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Mouillé M, Rio M, Breton S, Piketty ML, Afenjar A, Amiel J, Capri Y, Goldenberg A, Francannet C, Michot C, Mignot C, Perrin L, Quelin C, Van Gils J, Barcia G, Pingault V, Maruani G, Koumakis E, Cormier-Daire V. SATB2-associated syndrome: characterization of skeletal features and of bone fragility in a prospective cohort of 19 patients. Orphanet J Rare Dis 2022; 17:100. [PMID: 35241104 PMCID: PMC8895909 DOI: 10.1186/s13023-022-02229-5] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 02/06/2022] [Indexed: 11/10/2022] Open
Abstract
Background Individuals with pathogenic variants in SATB2 display intellectual disability, speech and behavioral disorders, dental abnormalities and often features of Pierre Robin sequence. SATB2 encodes a transcription factor thought to play a role in bone remodeling. The primary aim of our study was to systematically review the skeletal manifestations of SATB2-associated syndrome. For this purpose, we performed a non-interventional, multicenter cohort study, from 2017 to 2018. We included 19 patients, 9 females and 10 males ranging in age from 2 to 19 years-old. The following data were collected prospectively for each patient: clinical data, bone markers and calcium and phosphate metabolism parameters, skeletal X-rays and bone mineral density. Results Digitiform impressions were present in 8/14 patients (57%). Vertebral compression fractures affected 6/17 patients (35%). Skeletal demineralization (16/17, 94%) and cortical thinning of vertebrae (15/17) were the most frequent radiological features at the spine. Long bones were generally demineralized (18/19). The distal phalanges were short, thick and abnormally shaped. C-telopeptide (CTX) and Alkaline phosphatase levels were in the upper normal values and osteocalcin and serum procollagen type 1 amino-terminal propeptide (P1NP) were both increased. Vitamin D insufficiency was frequent (66.7%). Conclusion We conclude that SATB2 pathogenic variants are responsible for skeletal demineralization and osteoporosis. We found increased levels of bone formation markers, supporting the key role of SATB2 in osteoblast differentiation. These results support the need for bone evaluation in children and adult patients with SATB2-associated syndrome (SAS). Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02229-5.
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Affiliation(s)
- M Mouillé
- Clinical Genetics, Necker Enfants Malades Hospital, APHP, 149 rue de Sevres, Paris, 75015, France.,Department of Neonatal Medicine, Cochin-Port Royal Hospital, APHP, Paris, France
| | - M Rio
- Clinical Genetics, Necker Enfants Malades Hospital, APHP, 149 rue de Sevres, Paris, 75015, France
| | - S Breton
- Department of Pediatric Radiology, Necker Enfants Malades Hospital, APHP, Paris, France
| | - M L Piketty
- Functional Exploration Laboratory, Necker Enfants Malades Hospital, APHP, Paris, France
| | - A Afenjar
- Sorbonne University, Reference Center for Intellectual Disabilities, Department of Genetics and Medical Embryology, Armand-Trousseau Hospital, APHP, Paris, France
| | - J Amiel
- Clinical Genetics, Necker Enfants Malades Hospital, APHP, 149 rue de Sevres, Paris, 75015, France
| | - Y Capri
- Clinical Genetics Functional Unit, Robert Debré Hospital, APHP, Paris, France
| | | | - C Francannet
- Clinical Genetics, Clermont-Ferrand CHU, Clermont-Ferrand, France
| | - C Michot
- Clinical Genetics, Necker Enfants Malades Hospital, APHP, 149 rue de Sevres, Paris, 75015, France.,Paris Cité University, Reference Center for Constitutional Bone Diseases, INSERM UMR1163, Imagine Institute, Paris, France
| | - C Mignot
- Sorbonne University, Reference Center for Intellectual Disabilities, Department of Genetics and Medical Embryology, Armand-Trousseau Hospital, APHP, Paris, France.,Clinical Genetics, La Pitié Salpétrière Hospital, APHP, Paris, France
| | - L Perrin
- Clinical Genetics Functional Unit, Robert Debré Hospital, APHP, Paris, France
| | - C Quelin
- Clinical Genetics, Hospital Sud, Rennes, France
| | - J Van Gils
- Clinical Genetics, Hospital Pellegrin, Bordeaux, France
| | - G Barcia
- Molecular Genetics, Necker Enfants Malades Hospital, APHP, Paris, France
| | - V Pingault
- Molecular Genetics, Necker Enfants Malades Hospital, APHP, Paris, France
| | - G Maruani
- Department of Physiology, Hôpital Necker Enfants Malades and Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - E Koumakis
- Paris Cité University, Reference Center for Constitutional Bone Diseases, INSERM UMR1163, Imagine Institute, Paris, France.,Reference Center for Skeletal Dysplasia, Cochin Hospital, APHP, Paris, France
| | - V Cormier-Daire
- Clinical Genetics, Necker Enfants Malades Hospital, APHP, 149 rue de Sevres, Paris, 75015, France. .,Paris Cité University, Reference Center for Constitutional Bone Diseases, INSERM UMR1163, Imagine Institute, Paris, France.
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Abstract
Introduction: Study aim is to report the Magnetic Resonance Imaging (MRI) features of acute and chronic spontaneous spondylodiscitis. Case report: 57 year old female, complaining of a fever and longstanding cervical pain worsened during physical therapy. Methods: MR images were acquired using superconductive magnet 1.5 T, with the following sequences: sagittal PD and T2 TSE, sagittal T1 SE, axial PD and T2 TSE (lumbar spine), axial T2 GRE (cervical spine). Axial and sagittal T1 SE after administration of (gadolinium DTPA). Examination was reviewed by three radiologists and compared to CT findings. Results: Patient reported cervical pain associated with fever and minimal weight loss. Blood tests were normal except hyperglycemia (DM tip II). X Ray: vertebral destruction localized at C-4 and C-5: NECT: destruction of the C-4/C-5 vertebral bodies (ventral part). MRI: Low signal of the bone marrow on T1l images, which enhanced after Gd-DTPA administration and became intermediate or high on T2 images. The steady high signal intensity of the disk on T2 images and enhancement on T1 images is typical for an acute inflammatory process. Bone Scintigrafi results: Bone changes suspicious for metastasis. Whole body CT results: apart from spine, no other significant changes. Conclusion: MRI is the most sensitive technique for the diagnosis of spondylodiscitis in the acute phase and comparable to CT regarding chronial stage of the disease. The present imagining essay os aimed at showing the main magnetic resonance imaging findings of tuberculous discitis.
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Affiliation(s)
- Naser Ramadani
- Faculty of Medicine, Pristine University, Pristine City, Kosovo.,National Institute of Public Health of Kosovo, Pristine City, Kosovo
| | - Kreshnike Dedushi
- Faculty of Medicine, Pristine University, Pristine City, Kosovo.,Department of Radiology, Diagnostic Centre, UCCK, Pristine City, Kosovo
| | - Serbeze Kabashi
- Faculty of Medicine, Pristine University, Pristine City, Kosovo.,Department of Radiology, Diagnostic Centre, UCCK, Pristine City, Kosovo
| | - Sefedin Mucaj
- Faculty of Medicine, Pristine University, Pristine City, Kosovo.,National Institute of Public Health of Kosovo, Pristine City, Kosovo
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