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Frimat M, Gnemmi V, Stichelbout M, Provôt F, Fakhouri F. Pregnancy as a susceptible state for thrombotic microangiopathies. Front Med (Lausanne) 2024; 11:1343060. [PMID: 38476448 PMCID: PMC10927739 DOI: 10.3389/fmed.2024.1343060] [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: 11/22/2023] [Accepted: 02/12/2024] [Indexed: 03/14/2024] Open
Abstract
Pregnancy and the postpartum period represent phases of heightened vulnerability to thrombotic microangiopathies (TMAs), as evidenced by distinct patterns of pregnancy-specific TMAs (e.g., preeclampsia, HELLP syndrome), as well as a higher incidence of nonspecific TMAs, such as thrombotic thrombocytopenic purpura or hemolytic uremic syndrome, during pregnancy. Significant strides have been taken in understanding the underlying mechanisms of these disorders in the past 40 years. This progress has involved the identification of pivotal factors contributing to TMAs, such as the complement system, ADAMTS13, and the soluble VEGF receptor Flt1. Regardless of the specific causal factor (which is not generally unique in relation to the usual multifactorial origin of TMAs), the endothelial cell stands as a central player in the pathophysiology of TMAs. Pregnancy has a major impact on the physiology of the endothelium. Besides to the development of placenta and its vascular consequences, pregnancy modifies the characteristics of the women's microvascular endothelium and tends to render it more prone to thrombosis. This review aims to delineate the distinct features of pregnancy-related TMAs and explore the contributing mechanisms that lead to this increased susceptibility, particularly influenced by the "gravid endothelium." Furthermore, we will discuss the potential contribution of histopathological studies in facilitating the etiological diagnosis of pregnancy-related TMAs.
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Affiliation(s)
- Marie Frimat
- CHU Lille, Nephrology Department, Univ. Lille, Lille, France
- Inserm, Institut Pasteur de Lille, Univ. Lille, Lille, France
| | | | | | - François Provôt
- CHU Lille, Nephrology Department, Univ. Lille, Lille, France
| | - Fadi Fakhouri
- Service of Nephrology and Hypertension, CHUV and University of Lausanne, Lausanne, Switzerland
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2
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Hamroun A, Prouteau C, Lenain R, Roger C, Bauters A, Zawadzki C, Subtil D, Gibier JB, Stichelbout M, Coppo P, Lionet A, Maanaoui M, Hazzan M, Provôt F. The challenging follow-up of pregnancy in women with known thrombotic thrombocytopenic purpura: a single-center experience of a preemptive management protocol. J Nephrol 2023; 36:2519-2529. [PMID: 37816989 DOI: 10.1007/s40620-023-01790-x] [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] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/30/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Although thrombotic thrombocytopenic purpura frequently affects women of childbearing age, there is no clear recommendation for the management of subsequent pregnancies in women with established thrombotic thrombocytopenic purpura. METHODS This single-center, retrospective, observational study included all women with hereditary thrombotic thrombocytopenic purpura or immune thrombotic thrombocytopenic purpura who had had at least one subsequent pregnancy after thrombotic thrombocytopenic purpura diagnosis between 2003 and 2022. The strategy comprised weekly surveillance of platelet count during pregnancy (and quarterly monitoring of ADAMTS13 activity) for women with immune thrombotic thrombocytopenic purpura, without any routine prophylactic treatment. In case of thrombocytopenia < 150,000/mm3 (with or without hemolysis relapse), women with hereditary thrombotic thrombocytopenic purpura systematically received plasma infusions twice weekly until platelet count normalized. RESULTS A total of 13 patients were included (7 with hereditary thrombotic thrombocytopenic purpura and 6 with immune thrombotic thrombocytopenic purpura, with 20 planned pregnancies (11 and 9, respectively). All pregnancies resulted in live births, and all mothers survived. There was a marked improvement in pregnancy terms in the hereditary thrombotic thrombocytopenic purpura group compared to index pregnancies (37 [35;39] versus 31 [24;38] weeks, p = 0.037) and birth weights (3265 [3029;3410] versus 2160 [1240;2705] grams, p = 0.016), with need for plasma support mostly starting during the third trimester (5/7 patients, 7/11 pregnancies). A single hereditary thrombotic thrombocytopenic purpura relapse occurred, with rapid resolution after plasma support intensification. There were no relapses in the immune thrombotic thrombocytopenic purpura group, with ADAMTS13 activity systematically above 40% during all monitored pregnancies. CONCLUSION These real-life data support the feasibility of a preemptive approach to pregnancy monitoring in women with known thrombotic thrombocytopenic purpura who undergo active surveillance within a multidisciplinary network.
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Affiliation(s)
- Aghiles Hamroun
- Department of Nephrology, Dialysis, Transplantation, and Apheresis, Lille University, Lille University Hospital Center of Lille, 59000, Lille, France
- UMR1167 RID-AGE, Inserm, Institut Pasteur de Lille, Lille University, 59000, Lille, France
| | - Camille Prouteau
- Department of Nephrology, Dialysis, Transplantation, and Apheresis, Lille University, Lille University Hospital Center of Lille, 59000, Lille, France
| | - Rémi Lenain
- Department of Nephrology, Dialysis, Transplantation, and Apheresis, Lille University, Lille University Hospital Center of Lille, 59000, Lille, France
| | - Camille Roger
- Department of Nephrology, Dialysis, Transplantation, and Apheresis, Lille University, Lille University Hospital Center of Lille, 59000, Lille, France
| | - Anne Bauters
- Department of Hematology and Transfusion, Pôle de Biologie Pathologie Génétique, CHU Lille, Lille University, Lille, France
| | - Christophe Zawadzki
- Department of Hematology and Transfusion, Pôle de Biologie Pathologie Génétique, CHU Lille, Lille University, Lille, France
| | - Damien Subtil
- CHU Lille, Hôpital Jeanne de Flandre, Lille University, 59000, Lille, France
- Lille University, EA 2694 Santé Publique, Épidémiologie Et Qualité Des Soins, F-59000, Lille, France
| | - Jean-Baptiste Gibier
- Regional and University Hospital Center of Lille, Department of Pathology, Pathology Institute, Lille University, 59037, Lille, France
| | - Morgane Stichelbout
- Regional and University Hospital Center of Lille, Department of Pathology, Pathology Institute, Lille University, 59037, Lille, France
| | - Paul Coppo
- French Reference Centre for Thrombotic Microangiopathies, Saint-Antoine Hospital, Paris, France
- Hematology Department, Saint-Antoine Hospital, Paris, France
- Sorbonne University, Paris, France
| | - Arnaud Lionet
- Department of Nephrology, Dialysis, Transplantation, and Apheresis, Lille University, Lille University Hospital Center of Lille, 59000, Lille, France
| | - Mehdi Maanaoui
- Department of Nephrology, Dialysis, Transplantation, and Apheresis, Lille University, Lille University Hospital Center of Lille, 59000, Lille, France
- Inserm, CHU Lille, Institut Pasteur Lille, Lille University, U1190, EGID, F-59000, Lille, France
| | - Marc Hazzan
- Department of Nephrology, Dialysis, Transplantation, and Apheresis, Lille University, Lille University Hospital Center of Lille, 59000, Lille, France
| | - François Provôt
- Department of Nephrology, Dialysis, Transplantation, and Apheresis, Lille University, Lille University Hospital Center of Lille, 59000, Lille, France.
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3
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Ghesquière L, Perbet R, Lacan L, Hamoud Y, Stichelbout M, Sharma D, Nguyen S, Storme L, Houfflin-Debarge V, De Jonckheere J, Garabedian C. Associations between fetal heart rate variability and umbilical cord occlusions-induced neural injury: An experimental study in a fetal sheep model. Acta Obstet Gynecol Scand 2022; 101:758-770. [PMID: 35502642 DOI: 10.1111/aogs.14352] [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] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/27/2022] [Accepted: 03/07/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION This study evaluated the association between fetal heart rate variability (HRV) and the occurrence of hypoxic-ischemic encephalopathy in a fetal sheep model. MATERIAL AND METHODS The experimental protocol created a hypoxic condition with repeated cord occlusions in three phases (A, B, C) to achieve acidosis to pH <7.00. Hemodynamic, gasometric and HRV parameters were analyzed during the protocol, and the fetal brain, brainstem and spinal cord were assessed histopathologically 48 h later. Associations between the various parameters and neural injury were compared between phases A, B and C using Spearman's rho test. RESULTS Acute anoxic-ischemic brain lesions in all regions was present in 7/9 fetuses, and specific neural injury was observed in 3/9 fetuses. The number of brainstem lesions correlated significantly and inversely with the HRV fetal stress index (r = -0.784; p = 0.021) in phase C and with HRV long-term variability (r = -0.677; p = 0.045) and short-term variability (r = -0.837; p = 0.005) in phase B. The number of neurological lesions did not correlate significantly with other markers of HRV. CONCLUSIONS Neural injury caused by severe hypoxia was associated with HRV changes; in particular, brainstem damage was associated with changes in fetal-specific HRV markers.
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Affiliation(s)
- Louise Ghesquière
- Evaluation of Health Technologies and Medical Practices (METRICS) - ULR 2694, University of Lille, Centre Hospitalier Universitaire de Lille, Lille, France.,Department of Obstetrics, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Romain Perbet
- Department of Anatomopathology, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Laure Lacan
- Evaluation of Health Technologies and Medical Practices (METRICS) - ULR 2694, University of Lille, Centre Hospitalier Universitaire de Lille, Lille, France.,Department of Neuropediatrics, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Yasmine Hamoud
- Evaluation of Health Technologies and Medical Practices (METRICS) - ULR 2694, University of Lille, Centre Hospitalier Universitaire de Lille, Lille, France.,Department of Obstetrics, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Morgane Stichelbout
- Department of Anatomopathology, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Dyuti Sharma
- Evaluation of Health Technologies and Medical Practices (METRICS) - ULR 2694, University of Lille, Centre Hospitalier Universitaire de Lille, Lille, France.,Department of Pediatric Surgery, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Sylvie Nguyen
- Evaluation of Health Technologies and Medical Practices (METRICS) - ULR 2694, University of Lille, Centre Hospitalier Universitaire de Lille, Lille, France.,Department of Neuropediatrics, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Laurent Storme
- Evaluation of Health Technologies and Medical Practices (METRICS) - ULR 2694, University of Lille, Centre Hospitalier Universitaire de Lille, Lille, France.,Department of Neonatology, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Véronique Houfflin-Debarge
- Evaluation of Health Technologies and Medical Practices (METRICS) - ULR 2694, University of Lille, Centre Hospitalier Universitaire de Lille, Lille, France.,Department of Obstetrics, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Julien De Jonckheere
- Evaluation of Health Technologies and Medical Practices (METRICS) - ULR 2694, University of Lille, Centre Hospitalier Universitaire de Lille, Lille, France.,Clinical Investigation Center - Technological Innovation (CIC-IT 1403), Centre Hospitalier Universitaire de Lille, Lille, France
| | - Charles Garabedian
- Evaluation of Health Technologies and Medical Practices (METRICS) - ULR 2694, University of Lille, Centre Hospitalier Universitaire de Lille, Lille, France.,Department of Obstetrics, Centre Hospitalier Universitaire de Lille, Lille, France
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4
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Coste T, Vincent-Delorme C, Stichelbout M, Devisme L, Gelot A, Deryabin I, Pelluard F, Aloui C, Leutenegger AL, Jouannic JM, Héron D, Gould DB, Tournier-Lasserve E. COL4A1/COL4A2 and inherited platelet disorder gene variants in fetuses showing intracranial hemorrhage. Prenat Diagn 2022; 42:601-610. [PMID: 35150448 PMCID: PMC10434296 DOI: 10.1002/pd.6113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/22/2021] [Revised: 01/12/2022] [Accepted: 02/09/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Variants of COL4A1/COL4A2 genes have been reported in fetal intracranial hemorrhage (ICH) cases but their prevalence and characteristics have not been established in a large series of fetuses. Fetal neonatal alloimmune thrombocytopenia is a major acquired ICH factor but the prevalence and characteristics of inherited platelet disorder (IPD) gene variants leading to thrombocytopenia are unknown. Herein, we screened COL4A1/COL4A2 and IPD genes in a large series of ICH fetuses. METHODS A cohort of 194 consecutive ICH fetuses were first screened for COL4A1/COL4A2 variants. We manually curated a list of 64 genes involved in IPD and investigated them in COL4A1/COL4A2 negative fetuses, using exome sequencing data from 101 of these fetuses. RESULT Pathogenic variants of COL4A1/COL4A2 genes were identified in 36 fetuses (19%). They occurred de novo in 70% of the 32 fetuses for whom parental DNA was available. Pathogenic variants in two megakaryopoiesis genes (MPL and MECOM genes) were identified in two families with recurrent and severe fetal ICH, with variable extraneurological pathological features. CONCLUSION Our study emphasizes the genetic heterogeneity of fetal ICH and the need to screen both COL4A1/COL4A2 and IPD genes in the etiological investigation of fetal ICH to allow proper genetic counseling.
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Affiliation(s)
- Thibault Coste
- AP-HP, Service de génétique moléculaire Neurovasculaire, Hôpital Saint-Louis, Paris, France
- Université de Paris, INSERM UMR-1141 Neurodiderot, Paris, France
| | | | | | | | - Antoinette Gelot
- APHP, Service de fœtopathologie, Hôpital Trousseau, Paris, France
| | - Igor Deryabin
- APHP, Service de fœtopathologie, Hôpital Trousseau, Paris, France
| | - Fanny Pelluard
- University Bordeaux, INSERM, BaRITOn, U1053, Bordeaux, France
| | - Chaker Aloui
- Université de Paris, INSERM UMR-1141 Neurodiderot, Paris, France
| | | | - Jean-Marie Jouannic
- APHP Sorbonne Université, Service de médecine fœtale, Hôpital Trousseau, Paris, France
| | - Delphine Héron
- AP-HP, Service de génétique clinique, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Douglas B Gould
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
| | - Elisabeth Tournier-Lasserve
- AP-HP, Service de génétique moléculaire Neurovasculaire, Hôpital Saint-Louis, Paris, France
- Université de Paris, INSERM UMR-1141 Neurodiderot, Paris, France
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5
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Ghesh L, Musquer MD, Devisme L, Stichelbout M, Boutaud L, Elkhartoufi N, Vaast P, Boute O, Riteau AS, Le Vaillant C, Winer N, Joubert M, Bezieau S, Thomas S, Attie-Bitach T, Beneteau C. The first two non-Finnish HYLS1 variants: Expanding the phenotypic spectrum of hydrolethalus syndrome. Clin Genet 2021; 100:462-467. [PMID: 34212369 DOI: 10.1111/cge.14021] [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: 04/12/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 11/30/2022]
Abstract
Hydrolethalus syndrome (HLS) is a rare lethal fetal malformation disorder related to ciliogenesis disruption. This condition is more frequent in Finland where a founder missense variant in the HYLS1 gene was identified. No other HYLS1 variant has hitherto been implicated in HLS. We report two unrelated French fetuses presenting with a phenotype of HLS with brain abnormalities, limbs malformations with pre and postaxial hexadactyly and abnormal genitalia. These two fetuses have compound heterozygous variants in HYLS1. The first allele carries the same Finnish missense variant (NM_145014.2: c.632A > G, p.[Asp211Gly]) in both fetuses and the second allele carries a new missense variant (c.662G > C, p.[Arg221Pro]) in the first fetus, and a new nonsense variant (c.613C > T, p.[Arg205*]) in the second fetus. This is the first report of HYLS1 mutated cases outside Finland. Both cases presented here are consistent with HLS with additional malformations, allowing expansion of the phenotypic presentation previously described.
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Affiliation(s)
- Leïla Ghesh
- Service de Génétique Médicale, CHU Nantes, Nantes, France.,UF de Fœtopathologie et Génétique, CHU de Nantes, Nantes, France
| | - Marie Denis Musquer
- UF de Fœtopathologie et Génétique, CHU de Nantes, Nantes, France.,Service d'Anatomie et Cytologie Pathologiques, CHU Nantes, Nantes, France
| | - Louise Devisme
- Service d'Anatomie et Cytologie Pathologiques, CHRU de Lille, Lille, France
| | | | - Lucile Boutaud
- Service d'Histo-Embryologie et de Cytogénétique, Unité d'Embryofoetopathologie, Hôpital Necker Enfants-Malades, Assistance Publique Hôpitaux de Paris, Paris, France.,Institut Imagine, INSERM U1163, Université Paris Descartes, Sorbonne Paris Cite, Paris, France
| | - Nadia Elkhartoufi
- Service d'Histo-Embryologie et de Cytogénétique, Unité d'Embryofoetopathologie, Hôpital Necker Enfants-Malades, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Pascal Vaast
- Service d'Echographie Fœtale et de Médecine Fœtale, CHRU de Lille, Lille, France
| | - Odile Boute
- Service de Génétique Médicale, CHRU de Lille, Lille, France
| | - Anne-Sophie Riteau
- Service de Gynécologie-Obstétrique, CHU Nantes, Nantes, France.,Service de Gynécologie-Obstétrique, Clinique Jules Vernes, Nantes, France
| | | | - Norbert Winer
- Service de Gynécologie-Obstétrique, CHU Nantes, Nantes, France.,UMR PhAN 1280 NUN INRAE F-44000, Université de Nantes, Nantes, France
| | - Madeleine Joubert
- UF de Fœtopathologie et Génétique, CHU de Nantes, Nantes, France.,Service d'Anatomie et Cytologie Pathologiques, CHU Nantes, Nantes, France
| | - Stéphane Bezieau
- Service de Génétique Médicale, CHU Nantes, Nantes, France.,L'institut du Thorax, INSERM, CNRS, UNIV Nantes, CHU de Nantes, Nantes, France
| | - Sophie Thomas
- Institut Imagine, INSERM U1163, Université Paris Descartes, Sorbonne Paris Cite, Paris, France
| | - Tania Attie-Bitach
- Service d'Histo-Embryologie et de Cytogénétique, Unité d'Embryofoetopathologie, Hôpital Necker Enfants-Malades, Assistance Publique Hôpitaux de Paris, Paris, France.,Institut Imagine, INSERM U1163, Université Paris Descartes, Sorbonne Paris Cite, Paris, France
| | - Claire Beneteau
- Service de Génétique Médicale, CHU Nantes, Nantes, France.,UF de Fœtopathologie et Génétique, CHU de Nantes, Nantes, France
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6
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Gérard A, Levavasseur M, Gaboriau L, Stichelbout M, Staumont-Salle D. [Hemorrhagic bullous dermatosis (HBD): A rare side-effect of heparins]. Ann Dermatol Venereol 2020; 147:446-450. [PMID: 32005507 DOI: 10.1016/j.annder.2019.08.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 12/08/2018] [Revised: 02/04/2019] [Accepted: 08/21/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Bullous haemorrhagic dermatosis (BHD) induced by heparin is a rare and benign side effect of which we report two cases. PATIENTS AND METHODS Case 1: an 81-year-old man presented haemorrhagic bullae on the limbs and trunk 7 days after starting enoxaparin. The laboratory haemostasis assessment was normal. A diagnosis was made of BHD induced by enoxaparin and the patient's treatment was switched to apixaban, resulting in a favourable outcome with resolution of the lesions within 15 days. Case 2: a 71-year-old woman hospitalised for pulmonary embolism was given tinzaparin. At two months of treatment, haemorrhagic bullae were observed on her forearms at distance from the injection sites. A diagnosis of BHD induced by tinzaparin was made. Treatment with tinzaparin was continued and the lesions resolved within 15 days. DISCUSSION Heparin-induced BHD is a rare entity initially described in 2006. Ninety-five cases of heparin-induced BHD have been reported. It is characterized by multiple haemorrhagic bullae at a distance from the injection sites. Time to onset of lesions after heparin initiation ranges from 24h to 4 months. Laboratory assessment should be routinely performed to rule out any haemostasis disorders. Lesions subside within 15 days whether heparin is continued or withdrawn. CONCLUSION Heparin-induced BHD is a rare but benign side effect of heparins. In the absence of recommendations, therapeutic management should be adapted to the individual situation.
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Affiliation(s)
- A Gérard
- Service de dermatologie, hôpital Claude-Huriez, CHU de Lille, 59000 Lille, France; Université de Lille, 59000 Lille, France.
| | - M Levavasseur
- Service de dermatologie, hôpital Claude-Huriez, CHU de Lille, 59000 Lille, France; Université de Lille, 59000 Lille, France
| | - L Gaboriau
- Service de pharmacologie, CHU de Lille, Centre régional de pharmacovigilance, 59000 Lille, France
| | - M Stichelbout
- Laboratoire d'anatomie et de pathologie, centre de biopathologie, CHU de Lille, 59000 Lille, France
| | - D Staumont-Salle
- Service de dermatologie, hôpital Claude-Huriez, CHU de Lille, 59000 Lille, France; Université de Lille, 59000 Lille, France
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7
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Brunelle P, Jourdain AS, Escande F, Martinovic J, Dupont J, Busa T, Moncla A, Frénois F, Stichelbout M, Manouvrier-Hanu S, Petit F. WNT10B variants in split hand/foot malformation: Report of three novel families and review of the literature. Am J Med Genet A 2019; 179:1351-1356. [PMID: 31050392 DOI: 10.1002/ajmg.a.61177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 10/11/2018] [Revised: 04/11/2019] [Accepted: 04/16/2019] [Indexed: 12/12/2022]
Abstract
Split-hand/foot malformation (SHFM) is a genetically heterogeneous congenital limb malformation typically limited to a defect of the central rays of the autopod, presenting as a median cleft of hands and feet. It can be associated with long bone deficiency or included in more complex syndromes. Among the numerous genetic causes, WNT10B homozygous variants have been recently identified in consanguineous families, but remain still rarely described (SHFM6; MIM225300). We report on three novel SHFM families harboring WNT10B variants and review the literature, allowing us to highlight some clinical findings. The feet are more severely affected than the hands and there is a frequent asymmetry without obvious side-bias. Syndactyly of third-fourth fingers was a frequent finding (62%). Polydactyly, which was classically described in SHFM6, was only present in 27% of patients. No genotype-phenotype correlation is delineated but heterozygous individuals might have mild features of SHFM, suggesting a dose-effect of the WNT10B loss-of-function.
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Affiliation(s)
- Perrine Brunelle
- Clinique de Génétique Guy Fontaine, Hôpital Jeanne de Flandre, CHU Lille, Lille, France
| | - Anne-Sophie Jourdain
- Laboratoire de Biochimie et Biologie Moléculaire, Centre de Biologie Pathologie, CHU Lille, Lille, France.,EA7364-RADEME, Université de Lille, Lille, France
| | - Fabienne Escande
- Laboratoire de Biochimie et Biologie Moléculaire, Centre de Biologie Pathologie, CHU Lille, Lille, France.,EA7364-RADEME, Université de Lille, Lille, France
| | - Jelena Martinovic
- Unité de Foetopathologie, AP-HP, Hôpital Antoine Béclère, Clamart, France.,INSERM U1169, Kremlin Bicêtre, France
| | - Juliette Dupont
- Serviço de Genética Departamento da Criança e da Família, Hospital de Santa Maria, Lisbon, Portugal
| | - Tiffany Busa
- Service de Génétique Clinique, Département de Génétique, AP-HM CHU Timone Enfants, Marseille, France
| | - Anne Moncla
- Service de Génétique Clinique, Département de Génétique, AP-HM CHU Timone Enfants, Marseille, France
| | | | | | - Sylvie Manouvrier-Hanu
- Clinique de Génétique Guy Fontaine, Hôpital Jeanne de Flandre, CHU Lille, Lille, France.,EA7364-RADEME, Université de Lille, Lille, France
| | - Florence Petit
- Clinique de Génétique Guy Fontaine, Hôpital Jeanne de Flandre, CHU Lille, Lille, France.,EA7364-RADEME, Université de Lille, Lille, France
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8
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Bonnard C, Shboul M, Tonekaboni SH, Ng AYJ, Tohari S, Ghosh K, Lai A, Lim JY, Tan EC, Devisme L, Stichelbout M, Alkindi A, Banu N, Yüksel Z, Ghoumid J, Elkhartoufi N, Boutaud L, Micalizzi A, Brett MS, Venkatesh B, Valente EM, Attié-Bitach T, Reversade B, Kariminejad A. Novel mutations in the ciliopathy-associated gene CPLANE1 (C5orf42) cause OFD syndrome type VI rather than Joubert syndrome. Eur J Med Genet 2018; 61:585-595. [PMID: 29605658 DOI: 10.1016/j.ejmg.2018.03.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 06/30/2017] [Revised: 03/28/2018] [Accepted: 03/28/2018] [Indexed: 01/22/2023]
Abstract
Mutations in CPLANE1 (previously known as C5orf42) cause Oral-Facial-Digital Syndrome type VI (OFD6) as well as milder Joubert syndrome (JS) phenotypes. Seven new cases from five unrelated families diagnosed with pure OFD6 were systematically examined. Based on the clinical manifestations of these patients and those described in the literature, we revised the diagnostic features of OFD6 and include the seven most common characteristics: 1) molar tooth sign, 2) tongue hamartoma and/or lobulated tongue, 3) additional frenula, 4) mesoaxial polydactyly of hands, 5) preaxial polydactyly of feet, 6) syndactyly and/or bifid toe, and 7) hypothalamic hamartoma. By whole or targeted exome sequencing, we identified seven novel germline recessive mutations in CPLANE1, including missense, nonsense, frameshift and canonical splice site variants, all causing OFD6 in these patients. Since CPLANE1 is also mutated in JS patients, we examined whether a genotype-phenotype correlation could be established. We gathered and compared 46 biallelic CPLANE1 mutations reported in 32 JS and 26 OFD6 patients. Since no clear correlation between paired genotypes and clinical outcomes could be determined, we concluded that patient's genetic background and gene modifiers may modify the penetrance and expressivity of CPLANE1 causal alleles. To conclude, our study provides a comprehensive view of the phenotypic range, the genetic basis and genotype-phenotype association in OFD6 and JS. The updated phenotype scoring system together with the identification of new CPLANE1 mutations will help clinicians and geneticists reach a more accurate diagnosis for JS-related disorders.
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Affiliation(s)
- Carine Bonnard
- Institute of Medical Biology, A*STAR, Singapore, Singapore.
| | - Mohammad Shboul
- Institute of Medical Biology, A*STAR, Singapore, Singapore; Al-Balqa Applied University, Faculty of Science, Al-Salt, Jordan
| | | | - Alvin Yu Jin Ng
- Institute of Molecular and Cell Biology, A*STAR, Singapore, Singapore
| | - Sumanty Tohari
- Institute of Molecular and Cell Biology, A*STAR, Singapore, Singapore
| | - Kakaly Ghosh
- Institute of Medical Biology, A*STAR, Singapore, Singapore
| | - Angeline Lai
- Genetics Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Jiin Ying Lim
- Genetics Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Ene Choo Tan
- KK Research Centre, KK Women's and Children's Hospital, Singapore, Singapore
| | - Louise Devisme
- Institute of Pathology, Centre de Biologie Pathologie, CHRU Lille, France
| | | | - Adila Alkindi
- Genetics Department, Sultan Qaboos University Hospital, Oman
| | - Nazreen Banu
- Genetics Department, Sultan Qaboos University Hospital, Oman
| | - Zafer Yüksel
- Medical Genetics Department, School of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Jamal Ghoumid
- Service de Génétique Clinique et Université Lille 2, CHRU de Lille, Hôpital Jeanne de Flandre, Lille, France
| | - Nadia Elkhartoufi
- Département de Génétique, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Lucile Boutaud
- Département de Génétique, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, Paris, France; INSERM U1163, Laboratoire d'Embryologie et Génétique des malformations congénitales, Université Paris Descartes, Sorbonne Paris Cite et Institute Imagine, Paris, France
| | | | | | - Byrappa Venkatesh
- Institute of Molecular and Cell Biology, A*STAR, Singapore, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Enza Maria Valente
- Neurogenetics Unit, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Tania Attié-Bitach
- Département de Génétique, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, Paris, France; INSERM U1163, Laboratoire d'Embryologie et Génétique des malformations congénitales, Université Paris Descartes, Sorbonne Paris Cite et Institute Imagine, Paris, France
| | - Bruno Reversade
- Institute of Medical Biology, A*STAR, Singapore, Singapore; Institute of Molecular and Cell Biology, A*STAR, Singapore, Singapore
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Devisme L, Chauvière C, Franquet-Ansart H, Chudzinski A, Stichelbout M, Houfflin-Debarge V, Subtil D. Perinatal outcome of placental massive perivillous fibrin deposition: a case-control study. Prenat Diagn 2017; 37:323-328. [DOI: 10.1002/pd.5013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 12/29/2016] [Accepted: 01/20/2017] [Indexed: 02/05/2023]
Affiliation(s)
- Louise Devisme
- Department of Pathology; Lille University Hospital CHRU; Lille Cedex France
| | - Claire Chauvière
- Jeanne de Flandre Hospital; Lille University Hospital CHRU; Lille Cedex France
| | | | | | - Morgane Stichelbout
- Department of Pathology; Lille University Hospital CHRU; Lille Cedex France
- North of France University; Lille France
| | - Véronique Houfflin-Debarge
- Jeanne de Flandre Hospital; Lille University Hospital CHRU; Lille Cedex France
- EA 4489; Lille North of France University; Lille France
| | - Damien Subtil
- Jeanne de Flandre Hospital; Lille University Hospital CHRU; Lille Cedex France
- EA 4489; Lille North of France University; Lille France
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10
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Stichelbout M, Devisme L, Franquet-Ansart H, Massardier J, Vinatier D, Renaud F, Kerdraon O. SALL4 expression in gestational trophoblastic tumors: a useful tool to distinguish choriocarcinoma from placental site trophoblastic tumor and epithelioid trophoblastic tumor. Hum Pathol 2016; 54:121-6. [PMID: 27068524 DOI: 10.1016/j.humpath.2016.03.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [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: 12/04/2015] [Revised: 03/04/2016] [Accepted: 03/11/2016] [Indexed: 11/17/2022]
Abstract
SALL4 has important functions in embryonic stem cells. The aim of this study was to investigate SALL4 expression in gestational trophoblastic neoplasia. We hypothesized that it could help to distinguish choriocarcinoma, the presumed most primitive form of gestational trophoblastic neoplasia, from placental site trophoblastic tumor and epithelioid trophoblastic tumor, which would be more differentiated variants. This study included 31 gestational trophoblastic neoplasias: 19 choriocarcinomas, 9 placental site trophoblastic tumors, 1 epithelioid trophoblastic tumor, and 2 mixed tumors comprising a placental site trophoblastic tumor and an epithelioid trophoblastic tumor. Unlike usual markers of gestational trophoblastic neoplasia (p63, human chorionic gonadotrophin and human placental lactogen), SALL4 was expressed in 100% of choriocarcinomas and it was not detected in any placental site trophoblastic tumor and epithelioid trophoblastic tumor. However, the proportion of positive cells varied in a wide range, from 10% to 70%, reflecting the fact that SALL4 was specifically present in mononuclear cells consistent with neoplastic cytotrophoblast. So, SALL4 may be helpful in the differential diagnosis of gestational trophoblastic neoplasias.
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Affiliation(s)
- Morgane Stichelbout
- Department of Pathology, Lille University Hospital CHRU, 59037 Lille Cedex, France; North of France University, 59000 Lille, France.
| | - Louise Devisme
- Department of Pathology, Lille University Hospital CHRU, 59037 Lille Cedex, France.
| | | | - Jérôme Massardier
- French Trophoblastic Diseases Reference Center, Lyon Sud University Hospital, 69495 Pierre Benite, France.
| | - Denis Vinatier
- North of France University, 59000 Lille, France; Department of Gynecology, Lille University Hospital CHRU, 59037 Lille Cedex, France.
| | - Florence Renaud
- Department of Pathology, Lille University Hospital CHRU, 59037 Lille Cedex, France; North of France University, 59000 Lille, France.
| | - Olivier Kerdraon
- Department of Pathology, Lille University Hospital CHRU, 59037 Lille Cedex, France.
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11
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Stichelbout M, Dieux-Coeslier A, Clouqueur E, Collet C, Petit F. A new case of bent bone dysplasia--FGFR2 type and review of the literature. Am J Med Genet A 2015; 170:785-9. [PMID: 26573129 DOI: 10.1002/ajmg.a.37473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Accepted: 10/30/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Morgane Stichelbout
- Service d' Anatomie-Pathologie, Centre de Biologie Pathologie, CHU Lille, France
| | | | - Elodie Clouqueur
- Service de Gynécologie-Obstétrique, Hôpital Jeanne de Flandre, CHU Lille, France
| | - Corinne Collet
- Service de Biochimie et Biologie Moléculaire, Hôpital Lariboisière, CHU Paris, France
| | - Florence Petit
- Service de Génétique Clinique, Hôpital Jeanne de Flandre, CHU Lille, France
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12
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Farhat MM, Chanson N, Baillet C, Stichelbout M, Pokeerbux R, Hatron PY, Hachulla E. Une pseudo-tumeur pancréatique. Rev Med Interne 2015; 36:786-7. [DOI: 10.1016/j.revmed.2015.07.010] [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] [Received: 04/25/2015] [Revised: 06/18/2015] [Accepted: 07/25/2015] [Indexed: 10/23/2022]
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