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Dangles M, Malan V, Dumas G, Nabbout R, Kaminska A, Eisermann M. OC16: Electro-clinical features in epileptic children with chromosome 15qduplication syndrome. Clin Neurophysiol 2022. [DOI: 10.1016/j.clinph.2021.11.067] [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: 11/25/2022]
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Millischer AE, Grevent D, Sonigo P, Bahi-Buisson N, Desguerre I, Mahallati H, Bault JP, Quibel T, Couderc S, Moutard ML, Julien E, Dangouloff V, Bessieres B, Malan V, Attie T, Salomon LJ, Boddaert N. Feasibility and Added Value of Fetal DTI Tractography in the Evaluation of an Isolated Short Corpus Callosum: Preliminary Results. AJNR Am J Neuroradiol 2022; 43:132-138. [PMID: 34949593 PMCID: PMC8757544 DOI: 10.3174/ajnr.a7383] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/27/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE Prognosis of isolated short corpus callosum is challenging. Our aim was to assess whether fetal DTI tractography can distinguish callosal dysplasia from variants of normal callosal development in fetuses with an isolated short corpus callosum. MATERIALS AND METHODS This was a retrospective study of 37 cases referred for fetal DTI at 30.4 weeks (range, 25-34 weeks) because of an isolated short corpus callosum less than the 5th percentile by sonography at 26 weeks (range, 22-31 weeks). Tractography quality, the presence of Probst bundles, dysmorphic frontal horns, callosal length (internal cranial occipitofrontal dimension/length of the corpus callosum ratio), and callosal thickness were assessed. Cytogenetic data and neurodevelopmental follow-up were systematically reviewed. RESULTS Thirty-three of 37 fetal DTIs distinguished the 2 groups: those with Probst bundles (Probst bundles+) in 13/33 cases (40%) and without Probst bundles (Probst bundles-) in 20/33 cases (60%). Internal cranial occipitofrontal dimension/length of the corpus callosum was significantly higher in Probst bundles+ than in Probst bundles-, with a threshold value determined at 3.75 for a sensitivity of 92% (95% CI, 77%-100%) and specificity of 85% (95% CI, 63%-100%). Callosal lipomas (4/4) were all in the Probst bundles- group. More genetic anomalies were found in the Probst bundles+ than in Probst bundles- group (23% versus 10%, P = .08). CONCLUSIONS Fetal DTI, combined with anatomic, cytogenetic, and clinical characteristics could suggest the possibility of classifying an isolated short corpus callosum as callosal dysplasia and a variant of normal callosal development.
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Affiliation(s)
- A.-E. Millischer
- From the Department of Paediatric Radiology (A.-E.M., D.G., P.S., V.D., N.B.), Assistance Publique–Hôpitaux de Paris, Hôpital Necker Enfants Malades, Université de Paris, Paris France,Institut Imagine (A.-E.M., D.G., P.S., N.B.-B., I.D., V.D., N.B.), Institut National de la Santé et de la Recherche Médicale U1163, Université de Paris, Paris, France,LUMIERE Platform (A.-E.M., D.G., P.S., H.M., N.B., L.-J.S.), Paris, France,IMPC Bachaumont (A.-E.M.), Paris, France
| | - D. Grevent
- From the Department of Paediatric Radiology (A.-E.M., D.G., P.S., V.D., N.B.), Assistance Publique–Hôpitaux de Paris, Hôpital Necker Enfants Malades, Université de Paris, Paris France,Institut Imagine (A.-E.M., D.G., P.S., N.B.-B., I.D., V.D., N.B.), Institut National de la Santé et de la Recherche Médicale U1163, Université de Paris, Paris, France,LUMIERE Platform (A.-E.M., D.G., P.S., H.M., N.B., L.-J.S.), Paris, France
| | - P. Sonigo
- From the Department of Paediatric Radiology (A.-E.M., D.G., P.S., V.D., N.B.), Assistance Publique–Hôpitaux de Paris, Hôpital Necker Enfants Malades, Université de Paris, Paris France,Institut Imagine (A.-E.M., D.G., P.S., N.B.-B., I.D., V.D., N.B.), Institut National de la Santé et de la Recherche Médicale U1163, Université de Paris, Paris, France,LUMIERE Platform (A.-E.M., D.G., P.S., H.M., N.B., L.-J.S.), Paris, France
| | - N. Bahi-Buisson
- Institut Imagine (A.-E.M., D.G., P.S., N.B.-B., I.D., V.D., N.B.), Institut National de la Santé et de la Recherche Médicale U1163, Université de Paris, Paris, France,Departments of Pediatric Neurology (N.B.-B., I.D.)
| | - I. Desguerre
- Institut Imagine (A.-E.M., D.G., P.S., N.B.-B., I.D., V.D., N.B.), Institut National de la Santé et de la Recherche Médicale U1163, Université de Paris, Paris, France,Departments of Pediatric Neurology (N.B.-B., I.D.)
| | - H. Mahallati
- LUMIERE Platform (A.-E.M., D.G., P.S., H.M., N.B., L.-J.S.), Paris, France,Department of Radiology (H.M.), University of Calgary, Calgary, Alberta, Canada
| | - J.-P. Bault
- Departments of Gynecology and Obstetrics (J.-P.B., T.Q.)
| | - T. Quibel
- Departments of Gynecology and Obstetrics (J.-P.B., T.Q.)
| | - S. Couderc
- Pediatrics (S.C.), CHI, Poissy Saint-Germain, France
| | - M.-L. Moutard
- Department of Pediatric Neurology (M.-L.M.), Trousseau Hospital, CHU, Trousseau, Paris
| | - E. Julien
- Department of Gynecology-Obstetrics (E.J.), Hospital Le Mans, Le Mans, France
| | - V. Dangouloff
- From the Department of Paediatric Radiology (A.-E.M., D.G., P.S., V.D., N.B.), Assistance Publique–Hôpitaux de Paris, Hôpital Necker Enfants Malades, Université de Paris, Paris France,Institut Imagine (A.-E.M., D.G., P.S., N.B.-B., I.D., V.D., N.B.), Institut National de la Santé et de la Recherche Médicale U1163, Université de Paris, Paris, France
| | | | - V. Malan
- Genetics (V.M., T.A.), Necker Enfants Malades University Hospital, Université de Paris, Paris, France
| | - T. Attie
- Genetics (V.M., T.A.), Necker Enfants Malades University Hospital, Université de Paris, Paris, France
| | - L.-J. Salomon
- LUMIERE Platform (A.-E.M., D.G., P.S., H.M., N.B., L.-J.S.), Paris, France,Department of Gynecology-Obstetrics (L.-J.S.), Université de Paris, Paris, France
| | - N. Boddaert
- From the Department of Paediatric Radiology (A.-E.M., D.G., P.S., V.D., N.B.), Assistance Publique–Hôpitaux de Paris, Hôpital Necker Enfants Malades, Université de Paris, Paris France,Institut Imagine (A.-E.M., D.G., P.S., N.B.-B., I.D., V.D., N.B.), Institut National de la Santé et de la Recherche Médicale U1163, Université de Paris, Paris, France,LUMIERE Platform (A.-E.M., D.G., P.S., H.M., N.B., L.-J.S.), Paris, France
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Dangles MT, Malan V, Dumas G, Romana S, Raoul O, Coste-Zeitoun D, Soufflet C, Vignolo-Diard P, Bahi-Buisson N, Barnérias C, Chemaly N, Desguerre I, Gitiaux C, Hully M, Bourgeois M, Guimier A, Rio M, Munnich A, Nabbout R, Kaminska A, Eisermann M. Electro-clinical features in epileptic children with chromosome 15q duplication syndrome. Clin Neurophysiol 2021; 132:1126-1137. [PMID: 33773177 DOI: 10.1016/j.clinph.2021.02.010] [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: 12/08/2020] [Revised: 02/03/2021] [Accepted: 02/22/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We aimed to describe epilepsy and EEG patterns related to vigilance states and age, in chromosome15-long-arm-duplication-syndrome (dup15q) children with epilepsy, in both duplication types: interstitial (intdup15) and isodicentric (idic15). METHODS Clinical data and 70 EEGs of 12 patients (5 intdup15, 7 idic15), followed from 4.5 m.o to 17y4m (median follow-up 8y3m), were retrospectively reviewed. EEGs were analyzed visually and using power spectrum analysis. RESULTS Seventy video-EEGs were analyzed (1-16 per patient, median 6), follow-up lasting up to 8y10m (median 4y2m): 25 EEGs in intdup15 (8 m.o to 12y.o, median 4y6m) and 45 EEGs in idic15 (7 m.o to 12 y.o, median 15 m). Epilepsy: 6 West syndrome (WS) (2intdup15, 4idic15); 4 Lennox-Gastaut syndromes (LGS) (1 intdup15, 3 idic15), 2 evolving from WS; focal epilepsy (3 intdup15). In idic15, WS displayed additional myoclonic seizures (3), atypical (4) or no hypsarrhythmia (2) and posterior predominant spike and polyspike bursts (4). Beta-band rapid-rhythms (RR): present in 11 patients, power decreased during non-REM-sleep, localization shifted from diffuse to anterior, peak frequency increased with age. CONCLUSION WS with peculiar electro-clinical features and LGS, along with beta-band RR decreasing in non-REM-sleep and shifting from diffuse to anterior localization with age are recognizable features pointing towards dup15q diagnosis in children with autism spectrum disorder and developmental delay. SIGNIFICANCE This study describes electroclinical features in both interstitial and isodicentric duplications of chromosome 15q, in epileptic children, including some recent extensions regarding sleep features; and illustrates how the temporo-spatial organization of beta oscillations can be of significant help in directing towards dup15q diagnosis hypothesis.
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Affiliation(s)
- M-T Dangles
- Department of Clinical Neurophysiology, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France; Centre de Référence des Epilepsies Rares CRéER, Department of Pediatric Neurology, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France; Department of Pediatric Neurology, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France; Université de Paris, Paris, France.
| | - V Malan
- Université de Paris, Paris, France; Department of Cytogenetics, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France
| | - G Dumas
- Department of Clinical Neurophysiology, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France; Human Genetics and Cognitive Functions, Institut Pasteur, UMR3571 CNRS, Université de Paris, Paris, France; Department of Psychiatry, Université de Montreal, CHU Sainte-Justine Hospital, Montreal, QC, Canada
| | - S Romana
- Université de Paris, Paris, France; Department of Cytogenetics, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France
| | - O Raoul
- Department of Cytogenetics, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France
| | - D Coste-Zeitoun
- Department of Clinical Neurophysiology, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France; Centre de Référence des Epilepsies Rares CRéER, Department of Pediatric Neurology, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France
| | - C Soufflet
- Department of Clinical Neurophysiology, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France
| | - P Vignolo-Diard
- Department of Clinical Neurophysiology, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France
| | - N Bahi-Buisson
- Department of Pediatric Neurology, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France; Université de Paris, Paris, France
| | - C Barnérias
- Department of Pediatric Neurology, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France
| | - N Chemaly
- Centre de Référence des Epilepsies Rares CRéER, Department of Pediatric Neurology, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France; Department of Pediatric Neurology, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France
| | - I Desguerre
- Department of Pediatric Neurology, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France; Université de Paris, Paris, France
| | - C Gitiaux
- Department of Clinical Neurophysiology, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France; Department of Pediatric Neurology, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France; Université de Paris, Paris, France
| | - M Hully
- Department of Pediatric Neurology, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France
| | - M Bourgeois
- Department of Pediatric Neurosurgery, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France
| | - A Guimier
- Department of Genetics, Necker-Enfants Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France
| | - M Rio
- Department of Genetics, Necker-Enfants Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France
| | - A Munnich
- Université de Paris, Paris, France; Department of Genetics, Necker-Enfants Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France
| | - R Nabbout
- Centre de Référence des Epilepsies Rares CRéER, Department of Pediatric Neurology, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France; Department of Pediatric Neurology, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France; Université de Paris, Paris, France
| | - A Kaminska
- Department of Clinical Neurophysiology, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France; Université de Paris, Paris, France
| | - M Eisermann
- Department of Clinical Neurophysiology, Necker-Enfants-Malades Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France; Université de Paris, Paris, France
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Le Bras A, Salomon LJ, Bussières L, Malan V, Elie C, Mahallati H, Ville Y, Vekemans M, Durand-Zaleski I. Cost-effectiveness of five prenatal screening strategies for trisomies and other unbalanced chromosomal abnormalities: model-based analysis. Ultrasound Obstet Gynecol 2019; 54:596-603. [PMID: 31006923 DOI: 10.1002/uog.20301] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/08/2019] [Accepted: 04/12/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To evaluate the cost-effectiveness of five prenatal screening strategies for trisomies (13/18/21) and other unbalanced chromosomal abnormalities (UBCA), following the introduction of cell-free DNA (cfDNA) analysis. METHODS A model-based cost-effectiveness analysis was performed to estimate prevalence, safety, screening-program costs and healthcare costs of five different prenatal screening strategies, using a virtual cohort of 652 653 pregnant women in France. Data were derived from the French Biomedicine Agency and published articles. Uncertainty was addressed using one-way sensitivity analysis. The five strategies compared were: (i) cfDNA testing for women with a risk following first-trimester screening of ≥ 1/250; (ii) cfDNA testing for women with a risk of ≥ 1/1000 (currently recommended); (iii) cfDNA testing in the general population (regardless of risk); (iv) invasive testing for women with a risk of ≥ 1/250 (historical strategy); and (v) invasive testing for women with a risk of ≥ 1/1000. RESULTS In our virtual population, at similar risk thresholds, cfDNA testing compared with invasive testing was cheaper but less effective. Compared with the historical strategy, cfDNA testing at the ≥ 1/1000 risk threshold was a more expensive strategy that detected 158 additional trisomies, but also 175 fewer other UBCA. Implementation of cfDNA testing in the general population would give an incremental cost-effectiveness ratio of €9 166 689 per additional anomaly detected compared with the historical strategy. CONCLUSION Extending cfDNA to lower risk thresholds or even to all pregnancies would detect more trisomies, but at greater expense and with lower detection rate of other UBCA, compared with the historical strategy. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- A Le Bras
- AP-HP, DRCI-URC Eco Ile-de-France, Paris, France
| | - L J Salomon
- AP-HP, Hôpital Necker-Enfants Malades, Department of Obstetrics and Gynecology, Paris, France
- Collège Français d'Echographie Foetale (CFEF), France
| | - L Bussières
- AP-HP, Hôpital Necker-Enfants Malades, Department of Obstetrics and Gynecology, Paris, France
- AP-HP, Hôpital Necker-Enfants Malades, Clinical Unit Research/Clinic Investigation Center, Paris, France
| | - V Malan
- INSERM U1163, Hôpital Necker-Enfants Malades, Paris, France
- AP-HP, Hôpital Necker-Enfants Malades, Department of Histology, Embryology and Cytogenetics, Paris, France
| | - C Elie
- AP-HP, Hôpital Necker-Enfants Malades, Clinical Unit Research/Clinic Investigation Center, Paris, France
| | - H Mahallati
- AP-HP, Hôpital Necker-Enfants Malades, Department of Obstetrics and Gynecology, Paris, France
| | - Y Ville
- AP-HP, Hôpital Necker-Enfants Malades, Department of Obstetrics and Gynecology, Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Paris, France
| | - M Vekemans
- AP-HP, Hôpital Necker-Enfants Malades, Department of Histology, Embryology and Cytogenetics, Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Paris, France
| | - I Durand-Zaleski
- AP-HP, DRCI-URC Eco Ile-de-France, Paris, France
- Assistance Publique-Hôpitaux de Paris, Service de Santé Publique, Henri Mondor-Albert-Chenevier, Créteil, France
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Egloff M, Malan V. Reply. Ultrasound Obstet Gynecol 2019; 53:555. [PMID: 30938480 DOI: 10.1002/uog.20253] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- M Egloff
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, APHP, Paris, France
- Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - V Malan
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, APHP, Paris, France
- Sorbonne Paris Cité, Université Paris Descartes, Paris, France
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Egloff M, Hervé B, Quibel T, Jaillard S, Le Bouar G, Uguen K, Saliou AH, Valduga M, Perdriolle E, Coutton C, Coston AL, Coussement A, Anselem O, Missirian C, Bretelle F, Prieur F, Fanget C, Muti C, Jacquemot MC, Beneteau C, Le Vaillant C, Vekemans M, Salomon LJ, Vialard F, Malan V. Diagnostic yield of chromosomal microarray analysis in fetuses with isolated increased nuchal translucency: a French multicenter study. Ultrasound Obstet Gynecol 2018; 52:715-721. [PMID: 29027723 DOI: 10.1002/uog.18928] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/04/2017] [Accepted: 10/05/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To determine the frequency and nature of copy number variants (CNVs) identified by chromosomal microarray analysis (CMA) in a large cohort of fetuses with isolated increased nuchal translucency thickness (NT) ≥ 3.5 mm. METHODS This was a retrospective, multicenter study, including 11 French hospitals, of data from the period between April 2012 and December 2015. In total, 720 fetuses were analyzed by rapid aneuploidy test and the fetuses identified as euploid underwent CMA. CNVs detected were evaluated for clinical significance and classified into five groups: pathogenic CNVs; benign CNVs; CNVs predisposing to neurodevelopmental disorders; variants of uncertain significance (VOUS); and CNVs not related to the phenotype (i.e. incidental findings). RESULTS In 121 (16.8%) fetuses, an aneuploidy involving chromosome 13, 18 or 21 was detected by rapid aneuploidy test and the remaining 599 fetuses were euploid. Among these, 53 (8.8%) had a CNV detected by CMA: 16/599 (2.7%) were considered to be pathogenic, including 11/599 (1.8%) that were cryptic (not visible by karyotyping); 7/599 (1.2%) were CNVs predisposing to neurodevelopmental disorders; and 8/599 (1.3%) were VOUS. Additionally, there was one (0.2%) CNV that was unrelated to the reason for referral diagnosis (i.e. an incidental finding) and the remaining 21 were benign CNVs, without clinical consequence. Interestingly, we identified five genomic imbalances of the 1q21.1 or 15q11.2 regions known to be associated with congenital heart defects. CONCLUSION Our study demonstrates the benefit of CMA in the etiological diagnosis of fetuses with isolated increased NT. It is worth noting that most (69%) of the detected pathogenic CNVs were cryptic. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M Egloff
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, APHP, Paris, France
- Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - B Hervé
- Unité de Cytogénétique, CHI de Poissy St Germain, Poissy, France
- EA7404-GIG, UFR des Sciences de la Santé Simone Veil, UVSQ, Montigny-le-Bretonneux, France
| | - T Quibel
- Service de Gynécologie Obstétrique, CHI de Poissy St Germain, Poissy, France
| | - S Jaillard
- Service de Cytogénétique et Biologie Cellulaire, CHU de Rennes, Rennes, France
| | - G Le Bouar
- Département de Gynécologie Obstétrique et Reproduction Humaine, CHU de Rennes, Rennes, France
| | - K Uguen
- Laboratoire de Cytogénétique, Cytologie et Biologie de la Reproduction, CHRU, Brest, France
| | - A-H Saliou
- Centre Pluridisciplinaire de Diagnostic Prénatal, CHRU, Brest, France
| | - M Valduga
- Service de Génétique, CHRU Nancy-Brabois, Nancy, France
| | - E Perdriolle
- Service d'Obstétrique, CHRU Nancy-Brabois, Nancy, France
| | - C Coutton
- Laboratoire de Génétique Chromosomique, INSERM 1209, CNRS UMR 5309, CHU Grenoble Alpes, Institut Albert Bonniot, Université Grenoble Alpes, Grenoble, France
| | - A-L Coston
- Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Couple Enfant, Université Grenoble Alpes, CHU Grenoble Alpes, Grenoble, France
| | - A Coussement
- Laboratoire de Cytogénétique, Hôpital Cochin, APHP, Paris, France
| | - O Anselem
- Service de Gynécologie et Obstétrique de Port-Royal, Maternité Port-Royal, Groupe Hospitalier Cochin Broca Hôtel-Dieu, APHP, Paris, France
| | - C Missirian
- Département de Génétique Médicale, CHU Timone Enfants, APHM, Marseille, France
| | - F Bretelle
- Service de Gynécologie Obstétrique, CHU Nord, APHM, Marseille, France
| | - F Prieur
- Service de Génétique Clinique Chromosomique Moléculaire, CHU Saint-Etienne, Saint-Etienne, France
| | - C Fanget
- Service d'Obstétrique, CHU Saint-Etienne, Saint-Etienne, France
| | - C Muti
- Génétique Constitutionnelle, Laboratoire de Biologie, Centre Hospitalier de Versailles, Le Chesnay, France
| | - M-C Jacquemot
- Consultation de Diagnostic Prénatal, Service de Gynécologie Obstétrique, Centre Hospitalier de Versailles, Le Chesnay, France
| | - C Beneteau
- Service de Génétique Médicale, CHU Nantes, Nantes, France
| | - C Le Vaillant
- Service de Gynécologie-Obstétrique, CHU de Nantes, Nantes, France
| | - M Vekemans
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, APHP, Paris, France
- Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - L J Salomon
- Sorbonne Paris Cité, Université Paris Descartes, Paris, France
- Service d'Obstétrique, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - F Vialard
- Unité de Cytogénétique, CHI de Poissy St Germain, Poissy, France
- EA7404-GIG, UFR des Sciences de la Santé Simone Veil, UVSQ, Montigny-le-Bretonneux, France
| | - V Malan
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, APHP, Paris, France
- Sorbonne Paris Cité, Université Paris Descartes, Paris, France
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Malan V, Bussières L, Salomon LJ. [Cell-free fetal DNA screening tests for trisomy 21]. ACTA ACUST UNITED AC 2016; 44:675-678. [PMID: 27839716 DOI: 10.1016/j.gyobfe.2016.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Indexed: 10/20/2022]
Affiliation(s)
- V Malan
- Service de cytogénétique, hôpital Necker-Enfants-Malades, université Paris Descartes, 149, rue de Sèvres, 75015 Paris, France
| | - L Bussières
- Service de gynécologie-obstétrique, hôpital Necker-Enfants-Malades, université Paris Descartes, 149, rue de Sèvres, 75015 Paris, France
| | - L J Salomon
- Service de gynécologie-obstétrique, hôpital Necker-Enfants-Malades, université Paris Descartes, 149, rue de Sèvres, 75015 Paris, France.
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Alberti A, Salomon LJ, Le Lorc'h M, Couloux A, Bussières L, Goupil S, Malan V, Pelletier E, Hyon C, Vialard F, Rozenberg P, Bouhanna P, Oury JF, Schmitz T, Romana S, Weissenbach J, Vekemans M, Ville Y. Non-invasive prenatal testing for trisomy 21 based on analysis of cell-free fetal DNA circulating in the maternal plasma. Prenat Diagn 2016; 35:471-6. [PMID: 25643828 DOI: 10.1002/pd.4561] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 01/04/2015] [Accepted: 01/14/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE By-the-book implementation of non-invasive prenatal test and clinical validation for trisomy 21. STUDY DESIGN Publicly funded prospective study of 225 cases. Women at risk for trisomy 21 > 1/250 based on combined ultrasound and serum markers during first or second trimester were eligible following an informed consent. The technique was established from the available literature and performed on 10 mL of venous blood collected prior to chorionic villus sampling or amniocentesis. Investigators were blinded to the fetal karyotype. Results were expressed in Z-scores of the percentage of each chromosome. RESULTS Among 976 eligible cases, 225 were processed: 8 were used for pretesting phase and 23 to build a reference set. One hundred thirty six euploid cases and 47 with trisomy 21 were then run randomly. Eleven cases yielded no result (4.8%). Z-scores were above 3 (7.58+/-2.41) for chromosome 21 in all 47 trisomies and in none of the euploid cases (0.11+/-1.0). Z-scores were within normal range for the other chromosomes in both groups. Using a cut-off of 3, sensitivity and specificity were of 100% 95% CI [94.1, 100] and 100% 95% CI [98, 100], respectively. CONCLUSION Non-invasive prenatal test for trisomy 21 is a robust strategy that can be translated from seminal publications. Publicly funded studies should refine its indications and cost-effectiveness in prenatal screening and diagnosis. © 2015 John Wiley & Sons, Ltd.
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9
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Lefebvre M, Sanlaville D, Marle N, Thauvin-Robinet C, Gautier E, Chehadeh SE, Mosca-Boidron AL, Thevenon J, Edery P, Alex-Cordier MP, Till M, Lyonnet S, Cormier-Daire V, Amiel J, Philippe A, Romana S, Malan V, Afenjar A, Marlin S, Chantot-Bastaraud S, Bitoun P, Heron B, Piparas E, Morice-Picard F, Moutton S, Chassaing N, Vigouroux-Castera A, Lespinasse J, Manouvrier-Hanu S, Boute-Benejean O, Vincent-Delorme C, Petit F, Meur NL, Marti-Dramard M, Guerrot AM, Goldenberg A, Redon S, Ferrec C, Odent S, Caignec CL, Mercier S, Gilbert-Dussardier B, Toutain A, Arpin S, Blesson S, Mortemousque I, Schaefer E, Martin D, Philip N, Sigaudy S, Busa T, Missirian C, Giuliano F, Benailly HK, Kien PKV, Leheup B, Benneteau C, Lambert L, Caumes R, Kuentz P, François I, Heron D, Keren B, Cretin E, Callier P, Julia S, Faivre L. Genetic counselling difficulties and ethical implications of incidental findings from array-CGH: a 7-year national survey. Clin Genet 2016; 89:630-5. [PMID: 26582393 DOI: 10.1111/cge.12696] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 11/11/2015] [Accepted: 11/16/2015] [Indexed: 11/29/2022]
Abstract
Microarray-based comparative genomic hybridization (aCGH) is commonly used in diagnosing patients with intellectual disability (ID) with or without congenital malformation. Because aCGH interrogates with the whole genome, there is a risk of being confronted with incidental findings (IF). In order to anticipate the ethical issues of IF with the generalization of new genome-wide analysis technologies, we questioned French clinicians and cytogeneticists about the situations they have faced regarding IF from aCGH. Sixty-five IF were reported. Forty corresponded to autosomal dominant diseases with incomplete penetrance, 7 to autosomal dominant diseases with complete penetrance, 14 to X-linked diseases, and 4 were heterozygotes for autosomal recessive diseases with a high prevalence of heterozygotes in the population. Therapeutic/preventive measures or genetic counselling could be argued for all cases except four. These four IF were intentionally not returned to the patients. Clinicians reported difficulties in returning the results in 29% of the cases, mainly when the question of IF had not been anticipated. Indeed, at the time of the investigation, only 48% of the clinicians used consents mentioning the risk of IF. With the emergence of new technologies, there is a need to report such national experiences; they show the importance of pre-test information on IF.
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Affiliation(s)
- M Lefebvre
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Est, FHU-TRANSLAD, Dijon, France.,Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne, Dijon, France
| | - D Sanlaville
- Genetics Service, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, and Eastern Biology and Pathology Centre, Lyon, France
| | - N Marle
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Est, FHU-TRANSLAD, Dijon, France.,Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France
| | - C Thauvin-Robinet
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Est, FHU-TRANSLAD, Dijon, France.,Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne, Dijon, France
| | - E Gautier
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Est, FHU-TRANSLAD, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne, Dijon, France
| | - S E Chehadeh
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Est, FHU-TRANSLAD, Dijon, France.,Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France
| | - A-L Mosca-Boidron
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Est, FHU-TRANSLAD, Dijon, France.,Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France
| | - J Thevenon
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Est, FHU-TRANSLAD, Dijon, France.,Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne, Dijon, France
| | - P Edery
- Genetics Service, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, and Eastern Biology and Pathology Centre, Lyon, France
| | - M-P Alex-Cordier
- Genetics Service, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, and Eastern Biology and Pathology Centre, Lyon, France
| | - M Till
- Genetics Service, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, and Eastern Biology and Pathology Centre, Lyon, France
| | - S Lyonnet
- Département de Génétique, Hôpital Necker-Enfants Malades, Paris, France
| | - V Cormier-Daire
- Département de Génétique, Hôpital Necker-Enfants Malades, Paris, France
| | - J Amiel
- Département de Génétique, Hôpital Necker-Enfants Malades, Paris, France
| | - A Philippe
- Département de Génétique, Hôpital Necker-Enfants Malades, Paris, France
| | - S Romana
- Département de Génétique, Hôpital Necker-Enfants Malades, Paris, France
| | - V Malan
- Département de Génétique, Hôpital Necker-Enfants Malades, Paris, France
| | - A Afenjar
- Service de Génétique, Hôpital Pitié Salpêtrière, Paris, France
| | - S Marlin
- Département de Génétique, Hôpital Necker-Enfants Malades, Paris, France
| | - S Chantot-Bastaraud
- APHP, Hôpital Armand Trousseau, Service de Génétique et d'Embryologie Médicales, Paris, France
| | - P Bitoun
- Service de Pédiatrie, Hôpital Jean Verdier, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - B Heron
- Department of Neuropediatrics, Armand Trousseau Hospital, APHP, Paris, France
| | - E Piparas
- Cytogenetics Laboratory, Jean Verdier Hospital, Bondy, France
| | - F Morice-Picard
- Department of Clinical Genetics, Bordeaux Children's Hospital, CHU de Bordeaux, Bordeaux, France
| | - S Moutton
- Department of Clinical Genetics, Bordeaux Children's Hospital, CHU de Bordeaux, Bordeaux, France
| | - N Chassaing
- Service de Génétique Médicale, Hôpital Purpan, CHU Toulouse, Université Paul Sabatier Toulouse, Toulouse, France
| | - A Vigouroux-Castera
- Service de Génétique Médicale, Hôpital Purpan, CHU Toulouse, Université Paul Sabatier Toulouse, Toulouse, France
| | - J Lespinasse
- Cytogenetics Laboratory, Chambery Hospital, Chambery, France
| | - S Manouvrier-Hanu
- Service de Génétique Clinique, Hôpital Jeanne de Flandre, CHRU, Lille, France
| | - O Boute-Benejean
- Service de Génétique Clinique, Hôpital Jeanne de Flandre, CHRU, Lille, France
| | - C Vincent-Delorme
- Service de Génétique Clinique, Hôpital Jeanne de Flandre, CHRU, Lille, France
| | - F Petit
- Service de Génétique Clinique, Hôpital Jeanne de Flandre, CHRU, Lille, France
| | - N L Meur
- Cytogenetics Laboratory, Etablissement Français du Sang de Normandie, Rouen, France
| | - M Marti-Dramard
- Unité de Génétique Clinique, Hôpital Nord, CHU, Amiens, France
| | - A-M Guerrot
- Service de Pédiatrie Néonatale et Réanimation, Centre D'éducation Fonctionnelle de l'enfant, CHU de Rouen, Rouen, France
| | - A Goldenberg
- Unité de Génétique Médicale, CHU Rouen, Rouen, France
| | - S Redon
- Laboratoire de Génétique Moléculaire, CHU, Brest, France
| | - C Ferrec
- Laboratoire de Génétique Moléculaire, CHU, Brest, France
| | - S Odent
- Service de Génétique Clinique, CLAD-Ouest, Hôpital Sud, Rennes, France
| | - C L Caignec
- Service de Génétique Médicale, Unité de Génétique Clinique, CLAD-Ouest, CHU de Nantes, Nantes, France
| | - S Mercier
- Service de Génétique Médicale, Unité de Génétique Clinique, CLAD-Ouest, CHU de Nantes, Nantes, France
| | | | - A Toutain
- Service de Génétique, Centre Hospitalo-Universitaire, Tours, France
| | - S Arpin
- Service de Génétique, Centre Hospitalo-Universitaire, Tours, France
| | - S Blesson
- Service de Génétique, Centre Hospitalo-Universitaire, Tours, France
| | - I Mortemousque
- Service de Génétique, Centre Hospitalo-Universitaire, Tours, France
| | - E Schaefer
- Service de Génétique Médicale, Hôpital de Hautepierre, Strasbourg, France
| | - D Martin
- Service de Génétique Médicale, Hôpital du Mans, Le Mans, France
| | - N Philip
- Département de Génétique Médicale, Hôpital d'Enfants de La Timone, Marseille, France
| | - S Sigaudy
- Département de Génétique Médicale, Hôpital d'Enfants de La Timone, Marseille, France
| | - T Busa
- Département de Génétique Médicale, Hôpital d'Enfants de La Timone, Marseille, France
| | - C Missirian
- Département de Génétique Médicale, Hôpital d'Enfants de La Timone, Marseille, France
| | - F Giuliano
- Service de Génétique Médicale, Hôpital de l'Archet II, CHU de Nice, Nice, France
| | - H K Benailly
- Service de Génétique Médicale, Hôpital de l'Archet II, CHU de Nice, Nice, France
| | - P K V Kien
- Service de Génétique Médicale, Hôpital Caremeau, CHU de Nimes, Nimes, France
| | - B Leheup
- CHU de Nancy Pole Enfant, Centre de Référence Maladies Rares CLAD Est, Service de Médecine Infantile III et Génétique Clinique, Nancy, France
| | - C Benneteau
- CHU de Nancy Pole Enfant, Centre de Référence Maladies Rares CLAD Est, Service de Médecine Infantile III et Génétique Clinique, Nancy, France
| | - L Lambert
- CHU de Nancy Pole Enfant, Centre de Référence Maladies Rares CLAD Est, Service de Médecine Infantile III et Génétique Clinique, Nancy, France
| | - R Caumes
- APHP, Hôpital Robert Debré, Service de Neurologie Pédiatrique, Paris, France
| | - P Kuentz
- Service de génétique, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | | | - D Heron
- Service de Génétique, APHP, Groupe Hospitalier de la Pitié-Salpétrière, Paris, France
| | - B Keren
- Service de Génétique, APHP, Groupe Hospitalier de la Pitié-Salpétrière, Paris, France
| | - E Cretin
- FHU-TRANSLAD, Université de Bourgogne, Dijon, France.,Espace Régional Éthique Bourgogne-Franche Comté, CHU, Besançon, France
| | - P Callier
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Est, FHU-TRANSLAD, Dijon, France.,Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne, Dijon, France
| | - S Julia
- Service de Génétique Médicale, Hôpital Purpan, CHU Toulouse, Université Paul Sabatier Toulouse, Toulouse, France
| | - L Faivre
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Est, FHU-TRANSLAD, Dijon, France.,Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne, Dijon, France
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10
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Vayssière C, Sentilhes L, Ego A, Bernard C, Cambourieu D, Flamant C, Gascoin G, Gaudineau A, Grangé G, Houfflin-Debarge V, Langer B, Malan V, Marcorelles P, Nizard J, Perrotin F, Salomon L, Senat MV, Serry A, Tessier V, Truffert P, Tsatsaris V, Arnaud C, Carbonne B. Fetal growth restriction and intra-uterine growth restriction: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians. Eur J Obstet Gynecol Reprod Biol 2015. [PMID: 26207980 DOI: 10.1016/j.ejogrb.2015.06.021] [Citation(s) in RCA: 147] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Small for gestational age (SGA) is defined by weight (in utero estimated fetal weight or birth weight) below the 10th percentile (professional consensus). Severe SGA is SGA below the third percentile (professional consensus). Fetal growth restriction (FGR) or intra-uterine growth restriction (IUGR) usually correspond with SGA associated with evidence indicating abnormal growth (with or without abnormal uterine and/or umbilical Doppler): arrest of growth or a shift in its rate measured longitudinally (at least two measurements, 3 weeks apart) (professional consensus). More rarely, they may correspond with inadequate growth, with weight near the 10th percentile without being SGA (LE2). Birthweight curves are not appropriate for the identification of SGA at early gestational ages because of the disorders associated with preterm delivery. In utero curves represent physiological growth more reliably (LE2). In diagnostic (or reference) ultrasound, the use of growth curves adjusted for maternal height and weight, parity and fetal sex is recommended (professional consensus). In screening, the use of adjusted curves must be assessed in pilot regions to determine the schedule for their subsequent introduction at national level. This choice is based on evidence of feasibility and the absence of any proven benefits for individualized curves for perinatal health in the general population (professional consensus). Children born with FGR or SGA have a higher risk of minor cognitive deficits, school problems and metabolic syndrome in adulthood. The role of preterm delivery in these complications is linked. The measurement of fundal height remains relevant to screening after 22 weeks of gestation (Grade C). The biometric ultrasound indicators recommended are: head circumference (HC), abdominal circumference (AC) and femur length (FL) (professional consensus). They allow calculation of estimated fetal weight (EFW), which, with AC, is the most relevant indicator for screening. Hadlock's EFW formula with three indicators (HC, AC and FL) should ideally be used (Grade B). The ultrasound report must specify the percentile of the EFW (Grade C). Verification of the date of conception is essential. It is based on the crown-rump length between 11 and 14 weeks of gestation (Grade A). The HC, AC and FL measurements must be related to the appropriate reference curves (professional consensus); those modelled from College Francais d'Echographie Fetale data are recommended because they are multicentere French curves (professional consensus). Whether or not a work-up should be performed and its content depend on the context (gestational age, severity of biometric abnormalities, other ultrasound data, parents' wishes, etc.) (professional consensus). Such a work-up only makes sense if it might modify pregnancy management and, in particular, if it has the potential to reduce perinatal and long-term morbidity and mortality (professional consensus). The use of umbilical artery Doppler velocimetry is associated with better newborn health status in populations at risk, especially in those with FGR (Grade A). This Doppler examination must be the first-line tool for surveillance of fetuses with SGA and FGR (professional consensus). A course of corticosteroids is recommended for women with an FGR fetus, and for whom delivery before 34 weeks of gestation is envisaged (Grade C). Magnesium sulphate should be prescribed for preterm deliveries before 32-33 weeks of gestation (Grade A). The same management should apply for preterm FGR deliveries (Grade C). In cases of FGR, fetal growth must be monitored at intervals of no less than 2 weeks, and ideally 3 weeks (professional consensus). Referral to a Level IIb or III maternity ward must be proposed in cases of EFW <1500g, potential birth before 32-34 weeks of gestation (absent or reversed umbilical end-diastolic flow, abnormal venous Doppler) or a fetal disease associated with any of these (professional consensus). Systematic caesarean deliveries for FGR are not recommended (Grade C). In cases of vaginal delivery, fetal heart rate must be monitored continuously during labour, and any delay before intervention must be faster than in low-risk situations (professional consensus). Regional anaesthesia is preferred in trials of vaginal delivery, as in planned caesareans. Morbidity and mortality are higher in SGA newborns than in normal-weight newborns of the same gestational age (LE3). The risk of neonatal mortality is two to four times higher in SGA newborns than in non-SGA preterm and full-term infants (LE2). Initial management of an SGA newborn includes combatting hypothermia by maintaining the heat chain (survival blanket), ventilation with a pressure-controlled insufflator, if necessary, and close monitoring of capillary blood glucose (professional consensus). Testing for antiphospholipids (anticardiolipin, circulating anticoagulant, anti-beta2-GP1) is recommended in women with previous severe FGR (below third percentile) that led to birth before 34 weeks of gestation (professional consensus). It is recommended that aspirin should be prescribed to women with a history of pre-eclampsia before 34 weeks of gestation, and/or FGR below the fifth percentile with a probable vascular origin (professional consensus). Aspirin must be taken in the evening or at least 8h after awakening (Grade B), before 16 weeks of gestation, at a dose of 100-160mg/day (Grade A).
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Affiliation(s)
- C Vayssière
- Service de Gynécologie-Obstétrique, CHU Toulouse Hôpital Paule de Viguier, Toulouse, France; INSERM UMR1027, Université Toulouse III, Toulouse, France.
| | - L Sentilhes
- Service de Gynécologie-Obstétrique, CHU Angers, Angers, France
| | - A Ego
- Université Grenoble Alpes, TIMC-IMAG, Grenoble, France; CNRS, TIMC-IMAG, Grenoble, France; CHU Grenoble, Pôle Santé Publique, Grenoble, France
| | - C Bernard
- Collectif Interassociatif Autour de la Naissance, Paris, France
| | | | - C Flamant
- Service de réanimation et médecine néonatales, hôpital mère-enfant, CHU de Nantes, Nantes, France
| | - G Gascoin
- Service de réanimation et médecine néonatales, pôle femme-mère-enfant, CHU d'Angers, Angers, France
| | - A Gaudineau
- Département de gynécologie-obstétrique, hôpitaux universitaires de Strasbourg, Strasbourg, France
| | - G Grangé
- Maternité Port-Royal, groupe hospitalier Cochin - hôtel-Dieu, Paris, France
| | - V Houfflin-Debarge
- Clinique d'obstétrique, pôle femme - mère-nouveau-né, hôpital Jeanne-de-Flandre, CHRU de Lille, Lille, France
| | - B Langer
- Département de gynécologie-obstétrique, hôpitaux universitaires de Strasbourg, Strasbourg, France
| | - V Malan
- Cytogénétique, hôpital universitaire Necker-Enfants-Malades, Paris, France
| | - P Marcorelles
- Service d'anatomie pathologique, pôle biologie pathologie, hôpital Morvan, CHRU de Brest, Brest, France
| | - J Nizard
- Service de gynécologie obstétrique, CHU Pitié-Salpêtrière, Paris, France
| | - F Perrotin
- Pôle de gynécologie obstétrique, médecine fœtale, médecine et biologie de la reproduction, centre Olympe de Gouges, CHRU de Tours, Tours, France
| | - L Salomon
- Maternité, hôpital universitaire Necker-Enfants-Malades, Paris, France
| | - M-V Senat
- Service de gynécologie-obstétrique, hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - A Serry
- Collectif Interassociatif Autour de la Naissance, Paris, France
| | - V Tessier
- Service de gynécologie-obstétrique, hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - P Truffert
- Service de réanimation néonatale, hôpital Jeanne-de-Flandre, CHRU de Lille, Lille, France
| | - V Tsatsaris
- Maternité Port-Royal, groupe hospitalier Cochin - hôtel-Dieu, Paris, France
| | - C Arnaud
- INSERM UMR1027, Université Toulouse III, Toulouse, France
| | - B Carbonne
- Unité d'obstétrique - maternité, hôpital Trousseau, Assistance Publique - Hôpitaux de Paris, université Pierre-et-Marie-Curie-Paris 6, France
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Leroy C, Jacquemont ML, Doray B, Lamblin D, Cormier-Daire V, Philippe A, Nusbaum S, Patrat C, Steffann J, Colleaux L, Vekemans M, Romana S, Turleau C, Malan V. Xq25 duplication: the crucial role of the STAG2
gene in this novel human cohesinopathy. Clin Genet 2015; 89:68-73. [DOI: 10.1111/cge.12567] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 02/02/2015] [Accepted: 02/05/2015] [Indexed: 01/24/2023]
Affiliation(s)
- C. Leroy
- Service de Cytogénétique; Hôpital Necker-Enfants Malades; Paris France
| | - M.-L. Jacquemont
- Service de Néonatologie; Centre Hospitalier Universitaire de la Réunion; Saint-Pierre France
| | - B. Doray
- Service de Génétique; Centre Hospitalier Universitaire de La Réunion, Hôpital Félix Guyon; Saint-Denis France
| | - D. Lamblin
- Fondation Père Favron; CAMSP; Saint-Louis France
| | - V. Cormier-Daire
- Service de Génétique; Hôpital Necker-Enfants Malades; Paris France
- Sorbonne Paris Cité; Université Paris Descartes; Paris France
| | - A. Philippe
- Service de Génétique; Hôpital Necker-Enfants Malades; Paris France
- Sorbonne Paris Cité; Université Paris Descartes; Paris France
- Institut IMAGINE; INSERM UMR_S1163, Hôpital Necker-Enfants Malades; Paris France
| | - S. Nusbaum
- Service de Cytogénétique; Hôpital Necker-Enfants Malades; Paris France
| | - C. Patrat
- Laboratoire de Biologie De la Reproduction; Groupe Hospitalier Bichat-Claude Bernard; Paris France
| | - J. Steffann
- Service de Génétique; Hôpital Necker-Enfants Malades; Paris France
| | - L. Colleaux
- Sorbonne Paris Cité; Université Paris Descartes; Paris France
- Institut IMAGINE; INSERM UMR_S1163, Hôpital Necker-Enfants Malades; Paris France
| | - M. Vekemans
- Service de Cytogénétique; Hôpital Necker-Enfants Malades; Paris France
- Sorbonne Paris Cité; Université Paris Descartes; Paris France
| | - S. Romana
- Service de Cytogénétique; Hôpital Necker-Enfants Malades; Paris France
- Sorbonne Paris Cité; Université Paris Descartes; Paris France
| | - C. Turleau
- Service de Cytogénétique; Hôpital Necker-Enfants Malades; Paris France
| | - V. Malan
- Service de Cytogénétique; Hôpital Necker-Enfants Malades; Paris France
- Sorbonne Paris Cité; Université Paris Descartes; Paris France
- Institut IMAGINE; INSERM UMR_S1163, Hôpital Necker-Enfants Malades; Paris France
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13
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Seferian A, Vandenbrande L, Allamand V, de Becdelievre A, Richard P, Lyonnet S, Malan V, Servais L. P.1.7 Contiguous gene syndrome causing ColVI myopathy, dysmorphism, frontal atrophy and diaphragmatic hernia. Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.391] [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: 10/26/2022]
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Rio M, Royer G, Gobin S, de Blois MC, Ozilou C, Bernheim A, Nizon M, Munnich A, Bonnefont JP, Romana S, Vekemans M, Turleau C, Malan V. Monozygotic twins discordant for submicroscopic chromosomal anomalies in 2p25.3 region detected by array CGH. Clin Genet 2012; 84:31-6. [PMID: 23061379 DOI: 10.1111/cge.12036] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 10/04/2012] [Accepted: 10/05/2012] [Indexed: 02/06/2023]
Abstract
Although discordant phenotypes in monozygotic twins with developmental disorder are not an exception, underlying genetic discordance is rarely reported. Here, we report on the clinical and cytogenetic details of 4-year-old female monozygotic twins with discordant phenotypes. Twin 1 exhibited global developmental delay, overweight and hyperactivity. Twin 2 had an autistic spectrum disorder. Molecular karyotyping in twin 1 identified a 2p25.3 deletion, further confirmed by Fluorescence in situ hybridization (FISH) analysis on leukocytes. Interestingly, array comparative genomic hybridization was normal in twin 2 but FISH analysis using the same probe as twin 1 showed mosaicism with one-third of cells with a 2p25.3 deletion, one-third of cells with a 2p25.3 duplication, and one-third of normal cells. Genotyping with microsatellite markers confirmed the monozygosity of the twins. We propose that the chromosome imbalance may be due to a mitotic non-allelic recombination occurring during blastomeric divisions of a normal zygote. Such event will result in three distinct cell populations, whose proportion in each embryo formed after separation from the zygote may differ, leading to discordant chromosomal anomalies between twins. We also discuss that the MYTL1L and the SNTG2 genes within the reported region could probably relate to the phenotypic discordance of the monozygotic twins.
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Affiliation(s)
- M Rio
- Département de Génétique, Université Paris Descartes, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
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16
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Malan V, Romana S. Diagnostic des anomalies chromosomiques par CGH array en pathologie constitutionnelle : la fin du caryotype en première intention. Arch Pediatr 2012; 19:437-42. [DOI: 10.1016/j.arcped.2012.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 01/16/2012] [Accepted: 01/20/2012] [Indexed: 02/01/2023]
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Molin AM, Andrieux J, Koolen DA, Malan V, Carella M, Colleaux L, Cormier-Daire V, David A, de Leeuw N, Delobel B, Duban-Bedu B, Fischetto R, Flinter F, Kjaergaard S, Kok F, Krepischi AC, Le Caignec C, Ogilvie CM, Maia S, Mathieu-Dramard M, Munnich A, Palumbo O, Papadia F, Pfundt R, Reardon W, Receveur A, Rio M, Ronsbro Darling L, Rosenberg C, Sá J, Vallee L, Vincent-Delorme C, Zelante L, Bondeson ML, Annerén G. A novel microdeletion syndrome at 3q13.31 characterised by developmental delay, postnatal overgrowth, hypoplastic male genitals, and characteristic facial features. J Med Genet 2011; 49:104-9. [PMID: 22180640 PMCID: PMC3261728 DOI: 10.1136/jmedgenet-2011-100534] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Congenital deletions affecting 3q11q23 have rarely been reported and only five cases have been molecularly characterised. Genotype-phenotype correlation has been hampered by the variable sizes and breakpoints of the deletions. In this study, 14 novel patients with deletions in 3q11q23 were investigated and compared with 13 previously reported patients. METHODS Clinical data were collected from 14 novel patients that had been investigated by high resolution microarray techniques. Molecular investigation and updated clinical information of one cytogenetically previously reported patient were also included. RESULTS The molecular investigation identified deletions in the region 3q12.3q21.3 with different boundaries and variable sizes. The smallest studied deletion was 580 kb, located in 3q13.31. Genotype-phenotype comparison in 24 patients sharing this shortest region of overlapping deletion revealed several common major characteristics including significant developmental delay, muscular hypotonia, a high arched palate, and recognisable facial features including a short philtrum and protruding lips. Abnormal genitalia were found in the majority of males, several having micropenis. Finally, a postnatal growth pattern above the mean was apparent. The 580 kb deleted region includes five RefSeq genes and two of them are strong candidate genes for the developmental delay: DRD3 and ZBTB20. CONCLUSION A newly recognised 3q13.31 microdeletion syndrome is delineated which is of diagnostic and prognostic value. Furthermore, two genes are suggested to be responsible for the main phenotype.
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Affiliation(s)
- Anna-Maja Molin
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
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Ceballos-Picot I, Guest G, Moriniere V, Mockel L, Daudon M, Malan V, Antignac C, Heidet L. Maternal uniparental disomy of chromosome 16 in a patient with adenine phosphoribosyltransferase deficiency. Clin Genet 2011; 80:199-201. [PMID: 21749366 DOI: 10.1111/j.1399-0004.2011.01626.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Benko S, Gordon CT, Mallet D, Sreenivasan R, Thauvin-Robinet C, Brendehaug A, Thomas S, Bruland O, David M, Nicolino M, Labalme A, Sanlaville D, Callier P, Malan V, Huet F, Molven A, Dijoud F, Munnich A, Faivre L, Amiel J, Harley V, Houge G, Morel Y, Lyonnet S. Disruption of a long distance regulatory region upstream of SOX9 in isolated disorders of sex development. J Med Genet 2011; 48:825-30. [DOI: 10.1136/jmedgenet-2011-100255] [Citation(s) in RCA: 135] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bonnet C, Andrieux J, Beri-Dexheimer M, Leheup B, Boute O, Manouvrier S, Delobel B, Copin H, Receveur A, Mathieu M, Thiriez G, Le Caignec C, David A, de Blois MC, Malan V, Philippe A, Cormier-Daire V, Colleaux L, Flori E, Dollfus H, Pelletier V, Thauvin-Robinet C, Masurel-Paulet A, Faivre L, Tardieu M, Bahi-Buisson N, Callier P, Mugneret F, Edery P, Jonveaux P, Sanlaville D. Microdeletion at chromosome 4q21 defines a new emerging syndrome with marked growth restriction, mental retardation and absent or severely delayed speech. J Med Genet 2010; 47:377-84. [DOI: 10.1136/jmg.2009.071902] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Walters RG, Jacquemont S, Valsesia A, de Smith AJ, Martinet D, Andersson J, Falchi M, Chen F, Andrieux J, Lobbens S, Delobel B, Stutzmann F, El-Sayed Moustafa JS, Chèvre JC, Lecoeur C, Vatin V, Bouquillon S, Buxton JL, Boute O, Holder-Espinasse M, Cuisset JM, Lemaitre MP, Ambresin AE, Brioschi A, Gaillard M, Giusti V, Fellmann F, Ferrarini A, Hadjikhani N, Campion D, Guilmatre A, Goldenberg A, Calmels N, Mandel JL, Le Caignec C, David A, Isidor B, Cordier MP, Dupuis-Girod S, Labalme A, Sanlaville D, Béri-Dexheimer M, Jonveaux P, Leheup B, Ounap K, Bochukova EG, Henning E, Keogh J, Ellis RJ, Macdermot KD, van Haelst MM, Vincent-Delorme C, Plessis G, Touraine R, Philippe A, Malan V, Mathieu-Dramard M, Chiesa J, Blaumeiser B, Kooy RF, Caiazzo R, Pigeyre M, Balkau B, Sladek R, Bergmann S, Mooser V, Waterworth D, Reymond A, Vollenweider P, Waeber G, Kurg A, Palta P, Esko T, Metspalu A, Nelis M, Elliott P, Hartikainen AL, McCarthy MI, Peltonen L, Carlsson L, Jacobson P, Sjöström L, Huang N, Hurles ME, O'Rahilly S, Farooqi IS, Männik K, Jarvelin MR, Pattou F, Meyre D, Walley AJ, Coin LJM, Blakemore AIF, Froguel P, Beckmann JS. A new highly penetrant form of obesity due to deletions on chromosome 16p11.2. Nature 2010; 463:671-5. [PMID: 20130649 PMCID: PMC2880448 DOI: 10.1038/nature08727] [Citation(s) in RCA: 345] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Accepted: 12/01/2009] [Indexed: 01/04/2023]
Affiliation(s)
- R G Walters
- Section of Genomic Medicine, Imperial College London, London W12 0NN, UK
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Malan V, Raoul O, Firth HV, Royer G, Turleau C, Bernheim A, Willatt L, Munnich A, Vekemans M, Lyonnet S, Cormier-Daire V, Colleaux L. 19q13.11 deletion syndrome: a novel clinically recognisable genetic condition identified by array comparative genomic hybridisation. J Med Genet 2009; 46:635-40. [PMID: 19126570 DOI: 10.1136/jmg.2008.062034] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Deletions of chromosome 19 have rarely been reported, with the exception of some patients with deletion 19q13.2 and Blackfan-Diamond syndrome due to haploinsufficiency of the RPS19 gene. Such a paucity of patients might be due to the difficulty in detecting a small rearrangement on this chromosome that lacks a distinct banding pattern. Array comparative genomic hybridisation (CGH) has become a powerful tool for the detection of microdeletions and microduplications at high resolution in patients with syndromic mental retardation. METHODS AND RESULTS Using array CGH, this study identified three interstitial overlapping 19q13.11 deletions, defining a minimal critical region of 2.87 Mb, associated with a clinically recognisable syndrome. The three patients share several major features including: pre- and postnatal growth retardation with slender habitus, severe postnatal feeding difficulties, microcephaly, hypospadias, signs of ectodermal dysplasia, and cutis aplasia over the posterior occiput. Interestingly, these clinical features have also been described in a previously reported patient with a 19q12q13.1 deletion. No recurrent breakpoints were identified in our patients, suggesting that no-allelic homologous recombination mechanism is not involved in these rearrangements. CONCLUSIONS Based on these results, the authors suggest that this chromosomal abnormality may represent a novel clinically recognisable microdeletion syndrome caused by haploinsufficiency of dosage sensitive genes in the 19q13.11 region.
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Bourthoumieu S, Esclaire F, Terro F, Fiorenza M, Aubard V, Malan V, Romana S, Yardin C. First prenatally diagnosed case of 16p11.2p12.1 duplication. Prenat Diagn 2008; 28:254-6. [PMID: 18241085 DOI: 10.1002/pd.1949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Malan V, De Blois MC, Prieur M, Perrier-Waill MC, Huguet-Nedjar C, Gegas L, Turleau C, Vekemans M, Munnich A, Romana SP. Sotos syndrome caused by a paracentric inversion disrupting the NSD1 gene. Clin Genet 2007; 73:89-91. [PMID: 18042263 DOI: 10.1111/j.1399-0004.2007.00916.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Verkauskas G, Jaubert F, Lortat-Jacob S, Malan V, Thibaud E, Nihoul-Fékété C. The Long-Term Followup of 33 Cases of True Hermaphroditism: A 40-Year Experience With Conservative Gonadal Surgery. J Urol 2007; 177:726-31; discussion 731. [PMID: 17222668 DOI: 10.1016/j.juro.2006.10.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2006] [Indexed: 11/16/2022]
Abstract
PURPOSE Little is known about long-term outcomes of conservative gonadal surgery in true hermaphroditism. We present our experience with evaluation and treatment of a large series of children with this rare form of ambiguous genitalia, focusing on gonadal structure and function before and after conservative gonadal surgery. MATERIALS AND METHODS We retrospectively reviewed 33 consecutive patients with histologically confirmed true hermaphroditism treated at the Hopital des Enfants-Malades between 1965 and 2005. RESULTS The most common karyotype of true hermaphrodites was 46,XX, constituting 82% of our series. The frequency of finding the SRY gene in 46,XX cases was 35%. Ovotestis was the most frequent finding (65%) and testis the rarest (9%). Ovarian tissue was more often found on the left side, and testicular tissue on the right side (p <0.05). Proper gonadal tissue was preserved in 28 cases. No gonadal tumors were detected during followup. Ovarian tissue remained normal, while testicular tissue gradually developed signs of dysgenesis in all biopsied cases, confirmed by endocrinological studies. However, testosterone production remained satisfactory in the majority of cases during followup. CONCLUSIONS Diagnosis of true hermaphroditism is well defined and the condition can be recognized even prenatally. Conservative gonadal surgery is the procedure of choice after a diagnosis of true hermaphroditism. Continued followup is necessary because of the multiple psychological, gynecological and urological problems encountered postpubertally by these patients.
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Affiliation(s)
- G Verkauskas
- Department of Pediatric Surgery, Kaunas Medical University Hospital, Kaunas, Lithuania
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Abstract
The finding of a mixture of 46,XX and 46,XY cells in an individual has been rarely reported in literature. It usually results in individuals with ambiguous genitalia. Approximately 10% of true human hermaphrodites show this type of karyotype. However, the underlying mechanisms are poorly understood. It may be the result of mosaicism or chimerism. By definition, a chimera is produced by the fusion of two different zygotes in a single embryo, while a mosaic contains genetically different cells issued from a single zygote. Several mechanisms are involved in the production of chimera. Stricto sensu, chimerism occurs from the post-zygotic fusion of two distinct embryos leading to a tetragametic chimera. In addition, there are other entities, which are also referred to as chimera: parthenogenetic chimera and chimera resulting from fertilization of the second polar body. Furthermore, a particular type of chimera called 'androgenetic chimera' recently described in fetuses with placental mesenchymal dysplasia and in rare patients with Beckwith-Wiedemann syndrome is discussed. Strategies to study mechanisms leading to the production of chimera and mosaics are also proposed.
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Affiliation(s)
- V Malan
- Service de Cytogénétique, Hôpital Necker - Enfants Malades, APHP, Paris, René Descartes-Paris 5 University, Paris, France.
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Malan V, Pipiras E, Sifer C, Kanafani S, Cedrin-Durnerin I, Martin-Pont B, Hugues JN, Wolf JP, Benzacken B. Chromosome segregation in an infertile man carrying a unique pericentric inversion, inv(21)(p12q22.3), analysed using fluorescence in situ hybridization on sperm nuclei: significance for clinical genetics. A case report. Hum Reprod 2006; 21:2052-6. [PMID: 16585123 DOI: 10.1093/humrep/del090] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We report the case of a 40-year-old patient referred to our centre after 3 years of infertility. Karyotyping with the aid of fluorescence in situ hybridization (FISH) analysis showed a unique pericentric inversion of chromosome 21:46,XY,inv(21)(p12q22.3). This type of intrachromosomal structural rearrangement can lead to chromosome imbalance in offspring by producing unbalanced gametes if an odd number of crossover events occur within the inverted segment. Therefore, partial trisomy/monosomy with clinical consequences can be observed in the progeny of carriers. Semen samples from the inversion carrier were analysed by FISH using a combination of probes [a subtelomeric 21q probe and a locus-specific Down's syndrome critical region (DSCR) probe] to evaluate the proportion of recombinant chromosomes. Sperm-FISH analysis of 3400 spermatozoa revealed a 67.4% rate of balanced chromosomes (normal or inverted). The frequencies of recombinant chromosomes with duplication of the long arm and deletion of the short arm, and vice versa, were 11.2 and 21.4%, respectively. The risk for the couple of conceiving a child with an unbalanced chromosome 21 is estimated to be around 32%. This case study shows the utility of sperm-FISH analysis in the genetic counselling of a pericentric inversion in a male carrier to assess the frequency of recombinant chromosomes and therefore evaluate the probability of having a normal conception.
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Affiliation(s)
- V Malan
- Service d'Histologie-Embryologie et Cytogénétique, Biologie de la Reproduction, Hôpital Jean Verdier(AP-HP), UFR-SMBH, Bondy, France
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Denavit TM, Malan V, Grillon C, Sanlaville D, Ardalan A, Jacquemont ML, Burglen L, Taillemite JL, Portnoi MF. A new case of a severe clinical phenotype of the cat-eye syndrome. Genet Couns 2004; 15:443-8. [PMID: 15658620] [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] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
A new case of severe clinical phenotype of the cat-eye syndrome: We report on a female infant with severe clinical phenotype of Cat-Eye Syndrome (CES). At birth, she had respiratory distress and marked hypotonia. Physical examination showed major craniofacial anomalies including microcephaly, bilateral total absence of the external ears, hypertelorism, bilateral ocular coloboma of iris and micrognathia. In addition, she had anal stenosis, a patent ductus arteriosus and intra- and extra- hepatic biliary atresia. She deteriorated with the development of bradycardia. She died at age one month of cardiac failure. Cytogenetic analysis of the proband showed an extra de novo small bisatelllited marker chromosome in all cells examined. Molecular cytogenetic analysis with fluorescence in situ hybridization (FISH) identified the marker as a CES chromosome. Thus, the patient's karyotype was: 47, XX, +idic(22)(pter-->q11.2 ::q11.2-->pter). The duplication breakpoints giving rise to the CES chromosome were distal to the DiGeorge Syndrome (DGS) locus 22q11.2. The marker could be classed as a type 11 symmetrical (10). According to a recent review of CES literature (1) only 41 % of the CES patients have the combination of iris coloboma, anal anomalies and preauricular anomalies. Almost 60% are hard to recognize by their phenotype alone. Only twelve patients showed a severe clinical phenotype leading to the death of the child. This phenotypic variability increases the difficulties of genetic counseling.
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Affiliation(s)
- T Martin Denavit
- Laboratoire de Cytogénétique et d'Embryologie Pathologique, Hôpital Saint-Antoine Paris, France.
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