1
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Lupo V, Di Gregorio MG, Mastrogiorgio G, Magliozzi M, Scapillati ME, Maglione V, Romanelli E, Alegiani C, Haass C, Novelli A. Neonatal diagnosis of ACTA2-related disease: A case report and review of literature. Am J Med Genet A 2023; 191:1111-1118. [PMID: 36607831 DOI: 10.1002/ajmg.a.63118] [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] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/14/2022] [Accepted: 12/26/2022] [Indexed: 01/07/2023]
Abstract
Multisystemic smooth muscle dysfunction syndrome (MSMDS, OMIM # 613834) is a rare autosomal dominant condition caused by pathogenetic variants of ACTA2 gene that result in impaired muscle contraction. MSMDS is characterized by an increased susceptibility to aneurismal dilatations and dissections, patent ductus arteriosus, early onset coronary artery disease, congenital mydriasis, chronic interstitial lung disease, hypoperistalsis, hydrops of gall bladder, and hypotonic bladder. Here, we report an early diagnosis of a MSMDS related to ACTA2 p.Arg179His (R179H) mutation in a newborn and performed a review of the literature. An early diagnosis of MSMDS is extremely important, because of the severe involvement of cardiovascular system in the MSMDS. Multidisciplinary care and surveillance and timely management of symptoms are important to reduce the risk of complications.
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Affiliation(s)
- Viviana Lupo
- Medical Genetics Unit, San Pietro-Fatebenefratelli Hospital, Rome, Italy
| | | | | | - Monia Magliozzi
- Laboratory of Medical Genetics, Bambino Gesù Children's Hospital, IRCSS, Rome, Italy
| | | | - Vittorio Maglione
- Medical Genetics Unit, San Pietro-Fatebenefratelli Hospital, Rome, Italy
| | - Ester Romanelli
- Medical Genetics Unit, San Pietro-Fatebenefratelli Hospital, Rome, Italy
| | - Caterina Alegiani
- Neonatal Intensive Unit, San Pietro-Fatebenefratelli Hospital, Rome, Italy
| | - Cristina Haass
- Neonatal Intensive Unit, San Pietro-Fatebenefratelli Hospital, Rome, Italy
| | - Antonio Novelli
- Laboratory of Medical Genetics, Bambino Gesù Children's Hospital, IRCSS, Rome, Italy
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2
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Buonuomo P, El Hachem M, Mastrogiorgio G, Pisaneschi E, Diociaiuti A, Rana I, Macchiaiolo M, Capolino R, Gonfiantini M, Vecchio D, Novelli A, Bartuli A. A PEDIATRIC CASE OF TEK-RELATED MALFORMATIONS AND MARFANOID HABITUS: AN INCIDENTAL FINDING OR A FEATURE? Lymphology 2022. [DOI: 10.2458/lymph.5145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Vascular malformations encompass a wide range of complex vascular lesions. Due to the extreme variability of clinical presentation, classification and their related syndromes presents a challenge. Here we describe a case of a boy presenting with Marfanoid habitus, cutaneous vascular malformations, and severe acute anemia due to ileal venous malformations. Although a panel of genetic markers for the Marfan phenotype was negative, we identified a de novo mutation in the TEK gene in the patient. This case supports expansion of the phenotypic spectrum of TEK-related vascular malformations.
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Affiliation(s)
| | | | | | | | | | - I. Rana
- Bambino Gesù Children's Hospital
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3
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Rana I, Buonuomo P, Mastrogiorgio G, Del Fattore A, Jenkner A, Barbuti D, De Vito R, Pizzoferro M, Callea M, Crostelli M, Mazza O, Rotunno R, Bartuli A. EXPANDING THE SPECTRUM OF GORHAM STOUT DISEASE EXPLORING A SINGLE CENTER PEDIATRIC CASE SERIES. Lymphology 2022. [DOI: 10.2458/lymph.4839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Gorham-Stout Disease (GSD), also named vanishing bone disease, is an ultrarare condition characterized by progressive osteolysis with intraosseous lymphatic vessel proliferation and bone cortical loss. So far, about 300 cases have been reported. It may occur at any age but more commonly affects children and young adults. The aim of this study is to retrospectively review our internal patient series and to hypothesize a diagnostic-therapeutic protocol for earlier diagnosis and treatment. Clinical datasets from our center were examined to identify all GSD patients for collection and analysis. We identified 9 pediatric cases and performed a retrospective case-series review to examine and document both diagnosis and treatment. We found that delay in diagnosis after first symptoms played a critical role in determining morbidity and that multidisciplinary care is key for proper diagnosis and treatment. Our study provides additional insight to improve the critical challenge of early diagnosis and highlights a multidisciplinary treatment approach for the most appropriate management of patients with rare GSD disease. Although GSD is an ultrarare disease, physicians should keep in mind the main clinical features since neglected cases may result in potentially fatal complications.
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Affiliation(s)
- I. Rana
- Bambino Gesù Children's Hospital IRCCS, Rome
| | | | | | | | - A. Jenkner
- Bambino Gesù Children's Hospital IRCCS, Rome
| | - D. Barbuti
- Bambino Gesù Children's Hospital IRCCS, Rome
| | - R. De Vito
- Bambino Gesù Children's Hospital IRCCS, Rome
| | | | - M. Callea
- Bambino Gesù Children's Hospital IRCCS, Rome
| | | | - O. Mazza
- Bambino Gesù Children's Hospital IRCCS, Rome
| | - R. Rotunno
- Bambino Gesù Children's Hospital IRCCS, Rome
| | - A. Bartuli
- Bambino Gesù Children's Hospital IRCCS, Rome
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4
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Buonuomo PS, El Hachem M, Mastrogiorgio G, Pisaneschi E, Diociaiuti A, Rana I, Macchiaiolo M, Capolino R, Gonfiantini MV, Vecchio D, Novelli A, Bartuli A. A pediatric case of TEK-Related malformations and marfanoid habitus: an incidental finding or a feature? Lymphology 2022; 55:36-39. [PMID: 35896114] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Vascular malformations encompass a wide range of complex vascular lesions. Due to the extreme variability of clinical presentation, classification and their related syndromes presents a challenge. Here we describe a case of a boy presenting with Marfanoid habitus, cutaneous vascular malformations, and severe acute anemia due to ileal venous malformations. Although a panel of genetic markers for the Marfan phenotype was negative, we identified a de novo mutation in the TEK gene in the patient. This case supports expansion of the phenotypic spectrum of TEK-related vascular malformations.
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Affiliation(s)
- P S Buonuomo
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Italy
| | - M El Hachem
- Pediatric Dermatology, Bambino Gesù Children's Hospital Rome, Italy
| | - G Mastrogiorgio
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Italy
| | - E Pisaneschi
- Laboratory of Medical Genetics, Bambino Gesù Children's Hospital Rome, Italy
| | - A Diociaiuti
- Pediatric Dermatology, Bambino Gesù Children's Hospital Rome, Italy
| | - I Rana
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Italy
| | - M Macchiaiolo
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Italy
| | - R Capolino
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Italy
| | - M V Gonfiantini
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Italy
| | - D Vecchio
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Italy
| | - A Novelli
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Italy
| | - A Bartuli
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Italy
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5
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Buonuomo PS, Mastrogiorgio G, Leone G, Rana I, Gonfiantini MV, Macchiaiolo M, Vecchio D, Gnazzo M, Bartuli A. Evolocumab in the management of children <10 years of age affected by homozygous familial hypercholesterolemia. Atherosclerosis 2021; 324:148-150. [PMID: 33824001 DOI: 10.1016/j.atherosclerosis.2021.03.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/17/2021] [Accepted: 03/23/2021] [Indexed: 01/06/2023]
Affiliation(s)
- Paola Sabrina Buonuomo
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, IRCCS, Italy.
| | - Gerarda Mastrogiorgio
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, IRCCS, Italy
| | - Giovanna Leone
- Unit of Transfusion Medicine, Bambino Gesù Children's Hospital Rome, IRCCS, Italy
| | - Ippolita Rana
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, IRCCS, Italy
| | | | - Marina Macchiaiolo
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, IRCCS, Italy
| | - Davide Vecchio
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, IRCCS, Italy
| | - Maria Gnazzo
- Laboratory of Medical Genetics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Andrea Bartuli
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, IRCCS, Italy
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6
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Mastrogiorgio G, Macchiaiolo M, Buonuomo PS, Bellacchio E, Bordi M, Vecchio D, Brown KP, Watson NK, Contardi B, Cecconi F, Tartaglia M, Bartuli A. Clinical and molecular characterization of patients with adenylosuccinate lyase deficiency. Orphanet J Rare Dis 2021; 16:112. [PMID: 33648541 PMCID: PMC7919308 DOI: 10.1186/s13023-021-01731-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 08/25/2020] [Accepted: 02/03/2021] [Indexed: 12/15/2022] Open
Abstract
Background Adenylosuccinate lyase deficiency (ADSLD) is an ultrarare neurometabolic recessive disorder caused by loss-of-function mutations in the ADSL gene. The disease is characterized by wide clinical variability. Here we provide an updated clinical profiling of the disorder and discuss genotype–phenotype correlations.
Results Data were collected through "Our Journey with ADSL deficiency Association" by using a dedicated web survey filled-in by parents.
Clinical and molecular data were collected from 18 patients (12 males, median age 10.9 years ± 7.3), from 13 unrelated families. The age at onset ranged from birth to the first three years (median age 0.63 years ± 0.84 SD), and age at diagnosis varied from 2 months to 17 years, (median age 6.4 years ± 6.1 SD). The first sign was a psychomotor delay in 8/18 patients, epilepsy in 3/18, psychomotor delay and epilepsy in 3/18, and apneas, hypotonia, nystagmus in single cases. One patient (sibling of a previously diagnosed child) had a presymptomatic diagnosis. The diagnosis was made by exome sequencing in 7/18 patients. All patients were definitively diagnosed with ADSL deficiency based on pathogenic variants and/or biochemical assessment. One patient had a fatal neonatal form of ADSL deficiency, seven showed features fitting type I, and nine were characterized by a milder condition (type II), with two showing a very mild phenotype. Eighteen different variants were distributed along the entire ADSL coding sequence and were predicted to have a variable structural impact by impairing proper homotetramerization or catalytic activity of the enzyme. Six variants had not previously been reported. All but two variants were missense. Conclusions The study adds more details on the spectrum of ADSLD patients’ phenotypes and molecular data.
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Affiliation(s)
- Gerarda Mastrogiorgio
- Rare Diseases and Medical Genetics Unit, Academic Department of Pediatrics (DPUO), Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, 00165, Rome, Italy. .,Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Marina Macchiaiolo
- Rare Diseases and Medical Genetics Unit, Academic Department of Pediatrics (DPUO), Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, 00165, Rome, Italy.,Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Paola Sabrina Buonuomo
- Rare Diseases and Medical Genetics Unit, Academic Department of Pediatrics (DPUO), Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, 00165, Rome, Italy.,Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Emanuele Bellacchio
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Matteo Bordi
- Department of Biology, University of Rome Tor Vergata, Rome, Italy
| | - Davide Vecchio
- Rare Diseases and Medical Genetics Unit, Academic Department of Pediatrics (DPUO), Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, 00165, Rome, Italy.,Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Kari Payne Brown
- Parents of patients affected by Adenylosuccinate lyase deficiency, Patient's Association "Our Journey with ADSL deficiency", Rome, Italy
| | - Natalie Karen Watson
- Parents of patients affected by Adenylosuccinate lyase deficiency, Patient's Association "Our Journey with ADSL deficiency", Rome, Italy
| | - Benedetta Contardi
- Parents of patients affected by Adenylosuccinate lyase deficiency, Patient's Association "Our Journey with ADSL deficiency", Rome, Italy
| | - Francesco Cecconi
- Department of Biology, University of Rome Tor Vergata, Rome, Italy.,Onco-Haematology and Cellular and Gene Therapy Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Andrea Bartuli
- Rare Diseases and Medical Genetics Unit, Academic Department of Pediatrics (DPUO), Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, 00165, Rome, Italy.,Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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7
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Rana I, Buonuomo PS, Mastrogiorgio G, Del Fattore A, Jenkner A, Barbuti D, De Vito R, Pizzoferro M, Callea M, Crostelli M, Mazza O, Rotunno R, Bartuli A. Expanding the spectrum of Gorham Stout disease exploring a single center pediatric case series. Lymphology 2021; 54:182-194. [PMID: 35073622] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Gorham-Stout Disease (GSD), also named vanishing bone disease, is an ultrarare condition characterized by progressive osteolysis with intraosseous lymphatic vessel proliferation and bone cortical loss. So far, about 300 cases have been reported. It may occur at any age but more commonly affects children and young adults. The aim of this study is to retrospectively review our internal patient series and to hypothesize a diagnostic-therapeutic protocol for earlier diagnosis and treatment. Clinical datasets from our center were examined to identify all GSD patients for collection and analysis. We identified 9 pediatric cases and performed a retrospective case-series review to examine and document both diagnosis and treatment. We found that delay in diagnosis after first symptoms played a critical role in determining morbidity and that multidisciplinary care is key for proper diagnosis and treatment. Our study provides additional insight to improve the critical challenge of early diagnosis and highlights a multidisciplinary treatment approach for the most appropriate management of patients with rare GSD disease. Although GSD is an ultrarare disease, physicians should keep in mind the main clinical features since neglected cases may result in potentially fatal complications.
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Affiliation(s)
- I Rana
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - P S Buonuomo
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - G Mastrogiorgio
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - A Del Fattore
- Bone Physiopathology Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - A Jenkner
- Division of Immunology and Infectious Diseases, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - D Barbuti
- Pediatric Radiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - R De Vito
- Laboratory of Histopatology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Pizzoferro
- Nuclear Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Callea
- Unit of Dentistry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Crostelli
- Vertebral Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - O Mazza
- Pediatric Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - R Rotunno
- Pediatric Dermatology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - A Bartuli
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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8
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Macchiaiolo M, Panfili FM, Gonfiantini MV, Mastrogiorgio G, Buonuomo PS, Gaspari S, Longo D, Zollino M, Bartuli A. Langerhans cell histiocytosis in a young patient with Pitt-Hopkins syndrome. Am J Med Genet A 2020; 182:2746-2750. [PMID: 32945094 DOI: 10.1002/ajmg.a.61840] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 08/05/2020] [Accepted: 08/08/2020] [Indexed: 11/07/2022]
Abstract
Pitt-Hopkins syndrome (PTHS, MIM #610954) is a rare neurodevelopmental disease characterized by the association of intellectual disability, characteristic facial gestalt and episodes of abnormal and irregular breathing. PTHS is due to heterozygous loss-of-function variants in the TCF4 gene (transcription factor 4, MIM #602272) encoding for a basic helix-loop-helix transcription factor. TCF4 is highly expressed during early development of the nervous system, and it is involved in cellular differentiation and proliferation. Since the first clinical description in 1978, less than 200 PTHS patients have been described. A comprehensive phenotype, especially regarding cancer predisposition, is not yet well defined. We report the case of a 7-year-old boy affected by PTHS with a 4-week history of progressive swelling of the frontal bones diagnosed with Langerhans cell histiocytosis.
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Affiliation(s)
- Marina Macchiaiolo
- Rare Diseases and Genetic Unit, University Department of Paediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Michaela Veronika Gonfiantini
- Rare Diseases and Genetic Unit, University Department of Paediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Gerarda Mastrogiorgio
- Rare Diseases and Genetic Unit, University Department of Paediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Paola Sabrina Buonuomo
- Rare Diseases and Genetic Unit, University Department of Paediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Stefania Gaspari
- Hematology/Oncology, Cellular and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Daniela Longo
- Neuroradiology Unit, Imaging Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Marcella Zollino
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Genetica, Rome, Italy
- Università Cattolica Sacro Cuore, Istituto di Medicina Genomica, Rome, Italy
| | - Andrea Bartuli
- Rare Diseases and Genetic Unit, University Department of Paediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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9
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Buonuomo PS, Mastrogiorgio G, Carletti M, Rana I, Macchiaiolo M, Gonfiantini MV, Vecchio D, Porzio O, Bartuli A. New Insights into the Role of Lipoprotein(a) as Predictor of Early Onset of Cardiovascular Disease in Pediatric Familial Hypercholesterolemia (FH). Pediatr Cardiol 2020; 41:1242-1243. [PMID: 32518962 DOI: 10.1007/s00246-020-02392-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/06/2020] [Indexed: 10/24/2022]
Affiliation(s)
| | - Gerarda Mastrogiorgio
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Rome, Italy
| | - Michaela Carletti
- Laboratory of Chemistry, Bambino Gesù Children's Hospital Rome, Rome, Italy
| | - Ippolita Rana
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Rome, Italy
| | - Marina Macchiaiolo
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Rome, Italy
| | | | - Davide Vecchio
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Rome, Italy
| | - Ottavia Porzio
- Laboratory of Chemistry, Bambino Gesù Children's Hospital Rome, Rome, Italy
| | - Andrea Bartuli
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Rome, Italy
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10
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Mastrogiorgio G, Buonuomo PS, Rana I, Macchiaiolo M, Marchetti P, De Peppo F, Rinelli M, Gonfiantini MV, Novelli A, Bartuli A. Infantile myofibromatosis: a rare cause of subcutaneous nodules in an infant. Arch Dis Child 2020; 106:archdischild-2020-319229. [PMID: 32576562 DOI: 10.1136/archdischild-2020-319229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/10/2020] [Indexed: 11/03/2022]
Affiliation(s)
- Gerarda Mastrogiorgio
- Rare Diseases and Medical Genetics, Bambino Gesu Pediatric Hospital, Roma, Lazio, Italy
| | | | - Ippolita Rana
- Rare Diseases and Medical Genetics, Bambino Gesu Pediatric Hospital, Roma, Lazio, Italy
| | - Marina Macchiaiolo
- Rare Diseases and Medical Genetics, Bambino Gesu Pediatric Hospital, Roma, Lazio, Italy
| | - Paola Marchetti
- Pediatric Surgery, Bambino Gesu Pediatric Hospital, Roma, Lazio, Italy
| | | | - Martina Rinelli
- Medical Genetics Laboratory, Bambino Gesu Pediatric Hospital, Roma, Lazio, Italy
| | | | - Antonio Novelli
- Medical Genetics Laboratory, Bambino Gesu Pediatric Hospital, Roma, Lazio, Italy
| | - Andrea Bartuli
- Rare Diseases and Medical Genetics, Bambino Gesu Pediatric Hospital, Roma, Lazio, Italy
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11
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Nenna R, Turchetti A, Mastrogiorgio G, Midulla F. COL2A1 Gene Mutations: Mechanisms of Spondyloepiphyseal Dysplasia Congenita. Appl Clin Genet 2019; 12:235-238. [PMID: 31824186 PMCID: PMC6900288 DOI: 10.2147/tacg.s197205] [Citation(s) in RCA: 19] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 11/23/2019] [Indexed: 12/19/2022]
Abstract
The COL2A1 gene consists of 54 exons spanning over 31.5 kb and encodes for type II collagen. Type II collagen is the main component of hyaline cartilage extracellular matrix, nucleus pulposus of intervertebral discus, vitreous humor of the eye and inner ear structure. Molecular defects in COL2A1 gene cause a wide variety of rare autosomal-dominant conditions known as type II collagenopathies. A clear genotype-phenotype relationship is not yet known. However, some correlations are described. Spondyloephyseal dysplasia congenita was suggested for a short-trunk dwarfing condition affecting primarily the vertebrae and the proximal epiphyses of the long bones.
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Affiliation(s)
| | | | - Gerarda Mastrogiorgio
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Fabio Midulla
- Department of Paediatrics, Sapienza University, Rome, Italy
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12
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Buonuomo PS, Mastrogiorgio G, Macchiaiolo M, Rana I, Gonfiantini MV, Marafon DP, Bartuli A. Statins in children: A monocentric experience. J Clin Lipidol 2018; 12:1326-1327. [DOI: 10.1016/j.jacl.2018.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 06/20/2018] [Indexed: 11/28/2022]
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13
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Buonuomo PS, Macchiaiolo M, Mastrogiorgio G, Rana I, Gonfiantini MV, Bartuli A. Statin-associated myopathy in pediatric settings: Myth or fact? J Pediatr 2017; 191:279. [PMID: 28964429 DOI: 10.1016/j.jpeds.2017.08.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 08/21/2017] [Indexed: 10/18/2022]
Affiliation(s)
| | - Marina Macchiaiolo
- Rare Diseases and Medical Genetics Unit Bambino Gesù Children's Hospital Rome, Italy
| | - Gerarda Mastrogiorgio
- Rare Diseases and Medical Genetics Unit Bambino Gesù Children's Hospital Rome, Italy
| | - Ippolita Rana
- Rare Diseases and Medical Genetics Unit Bambino Gesù Children's Hospital Rome, Italy
| | | | - Andrea Bartuli
- Rare Diseases and Medical Genetics Unit Bambino Gesù Children's Hospital Rome, Italy
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14
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Buonuomo PS, Polizzi BM, Macchiaiolo M, Mastrogiorgio G, Iughetti L, Scalzone M, Casucci P, Rana I, Bartuli A. Pediatric Cholesterol Screening In Italy: The Spif Project†. J Clin Lipidol 2016. [DOI: 10.1016/j.jacl.2016.03.055] [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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Nenna R, Petrarca L, Verdecchia P, Florio M, Pietropaoli N, Mastrogiorgio G, Bavastrelli M, Bonamico M, Cucchiara S. Celiac disease in a large cohort of children and adolescents with recurrent headache: A retrospective study. Dig Liver Dis 2016; 48:495-498. [PMID: 26826905 DOI: 10.1016/j.dld.2015.12.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [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: 07/08/2015] [Revised: 11/23/2015] [Accepted: 12/27/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND The clinical picture of celiac disease is changing with the emergence of subclinical forms and growing evidence reporting associated neurological disorders. AIMS To establish the prevalence of celiac disease in children suffering from recurrent headache. METHODS In our retrospective study we collected charts from 1131 children attending our tertiary care Centre for Paediatric Headache over the period 2001-2012. They were screened for celiac disease and positive patients were referred to our Operative Unit for Coeliac disease and confirmed positive children underwent upper endoscopy with multiple duodenal biopsies. Celiac children started a gluten-free diet. RESULTS 883 children (481 females; median age, 9.8 years, range 3-19) performed celiac disease screening, and among them, 11 children (7 females; median age, 8.2 years, range: 4.8-13.9) were diagnosed with celiac disease. Seven children (5 females, median age, 11.9 years, range: 10.3-13.9) had been diagnosed as celiac prior to the neurological evaluation. The prevalence of celiac disease in our sample is 2.04% vs. 1.2% of the general population (p=0.034). CONCLUSIONS Our study demonstrates, on a large series, that celiac disease prevalence is doubled in patients with chronic headache. Screening for celiac disease could be advised as part of the diagnostic work-up in these paediatric patients, particularly among pharmacological non-responders.
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Affiliation(s)
- Raffaella Nenna
- Department of Paediatrics and Infant Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy.
| | - Laura Petrarca
- Department of Paediatrics and Infant Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Paola Verdecchia
- Department of Paediatrics and Infant Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Matteo Florio
- Department of Paediatrics and Infant Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Nicoletta Pietropaoli
- Department of Paediatrics and Infant Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Gerarda Mastrogiorgio
- Department of Paediatrics and Infant Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Maria Bavastrelli
- Department of Paediatrics and Infant Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Margherita Bonamico
- Department of Paediatrics and Infant Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Salvatore Cucchiara
- Department of Paediatrics and Infant Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy
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Buonuomo PS, Macchiaiolo M, Bottero S, Secinaro A, Mastrogiorgio G, Scalzone M, Rana I, Tomà P, Bartuli A. An 8-Month-Old Infant with Persistent Stridor. Pediatr Ann 2016; 45:e42-3. [PMID: 26878180 DOI: 10.3928/00904481-20160111-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Parisi P, Pietropaoli N, Ferretti A, Nenna R, Mastrogiorgio G, Del Pozzo M, Principessa L, Bonamico M, Villa MP. Role of the gluten-free diet on neurological-EEG findings and sleep disordered breathing in children with celiac disease. Seizure 2014; 25:181-3. [PMID: 25457448 DOI: 10.1016/j.seizure.2014.09.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [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: 07/10/2014] [Revised: 09/16/2014] [Accepted: 09/30/2014] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To determine whether celiac children are at risk for EEG-neurological features and sleep disordered breathing (SDB), and whether an appropriate gluten-free diet (GFD) influences these disorders. METHODS We consecutively enrolled 19 children with a new biopsy-proven celiac disease (CD) diagnosis. At CD diagnosis and after 6 months of GFD, each patient underwent a general and neurological examination, an electroencephalogram, a questionnaire about neurological features, and a validated questionnaire about SDB: OSA (obstructive sleep apnea) scores<0 predict normality; values>0 predict OSA. RESULTS At CD diagnosis, 37% of patients complained headache that affected daily activities and 32% showed positive OSA score. The EEG examinations revealed abnormal finding in 48% of children. After 6 months of GFD headache disappeared in 72% of children and EEG abnormalities in 78%; all children showed negative OSA score. CONCLUSION According to our preliminary data, in the presence of unexplained EEG abnormalities and/or other neurological disorders/SDB an atypical or silent CD should also be taken into account.
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Affiliation(s)
- P Parisi
- Pediatric Sleep Disease Centre, Child Neurology, NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, S. Andrea Hospital, Via di Grottarossa 1035-39, 00189 Rome, Italy
| | - N Pietropaoli
- Pediatric Sleep Disease Centre, Child Neurology, NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, S. Andrea Hospital, Via di Grottarossa 1035-39, 00189 Rome, Italy
| | - A Ferretti
- Pediatric Sleep Disease Centre, Child Neurology, NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, S. Andrea Hospital, Via di Grottarossa 1035-39, 00189 Rome, Italy
| | - R Nenna
- Celiac Disease and Malabsorptive Diseases Unit, Department of Pediatrics, Sapienza University, Viale Regina Margherita 324, 00161 Rome, Italy
| | - G Mastrogiorgio
- Pediatric Sleep Disease Centre, Child Neurology, NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, S. Andrea Hospital, Via di Grottarossa 1035-39, 00189 Rome, Italy
| | - M Del Pozzo
- Pediatric Sleep Disease Centre, Child Neurology, NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, S. Andrea Hospital, Via di Grottarossa 1035-39, 00189 Rome, Italy
| | - L Principessa
- Pediatric Sleep Disease Centre, Child Neurology, NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, S. Andrea Hospital, Via di Grottarossa 1035-39, 00189 Rome, Italy
| | - M Bonamico
- Celiac Disease and Malabsorptive Diseases Unit, Department of Pediatrics, Sapienza University, Viale Regina Margherita 324, 00161 Rome, Italy
| | - M P Villa
- Pediatric Sleep Disease Centre, Child Neurology, NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, S. Andrea Hospital, Via di Grottarossa 1035-39, 00189 Rome, Italy.
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Petrarca L, Nenna R, Mastrogiorgio G, Florio M, Brighi M, Pontone S. Dyspepsia and celiac disease: Prevalence, diagnostic tools and therapy. World J Methodol 2014; 4:189-196. [PMID: 25332916 PMCID: PMC4202456 DOI: 10.5662/wjm.v4.i3.189] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 06/17/2014] [Accepted: 09/10/2014] [Indexed: 02/06/2023] Open
Abstract
The prevalence of dyspepsia is up to 40% in population-based study. Functional dyspepsia is an exclusion diagnosis and it is classified as a chronic abdominal pain-related functional disorder, characterized by the presence of persistent or recurrent pain or discomfort centered in the upper abdomen, neither relief by defecation, nor association with the onset of a change in stool frequency or form. Celiac disease (CD) is a common autoimmune enteropathy, with a prevalence around 1% in the general population. Its diagnosis includes a serological screening and an upper gastrointestinal endoscopy with multiple biopsies. Gluten-free diet is the only effective treatment. CD diagnosis is often delayed in asymptomatic patients or in individuals with less clinical gastrointestinal symptoms. Several studies performed coeliac disease screening in patients with symptoms suggestive of dyspepsia, showing a biopsy-proved prevalence that ranged from 0.5% to 2%. The typical endoscopic markers of villous atrophy are not sufficiently sensitive, so some endoscopic techniques, such as “water immersion” and confocal endomicroscopy were proposed to improve the diagnostic sensitivity and target biopsies. A recent meta-analysis estimated that the prevalence of CD was higher in patients with dyspepsia, but not in a statistically significant way. However this assumption should be confirmed further larger studies.
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Iagnocco A, Ceccarelli F, Mennini M, Rutigliano IM, Perricone C, Nenna R, Petrarca L, Mastrogiorgio G, Valesini G, Bonamico M. Subclinical synovitis detected by ultrasound in children affected by coeliac disease: a frequent manifestation improved by a gluten-free diet. Clin Exp Rheumatol 2014; 32:137-142. [PMID: 24447910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Accepted: 04/03/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVES Coeliac disease (CD) is a chronic autoimmune disease of the small intestine caused by the ingestion of gluten, in which musculoskeletal manifestations may occur. Aim of this study was to evaluate the prevalence and severity of joint involvement in paediatric patients with CD using musculoskeletal ultrasound (US). METHODS Consecutive paediatric CD patients were enrolled and underwent US evaluations at level of knees, hips and ankles. The presence of joint effusion (JE), synovial hypertrophy, power Doppler signal and structural damage lesions (bone irregularities and erosions) was registered. Inflammatory abnormalities were scored on a semi-quantitative scale (0-3), and structural damage lesions on a dichotomous scale (0-1). RESULTS Seventy-four CD children (mean age: 7.6 years; range: 1-14.2; M/F 24/50) were enrolled. Thirty-eight were on a gluten-containing diet (GCD) and 36 on a gluten-free diet (GFD). US showed the presence of abnormalities in 23 patients overall (31.1%); JE was the most frequently observed change (23/23). US abnormalities were observed in 19 patients (50.0%) of GCD group and in 4 of GFD group (11.1%, p=0.007). Interestingly, 12/23 (52.2%) patients with US-detected changes were asymptomatic. CONCLUSIONS This is the first US study demonstrating joint involvement in children with CD. JE, the most frequent manifestation, was present also in asymptomatic patients and was reduced in those on GFD. These findings may indicate that, also at joint level, an inflammatory response represented by the appearance of JE may be induced by exposure to gluten.
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Affiliation(s)
- Annamaria Iagnocco
- Rheumatology Unit, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Roma, Italy.
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Nenna R, Tiberti C, Petrarca L, Mennini M, Mastrogiorgio G, Lucantoni F, Panimolle F, Pontone S, Bavastrelli M, Magliocca FM, Bonamico M. Anti-transglutaminase immunoreactivity and histological lesions of the duodenum in coeliac patients. Int Immunol 2013; 25:389-94. [PMID: 23446848 DOI: 10.1093/intimm/dxs159] [Citation(s) in RCA: 4] [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] [Indexed: 12/23/2022] Open
Abstract
Coeliac disease (CD) is characterized by several markers, including anti-transglutaminase auto-antibodies (tTGAb) directed against multiple epitopes of the gliadin protein. We aimed to investigate the correlation among CD duodenal lesions, tTGAb titres and the immunoreactivity against tTG constructs. A total of 345 CD patients (209 females, 136 males, overall median age: 7.3 years) were tested for full-length (fl) tTGAb with a fluid-phase radioimmunoassay. Out of the total, 231 patients were also tested for immunoreactivity against tTG fragments (F1: a.a. 227-687 and F2: a.a. 473-687). Patients were classified according to diffuse (D), patchy (P) or bulb (B) histological lesions. All sera were found fltTGAb positive. Patients with D, P and B lesions had a mean Ab index of 0.84±0.39, 0.57±0.39 and 0.45±0.24, respectively. Mean tTGAb titre varied between D and localized (P+B) patients (0.84±0.39 versus 0.52±0.34, P < 0.0001). Overall, 86.1% of patients were F1 auto-antibody (F1Ab) positive (D: 89%, P: 75%, B: 40%; D versus P+B: P = 0.004) and 49% of patients were F2 auto-antibody (F2Ab) positive (D: 53%, P: 19%, B: 10%; D versus P+B: P = 0.0006). Of the D patients 50.7% showed combined F1Ab-F2Ab (D versus P+B: P = 0.001), whereas 60% of B patients were negative for both F1Ab and F2Ab (B versus D: P < 0.0001). Coeliac-specific tTGAb immunoreactivity correlates with the grading and extension of histological duodenal lesions in CD patients at diagnosis. The immunoreactivity against single and combined tTG fragments is significantly higher in patients with D lesions. This is the first evidence of a distinct coeliac-specific immunoreactivity in patients with different duodenal involvement.
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Affiliation(s)
- Raffaella Nenna
- Department of Paediatrics, Sapienza University of Rome, Rome, Italy.
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Nenna R, Pontone S, Mennini M, Petrarca L, Mastrogiorgio G, Bonamico M. Duodenal bulb for diagnosing adult celiac disease: much more than an optimal biopsy site. Gastrointest Endosc 2012; 76:1081-2; author reply 1082. [PMID: 23078941 DOI: 10.1016/j.gie.2012.06.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Accepted: 06/18/2012] [Indexed: 12/11/2022]
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