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8
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Osborne B, Oltean I, Sucha E, Mitsakakis N, Barrowman N, Bainbridge S, El Demellawy D. Association of distinct features of villitis of unknown etiology histopathology and fetal growth restriction diagnosis in a retrospective cohort from Eastern Ontario. Placenta 2022; 128:83-90. [DOI: 10.1016/j.placenta.2022.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 08/24/2022] [Indexed: 11/29/2022]
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9
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Spurr A, DeBiasio C, El Demellawy D, Gavigan G. An unusual case of pediatric embryonal rhabdomyosarcoma with subsequent diagnosis of neurofibromatosis type 1. Pediatr Dermatol 2022; 39:664-666. [PMID: 35504621 DOI: 10.1111/pde.15009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/01/2022] [Accepted: 03/29/2022] [Indexed: 11/29/2022]
Abstract
A 10-month-old girl presented with a 4-month history of a rapidly growing lesion on the lower lip. Initial assessment and Doppler ultrasound supported a diagnosis of pyogenic granuloma. However, emergent biopsy revealed an embryonal rhabdomyosarcoma, a highly malignant tumor commonly associated with cancer-susceptible syndromes including neurofibromatosis type 1 (NF1). Despite having no apparent clinical features of NF1 at initial presentation, she was later found to have multiple café-au-lait spots and a subsequent diagnosis of NF1 was made.
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Affiliation(s)
- Alison Spurr
- Division of Dermatology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Celina DeBiasio
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Dina El Demellawy
- Department of Pathology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.,University of Ottawa, Ottawa, Ontario, Canada
| | - Genevieve Gavigan
- Division of Dermatology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Division of Dermatology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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10
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Bardwell C, El Demellawy D, Oltean I, Murphy M, Agarwal A, Hamid JS, Reddy D, Barrowman N, de Nanassy J, Nasr A. Establishing normal ranges for fetal and neonatal small and large intestinal lengths: results from a prospective postmortem study. World Jnl Ped Surgery 2022; 5:e000397. [DOI: 10.1136/wjps-2021-000397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/22/2022] [Indexed: 11/03/2022] Open
Abstract
ObjectiveTo establish reference intervals (RIs) for fetal and neonatal small and large intestinal lengths.MethodsLinear measurements on small and large intestines were made upon postmortem examination of 131 preterm and term infants with gestational ages between 13 and 41 weeks. All cases were referred from the Eastern Ontario and Western Québec regions to a tertiary care hospital. Age and sex partitions were considered and RI limits were estimated.ResultsData consisted of 72 male (54.96%) and 59 female (45.04%) fetuses and neonates with mean gestational age of 25.6 weeks. Results showed that small and large intestinal lengths increased linearly with gestational age. RIs for small intestinal length (cm) of fetuses and neonates aged 13–20 weeks were (21.1, 122.4); of those aged 21–28 weeks were (57.7, 203.8); of those aged 29–36 weeks were (83.6, 337.1); and of those aged 37–41 weeks were (132.8, 406.4). RIs for large intestinal length (cm) of fetuses and neonates from the same four age groups were (5.1, 21.4), (12.7, 39.7), (32.4, 62.4), and (29.1, 82.2).ConclusionsEstablishing accurate RIs for premature and term infants has clinical relevance for pathologists performing postmortem analysis and for surgeons planning postoperative management of patients. The results of this study reaffirm that fetal small and large intestinal lengths increase linearly with gestational age irrespective of sex. Future studies should aim to further investigate the role of possible confounders on growth of fetal intestinal length, including maternal factors such as age and substance use during pregnancy.
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11
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El Demellawy D, Oltean I, Hayawi L, Agarwal A, Webster R, de Nanassy J, Chernetsova E. Evaluating the Prognostic Implication of the Collins Histology Scoring System in a Pediatric Eastern Ontario Population With Eosinophilic Esophagitis. Pediatr Dev Pathol 2022; 25:296-303. [PMID: 34974771 DOI: 10.1177/10935266211064698] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Collins et al developed a histology scoring system (EoE HSS) to assess multiple pathologic features. The aim of this study is to identify if the EoE HSS can better detect endoscopic and symptom improvement vs the Peak Eosinophilic Count (PEC). METHODS A retrospective chart review was performed for patients during 2014-2016. All patients ≤18 years old with a diagnosis of EoE and whose records included initial and follow-up upper gastrointestinal endoscopies were included. Severity and extent of endoscopic features were scored using 8 parameters, from normal to maximum change for each location of the esophageal biopsy. RESULTS Forty patients with EoE were included in the study, of which 35 (87.5%) patients demonstrated symptom and 25 (62.5%) endoscopic improvement at the time of follow-up. In the proximal esophagus, the EoE HSS outperformed the change in eosinophil count of the Children's Hospital of Eastern Ontario (CHEO) practice in predicting endoscopic improvement by 16.8% when examining the change in grade and 17.1% when examining the change in stage scores. CONCLUSIONS At our institution, adoption of the EoE HSS in assessing biopsies of EoE patients might be warranted, compared to the traditional practice. However, a bigger sample size may give a more robust difference in all locations.
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Affiliation(s)
- Dina El Demellawy
- Department of Pathology, 274065Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.,Faculty of Medicine, 12365University of Ottawa, Ottawa, ON, Canada
| | - Irina Oltean
- Department of Pathology, 274065Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.,Clinical Research Unit, 274065Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Lamia Hayawi
- Clinical Research Unit, 274065Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Amisha Agarwal
- Clinical Research Unit, 274065Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Richard Webster
- Clinical Research Unit, 274065Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Joseph de Nanassy
- Department of Pathology, 274065Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.,Clinical Research Unit, 274065Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Elizaveta Chernetsova
- Department of Pathology, 274065Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.,Faculty of Medicine, 12365University of Ottawa, Ottawa, ON, Canada
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12
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Brien ME, Bouron-Dal Soglio D, Dal Soglio S, Couture C, Boucoiran I, Nasr Y, Widdows K, Sharps MC, El Demellawy D, Heazell AE, Mottet N, Girard S. Corrigendum to "Pandemic stress and SARS-CoV-2 infection are associated with pathological changes at the maternal-fetal interface" [Placenta 115 (2021) 37-44]. Placenta 2022; 120:59. [PMID: 35217316 PMCID: PMC8863388 DOI: 10.1016/j.placenta.2022.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Marie-Eve Brien
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada; Department of Microbiology, Infectiology and Immunology, Universitee de Montreal, Montreal, Quebec, Canada
| | - Dorothee Bouron-Dal Soglio
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada; Department of Pathology and Cell Biology, Universite de Montreal, Montreal, Quebec, Canada
| | | | - Camille Couture
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada; Department of Microbiology, Infectiology and Immunology, Universitee de Montreal, Montreal, Quebec, Canada
| | - Isabelle Boucoiran
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada; Department of Obstetrics and Gynecology, Universite de Montreal, Montreal, Quebec, Canada; School of Public Health, Universite de Montreal, Montreal, Quebec, Canada
| | - Youssef Nasr
- University of Ottawa, Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Canada
| | - Kate Widdows
- Maternal and Fetal Health Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Megan C Sharps
- Maternal and Fetal Health Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Dina El Demellawy
- University of Ottawa, Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Canada; The Children's Hospital of Eastern Ontario, Department of Pathology and Laboratory Medicine, Ottawa, Canada
| | - Alexander Ep Heazell
- Maternal and Fetal Health Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Nicolas Mottet
- Department of Obstetrics and Gynecology, University Hospital Jean Minjoz, Besancon, France; Nanomedecine Laboratory, Imagery and Therapeutics, EA 4662, University of Franche-Comté, 25000, COMUE UBFC, France
| | - Sylvie Girard
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada; Department of Microbiology, Infectiology and Immunology, Universitee de Montreal, Montreal, Quebec, Canada; Department of Obstetrics and Gynecology, Universite de Montreal, Montreal, Quebec, Canada.
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13
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Kemps PG, Picarsic J, Durham BH, Hélias-Rodzewicz Z, Hiemcke-Jiwa L, van den Bos C, van de Wetering MD, van Noesel CJM, van Laar JAM, Verdijk RM, Flucke UE, Hogendoorn PCW, Woei-A-Jin FJSH, Sciot R, Beilken A, Feuerhake F, Ebinger M, Möhle R, Fend F, Bornemann A, Wiegering V, Ernestus K, Méry T, Gryniewicz-Kwiatkowska O, Dembowska-Baginska B, Evseev DA, Potapenko V, Baykov VV, Gaspari S, Rossi S, Gessi M, Tamburrini G, Héritier S, Donadieu J, Bonneau-Lagacherie J, Lamaison C, Farnault L, Fraitag S, Jullié ML, Haroche J, Collin M, Allotey J, Madni M, Turner K, Picton S, Barbaro PM, Poulin A, Tam IS, El Demellawy D, Empringham B, Whitlock JA, Raghunathan A, Swanson AA, Suchi M, Brandt JM, Yaseen NR, Weinstein JL, Eldem I, Sisk BA, Sridhar V, Atkinson M, Massoth LR, Hornick JL, Alexandrescu S, Yeo KK, Petrova-Drus K, Peeke SZ, Muñoz-Arcos LS, Leino DG, Grier DD, Lorsbach R, Roy S, Kumar AR, Garg S, Tiwari N, Schafernak KT, Henry MM, van Halteren AGS, Abla O, Diamond EL, Emile JF. ALK-positive histiocytosis: a new clinicopathologic spectrum highlighting neurologic involvement and responses to ALK inhibition. Blood 2022; 139:256-280. [PMID: 34727172 PMCID: PMC8759533 DOI: 10.1182/blood.2021013338] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/18/2021] [Indexed: 11/20/2022] Open
Abstract
ALK-positive histiocytosis is a rare subtype of histiocytic neoplasm first described in 2008 in 3 infants with multisystemic disease involving the liver and hematopoietic system. This entity has subsequently been documented in case reports and series to occupy a wider clinicopathologic spectrum with recurrent KIF5B-ALK fusions. The full clinicopathologic and molecular spectra of ALK-positive histiocytosis remain, however, poorly characterized. Here, we describe the largest study of ALK-positive histiocytosis to date, with detailed clinicopathologic data of 39 cases, including 37 cases with confirmed ALK rearrangements. The clinical spectrum comprised distinct clinical phenotypic groups: infants with multisystemic disease with liver and hematopoietic involvement, as originally described (Group 1A: 6/39), other patients with multisystemic disease (Group 1B: 10/39), and patients with single-system disease (Group 2: 23/39). Nineteen patients of the entire cohort (49%) had neurologic involvement (7 and 12 from Groups 1B and 2, respectively). Histology included classic xanthogranuloma features in almost one-third of cases, whereas the majority displayed a more densely cellular, monomorphic appearance without lipidized histiocytes but sometimes more spindled or epithelioid morphology. Neoplastic histiocytes were positive for macrophage markers and often conferred strong expression of phosphorylated extracellular signal-regulated kinase, confirming MAPK pathway activation. KIF5B-ALK fusions were detected in 27 patients, whereas CLTC-ALK, TPM3-ALK, TFG-ALK, EML4-ALK, and DCTN1-ALK fusions were identified in single cases. Robust and durable responses were observed in 11/11 patients treated with ALK inhibition, 10 with neurologic involvement. This study presents the existing clinicopathologic and molecular landscape of ALK-positive histiocytosis and provides guidance for the clinical management of this emerging histiocytic entity.
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Affiliation(s)
- Paul G Kemps
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Jennifer Picarsic
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Benjamin H Durham
- Human Oncology and Pathogenesis Program, Department of Medicine, and
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Zofia Hélias-Rodzewicz
- Department of Pathology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne, France
- EA4340-Biomarqueurs et Essais Cliniques en Cancérologie et Onco-Hématologie, Versailles Saint-Quentin-en-Yvelines University, Boulogne, France
| | | | - Cor van den Bos
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology, Emma Children's Hospital, and
| | - Marianne D van de Wetering
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology, Emma Children's Hospital, and
| | - Carel J M van Noesel
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Jan A M van Laar
- Department of Internal Medicine and Immunology, and
- Section of Clinical Immunology, Department of Immunology, and
| | - Robert M Verdijk
- Department of Pathology, Erasmus Medical Center University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Uta E Flucke
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - F J Sherida H Woei-A-Jin
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, Belgium
| | | | | | - Martin Ebinger
- Department I - General Pediatrics, Children's Hospital, Hematology and Oncology
| | | | - Falko Fend
- Department of Pathology and Neuropathology and Comprehensive Cancer Center, University Hospital Tuebingen, Tuebingen, Germany
| | - Antje Bornemann
- Department of Pathology and Neuropathology and Comprehensive Cancer Center, University Hospital Tuebingen, Tuebingen, Germany
| | - Verena Wiegering
- Department of Oncology, Hematology and Stem Cell Transplantation, University Children's Hospital Würzburg, Würzburg, Germany
| | - Karen Ernestus
- Department of Pathology, University of Würzburg and Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Tina Méry
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Klinikum Chemnitz, Chemnitz, Germany
| | | | | | - Dmitry A Evseev
- Dmitriy Rogachev National Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Vsevolod Potapenko
- Department of Hematology and Oncology, Municipal Educational Hospital N°31, Saint Petersburg, Russia
- Department of Bone Marrow Transplantation and
| | - Vadim V Baykov
- Department of Pathology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
| | - Stefania Gaspari
- Department of Hematology/Oncology, Cell and Gene Therapy, Bambino Gesù Children's Hospital Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Sabrina Rossi
- Pathology Unit, Laboratories Department, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | | | - Gianpiero Tamburrini
- Department of Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Sébastien Héritier
- Department of Pediatric Hematology and Oncology, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean Donadieu
- EA4340-Biomarqueurs et Essais Cliniques en Cancérologie et Onco-Hématologie, Versailles Saint-Quentin-en-Yvelines University, Boulogne, France
- Department of Pediatric Hematology and Oncology, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Claire Lamaison
- Department of Pathology, Rennes University Hospital, Rennes, France
| | - Laure Farnault
- Department of Hematology, La Conception, University Hospital of Marseille, Marseille, France
| | - Sylvie Fraitag
- Department of Pathology, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marie-Laure Jullié
- Department of Pathology, University Hospital of Bordeaux, Bordeaux, France
| | - Julien Haroche
- Department of Internal Medicine, University Hospital La Pitié-Salpêtrière Paris, French National Reference Center for Histiocytoses, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Matthew Collin
- Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom
| | | | - Majid Madni
- Department of Pediatric Hematology and Oncology, Nottingham University Hospitals, Nottingham, United Kingdom
| | | | - Susan Picton
- Department of Pediatric Oncology, Leeds Children's Hospital, Leeds, United Kingdom
| | - Pasquale M Barbaro
- Department of Hematology, Queensland Children's Hospital, Brisbane, QLD, Australia
| | - Alysa Poulin
- Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Ingrid S Tam
- Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Dina El Demellawy
- Department of Pathology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Brianna Empringham
- Department of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - James A Whitlock
- Department of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | | | - Amy A Swanson
- Division of Anatomic Pathology, Mayo Clinic Rochester, Rochester, MN
| | - Mariko Suchi
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI
| | - Jon M Brandt
- Department of Pediatric Oncology, Hospital Sisters Health System St Vincent Children's Hospital, Green Bay, WI
| | - Nabeel R Yaseen
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Joanna L Weinstein
- Department of Hematology, Oncology and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Irem Eldem
- Department of Pediatric Hematology and Oncology, St Louis Children's Hospital, Washington University in St Louis, St Louis, MO
| | - Bryan A Sisk
- Department of Pediatric Hematology and Oncology, St Louis Children's Hospital, Washington University in St Louis, St Louis, MO
| | - Vaishnavi Sridhar
- Department of Pediatric Hematology and Oncology, Carilion Children's Pediatric Hematology and Oncology, Roanoke, VA
| | - Mandy Atkinson
- Department of Pediatric Hematology and Oncology, Carilion Children's Pediatric Hematology and Oncology, Roanoke, VA
| | - Lucas R Massoth
- Department of Pathology, Massachusetts General Hospital, and
| | - Jason L Hornick
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Sanda Alexandrescu
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- Department of Pathology, Boston Children's Hospital, Boston, MA
| | - Kee Kiat Yeo
- Department of Pediatric Oncology, Dana Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA
| | | | - Stephen Z Peeke
- Department of Hematology and Medical Oncology, Maimonides Medical Center, Brooklyn, NY
| | - Laura S Muñoz-Arcos
- Department of Internal Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Daniel G Leino
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - David D Grier
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Robert Lorsbach
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Somak Roy
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Ashish R Kumar
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | | | | | | | - Michael M Henry
- Center for Cancer and Blood Disorders, Phoenix Children's Hospital, Phoenix, AZ
| | - Astrid G S van Halteren
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands; and
| | - Oussama Abla
- Department of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Eli L Diamond
- Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Jean-François Emile
- Department of Pathology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne, France
- EA4340-Biomarqueurs et Essais Cliniques en Cancérologie et Onco-Hématologie, Versailles Saint-Quentin-en-Yvelines University, Boulogne, France
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14
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Gupta N, Martinez-Rios C, El Demellawy D, Barrowman N, Miller E. Diagnostic Evaluation of the Posterior Fossa with Antenatal and Post-Mortem MRI: An Unfolded View. J Fetal Med 2022. [DOI: 10.1007/s40556-021-00329-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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Castle AMR, Ramien ML, Kanigsberg N, El Demellawy D, McGowan-Jordan J, Beaulieu Bergeron M, Armour CM. Porokeratotic eccrine ostial and dermal duct nevus associated with an 11 megabase 3p deletion. Pediatr Dermatol 2022; 39:107-111. [PMID: 34929758 DOI: 10.1111/pde.14850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/04/2021] [Accepted: 10/17/2021] [Indexed: 11/28/2022]
Abstract
Porokeratotic eccrine ostial and dermal duct nevus (PEODDN) is a rare eccrine hamartoma; the etiology is incompletely understood. A patient presented with congenital, widespread PEODDN. Clinical assessment, histopathologic, cytogenetic, and molecular genetic investigations on affected cells were pursued. Histopathology confirmed PEODDN, and chromosomal microarray on affected tissues identified a mosaic 3p26.3p25.3 deletion in affected tissues. This 11Mb deletion encompasses 47 OMIM genes. We propose that this and other chromosomal deletions may be implicated in some cases of PEODDN, suggesting locus heterogeneity and underscoring the importance of incorporating cytogenetic and molecular investigations into the multidisciplinary care of individuals with suspected mosaic genetic skin disorders.
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Affiliation(s)
- Alison M R Castle
- Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Michele L Ramien
- Division of Community Pediatrics, Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Nordau Kanigsberg
- Division of Dermatology and Rheumatology, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Dina El Demellawy
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jean McGowan-Jordan
- Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.,Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Melanie Beaulieu Bergeron
- Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.,Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Christine M Armour
- Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.,Prenatal Screening Ontario (PSO), Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Ontario, Canada.,Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Ontario, Canada
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16
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Mavedatnia D, Tran J, Oltean I, Bijelić V, Moretti F, Lawrence S, El Demellawy D. Impact of Co-Existing Placental Pathologies in Pregnancies Complicated by Placental Abruption and Acute Neonatal Outcomes. J Clin Med 2021; 10:5693. [PMID: 34884395 PMCID: PMC8658381 DOI: 10.3390/jcm10235693] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 11/30/2022] Open
Abstract
Placental abruption (PA) is a concern for maternal and neonatal morbidity. Adverse neonatal outcomes in the setting of PA include higher risk of prematurity. Placental pathologies include maternal vascular malperfusion (MVM), fetal vascular malperfusion (FVM), acute chorioamnionitis, and villitis of unknown etiology (VUE). We aimed to investigate how placental pathology contributes to acute neonatal outcome in PA. A retrospective cohort study of all placentas with PA were identified. Exposures were MVM, FVM, acute chorioamnionitis and VUE. The primary outcome was NICU admission and the secondary outcomes included adverse base deficit and Apgar scores, need for resuscitation, and small-for-gestational age. A total of 287 placentas were identified. There were 160 (59.9%) of placentas with PA alone vs 107 (40.1%) with PA and additional placental pathologies. Odds of NICU admission were more than two times higher in pregnancies with placental pathologies (OR = 2.37, 95% CI 1.28-4.52). These estimates were in large part mediated by prematurity and birthweight, indirect effect acting through prematurity was OR 1.79 (95% CI 1.12-2.75) and through birthweight OR 2.12 (95% CI 1.40-3.18). Odds of Apgar score ≤ 5 was more than four times higher among pregnancies with placental pathologies (OR = 4.56, 95% CI 1.28-21.26). Coexisting placental pathology may impact Apgar scores in pregnancies complicated by PA. This knowledge could be used by neonatal teams to mobilize resources in anticipation of the need for neonatal resuscitation.
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Affiliation(s)
- Dorsa Mavedatnia
- Department of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (D.M.); (J.T.); (F.M.)
| | - Jason Tran
- Department of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (D.M.); (J.T.); (F.M.)
| | - Irina Oltean
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada; (I.O.); (V.B.)
- Department of Pathology, Children’s Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada
| | - Vid Bijelić
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada; (I.O.); (V.B.)
| | - Felipe Moretti
- Department of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (D.M.); (J.T.); (F.M.)
| | - Sarah Lawrence
- Department of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (D.M.); (J.T.); (F.M.)
| | - Dina El Demellawy
- Department of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (D.M.); (J.T.); (F.M.)
- Department of Pathology, Children’s Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada
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17
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Taori A, Shenouda N, Demellawy DE, Putnins R. Concurrent Extramedullary Hematopoiesis and Pseudometastatic Hypervascular Lesions Masquerading as Metastases in Liver in a Case of Neuroblastoma. Indian J Radiol Imaging 2021; 31:714-718. [PMID: 34790321 PMCID: PMC8590576 DOI: 10.1055/s-0041-1736400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/30/2022] Open
Abstract
Neuroblastoma is a common embryonic tumor presenting in childhood. Improving treatment protocols which include a combination of chemotherapy, surgical resection, hematopoietic stem cell rescue, and radiation therapy have tremendously improved outcomes. Childhood survivors are at risk of developing lesions which may mimic metastases. It is essential to accurately diagnose these due to its prognostic implications.
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Affiliation(s)
- Abhijeet Taori
- Department of Medical Imaging, CHEO, University of Ottawa, Ontario, Canada
| | - Nazih Shenouda
- Department of Medical Imaging, CHEO, University of Ottawa, Ontario, Canada
| | - Dina El Demellawy
- Department of Pathology, CHEO, University of Ottawa, Ontario, Canada
| | - Rita Putnins
- Department of Medical Imaging, CHEO, University of Ottawa, Ontario, Canada
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18
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Ruschkowski B, Nasr A, Oltean I, Lawrence S, El Demellawy D. Examining the Relationship Between Gastroschisis and Placental Fetal Vascular Malperfusion. Pediatr Dev Pathol 2021; 24:531-541. [PMID: 34284667 PMCID: PMC8652372 DOI: 10.1177/10935266211029629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Gastroschisis is a congenital malformation characterized by intestinal herniation through an abdominal wall defect. Despite its unknown pathogenesis, known risk factors include maternal smoking, alcohol use, and young maternal age. Previous work has shown that gastroschisis is associated with placental delayed villous maturation, and the goal of this study was to assess for additional associated placental pathologies that may help clarify the pathogenesis of gastroschisis. METHODS We conducted a retrospective slide review of 29 placentas of neonates with gastroschisis. Additionally, we reviewed pathology reports from one control group of 30 placentas with other congenital malformations. Gross and histological data were collected based on a standardized rubric. RESULTS Gastroschisis was associated with increased placental fetal vascular malperfusion (FVM) in 62% of cases (versus 0% of controls, p < 0.0001). It was also associated with increased placental villous maldevelopment in 76% of cases (versus 3% of controls, p < 0.0001). CONCLUSION Our study demonstrates an association between gastroschisis and FVM. While FVM could be the consequence of vascular disruption due to the ventral location of gastroschisis, it could also reflect estrogen-induced thrombosis in early pregnancy. Further research is needed to separate these possibilities and determine the cause of the placental FVM observed in gastroschisis.
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Affiliation(s)
| | - Ahmed Nasr
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada,Department of Pediatric Surgery, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Irina Oltean
- Department of Pediatric Surgery, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Sarah Lawrence
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada,Department of Pediatrics, Neonatology Division, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Dina El Demellawy
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada,Department of Pathology, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada,Dina El Demellawy, Department of Pathology, Children's Hospital of Eastern Ontario, Ottawa, Ontario K1H 8L1, Canada.
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19
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Mery E, Dancey S, Esteves A, Oltean I, Hayawu L, Tang K, Bainbridge S, El Demellawy D. Histopathology findings in pregnancies with placental disease according to recipient versus donor oocyte derivation for in vitro fertilization. Placenta 2021. [DOI: 10.1016/j.placenta.2021.07.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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20
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Dancey S, Mery E, Esteves A, Oltean I, Hayawi L, Tang K, Bainbridge S, El Demellawy D. Placenta pathology in recipient versus donor oocyte derivation for in vitro fertilization in a setting of hypertensive disorders of pregnancy and IUGR. Placenta 2021; 108:114-121. [PMID: 33865182 DOI: 10.1016/j.placenta.2021.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Assisted reproductive technology including in vitro fertilization (IVF) and oocyte donation (OD) may increase risk for placenta-mediated diseases. Comprehensive analysis of histopathological placental lesions according to source of oocytes used in the IVF procedure - recipient derived (RD-IVF) vs oocyte donation (OD-IVF), has not been conducted in a population with a hypertensive disorder of pregnancy (HDP) and/or intrauterine growth restriction (IUGR). METHODS A retrospective cohort study of archived placenta specimens from RD-IVF and OD-IVF pregnancies affected by HDP and/or IUGR was conducted with blinded histopathological placental examination. Three categories of lesions were differentiated and defined as main outcomes: maternal vascular malperfusion (MVM), chronic inflammation, and fetal vascular malperfusion (FVM). To determine the relationship between conception method and placental lesions, multivariable regressions were performed with maternal age, gestational age, HDP, birth and placental weight percentiles as model covariates. RESULTS 115 placentas were included 83 (72.2%) RD-IVF, 32 (27.8%) OD-IVF. Adjusted OR (aOR) for conception method was 5.05 (95%CI 0.58-43.90, p=0.142) for MVM, 1.87 (95%CI 0.68-5.15, p=0.228) for chronic inflammatory and 0.61 (95%CI 0.15-2.37, p=0.471) for FVM lesions. Multiple gestation demonstrated borderline association with MVM (aOR=0.24, 95%CI 0.04-1.51, p=0.129) and total pathology score (aRR=0.79, 95%CI 0.62-1.01, p=0.058). Subgroup analysis suggested greater odds of villitis of unknown etiology (VUE) for OD-IVF (aOR=2.98, 95%CI 1.12-7.93, p=0.029). DISCUSSION Source of oocyte derivation demonstrated no evidence of association with main outcomes in cases of HDP and/or IUGR. Subgroup analysis demonstrated increased rates of inflammatory lesions for OD-IVF. Multiple gestation may be associated with decreased MVM and total lesions.
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Affiliation(s)
- Sonia Dancey
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON K1H 8M5, Canada.
| | - Erika Mery
- Faculty of Health Sciences, University of Ottawa, 25 University Private, Ottawa, ON K1N 7K4, Canada.
| | - Ashley Esteves
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON K1H 8M5, Canada.
| | - Irina Oltean
- Department of Pathology, University of Ottawa, Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON K1H 8L1, Canada.
| | - Lamia Hayawi
- Clinical Research Unit, Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON K1H 8L1, Canada.
| | - Ken Tang
- Clinical Research Unit, Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON K1H 8L1, Canada.
| | - Shannon Bainbridge
- Faculty of Health Sciences, University of Ottawa, 25 University Private, Ottawa, ON K1N 7K4, Canada.
| | - Dina El Demellawy
- Department of Pathology, University of Ottawa, Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON K1H 8L1, Canada.
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21
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Oltean I, Tran J, Lawrence S, Ruschkowski BA, Zeng N, Bardwell C, Nasr Y, de Nanassy J, El Demellawy D. Impact of SARS-CoV-2 on the clinical outcomes and placental pathology of pregnant women and their infants: A systematic review. Heliyon 2021; 7:e06393. [PMID: 33688585 PMCID: PMC7923950 DOI: 10.1016/j.heliyon.2021.e06393] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/18/2020] [Accepted: 02/25/2021] [Indexed: 01/08/2023] Open
Abstract
Pregnant women are susceptible to viral infections due to physiological changes such as cell-mediated immunity. No severe adverse pregnancy or neonatal outcomes have been consistently reported in 2019 novel coronavirus disease (COVID-19) positive pregnancy cases. There are controversies around the role of COVID-19 in pregnancy. A systematic review was conducted to examine clinical maternal and neonatal clinical outcomes. Studies were included if they reported SARS-CoV-2 infection among pregnant women and/or COVID-19 positive neonates as validated by positive antibody testing or viral testing using polymerase chain reaction. Case series, case reports, case-control studies, and comparative studies were included. Eight hundred and thirty-seven records were identified, resulting in 525 records for level I screening. Forty-one were included after full-text review. Results suggest elevated rates of intensive care unit (ICU) admission, gestational diabetes, preeclampsia, C-sections, pre-term birth, and C-reactive protein (CRP) in comparison to pregnant women without SARS-CoV-2. Careful monitoring of pregnancies with SARS-CoV-2 is recommended.
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Affiliation(s)
- Irina Oltean
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, K1H 8L1, Canada
| | - Jason Tran
- Department of Medicine, University of Ottawa, Ottawa, Ontario, K1H 8M5 Canada
| | - Sarah Lawrence
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, K1H 8L1, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, K1H 8M5 Canada
- Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, K1H 8L1, Canada
| | | | - Na Zeng
- Department of Medicine, University of Ottawa, Ottawa, Ontario, K1H 8M5 Canada
| | - Cameron Bardwell
- Department of Medicine, University of Ottawa, Ottawa, Ontario, K1H 8M5 Canada
| | - Youssef Nasr
- Department of Medicine, University of Ottawa, Ottawa, Ontario, K1H 8M5 Canada
| | - Joseph de Nanassy
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, K1H 8L1, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, K1H 8M5 Canada
- Department of Pathology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, K1H 8L1, Canada
| | - Dina El Demellawy
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, K1H 8L1, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, K1H 8M5 Canada
- Department of Pathology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, K1H 8L1, Canada
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22
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Perreault S, Chami R, Deyell RJ, El Demellawy D, Ellezam B, Jabado N, Morgenstern DA, Narendran A, Sorensen PHB, Wasserman JD, Yip S. Canadian Consensus for Biomarker Testing and Treatment of TRK Fusion Cancer in Pediatric Patients. Curr Oncol 2021; 28:346-366. [PMID: 33435412 PMCID: PMC7903261 DOI: 10.3390/curroncol28010038] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/03/2021] [Accepted: 01/05/2021] [Indexed: 12/11/2022] Open
Abstract
Neurotrophic tyrosine receptor kinase gene fusions (NTRK) are oncogenic drivers present at a low frequency in most tumour types (<5%), and at a higher frequency (>80%) in a small number of rare tumours (e.g., infantile fibrosarcoma [IFS]) and considered mutually exclusive with other common oncogenic drivers. Health Canada recently approved two tyrosine receptor kinase (TRK) inhibitors, larotrectinib (for adults and children) and entrectinib (for adults), for the treatment of solid tumours harbouring NTRK gene fusions. In Phase I/II trials, these TRK inhibitors have demonstrated promising overall response rates and tolerability in patients with TRK fusion cancer who have exhausted other treatment options. In these studies, children appear to have similar responses and tolerability to adults. In this report, we provide a Canadian consensus on when and how to test for NTRK gene fusions and when to consider treatment with a TRK inhibitor for pediatric patients with solid tumours. We focus on three pediatric tumour types: non-rhabdomyosarcoma soft tissue sarcoma/unspecified spindle cell tumours including IFS, differentiated thyroid carcinoma, and glioma. We also propose a tumour-agnostic consensus based on the probability of the tumour harbouring an NTRK gene fusion. For children with locally advanced or metastatic TRK fusion cancer who have either failed upfront therapy or lack satisfactory treatment options, TRK inhibitor therapy should be considered.
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Affiliation(s)
- Sébastien Perreault
- Department of Neurosciences, Division of Child Neurology CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
| | - Rose Chami
- Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada;
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Rebecca J. Deyell
- Division of Pediatric Hematology, Oncology and Bone Marrow Transplant, British Columbia Children’s Hospital and Research Institute, Vancouver, BC V6H 3N1, Canada;
| | - Dina El Demellawy
- Pathology Department, Children’s Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada;
| | - Benjamin Ellezam
- Department of Pathology, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, QC H3T 1C5, Canada;
| | - Nada Jabado
- Department of Pediatric Hematology-Oncology, MUHC, Montreal, QC H4A 3J1, Canada;
| | - Daniel A. Morgenstern
- Division of Pediatric Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada;
| | - Aru Narendran
- Departments of Pediatrics, Oncology and, Biochemistry and Molecular Biology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada;
| | - Poul H. B. Sorensen
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Department of Molecular Oncology, BC Cancer, Vancouver, BC V5Z 1L3, Canada;
| | - Jonathan D. Wasserman
- Division of Endocrinology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada;
| | - Stephen Yip
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
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Chernetsova E, Agarwal A, Weir A, Oltean I, Barkey J, Demellawy DE. Diagnostic Value of Mid-esophageal Biopsies in Pediatric Patients With Eosinophilic Esophagitis. Pediatr Dev Pathol 2021; 24:34-42. [PMID: 33496644 DOI: 10.1177/1093526620961359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Eosinophilic esophagitis (EoE) is histologically defined as the presence of 15 or more intraepithelial eosinophils per high-power fields. Limited consensus exists on where to sample the esophagus in pediatrics. This study aimed to identify whether endoscopic and histologic examination of the mid esophagus offers diagnostic value compared to proximal/distal esophageal biopsies. METHODS A retrospective chart review of pediatric patients with EoE was performed. Endoscopic and histologic parameters were assessed at the initial and follow-up visits, and concordance between proximal/distal biopsy and mid biopsy was determined. RESULTS A total of 100 patients with a mean age of 9.6 ± 4.07 years were included. Endoscopic parameters between proximal/distal and mid esophagus were concordant in 84% to 97% of patients (initial assessment) and in 80% to 97% of patients (at follow-up). Mid esophagus showed endoscopic abnormalities, which were absent at the proximal/distal esophagus in 1% to 5% of patients, as well as histologic abnormalities in 2% to 8% of patients overall at initial and follow-up examinations. CONCLUSIONS We recommend continued endoscopic and histologic assessment of the proximal/distal biopsy; however, examination of the mid esophagus does offer small diagnostic value in our subset of patients. Future studies need to be conducted before conclusive recommendations supporting the use of mid-esophageal biopsies can be made.
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Affiliation(s)
- Elizaveta Chernetsova
- Department of Pathology, University of Ottawa, Ottawa, Ontario, Canada.,Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Amisha Agarwal
- Department of Pathology, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Arielle Weir
- Department of Pathology, University of Ottawa, Ottawa, Ontario, Canada.,Department of Pathology, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Irina Oltean
- Department of Pathology, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Janet Barkey
- Department of Pathology, University of Ottawa, Ottawa, Ontario, Canada.,Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Dina El Demellawy
- Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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24
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Esteves A, Rozon C, Clancy J, Liao Y, Wen SW, Fung KFK, El Demellawy D. Abnormal placental pathological findings and adverse clinical outcomes of oocyte donation. Placenta 2020; 101:169-175. [PMID: 33007665 DOI: 10.1016/j.placenta.2020.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/08/2020] [Accepted: 09/10/2020] [Indexed: 10/23/2022]
Abstract
We sought to assess chronic inflammatory responses in patients who achieved pregnancy by oocyte donation and non-oocyte donation-assisted reproductive technology and delivered at The Ottawa Hospital. Data describing maternal health, obstetrical outcomes, neonatal outcomes, and placental pathology were collected and analyzed from electronic medical records. An increased frequency of adverse obstetrical outcomes was observed. In the oocyte donation-assisted reproductive technology group, placental pathology data demonstrated increased frequency of fetal vascular malperfusion (p = 0.02) and placenta accreta (p < 0.001), representing a chronic inflammatory response. Placental pathology reflecting dysregulated immune processes and vasculopathy is associated with oocyte donation.
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Affiliation(s)
- Ashley Esteves
- Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - Chloé Rozon
- Department of Obstetrics and Gynecology, The Ottawa Hospital, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - Jennifer Clancy
- Department of Obstetrics and Gynecology, The Ottawa Hospital, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - Yan Liao
- OMNI Research Group, Department of Obstetrics & Gynecology, University of Ottawa Faculty of Medicine, ON, Canada
| | - Shi Wu Wen
- OMNI Research Group, Department of Obstetrics & Gynecology, University of Ottawa Faculty of Medicine, ON, Canada
| | - Karen Fung-Kee Fung
- Department of Obstetrics and Gynecology, The Ottawa Hospital, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - Dina El Demellawy
- Department of Pediatric Pathology, Children's Hospital of Eastern Ontario, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
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25
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Cyr J, Langley A, Demellawy DE, Ramien M. A neonate with Langerhans cell histiocytosis presenting as blueberry muffin rash: Case report and review of the literature. SAGE Open Med Case Rep 2020; 8:2050313X20919616. [PMID: 32547754 PMCID: PMC7273623 DOI: 10.1177/2050313x20919616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
In our case report, we discuss a 1-day-old boy presenting with blueberry muffin
syndrome diagnosed with Langerhans cell histiocytosis. The diagnosis complicated
by an initial difficult-to-interpret biopsy showing only a hint of
perifollicular CD1a-positive cells; however, given our team’s strong clinical
suspicion of Langerhans cell histiocytosis, a second biopsy of a more mature
lesion was done and showed typical histopathology. This case introduces the
possibility of perifollicular Langerhans cells early in this condition,
demonstrates the importance of appropriate biopsy site selection, and highlights
the importance of maintaining a high degree of suspicion when there is poor
clinicopathologic correlation. Our case report contains a comprehensive table
which reviews the systemic and cutaneous clinical features, as well as the
laboratory, pathology, and imaging findings for the differential diagnoses of
blueberry muffin baby.
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Affiliation(s)
- Janelle Cyr
- Division of Dermatology, University of Toronto, Ottawa, ON, Canada
| | - Annie Langley
- Division of Dermatology, The Ottawa Hospital, Ottawa, ON, Canada
| | - Dina El Demellawy
- Division of Pathology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Michele Ramien
- Division of Dermatology, The Ottawa Hospital, Ottawa, ON, Canada.,Division of Rheumatology and Dermatology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
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26
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Abstract
Gastroschisis is a congenital abnormality characterized by visceral herniation through an abdominal wall defect. While the cause of gastroschisis is unknown, it has been linked to risk factors including young maternal age, smoking, and alcohol use during pregnancy. To date, the only established placental correlate is amniocyte vacuolization. Based on our clinical experience, we hypothesized that delayed villous maturation (DVM) is also associated with gastroschisis. We conducted a retrospective slide review of 23 placentas of neonates with gastroschisis. Additionally, we selected 2 control groups of placentas: 1 with a previous diagnosis of DVM and 1 with normal villous morphology. All placentas were randomized and reviewed by 2 perinatal pathologists, who were blinded to the group; DVM and amniocyte vacuolization were assessed. Gastroschisis was associated with increased placental DVM in 65.2% of cases (vs 13.6% of controls; P = .0007) and increased amniocyte vacuolization in 52.2% of cases (vs 9.1% of controls; P = .003) compared to the control group. Based on the normal and DVM groups, kappa agreement between current slide review and initial pathology diagnosis was 0.419, indicating moderate agreement. Our study shows that gastroschisis is associated with placental DVM. This association may be due to (1) a common upstream factor contributing to both gastroschisis and DVM or (2) DVM may be a consequence of the altered placental and amniotic environment in the context of gastroschisis.
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Affiliation(s)
| | | | - Dina El Demellawy
- Department of Pathology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - David Grynspan
- Department of Pathology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
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27
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Al Shammary M, Shaw A, Bacal V, Menzies-Toman D, Rozon C, Weir A, Tang K, de Nanassy J, El Demellawy D. Risk of Lower Birth Weight and Shorter Gestation in Oocyte Donation Pregnancies Compared With Other Assisted Reproductive Technology Methods: Systematic Review. J Obstet Gynaecol Can 2019; 42:889-899.e1. [PMID: 31882287 DOI: 10.1016/j.jogc.2019.08.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/29/2019] [Accepted: 08/30/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Oocyte donation (OD) is associated with an increased risk of pregnancy-induced hypertension, but the evidence of an association between OD and infant outcomes, including birth weight and gestational age, is conflicting. This study sought to determine the associations between oocyte donation and birth weight or gestational age compared with other forms of autologous oocyte assisted reproductive technology (ART). METHODS Medline, Embase, and the CENTRAL Trials Registry of the Cochrane Collaboration were searched using a comprehensive search strategy. Studies of women over 24 weeks gestation compared infant outcomes among OD pregnancies versus other ART. Study quality was assessed, and a meta-analysis of mean birth weight and gestational age was conducted using a random effects model. RESULTS Nineteen studies were included. Four studies showed a significant association between OD and lower birth weights, and five studies found significant differences in gestational age between OD and autologous oocyte ART. The pooled difference in birth weight means between OD and autologous ART was -42 (-88, 4) . The pooled difference in gestational age was -0.4 weeks (-0.8, 0.0 weeks). CONCLUSION A high degree of interstudy heterogeneity exists, and the association between OD and infant outcomes remains unclear.
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Affiliation(s)
- Mofeedah Al Shammary
- Department of Obstetrics and Gynecology, King Fahad Specialist Hospital- Dammam, Damman, Saudi Arabia
| | - Ashley Shaw
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON
| | - Vanessa Bacal
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON
| | | | - Chloé Rozon
- Pathology Department, Children's Hospital of Eastern Ontario, Ottawa, ON
| | - Arielle Weir
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON; Pathology Department, Children's Hospital of Eastern Ontario, Ottawa, ON
| | - Ken Tang
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON
| | - Joseph de Nanassy
- Pathology Department, Children's Hospital of Eastern Ontario, Ottawa, ON
| | - Dina El Demellawy
- Pathology Department, Children's Hospital of Eastern Ontario, Ottawa, ON.
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28
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Abstract
We report a rare case of sclerosing pneumocytoma occurring in a child with PTEN mutation. A 13-year-old female presented to the emergency department of an adult hospital following 2 to 3 days of upper respiratory tract infection symptoms. A primary lung lesion was discovered during her initial chest X-ray to rule out pneumonia. The patient underwent an uneventful thoracoscopic right upper lobe segmentectomy. The pathology demonstrated a sclerosing pneumocytoma of the lung. She tested positive for PTEN hamartoma tumor syndrome with a pathogenic variant at c.388 C > T. The PTEN mutation was also identified in the sclerosing pneumocytoma. Further study of PTEN mutation in sclerosing pneumocytoma is warranted.
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Affiliation(s)
- Youssef Nasr
- Biomedical Sciences Program, Faculty of Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Marcos Bettoli
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Department of Pediatric Surgery, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Dina El Demellawy
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Department of Pediatric Surgery, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Harman Sekhon
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Department of Pathology, The Ottawa Hospitals, Ottawa, Ontario, Canada
| | - Joseph de Nanassy
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Department of Pediatric Pathology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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29
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Chen HC, Brownstein S, Tang T, Grynspan D, Belliveau MJ, El Demellawy D, O'Connor M. Pilomatrixoma of the ocular adnexa: report of 3 cases with variations in the histopathological findings. Can J Ophthalmol 2019; 54:413-416. [PMID: 31358136 DOI: 10.1016/j.jcjo.2018.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 10/14/2018] [Accepted: 10/22/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To report the clinical and variations in the histopathological features of pilomatrixoma of the ocular adnexa in 3 young individuals. DESIGN A retrospective case series was performed with clinical, histological, and immunohistochemical analysis. PARTICIPANTS Case 1 is an 18-year-old male who presented with a reddish-blue swelling under the left eyebrow. The lesion measured 2 × 1 cm. Case 2 is a 2-year-old female who presented with a reddish-blue nodule inferior to the right eyebrow with telangiectatic vessels. The lesion measured 6 × 4 × 4 mm. Case 3 is a 14-year-old female who presented with a subcutaneous lesion under the right upper eyebrow with fluctuating inflammation. The lesion measured 12 × 3 × 2 mm. Histopathological examination of case 1 disclosed peripheral basaloid cells and central shadow cells containing calcific foci, separated by a transition zone. In case 2, histopathological analysis revealed central calcific foci in islands of shadow cells with more peripheral basaloid cells. In case 3, we observed numerous clusters of shadow cells with focal calcifications, as well as basaloid cells in a disorganized configuration. CONCLUSION Pilomatrixoma is an uncommon benign skin neoplasm originating from the matrix of the hair root. We describe a spectrum of histopathological findings in pilomatrixoma of the ocular adnexal in 3 young individuals.
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Affiliation(s)
- Henry C Chen
- Departments of Ophthalmology, The Ottawa Hospital and University of Ottawa, Ottawa, Ont.; Departments of Pathology and Laboratory Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, Ont
| | - Seymour Brownstein
- Departments of Ophthalmology, The Ottawa Hospital and University of Ottawa, Ottawa, Ont.; Departments of Pathology and Laboratory Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, Ont..
| | - Tina Tang
- Departments of Ophthalmology, The Ottawa Hospital and University of Ottawa, Ottawa, Ont.; Departments of Pathology and Laboratory Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, Ont
| | - David Grynspan
- Departments of Pathology and Laboratory Medicine, The Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Ont
| | - Michel J Belliveau
- Departments of Ophthalmology, The Ottawa Hospital and University of Ottawa, Ottawa, Ont
| | - Dina El Demellawy
- Departments of Pathology and Laboratory Medicine, The Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Ont
| | - Michael O'Connor
- Departments of Ophthalmology, The Ottawa Hospital and University of Ottawa, Ottawa, Ont.; Departments of Ophthalmology, The Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Ont
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30
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Wang Y, Le A, El Demellawy D, Shago M, Odell M, Johnson-Obaseki S. An aggressive central giant cell granuloma in a pediatric patient: case report and review of literature. J Otolaryngol Head Neck Surg 2019; 48:32. [PMID: 31319877 PMCID: PMC6637537 DOI: 10.1186/s40463-019-0356-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 07/09/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Central giant cell granulomas are benign tumours of the mandible, presenting in children and young adults. Divided into non- and aggressive subtypes, the aggressive subtype is relatively rare and can occasionally progress rapidly, resulting in significant morbidity. CASE PRESENTATION We present a case of an aggressive central giant cell granuloma (CGCG) in a six year-old female. The lesion originated in the right mandibular ramus and progressed rapidly to involve the condyle. Diagnosis was made using a combination of imaging and pathology. A timely en bloc resection of the hemi-mandible was performed with placement of a reconstructive titanium plate and condylar prosthesis. CONCLUSION Our case demonstrates the importance of considering CGCG in the differential diagnosis of rapidly progressive mandibular lesions in the pediatric population. Prompt diagnosis and management can greatly improve long-term outcomes.
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Affiliation(s)
- Yiqiao Wang
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Andre Le
- Department of Otolaryngology – Head and Neck Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Dina El Demellawy
- Department of Pathology, Children’s Hospital of Eastern Ontario, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Mary Shago
- Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Michael Odell
- Department of Otolaryngology – Head and Neck Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Stephanie Johnson-Obaseki
- Department of Otolaryngology – Head and Neck Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Canada
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31
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El Demellawy D, Menzies‐Toman D, Murphy M, Kabir N, Shaw A, Chernetsova E, Serlo JA, Nanassy J. Viable versus nonviable positive margins in Ewing sarcoma and associated recurrence rates: A systematic review. Asia Pac J Clin Oncol 2019; 15:e79-e90. [DOI: 10.1111/ajco.13181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 05/27/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Dina El Demellawy
- Department of PathologyChildren's Hospital of Eastern Ontario (CHEO) Ottawa Ontario Canada
- Faculty of MedicineDepartment of Pathology and Laboratory MedicineUniversity of Ottawa Ottawa Ontario Canada
| | - Danielle Menzies‐Toman
- Department of PathologyChildren's Hospital of Eastern Ontario (CHEO) Ottawa Ontario Canada
| | - Michelle Murphy
- Faculty of MedicineDepartment of Pathology and Laboratory MedicineUniversity of Ottawa Ottawa Ontario Canada
| | - Nooh Kabir
- Faculty of MedicineDepartment of Pathology and Laboratory MedicineUniversity of Ottawa Ottawa Ontario Canada
| | - Ashley Shaw
- Department of PathologyChildren's Hospital of Eastern Ontario (CHEO) Ottawa Ontario Canada
| | - Elizavita Chernetsova
- Faculty of MedicineDepartment of Pathology and Laboratory MedicineUniversity of Ottawa Ottawa Ontario Canada
| | - Joni A. Serlo
- Department of Orthopedics and TraumatologyHelsinki University Central Hospital Helsinki Finland
| | - Joseph Nanassy
- Department of PathologyChildren's Hospital of Eastern Ontario (CHEO) Ottawa Ontario Canada
- Faculty of MedicineDepartment of Pathology and Laboratory MedicineUniversity of Ottawa Ottawa Ontario Canada
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32
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El Demellawy D, Lee JY, McDonell L, Dyment DA, Knisely AS, McGowan-Jordan J, Ngan B, Finegold M, Kapur RP, Nasr A. Atypical Hepatic Mesenchymal Hamartoma: Histologic Appearance, Immunophenotype, and Molecular Findings. Pediatr Dev Pathol 2019; 22:365-369. [PMID: 30497332 DOI: 10.1177/1093526618806750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Hepatic mesenchymal hamartoma is a rare benign neoplasm principally encountered in young children. Its origin is unknown. We report an unusual hepatic mesenchymal hamartoma in a 7-month-old girl, including histopathologic findings, immunophenotype, and karyotype. Chromosomal microarray analysis of tumoral tissue and circulating lymphocytes found 4 copies of a segment at 1q44 and fluorescence in situ hybridization indicated tandem triplication, ascribed to expansion of a paternal tandem duplication. This genetic abnormality may have played a role in pathogenesis.
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Affiliation(s)
- Dina El Demellawy
- 1 Department of Pathology, Children's Hospital of Eastern Ontario and University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | | | - Laura McDonell
- 3 Department of Clinical Genetics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - David A Dyment
- 3 Department of Clinical Genetics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - A S Knisely
- 4 Institut für Pathologie, Medizinische Universität Graz, Graz, Austria
| | - Jean McGowan-Jordan
- 5 Department of Genetics, Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Ontario, Canada
| | - Bo Ngan
- 6 Department of Pathology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Milton Finegold
- 7 Department of Pathology, Baylor College of Medicine, Houston, Texas
| | - Raj P Kapur
- 8 Department of Pathology, Seattle Children's Hospital, Seattle, Washington
| | - Ahmed Nasr
- 9 Department of Pediatric Surgery, Children's Hospital of Eastern Ontario and University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
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33
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Abstract
Cow's milk protein allergy/intolerance (CMPA/CMPI) is a common entity in the pediatric population with a nonspecific presentation ranging from gastrointestinal symptoms to systemic manifestations. Most infants with CMPI are term, and symptoms often appear in the week following the introduction of cow's milk-based formula. There is typically a significant delay in the onset of milk allergy in premature infants compared to full term. We report a rare case of a premature neonate who presented with symptoms of CMPA within the first 2 days of life.
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Affiliation(s)
- Emanuela Ferretti
- 1 Division of Neonatology, Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada.,2 Division of Newborn Care, The Ottawa Hospital-General Campus, University of Ottawa, Ottawa, Canada.,3 Department of Pediatrics, Division of Gastroenterology, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Sarah Pilon
- 4 Developmental Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Margaret Boland
- 3 Department of Pediatrics, Division of Gastroenterology, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Dina El Demellawy
- 3 Department of Pediatrics, Division of Gastroenterology, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.,5 Department of Pathology, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, Canada
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34
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Hill KM, Masoudian P, Fung-Kee-Fung K, El Demellawy D. Intrauterine Interventions for the Treatment of Twin Anemia-Polycythemia Sequence: A Systematic Review. J Obstet Gynaecol Can 2018; 41:981-991. [PMID: 31230662 DOI: 10.1016/j.jogc.2018.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 04/03/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Twin anemia-polycythemia sequence (TAPS) is a complication of monochorionic, multiple gestation pregnancies in which blood shunting through placental anastomoses results in chronic anemia in one fetus and chronic polycythemia in another. The outcomes of different treatment modalities for TAPS are not well known. OBJECTIVE To determine the outcomes of the intrauterine interventions used to treat TAPS. STUDY DESIGN A systematic literature search of MEDLINE, EMBASE, and CENTRAL was performed in June 2016. Primary outcomes were mortality, morbidity, and adverse perinatal outcomes. Data were summarized in the form of weighted means, and statistical difference was determined. RESULTS Twenty-one articles were identified for inclusion in this review and were composed of 105 cases of TAPS. In the cases presented in the literature, there was no statistically significant difference in mortality, morbidity, or emergent Caesarean section rates between expectant management, intrauterine transfusion (IUT), and laser ablation therapy. Laser ablation therapy and IUT were found to have a significantly lower rate of adverse perinatal outcomes when compared to expectantly managed cases. CONCLUSIONS The literature looking into the treatment of TAPS is very limited, with no randomized controlled trials and only one includable comparative study. Based on the data in the case report and case study literature, there is no mortality difference between any of the treatment modalities. Expectant management may be associated with an increase in adverse perinatal outcomes when compared to laser therapy and IUT. More comparative studies are needed to assist clinicians in adopting an evidence-based approach to the treatment of TAPS.
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Affiliation(s)
- Kevin M Hill
- Faculty of Medicine, University of Ottawa, Ottawa, ON
| | | | - Karen Fung-Kee-Fung
- Faculty of Medicine, University of Ottawa, Ottawa, ON; Department of Obstetrics and Gynecology, The Ottawa Hospital, Ottawa, ON
| | - Dina El Demellawy
- Faculty of Medicine, University of Ottawa, Ottawa, ON; Department of Pediatric Pathology, Children's Hospital of Eastern Ontario, Ottawa, ON.
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35
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Abstract
Dermal non-neural granular cell tumors, also known as primitive polypoid granular cell tumors, are a rare group of distinct cutaneous non-neural granular cell tumors. Pediatric cases are rare, and to the best of our knowledge, we report the youngest patient with dermal non-neural granular cell tumors.
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Affiliation(s)
- Bilaal Kabir
- Faculty of Health Sciences at the University of Ottawa, Ottawa, ON, Canada
| | - Michele Ramien
- Faculty of Health Sciences at the University of Ottawa, Ottawa, ON, Canada.,Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | | | - Joseph de Nanassy
- Faculty of Health Sciences at the University of Ottawa, Ottawa, ON, Canada.,Department of Pediatric Pathology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Dina El Demellawy
- Faculty of Health Sciences at the University of Ottawa, Ottawa, ON, Canada.,Department of Pediatric Pathology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
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36
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Bloom K, Mohsen AW, Karunanidhi A, El Demellawy D, Reyes-Múgica M, Wang Y, Ghaloul-Gonzalez L, Otsubo C, Tobita K, Muzumdar R, Gong Z, Tas E, Basu S, Chen J, Bennett M, Hoppel C, Vockley J. Investigating the link of ACAD10 deficiency to type 2 diabetes mellitus. J Inherit Metab Dis 2018; 41:49-57. [PMID: 28120165 PMCID: PMC5524623 DOI: 10.1007/s10545-017-0013-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 11/27/2016] [Accepted: 01/03/2017] [Indexed: 12/12/2022]
Abstract
The Native American Pima population has the highest incidence of insulin resistance (IR) and type 2 diabetes mellitus (T2DM) of any reported population, but the pathophysiologic mechanism is unknown. Genetic studies in Pima Indians have linked acyl-CoA dehydrogenase 10 (ACAD10) gene polymorphisms, among others, to this predisposition. The gene codes for a protein with a C-terminus region that is structurally similar to members of a family of flavoenzymes-the acyl-CoA dehydrogenases (ACADs)-that catalyze α,β-dehydrogenation reactions, including the first step in mitochondrial FAO (FAO), and intermediary reactions in amino acids catabolism. Dysregulation of FAO and an increase in plasma acylcarnitines are recognized as important in the pathophysiology of IR and T2DM. To investigate the deficiency of ACAD10 as a monogenic risk factor for T2DM in human, an Acad-deficient mouse was generated and characterized. The deficient mice exhibit an abnormal glucose tolerance test and elevated insulin levels. Blood acylcarnitine analysis shows an increase in long-chain species in the older mice. Nonspecific variable pattern of elevated short-terminal branch-chain acylcarnitines in a variety of tissues was also observed. Acad10 mice accumulate excess abdominal adipose tissue, develop an early inflammatory liver process, exhibit fasting rhabdomyolysis, and have abnormal skeletal muscle mitochondria. Our results identify Acad10 as a genetic determinant of T2DM in mice and provide a model to further investigate genetic determinants for insulin resistance in humans.
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MESH Headings
- Abdominal Fat/enzymology
- Abdominal Fat/physiopathology
- Acyl-CoA Dehydrogenase/genetics
- Adiposity
- Animals
- Blood Glucose/metabolism
- Diabetes Mellitus, Type 2/genetics
- Diabetes Mellitus, Type 2/pathology
- Diabetes Mellitus, Type 2/physiopathology
- Disease Models, Animal
- Genetic Predisposition to Disease
- Insulin/blood
- Insulin Resistance/genetics
- Lipid Metabolism, Inborn Errors/enzymology
- Lipid Metabolism, Inborn Errors/genetics
- Lipid Metabolism, Inborn Errors/pathology
- Lipid Metabolism, Inborn Errors/physiopathology
- Liver/enzymology
- Liver/pathology
- Mice, 129 Strain
- Mice, Inbred C57BL
- Mice, Knockout
- Mitochondria, Muscle/enzymology
- Mitochondria, Muscle/pathology
- Muscle, Skeletal/enzymology
- Muscle, Skeletal/pathology
- Non-alcoholic Fatty Liver Disease/enzymology
- Non-alcoholic Fatty Liver Disease/genetics
- Non-alcoholic Fatty Liver Disease/pathology
- Obesity, Abdominal/enzymology
- Obesity, Abdominal/genetics
- Obesity, Abdominal/physiopathology
- Phenotype
- Rhabdomyolysis/enzymology
- Rhabdomyolysis/genetics
- Rhabdomyolysis/pathology
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Affiliation(s)
- Kaitlyn Bloom
- Department of Pediatrics, School of Medicine, University of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Al-Walid Mohsen
- Department of Pediatrics, School of Medicine, University of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA
| | - Anuradha Karunanidhi
- Department of Pediatrics, School of Medicine, University of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA
| | - Dina El Demellawy
- Department of Pediatrics, School of Medicine, University of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA
| | - Miguel Reyes-Múgica
- Department of Pathology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yudong Wang
- Department of Pediatrics, School of Medicine, University of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA
| | - Lina Ghaloul-Gonzalez
- Department of Pediatrics, School of Medicine, University of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA
| | - Chikara Otsubo
- Department of Pediatrics, School of Medicine, University of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA
| | - Kimi Tobita
- Department of Pediatrics, School of Medicine, University of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA
| | - Radhika Muzumdar
- Department of Pediatrics, School of Medicine, University of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA
| | - Zhenwei Gong
- Department of Pediatrics, School of Medicine, University of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA
| | - Emir Tas
- Department of Pediatrics, School of Medicine, University of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA
| | - Shrabani Basu
- Department of Pediatrics, School of Medicine, University of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA
| | - Jie Chen
- Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Michael Bennett
- Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Charles Hoppel
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Jerry Vockley
- Department of Pediatrics, School of Medicine, University of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA.
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
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37
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Lacaria M, El Demellawy D, McGowan-Jordan J. A rare case of pediatric lipoma with t(9;12)(p22;q14) and evidence of HMGA2-NFIB gene fusion. Cancer Genet 2017; 216-217:100-104. [PMID: 29025583 DOI: 10.1016/j.cancergen.2017.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 04/06/2017] [Accepted: 07/27/2017] [Indexed: 01/05/2023]
Abstract
Lipoma is a benign tumor, typically of adulthood, with characteristic cytogenetic findings, including rearrangement of 12q13-15; these rearrangements often lead to the fusion of the HMGA2 gene at this locus to the transcriptional regulatory domain of its fusion partner, resulting in neomorphic activity that presumably facilitates the neoplastic process. Herein, we report a rare case of pediatric lipoma with t(9;12)(p22;q14) and evidence of HMGA2-NFIB gene fusion in a 9 year-old boy. This case provides further evidence of the link between NFIB rearrangement and early-onset, deep-seated lipomatous tumors.
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Affiliation(s)
- Melanie Lacaria
- Genetics Department, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Dina El Demellawy
- Pediatric Pathology Department, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Canada
| | - Jean McGowan-Jordan
- Genetics Department, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Canada.
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38
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Sullivan KJ, Wei M, Chernetsova E, Hallani S, de Nanassy J, Benchimol EI, Mack DR, Nasr A, El Demellawy D. Value of upper endoscopic biopsies in predicting medical refractoriness in pediatric patients with ulcerative colitis. Hum Pathol 2017; 66:167-176. [PMID: 28652148 DOI: 10.1016/j.humpath.2017.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/30/2017] [Accepted: 06/10/2017] [Indexed: 12/13/2022]
Abstract
Refractory ulcerative colitis (UC) occurs in patients who experience a severe disease manifestation that is unresponsive to medical therapy. The assessment of upper endoscopic microscopic findings and its correlation with refractory UC has not been fully studied in pediatric patients and is the focus of this study. Medical records of UC patients treated at a tertiary pediatric center between 2000 and 2014 were reviewed. Endoscopic biopsies of the upper gastrointestinal (GI) tract of patients meeting a priori inclusion criteria were compared between refractory UC patients and nonrefractory UC patients for active inflammation. Statistically significant differences were determined between groups, and tissues shown to have significant differences were further evaluated for their diagnostic performance. A total of 52 patients were included, 26 in each group. Significant differences were observed in intraepithelial neutrophil infiltration and percentage involvement of crypts/glands for the antrum, body, and duodenal bulb (P ≤ .001, .005, and .01 [intraepithelial neutrophil infiltration] and P = .001, .009, and .015 [% involvement], respectively). Microabscesses of mucosal glands/crypts were also experienced in a greater number of refractory UC patients in the stomach (ie, antrum and/or body of stomach; P = .005) and duodenum (ie, duodenum and/or duodenal bulb; P = .023). The sensitivity and specificity of upper GI tissues to predict refractory UC were moderate, with sensitivities ranging from 38% to 67% and specificities ranging from 81% to 100%. Our results suggest that children with refractory UC are more likely to have active inflammation in the upper GI tract, and thus, this may represent a predictor of responsiveness to current medical therapy.
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Affiliation(s)
- Katrina J Sullivan
- Department of Pathology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada K1H 8L1.
| | - Mike Wei
- Faculty of Medicine, Public Health and Preventative Medicine, University of Ottawa, Ottawa, ON, Canada K1H 8M5.
| | - Elizabeth Chernetsova
- Faculty of Medicine, Public Health and Preventative Medicine, University of Ottawa, Ottawa, ON, Canada K1H 8M5.
| | - Soufiane Hallani
- Faculty of Medicine, Public Health and Preventative Medicine, University of Ottawa, Ottawa, ON, Canada K1H 8M5.
| | - Joseph de Nanassy
- Department of Pathology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada K1H 8L1; Faculty of Medicine, Public Health and Preventative Medicine, University of Ottawa, Ottawa, ON, Canada K1H 8M5.
| | - Eric I Benchimol
- Faculty of Medicine, Public Health and Preventative Medicine, University of Ottawa, Ottawa, ON, Canada K1H 8M5; Department of Pediatrics, Public Health and Preventative Medicine, University of Ottawa, Ottawa, ON, Canada K1H 8M5; Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada K1H 8L1; School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa, Ottawa, ON, Canada K1H 8M5; Institute for Clinical Evaluative Sciences, Veterans Hill Trail, Toronto, ON, Canada M4N 3M5.
| | - David R Mack
- Faculty of Medicine, Public Health and Preventative Medicine, University of Ottawa, Ottawa, ON, Canada K1H 8M5; Department of Pediatrics, Public Health and Preventative Medicine, University of Ottawa, Ottawa, ON, Canada K1H 8M5; Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada K1H 8L1.
| | - Ahmed Nasr
- Faculty of Medicine, Public Health and Preventative Medicine, University of Ottawa, Ottawa, ON, Canada K1H 8M5; Department of Surgery, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada K1H 8L1.
| | - Dina El Demellawy
- Department of Pathology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada K1H 8L1; Faculty of Medicine, Public Health and Preventative Medicine, University of Ottawa, Ottawa, ON, Canada K1H 8M5.
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39
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de Nanassy J, El Demellawy D. Review of Current Applications of Immunohistochemistry in Pediatric Nonneoplastic Gastrointestinal, Hepatobiliary, and Pancreatic Lesions. Anal Chem Insights 2017; 12:1177390117690140. [PMID: 28469406 PMCID: PMC5400017 DOI: 10.1177/1177390117690140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 01/02/2017] [Indexed: 12/13/2022]
Abstract
Immunohistochemical (IHC) stains are widely used by pathologists for a variety of considerations in the diagnostic workup of pediatric nonneoplastic lesions in gastrointestinal (GI), hepatic, biliary, and pancreatic lesions. The pathologic changes cover a wide range and types of presentations, including inflammatory (bacterial and viral), metaplastic, posttransplant lymphoproliferative, autoimmune, metabolic, degenerative, developmental, and genetic conditions, among others. The everyday practical value of IHC stains covers primary identification, confirmation, differential, and/or exclusionary roles in the hands and eyes and minds of the practitioners. This article is intended to review and discuss the currently available IHC stains for a variety of pediatric GI, hepatobiliary, and pancreatic lesions as encountered in the day-to-day practice of pathologists and clinicians. It reflects the most recent methods and types of IHC stains with the stated aim of helping to provide a quick reference for diagnostic considerations and thereby facilitate the workup of a broad range of GI and related conditions in a pediatric population. The tables provide a handy reference on a wide range of IHC stains for commonly encountered lesions covering a variety of pediatric GI, hepatobiliary, and pancreatic conditions that are amenable to light microscopic diagnostic interpretation.
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Affiliation(s)
- Joseph de Nanassy
- Department of Anatomical Pathology, Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada.,Department of Pathology, University of Ottawa, Ottawa, ON, Canada
| | - Dina El Demellawy
- Department of Anatomical Pathology, Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada.,Department of Pathology, University of Ottawa, Ottawa, ON, Canada
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40
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Affiliation(s)
| | - Michael T Geraghty
- University of Ottawa, Ottawa, Ontario Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, OntarioDivision of Metabolics, Western University, London, Ontario
| | | | - Dina El Demellawy
- University of Ottawa, Ottawa, OntarioDepartment of Pathology, Children's Hospital of Eastern Ontario, Ottawa, Ontario
| | - Carolina Jimenez-Rivera
- University of Ottawa, Ottawa, OntarioDepartment of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, OntarioDivision of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Eastern Ontario, Ottawa, Ontario
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41
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El Demellawy D, McGowan-Jordan J, de Nanassy J, Chernetsova E, Nasr A. Update on molecular findings in rhabdomyosarcoma. Pathology 2017; 49:238-246. [PMID: 28256213 DOI: 10.1016/j.pathol.2016.12.345] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 12/12/2016] [Accepted: 12/20/2016] [Indexed: 12/13/2022]
Abstract
Rhabdomyosarcoma (RMS) is the most common malignant soft tissue tumour in children and adolescents. Histologically RMS resembles developing fetal striated skeletal muscle. RMS is stratified into different histological subtypes which appear to influence management plans and patient outcome. Importantly, molecular classification of RMS seems to more accurately capture the true biology and clinical course and prognosis of RMS to guide therapeutic decisions. The identification of PAX-FOXO1 fusion status in RMS is one of the most important updates in the risk stratification of RMS. There are several genes close to PAX that are frequently altered including the RAS family, FGFR4, PIK3CA, CTNNB1, FBXW7, and BCOR. As with most paediatric blue round cell tumours and sarcomas, chemotherapy is the key regimen for RMS therapy. Currently there are no direct inhibitors against PAX-FOXO1 fusion oncoproteins and targeting epigenetic cofactors is limited to clinical trials. Failure of therapy in RMS is usually related to drug resistance and metastatic disease. Through this review we have highlighted most of the molecular aspects in RMS and have attempted to correlate with RMS classification, treatment and prognosis.
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Affiliation(s)
- Dina El Demellawy
- Faculty of Medicine, University of Ottawa, Ontario, Canada; Pediatric Pathology, Children's Hospital of Eastern Ontario, Ontario, Canada.
| | - Jean McGowan-Jordan
- Faculty of Medicine, University of Ottawa, Ontario, Canada; Genetics, Children's Hospital of Eastern Ontario, Ontario, Canada
| | - Joseph de Nanassy
- Faculty of Medicine, University of Ottawa, Ontario, Canada; Pediatric Pathology, Children's Hospital of Eastern Ontario, Ontario, Canada
| | | | - Ahmed Nasr
- Faculty of Medicine, University of Ottawa, Ontario, Canada; Pediatric Surgery, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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42
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Valdez Quintana M, Michaud J, El-Chaar D, El Demellawy D, Nikkel SM, Miller E. Fetal segmental spinal dysgenesis and unusual segmental agenesis of the anterior spinal artery. Childs Nerv Syst 2016; 32:1537-41. [PMID: 26969176 DOI: 10.1007/s00381-016-3054-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 03/04/2016] [Indexed: 12/26/2022]
Abstract
Segmental spinal dysgenesis (SSD) is a rare congenital spinal abnormality characterized by segmental dysgenesis or agenesis of the thoracolumbar or lumbar spine, congenital kyphosis, and abnormal configuration of the underlying spinal cord. A unique feature of SSD is that the vertebrae are present above and below the defect, and there is often a lower cord segment in the caudal spinal canal. We report a fetal MRI case of SSD with postmortem and neuropathological correlations. Our report confirms already published findings including the presence of a neurenteric cyst but is the first to document anterior spinal artery segmental agenesis in SSD.
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Affiliation(s)
- Melissa Valdez Quintana
- Department of Medical Imaging, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada.
| | - Jean Michaud
- Department of Pathology and Laboratory Medicine, Children's Hospital of Eastern Ontario, University of Ottawa, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada
| | - Darine El-Chaar
- Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, University of Ottawa, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada
| | - Dina El Demellawy
- Department of Pathology and Laboratory Medicine, Children's Hospital of Eastern Ontario, University of Ottawa, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada
| | - Sarah M Nikkel
- Department of Genetics, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada
| | - Elka Miller
- Department of Medical Imaging, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada
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43
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Chernetsova E, Sullivan K, de Nanassy J, Barkey J, Mack D, Nasr A, El Demellawy D. Histologic analysis of eosinophils and mast cells of the gastrointestinal tract in healthy Canadian children. Hum Pathol 2016; 54:55-63. [DOI: 10.1016/j.humpath.2016.03.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 02/29/2016] [Accepted: 03/03/2016] [Indexed: 12/16/2022]
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44
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Lee JYJ, Sullivan K, El Demellawy D, Nasr A. The value of preoperative liver biopsy in the diagnosis of extrahepatic biliary atresia: A systematic review and meta-analysis. J Pediatr Surg 2016; 51:753-61. [PMID: 26932252 DOI: 10.1016/j.jpedsurg.2016.02.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 02/07/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND In extrahepatic biliary atresia (EHBA) obstruction of the biliary tree causes severe cholestasis leading to cirrhosis and death if left untreated in a timely manner. Infants with cholestasis may undergo many tests before EHBA diagnosis is reached. The role and place of preoperative liver biopsy in the diagnostic paradigm for EHBA have not been established. METHODS We conducted a systematic review of MEDLINE, Embase, and CENTRAL to obtain all publications describing the sensitivity/specificity/accuracy/positive predictive value (PPV)/negative predictive value (NPV) of preoperative liver biopsy in infants with cholestasis. Screening, data extraction, and quality assessment were done in duplicate. Extracted data are described narratively and analyzed using forest plots and receiver operating characteristic curves. RESULTS A total of 22 articles were included. Overall, the pooled accuracy of preoperative liver biopsy was 91.7%, with a sensitivity of 91.2%, specificity of 93.0% (n=1231), PPV of 91.2%, NPV of 92.5% (n=1182), and accuracy of 91.6% (n=1106). In patients who were 60days or less at time of presentation or diagnosis, the pooled sensitivity, specificity, PPV, NPV, and accuracy were 96.4%, 96.3%, 95.8%, 96.3%, and 94.9%, respectively. CONCLUSION Quantitative analysis demonstrated preoperative biopsy to be both highly specific and sensitive in diagnosing EHBA preoperatively. It is a highly reliable test that offers a means of arriving at an early definitive diagnosis of EHBA.
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Affiliation(s)
- James Y J Lee
- Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, Canada K1H 8M5
| | - Katrina Sullivan
- Children's Hospital of Eastern Ontario, Pediatric Surgery, 401 Smyth Rd, Ottawa, ON, K1H 8L1
| | - Dina El Demellawy
- Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, Canada K1H 8M5; Children's Hospital of Eastern Ontario, Pediatric Pathology, 401 Smyth Rd, Ottawa, ON, K1H 8L1
| | - Ahmed Nasr
- Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, Canada K1H 8M5; Children's Hospital of Eastern Ontario, Pediatric Surgery, 401 Smyth Rd, Ottawa, ON, K1H 8L1.
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45
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Masoudian P, Nasr A, de Nanassy J, Fung-Kee-Fung K, Bainbridge SA, El Demellawy D. Oocyte donation pregnancies and the risk of preeclampsia or gestational hypertension: a systematic review and metaanalysis. Am J Obstet Gynecol 2016; 214:328-39. [PMID: 26627731 DOI: 10.1016/j.ajog.2015.11.020] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 11/17/2015] [Accepted: 11/20/2015] [Indexed: 12/25/2022]
Abstract
The purpose of this study was to determine whether pregnancies that were achieved via oocyte donation, compared with pregnancies achieved via other assisted reproductive technology methods or natural conception, demonstrate increased risk of preeclampsia or gestational hypertension. Comparative studies of pregnancies that were achieved with oocyte donation vs other methods of assisted reproductive technology or natural conception with preeclampsia or gestational hypertension were included as 1 of the measured outcomes. Abstracts and unpublished studies were excluded. Two reviewers independently selected studies, which were assessed for quality with the use of methodological index for non-randomized studies, and extracted the data. Statistical analysis was conducted. Of the 523 studies that were reviewed initially, 19 comparative studies met the predefined inclusion and exclusion criteria and were included in the metaanalysis, which allowed for analysis of a total of 86,515 pregnancies. Our pooled data demonstrated that the risk of preeclampsia is higher in oocyte-donation pregnancies compared with other methods of assisted reproductive technology (odds ratio, 2.54; 95% confidence interval, 1.98-3.24; P < .0001) or natural conception (odds ratio, 4.34; 95% confidence interval, 3.10-6.06; P < .0001). The risk of gestational hypertension was also increased significantly in oocyte donation pregnancies in comparison with other methods of assisted reproductive technology (odds ratio, 3.00; 95% confidence interval, 2.44-3.70; P < .0001) or natural conception (odds ratio, 7.94; 95% confidence interval, 1.73-36.36; P = .008). Subgroup analysis that was conducted for singleton and multiple gestations demonstrated a similar risk for preeclampsia and gestational hypertension in both singleton and multiple gestations. This metaanalysis provides further evidence that supports that egg donation increases the risk of preeclampsia and gestational hypertension compared with other assisted reproductive technology methods or natural conception.
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46
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El Demellawy D, Cundiff CA, Nasr A, Ozolek JA, Elawabdeh N, Caltharp SA, Masoudian P, Sullivan KJ, de Nanassy J, Shehata BM. Congenital mesoblastic nephroma: a study of 19 cases using immunohistochemistry and ETV6-NTRK3 fusion gene rearrangement. Pathology 2015; 48:47-50. [PMID: 27020209 DOI: 10.1016/j.pathol.2015.11.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 08/06/2015] [Accepted: 08/11/2015] [Indexed: 11/30/2022]
Abstract
Mesoblastic nephroma (MN) is the most common renal tumour in the first 3 months of life and accounts for 3-5% of all paediatric renal neoplasms. To further understand the morphological variants of MN, we identified 19 cases of MN (five classic, eight cellular and six mixed) and examined each case for markers known to be important in urogenital embryological development (PAX8, WT1 and RCC), stem cell associated markers (Oct 4, CD34 and c-kit), muscle/myofibroblastic markers (muscle specific actin, calponin and h-caldesmon), aberrant transcription factors, cell cycle regulation and other oncogenic proteins (p16, cyclin D1 and beta-catenin). Fluorescence in situ hybridisation (FISH) testing for ETV6-NTRK3 gene fusion/rearrangement revealed further differentiation between the subtypes with ETV6-NTRK3 gene fusion detected in 0/5 of the classic MN, 8/8 of the cellular MN and 5/6 of the mixed MN cohorts, respectively. Our results conclude that cyclin D1 and beta-catenin may be useful markers for differentiating between cellular MN and classic MN when the histology is not conclusive. The absence of expression of stem cell markers and markers involved in urogenital development suggests that MN is not a nephroma and most likely represents a soft tissue tumour, with congenital infantile fibrosarcoma representing cellular MN with a predilection to arise in the kidney. In addition, the immunophenotype and genetic fingerprint of mixed MN most likely represents a heterogenous group of tumours that are mostly cellular type, with areas that are phenotypically less cellular.
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Affiliation(s)
- Dina El Demellawy
- Children's Hospital of Eastern Ontario and University of Ottawa, Canada.
| | - Caitlin A Cundiff
- Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, United States
| | - Ahmed Nasr
- Children's Hospital of Eastern Ontario and University of Ottawa, Canada
| | - John A Ozolek
- Children's Hospital of Pittsburgh and University of Pittsburgh Medical Center, Pittsburgh, United States
| | - Nancy Elawabdeh
- Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, United States
| | - Shelley A Caltharp
- Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, United States
| | - Pourya Masoudian
- Children's Hospital of Eastern Ontario and University of Ottawa, Canada
| | | | - Joseph de Nanassy
- Children's Hospital of Eastern Ontario and University of Ottawa, Canada
| | - Bahig M Shehata
- Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, United States
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47
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Williams K, Chernetsova E, Michaud J, El Demellawy D. Neurogenic Ovarian Cyst--A Rare, Monodermal Teratoma. Pediatr Dev Pathol 2015; 18:341-2. [PMID: 26261871 DOI: 10.2350/14-11-1576-let.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Kona Williams
- Department of Pathology and Laboratory Medicine, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada
| | | | - Jean Michaud
- Department of Pathology and Laboratory Medicine, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada
| | - Dina El Demellawy
- Department of Pathology and Laboratory Medicine, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada
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48
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Keller RB, El Demellawy D, Quaglia A, Finegold M, Kapur RP. Methylation status of the chromosome arm 19q MicroRNA cluster in sporadic and androgenetic-Biparental mosaicism-associated hepatic mesenchymal hamartoma. Pediatr Dev Pathol 2015; 18:218-27. [PMID: 25751191 DOI: 10.2350/15-01-1600-oa.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The C19MC gene on chromosome band 19q13.4 encodes a cluster of 46 microRNAs; those microRNAs are normally only expressed from the paternal allele and in the placenta. Placental expression correlates with selective demethylation of the paternal C19MC promoter, in contrast to methylation of both maternal and paternal alleles in nonplacental tissues. Prior investigations demonstrated "ectopic" activation of this gene in most hepatic mesenchymal hamartomas, including sporadic tumors and others with androgenetic-biparental mosaicism (subset of cells are diploid, but contain only paternally derived chromosomes). In the present investigation of C19MC promoter methylation status in a series of 14 mesenchymal hamartomas, a demethylated allele was identified in 6 tumors, including all 4 with androgenetic-biparental mosaicism. Conversely, only methylated alleles were cloned from sporadic hamartomas, including 3 tumors with chromosomal rearrangements thought likely to activate C19MC expression independent of the native promoter. In conjunction with published data, the findings suggest multiple molecular mechanisms for C19MC activation in hepatic mesenchymal hamartoma, including the existence of a normal placental imprinting pattern in mesenchymal cells in a subset of cases. Some or all of the latter hamartomas may result from placental "grafting," a hypothesis supported by endothelial expression of the placental vascular marker, glucose transporter-1, in 1 of the 6 cases with a demethylated allele.
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Affiliation(s)
- Rachel B. Keller
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Dina El Demellawy
- Pathology and Laboratory Medicine, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Alberto Quaglia
- Institute of Liver Studies, King's College Hospital, London, UK
| | - Milton Finegold
- Department of Pathology, Baylor College of Medicine, Houston, TX, USA
| | - Raj P. Kapur
- Department of Pathology, University of Washington, Seattle, WA, USA
- Department of Laboratories, Seattle Children's Hospital, Seattle, WA, USA
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49
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Cundiff CA, Elawabdeh N, Naguib MM, Jactel SN, Demellawy DE, Abramowsky CR, Durham MM, Youssef L, Wittkamp ML, Shehata BM. Does MAP2 have a role in predicting the development of anti-NMDAR encephalitis associated with benign ovarian teratoma? A report of six new pediatric cases. Pediatr Dev Pathol 2015; 18:122-6. [PMID: 25569473 DOI: 10.2350/14-09-1554-oa.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is a potentially fatal neurologic syndrome in which patients present with a spectrum of central nervous system deficits. Sixty percent of the cases can be attributed to the presence of tumors, most often ovarian teratomas. This report examines 6 pediatric patients who presented with neurologic deficits associated with the presence of such tumors. These cases illustrate a perplexing phenomenon, where benign teratomas could have a possible association with anti-NMDAR encephalitis. The purpose of this study was to compare the histology and immunohistochemistry of tumors associated with this syndrome to ovarian teratomas found in patients presenting with no neurologic symptoms. After obtaining institutional review board approval, 57 cases of ovarian teratomas were identified at our institution over 12 years. Six patients were identified with anti-NMDAR encephalitis. A panel of immunostains, including S100, GFAP, MAP2, and NeuN was applied to patients' tumor sections as well as the 6 controls from age-matched patients. No qualitative histologic or immunohistochemical differences were seen between the study cases and control group. Because no qualitative differences were identified between the study cases and the control group, testing of paired serum and cerebrospinal fluid remains the best method for diagnosis of anti-NMDAR encephalitis. Tumor banking with molecular analysis of ovarian teratomas, including whole-genome sequencing and comparative genomic hybridization between ovarian tissue saved from patients with and without anti-NMDAR encephalitis, is necessary to fully understand the etiopathogenesis of anti-NMDAR encephalitis.
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Affiliation(s)
- Caitlin A Cundiff
- 1 Department of Pathology, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, USA
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El Demellawy D, Robison JG, Pollack IF, Green MD, Alper CM, Reyes-Múgica M. Idiopathic intervertebral disc calcification in childhood: an atypical case of an uncommon entity for pediatric pathologists. Pediatr Dev Pathol 2013; 16:432-7. [PMID: 23901810 DOI: 10.2350/13-06-1343-cr.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Calcification of the intervertebral disc is a common occurrence in the adult population, but it is rare in children. However, its radiological and clinical findings are well described in the pediatric age group, with close to 150 publications on record. In contrast, little information is available regarding the histological features of this entity, which may prove to be challenging to surgical pathologists. Here we provide a detailed description of a young patient with an inflammatory retropharyngeal mass originating in a calcified intervertebral disc. A review of the pathological features described in the literature in English, with pathogenic considerations, is presented.
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Affiliation(s)
- Dina El Demellawy
- 1 Division of Pediatric Pathology, Children's Hospital of Pittsburgh of the University of Pittsburgh School of Medicine, Pittsburgh, PA 15224, USA
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