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Nascimento LPC, Mergener R, Nunes MR, Muniz VF, Catao JR, da Silveira AKB, Dorfman LE, Graziadio C, Zen PRG. 16p11.2 Microduplication Syndrome with Increased Fluid in the Cisterna: Coincidence or Phenotype Extension? Genes (Basel) 2023; 14:1583. [PMID: 37628634 PMCID: PMC10454344 DOI: 10.3390/genes14081583] [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: 06/29/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023] Open
Abstract
We report the first case of a child with 16p11.2 microduplication syndrome with increased fluid in the cisterna magna seen on magnetic resonance imaging (MRI). This finding may correspond to a Blake's Pouch Cyst (BPC) or a Mega Cisterna Magna (MCM), being impossible to differentiate through image examination. The molecular duplication was diagnosed using chromosomal microarray analysis with single nucleotide polymorphism (SNP). We review the clinical and neuroimaging features in published case reports in order to observe the findings described in the literature so far and present a skull three-dimensional model to contribute to a better understanding. Despite the variable expressivity of the syndrome being well known, there is no case described in the available literature that mentions the association of 16p11.2 microduplication and the presence of BPC or MCM seen in neuroimaging exams. This finding may represent an extension of the phenotype not yet reported or may present itself as a coincidence in a child with various malformations.
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Affiliation(s)
- Lívia Polisseni Cotta Nascimento
- Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre 90050-170, RS, Brazil; (L.P.C.N.); (R.M.); (V.F.M.)
- Medical Residency Committee, Federal University of Health Sciences of Porto Alegre (UFCSPA)/Brotherhood of the Santa Casa de Misericórdia of Porto Alegre (ISCMPA), Porto Alegre 90050-170, RS, Brazil;
| | - Rafaella Mergener
- Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre 90050-170, RS, Brazil; (L.P.C.N.); (R.M.); (V.F.M.)
| | - Marcela Rodrigues Nunes
- Medical Residency Committee, Federal University of Health Sciences of Porto Alegre (UFCSPA)/Brotherhood of the Santa Casa de Misericórdia of Porto Alegre (ISCMPA), Porto Alegre 90050-170, RS, Brazil;
| | - Victória Feitosa Muniz
- Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre 90050-170, RS, Brazil; (L.P.C.N.); (R.M.); (V.F.M.)
| | - Juliana Rossi Catao
- Medicine Course, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre 90050-170, RS, Brazil;
| | - Ana Kalise Böttcher da Silveira
- Undergraduate Program in Biomedical Science, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre 90050-170, RS, Brazil;
| | - Luiza Emy Dorfman
- Health School, University of Vale do Rio dos Sinos (Unisinos), São Leopoldo 93022-750, RS, Brazil;
| | - Carla Graziadio
- Department of Clinical Medicine, Federal University of Health Sciences of Porto Alegre (UFCSPA)/Brotherhood of the Santa Casa de Misericórdia of Porto Alegre (ISCMPA), Porto Alegre 90050-170, RS, Brazil;
| | - Paulo Ricardo Gazzola Zen
- Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre 90050-170, RS, Brazil; (L.P.C.N.); (R.M.); (V.F.M.)
- Department of Clinical Medicine, Federal University of Health Sciences of Porto Alegre (UFCSPA)/Brotherhood of the Santa Casa de Misericórdia of Porto Alegre (ISCMPA), Porto Alegre 90050-170, RS, Brazil;
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Cincione IR, Graziadio C, Marino F, Vetrani C, Losavio F, Savastano S, Colao A, Laudisio D. Short-time effects of ketogenic diet or modestly hypocaloric Mediterranean diet on overweight and obese women with polycystic ovary syndrome. J Endocrinol Invest 2023; 46:769-777. [PMID: 36401759 DOI: 10.1007/s40618-022-01943-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/14/2022] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women during reproductive age. It is characterized clinically by oligo-ovulation or anovulation, hyper-androgenism, and the presence of polycystic ovaries. Often comorbid with insulin resistance, dyslipidemia, and obesity, it also carries significant risk for the development of cardio-vascular and metabolic sequelae, including diabetes and metabolic syndrome. In light of these evidences, the most therapeutic option prescribed to PCOS women with obesity, regardless of the phenotype from the severity of clinical expression, is lifestyle correction by diet and physical activity. PURPOSE The aim of this study was to evaluate the association between PCOS with KD in overweight and/or obese women with PCOS, and evaluate the possible beneficial effects on metabolic and endocrine parameters, compared to a standard, balanced hypocaloric diet such as Mediterranean diet (MD). METHODS Participants were assigned to receive, in a 1:1 ratio, one of the two following dietary sequences: KD or MD. In all subjects anthropometric parameters, body composition and metabolic and endocrine parameters were obtained at baseline and after dietetic treatment. RESULTS Our results showed a significant change in the anthropometric and biochemical parameters in both groups after both diet therapies, with statistically significant differences (p < 0.001). Though, the reductions of all parameters were significantly greater in KD group than in MD group. CONCLUSION Our results suggest that a reduction of dietary intake of carbohydrates by KD may be considered as a valuable non-pharmacological treatment for PCOS.
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Affiliation(s)
- I R Cincione
- Department of Clinical and Experimental Medicine, University of Foggia, 71100, Foggia, Italy
| | - C Graziadio
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Via Sergio Pansini, 5, 80131, Naples, Italy
- Centro Italiano per la Cura e Il Benessere del Paziente Con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Via Sergio Pansini, 5, Naples, Italy
| | - F Marino
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Via Sergio Pansini, 5, 80131, Naples, Italy
- Centro Italiano per la Cura e Il Benessere del Paziente Con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Via Sergio Pansini, 5, Naples, Italy
| | - C Vetrani
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Via Sergio Pansini, 5, 80131, Naples, Italy
- Centro Italiano per la Cura e Il Benessere del Paziente Con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Via Sergio Pansini, 5, Naples, Italy
| | - F Losavio
- Department of Clinical and Experimental Medicine, University of Foggia, 71100, Foggia, Italy
| | - S Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Via Sergio Pansini, 5, 80131, Naples, Italy
- Centro Italiano per la Cura e Il Benessere del Paziente Con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Via Sergio Pansini, 5, Naples, Italy
| | - A Colao
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Via Sergio Pansini, 5, 80131, Naples, Italy
- Centro Italiano per la Cura e Il Benessere del Paziente Con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Via Sergio Pansini, 5, Naples, Italy
- Cattedra Unesco "Educazione alla Salute e Allo Sviluppo Sostenibile", Università "Federico II" di Napoli, Naples, Italy
| | - D Laudisio
- Centro Italiano per la Cura e Il Benessere del Paziente Con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Via Sergio Pansini, 5, Naples, Italy.
- Dipartimento di Sanità Pubblica, Università "Federico II" di Napoli, Via Sergio Pansini, 5, 80131, Naples, Italy.
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Perrone E, Perez ABA, D'Almeida V, de Mello CB, Jacobina MAA, Loureiro RM, Burlin S, Migliavacca M, do Amaral Virmond L, Graziadio C, Pedroso JL, Mendes EL, Gomy I, de Macena Sobreira NL. Clinical and molecular evaluation of 13 Brazilian patients with Gomez-López-Hernández syndrome. Am J Med Genet A 2020; 185:1047-1058. [PMID: 33381921 DOI: 10.1002/ajmg.a.62059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/17/2020] [Accepted: 12/19/2020] [Indexed: 01/21/2023]
Abstract
We aim to characterize patients with Gomez-López-Hernández syndrome (GLHS) clinically and to investigate them molecularly. A clinical protocol, including a morphological and neuropsychological assessment, was applied to 13 patients with GLHS. Single-nucleotide polymorphism (SNP) array and whole-exome sequencing were undertaken; magnetic resonance imaging was performed in 12 patients, including high-resolution, heavily T2-weighted sequences (HRT2) in 6 patients to analyze the trigeminal nerves. All patients presented alopecia; two did not present rhombencephalosynapsis (RES); trigeminal anesthesia was present in 5 of the 11 patients (45.4%); brachycephaly/brachyturricephaly and mid-face retrusion were found in 84.6 and 92.3% of the patients, respectively. One patient had intellectual disability. HRT2 sequences showed trigeminal nerve hypoplasia in four of the six patients; all four had clinical signs of trigeminal anesthesia. No common candidate gene was found to explain GLHS phenotype. RES does not seem to be an obligatory finding in respect of GLHS diagnosis. We propose that a diagnosis of GLHS should be considered in patients with at least two of the following criteria: focal non-scarring alopecia, rhombencephalosynapsis, craniofacial anomalies (brachyturrycephaly, brachycephaly or mid-face retrusion), trigeminal anesthesia or anatomic abnormalities of the trigeminal nerve. Studies focusing on germline whole genome sequencing or DNA and/or RNA sequencing of the alopecia tissue may be the next step for the better understanding of GLHS etiology.
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Affiliation(s)
- Eduardo Perrone
- Clinical Genetics Department, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | | | - Vânia D'Almeida
- Psychobiology Department, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | | | | | - Rafael Maffei Loureiro
- Department of Radiology, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
| | - Stênio Burlin
- Department of Radiology, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | | | - Luiza do Amaral Virmond
- Clinical Genetics Department, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | - Carla Graziadio
- Department of Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - José Luiz Pedroso
- Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | | | - Israel Gomy
- Departament of Pediatrics, Universidade Federal do Paraná, Paraná, Brazil
| | - Nara Lygia de Macena Sobreira
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Bueno ALA, de Souza MEV, Graziadio C, Kiszewski AE. Multiple pilomatricomas in twins with Rubinstein-Taybi syndrome. An Bras Dermatol 2020; 95:619-622. [PMID: 32778355 PMCID: PMC7563002 DOI: 10.1016/j.abd.2020.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 03/05/2020] [Indexed: 12/03/2022] Open
Abstract
Pilomatricomas are benign tumors originating from the capillary matrix, which may present as solitary lesions or, less commonly, multiple. Myotonic dystrophy and familial adenomatous polyposis are the most frequently associated disorders with multiple pilomatricomas. There are few reports relating these tumors to other genetic syndromes. Rubinstein-Taybi syndrome is a rare autosomal dominant disorder characterized by intellectual disability and typical dysmorphic characteristics. There are five case reports relating to multiple pilomatricoma to Rubinstein-Taybi syndrome, an association that needs to be clarified. For this reason, we report the first case of multiple pilomatricoma in monozygotic twins with typical Rubinstein-Taybi syndrome.
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Affiliation(s)
- Ana Laura Andrade Bueno
- Dermatology Service, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil; Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
| | - Maria Emilia Vieira de Souza
- Dermatology Service, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil; Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
| | - Carla Graziadio
- Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil; Discipline of Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Ana Elisa Kiszewski
- Dermatology Service, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil; Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil; Pediatric Dermatology Unit, Dermatology Service, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
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Trevisan P, Graziadio C, Rodrigues DBK, Rosa RFM, Soares FP, Provenzi VO, de Oliveira CAV, Paskulin GA, Varella-Garcia M, Zen PRG. Clinical and Molecular Characterization of Adult Glioblastomas in Southern Brazil. J Neuropathol Exp Neurol 2020; 78:297-304. [PMID: 30840759 DOI: 10.1093/jnen/nlz006] [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] [Indexed: 12/14/2022] Open
Abstract
We investigated 113 adult Brazilian patients with glioblastoma (GBM) for comparison with patients from distinct geographical areas and evaluation of suitability for novel targeted therapies. Patients were assessed for clinical features and tumor genomic characteristics such as ROS1 and NTRK1 rearrangements, KIT, PDGFRA, and KDR amplification, and RB1 deletion using multicolor fluorescence in situ hybridization. The majority of patients were male (53%), over 40 years (94%), with tumor located in single site (64%), in the right cerebral hemisphere (60%), and underwent partial resection (71%); 14% presented complications after surgery. The main clinical sign at diagnosis was focal abnormality (57%); frontal (31%); and temporal (20%) regions were most commonly affected. Median hospitalization time was 20 days, median survival was 175 days. One tumor was positive for rearrangement in NTRK1 and another in ROS1 (0.9% each). PDGFRA was amplified in 20% of cases, often co-amplified with KDR (>90%) and KIT (>60%). RB1 was deleted in 16% of patients. There was no association between these molecular abnormalities and patient survival. However, older age, complications after surgery, and right-sided tumors were independent variables associated with patient survival. This study contributes information on the molecular profile of glioblastomas in Latin America possibly supporting new target therapies.
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Affiliation(s)
| | - Carla Graziadio
- Clinical Genetics, Department of Internal Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Rafael Fabiano Machado Rosa
- Graduate Program in Pathology.,Clinical Genetics, Department of Internal Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Fabiano Pasqualotto Soares
- Neurosurgery Section, Hospital Beneficência Portuguesa de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | | | | | - Paulo Ricardo Gazzola Zen
- Graduate Program in Pathology.,Clinical Genetics, Department of Internal Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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Floriani MA, Bau AEK, Silva RP, Graziadio C, Dorfman LE, Zen TD, Rosa RFM, Zen PRG. Applications of electron microscopy in health: the example of epidermolysis
bullosa. Jornal Brasileiro de Patologia e Medicina Laboratorial 2017. [DOI: 10.5935/1676-2444.20170011] [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: 11/20/2022] Open
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Goetze TB, Sleifer P, Rosa RFM, da Silva AP, Graziadio C, Zen PRG. Hearing characterization in oculoauriculovertebral spectrum: A prospective study with 10 patients. Am J Med Genet A 2016; 173:309-314. [PMID: 27774762 DOI: 10.1002/ajmg.a.38017] [Citation(s) in RCA: 4] [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: 03/31/2015] [Accepted: 09/23/2016] [Indexed: 11/09/2022]
Abstract
Oculoauriculovertebral spectrum (OAVS), also known as Goldenhar syndrome, is considered a condition associated to failing of embryogenesis involving the first and second branchial arches, leading to structural abnormalities arising from it. The aim of this study is to verify the hearing features presented by patients with OAVS and provide additional information that may contribute to improvement of speech therapy. The sample consisted of 10 individuals diagnosed with OAVS and cared for by the Clinical Genetics Service. All patients underwent objective assessment of auditory function through tonal and vocal audiometry. This evaluation was completed using TOAE and BERA. The patient's age ranged from 1 year and 9 months to 27 years and 4 months. At physical examination it was found that 10 had microtia, 7 preauricular tags, 6 low-set ears, 6 ear canal atresia, and 2 preauricular pits. Among the patients, five presented with abnormal hearing. Three patients had conductive hearing loss ranging from mild to moderate, and two patients had sensorineural hearing loss from mild to profound. Three patients had hearing loss in both ears. Speech-language disorders are common in children with OAVS. Thus, the referral to the audiologist and speech pathologist is indicated as soon as possible. Early recognition and detailed understanding of aspects related to the etiology, clinical features, and outcome of patients with OAVS are essential for their proper management. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Thayse Bienert Goetze
- Graduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Pricila Sleifer
- Speech Language Pathology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Rafael Fabiano Machado Rosa
- Graduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.,Clinical Genetics, UFCSPA and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, RS, Brazil.,Graduate Program in Biosciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Alessandra Pawelec da Silva
- Graduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Carla Graziadio
- Clinical Genetics, UFCSPA and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, RS, Brazil
| | - Paulo Ricardo Gazzola Zen
- Graduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.,Clinical Genetics, UFCSPA and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, RS, Brazil.,Graduate Program in Biosciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
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Rosa RFM, Enk F, Camargo K, Travi GM, Freitas A, Rosa RCM, Graziadio C, de Mattos VF, Zen PRG. Microcephaly-chorioretinopathy syndrome, autosomal recessive form. A case report. SAO PAULO MED J 2015; 133:377-80. [PMID: 25337662 PMCID: PMC10876356 DOI: 10.1590/1516-3180.2013.7930003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 11/08/2013] [Revised: 11/08/2013] [Accepted: 06/03/2014] [Indexed: 11/22/2022] Open
Abstract
CONTEXT The autosomal recessive form of microcephaly-chorioretinopathy syndrome is a rare genetic condition that is considered to be an important differential diagnosis with congenital toxoplasmosis. CASE REPORT Our patient was a seven-year-old white boy who was initially diagnosed with congenital toxoplasmosis. However, his serological tests for congenital infections, including toxoplasmosis, were negative. He was the first child of young, healthy and consanguineous parents (fourth-degree relatives). The parents had normal head circumferences and intelligence. The patient presented microcephaly and specific abnormalities of the retina, with multiple diffuse oval areas of pigmentation and patches of chorioretinal atrophy associated with diffuse pigmentation of the fundus. Ophthalmological evaluations on the parents were normal. A computed tomography scan of the child's head showed slight dilation of lateral ventricles and basal cisterns without evidence of calcifications. We did not find any lymphedema in his hands and feet. He had postnatal growth retardation, severe mental retardation and cerebral palsy. CONCLUSIONS The finding of chorioretinal lesions in a child with microcephaly should raise suspicions of the autosomal recessive form of microcephaly-chorioretinopathy syndrome, especially in cases with an atypical pattern of eye fundus and consanguinity. A specific diagnosis is essential for an appropriate clinical evaluation and for genetic counseling for the patients and their families.
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Affiliation(s)
- Rafael Fabiano Machado Rosa
- PhD. Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Flávia Enk
- Undergraduate Medical Student, Universidade Luterana do Brasil (ULBRA), Canoas, Rio Grande do Sul, Brazil.
| | - Korine Camargo
- Undergraduate Medical Student, Universidade Luterana do Brasil (ULBRA), Canoas, Rio Grande do Sul, Brazil.
| | - Giovanni Marco Travi
- MD. Ophthalmologist, Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - André Freitas
- MD. Ophthalmologist, Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | | | - Carla Graziadio
- MD. Assistant Professor of Clinical Genetics and Student in the Postgraduate Program on Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Vinicius Freitas de Mattos
- MD. Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Paulo Ricardo Gazzola Zen
- PhD. Adjunct Professor of Clinical Genetics and of the Postgraduate Program on Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
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Rosa RFM, D'Ecclesiis WFB, Dibbi RP, Rosa RCM, Trevisan P, Graziadio C, Paskulin GA, Zen PRG. 45,X/46,XY mosaicism: report on 14 patients from a Brazilian hospital. A retrospective study. SAO PAULO MED J 2014; 132:332-8. [PMID: 25351753 PMCID: PMC10496778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Revised: 08/15/2013] [Accepted: 10/22/2013] [Indexed: 04/07/2023] Open
Abstract
CONTEXT AND OBJECTIVE 45,X/46,XY mosaicism, or mixed gonadal dysgenesis, is considered to be a rare disorder of sex development. The aim of our study was to investigate the clinical and cytogenetic characteristics of patients with this mosaicism. DESIGN AND SETTING A retrospective study in a referral hospital in southern Brazil. METHODS Our sample consisted of patients diagnosed at the clinical genetics service of a referral hospital in southern Brazil, from 1975 to 2012. Clinical and cytogenetic data were collected from the medical records. RESULTS Fourteen patients were included in the sample, with ages at the first evaluation ranging from 2 days to 38 years. Nine of them had female sex of rearing and five, male. Regarding the external genitalia, most were ambiguous (n = 10). One patient presented male phenotype and was treated for a history of azoospermia, while three patients presented female phenotype, of whom two had findings of Turner syndrome and one presented secondary amenorrhea alone. Some findings of Turner syndrome were observed even among patients with ambiguous genitalia. None presented gonadal malignancy. One patient underwent surgical correction for genital ambiguity and subsequent exchange of sex of rearing. Regarding cytogenetics, we did not observe any direct correlation between percentages of cell lines and phenotype. CONCLUSIONS 45,X/46,XY mosaicism can present with a wide variety of phenotypes resulting from the involvement of different aspects of the individual. All these observations have important implications for early recognition of these patients and their appropriate management.
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Affiliation(s)
- Rafael Fabiano Machado Rosa
- PhD. Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Willy Francisco Bartel D'Ecclesiis
- MD. Physician, Residency Program in Obstetrics and Gynecology, Hospital Materno Infantil Presidente Vargas (HMIPV), Porto Alegre, Rio Grande do Sul, Brazil
| | - Raquel Papandreus Dibbi
- MD. Postgraduate Student, Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Gynecologist and Obstetrician, Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Rosana Cardoso Manique Rosa
- MD. Postgraduate Student, Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Pediatrician, Grupo Hospitalar Conceição (GHC), Porto Alegre, Rio Grande do Sul, Brazil
| | - Patrícia Trevisan
- MD. Postgraduate Student, Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Pharmacist, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Carla Graziadio
- MD. Postgraduate Student, Postgraduate Program in Pathology and Professor of Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Giorgio Adriano Paskulin
- PhD. Professor of Clinical Genetics and of the Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Paulo Ricardo Gazzola Zen
- PhD. Professor of Clinical Genetics and of the Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
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Rosa RFM, D'Ecclesiis WFB, Dibbi RP, Rosa RCM, Trevisan P, Graziadio C, Paskulin GA, Zen PRG. 45,X/46,XY mosaicism: report on 14 patients from a Brazilian hospital. A retrospective study. SAO PAULO MED J 2014; 132:332-338. [PMID: 25351753 PMCID: PMC10496778 DOI: 10.1590/1516-3180-2014-1326729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Revised: 08/15/2013] [Accepted: 10/22/2013] [Indexed: 02/01/2024] Open
Abstract
CONTEXT AND OBJECTIVE 45,X/46,XY mosaicism, or mixed gonadal dysgenesis, is considered to be a rare disorder of sex development. The aim of our study was to investigate the clinical and cytogenetic characteristics of patients with this mosaicism. DESIGN AND SETTING A retrospective study in a referral hospital in southern Brazil. METHODS Our sample consisted of patients diagnosed at the clinical genetics service of a referral hospital in southern Brazil, from 1975 to 2012. Clinical and cytogenetic data were collected from the medical records. RESULTS Fourteen patients were included in the sample, with ages at the first evaluation ranging from 2 days to 38 years. Nine of them had female sex of rearing and five, male. Regarding the external genitalia, most were ambiguous (n = 10). One patient presented male phenotype and was treated for a history of azoospermia, while three patients presented female phenotype, of whom two had findings of Turner syndrome and one presented secondary amenorrhea alone. Some findings of Turner syndrome were observed even among patients with ambiguous genitalia. None presented gonadal malignancy. One patient underwent surgical correction for genital ambiguity and subsequent exchange of sex of rearing. Regarding cytogenetics, we did not observe any direct correlation between percentages of cell lines and phenotype. CONCLUSIONS 45,X/46,XY mosaicism can present with a wide variety of phenotypes resulting from the involvement of different aspects of the individual. All these observations have important implications for early recognition of these patients and their appropriate management.
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Affiliation(s)
- Rafael Fabiano Machado Rosa
- PhD. Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Willy Francisco Bartel D'Ecclesiis
- MD. Physician, Residency Program in Obstetrics and Gynecology, Hospital Materno Infantil Presidente Vargas (HMIPV), Porto Alegre, Rio Grande do Sul, Brazil
| | - Raquel Papandreus Dibbi
- MD. Postgraduate Student, Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Gynecologist and Obstetrician, Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Rosana Cardoso Manique Rosa
- MD. Postgraduate Student, Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Pediatrician, Grupo Hospitalar Conceição (GHC), Porto Alegre, Rio Grande do Sul, Brazil
| | - Patrícia Trevisan
- MD. Postgraduate Student, Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Pharmacist, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Carla Graziadio
- MD. Postgraduate Student, Postgraduate Program in Pathology and Professor of Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Giorgio Adriano Paskulin
- PhD. Professor of Clinical Genetics and of the Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Paulo Ricardo Gazzola Zen
- PhD. Professor of Clinical Genetics and of the Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
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Rosa RFM, Rosa RCM, Lorenzen MB, Zen PRG, Graziadio C, Paskulin GA. Craniofacial abnormalities among patients with Edwards Syndrome. Rev Paul Pediatr 2014; 31:293-8. [PMID: 24142310 PMCID: PMC4182981 DOI: 10.1590/s0103-05822013000300004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 03/25/2013] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To determine the frequency and types of craniofacial abnormalities observed
in patients with trisomy 18 or Edwards syndrome (ES). METHODS This descriptive and retrospective study of a case series included all
patients diagnosed with ES in a Clinical Genetics Service of a reference
hospital in Southern Brazil from 1975 to 2008. The results of the karyotypic
analysis, along with clinical data, were collected from medical records.
RESULTS: The sample consisted of 50 patients, of which 66% were female. The median
age at first evaluation was 14 days. Regarding the karyotypes, full trisomy
of chromosome 18 was the main alteration (90%). Mosaicism was observed in
10%. The main craniofacial abnormalities were: microretrognathia (76%),
abnormalities of the ear helix/dysplastic ears (70%), prominent occiput
(52%), posteriorly rotated (46%) and low set ears (44%), and short palpebral
fissures/blepharophimosis (46%). Other uncommon - but relevant -
abnormalities included: microtia (18%), orofacial clefts (12%), preauricular
tags (10%), facial palsy (4%), encephalocele (4%), absence of external
auditory canal (2%) and asymmetric face (2%). One patient had an initial
suspicion of oculo-auriculo-vertebral spectrum (OAVS) or Goldenhar syndrome.
CONCLUSIONS: Despite the literature description of a characteristic clinical presentation
for ES, craniofacial alterations may be variable among these patients. The
OAVS findings in this sample are noteworthy. The association of ES with OAVS
has been reported once in the literature.
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de Mattos VF, Graziadio C, Machado Rosa RF, Lenhardt R, Alves RPM, Trevisan P, Paskulin GA, Zen PRG. Gómez-López-Hernández syndrome in a child born to consanguineous parents: new evidence for an autosomal-recessive pattern of inheritance? Pediatr Neurol 2014; 50:612-5. [PMID: 24690526 DOI: 10.1016/j.pediatrneurol.2014.01.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 01/10/2014] [Accepted: 01/18/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Gómez-López-Hernández syndrome is a rare genetic disease characterized by scalp alopecia with trigeminal anesthesia, brachycephaly or turribrachycephaly, midface retrusion, and rhombencephalosynapsis. We report the second case with this condition who presented with consanguineous parents. PATIENT This boy was evaluated shortly after birth because of suspected craniosynostosis. He was the only son of healthy, consanguineous parents (his maternal grandmother and his paternal great-grandfather were siblings). His examination was notable for turribrachycephaly, prominent forehead, bilateral parietotemporal alopecia, midfacial retrusion, anteverted nostrils, micrognathia, low-set and posteriorly rotated ears, and short neck with redundant skin. Radiographs and tridimensional computed tomography scan of skull revealed lambdoid craniosynostosis. Brain magnetic resonance imaging revealed complete rhombencephalosynapsis, aqueductal stenosis, fused colliculi, abnormal superior cerebellar penducle, mild ventriculomegaly, and dysgenesis of the corpus callosum. CONCLUSIONS Since its first description, 34 patients with this condition have been reported. The etiology of Gómez-López-Hernández syndrome is unknown. However, it is noteworthy that the patient in this report presented with a family history of consanguinity because this finding reinforces the possibility of an autosomal-recessive inheritance for this condition.
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Affiliation(s)
- Vinicius Freitas de Mattos
- Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Carla Graziadio
- Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil; Postgraduate Program in Pathology, UFCSPA, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rafael Fabiano Machado Rosa
- Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil; Postgraduate Program in Pathology, UFCSPA, Porto Alegre, Rio Grande do Sul, Brazil; Clinical Genetics, Hospital Materno Infantil Presidente Vargas (HMIPV), Porto Alegre, Rio Grande do Sul, Brazil
| | - Rene Lenhardt
- Radiology Service, CHSCPA, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Patrícia Trevisan
- Postgraduate Program in Pathology, UFCSPA, Porto Alegre, Rio Grande do Sul, Brazil
| | - Giorgio Adriano Paskulin
- Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil; Postgraduate Program in Pathology, UFCSPA, Porto Alegre, Rio Grande do Sul, Brazil
| | - Paulo Ricardo Gazzola Zen
- Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil; Postgraduate Program in Pathology, UFCSPA, Porto Alegre, Rio Grande do Sul, Brazil.
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Rosa RFM, Rosa RCM, Trevisan P, Graziadio C, Varella-Garcia M, Paskulin GA, Zen PRG. Screening for 22q11 deletion syndrome among patients with congenital heart defects. SAO PAULO MED J 2014; 132:125-6. [PMID: 24714995 PMCID: PMC4116674 DOI: 10.1590/1516-3180.2014.1322655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 08/30/2013] [Indexed: 11/21/2022] Open
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Trevisan P, de Moraes FN, de Mattos VF, Graziadio C, Rosa RFM, Paskulin GA, Zen PRG. Cytogenetic profile of patients with Down syndrome in southern Brazil. SAO PAULO MED J 2014; 132:253-4. [PMID: 25055073 PMCID: PMC10496740 DOI: 10.1590/1516-3180.2014.1324765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 05/01/2013] [Accepted: 11/28/2013] [Indexed: 11/21/2022] Open
Affiliation(s)
- Patrícia Trevisan
- BPharm. Postgraduate Student, Postgraduate Program on Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Felipe Nora de Moraes
- Medical Student, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Vinicius Freitas de Mattos
- MD. Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Carla Graziadio
- MD. Assistant Professor of Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Rafael Fabiano Machado Rosa
- MD, PhD. Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Giorgio Adriano Paskulin
- PhD. Associate Professor of Clinical Genetics and Coordinator of the Postgraduate Program on Pathology, and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Paulo Ricardo Gazzola Zen
- PhD. Adjunct Professor of Clinical Genetics and Professor of the Postgraduate Program on Pathology, and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
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Polli JB, Groff DDP, Petry P, Mattos VF, Rosa RCM, Zen PRG, Graziadio C, Paskulin GA, Rosa RFM. Trisomy 13 (Patau syndrome) and congenital heart defects. Am J Med Genet A 2013; 164A:272-5. [PMID: 24214527 DOI: 10.1002/ajmg.a.36193] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 07/17/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Janaina B Polli
- Pediatrics Service, Hospital Materno Infantil Presidente Vargas (HMIPV), Porto Alegre, RS, Brazil
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Rosa RFM, Trevisan P, Rosa RCM, Lorenzen MB, Zen PRG, Oliveira CA, Graziadio C, Paskulin GA. Trisomy 18 and neural tube defects. Pediatr Neurol 2013; 49:203-4. [PMID: 23831245 DOI: 10.1016/j.pediatrneurol.2013.03.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 03/11/2013] [Accepted: 03/24/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Trisomy 18 or Edwards syndrome is a chromosomal abnormality characterized by a broad clinical picture and a limited survival. More than 130 different abnormalities have been described in these patients-among them are neural tube defects. METHODS We verified the frequency and types of major neural tube defects observed among patients with trisomy 18. Our sample consisted of consecutive patients evaluated by a clinical genetics service of a referral hospital in southern Brazil between 1975 and 2008. Fisher's exact test (two-tailed) and chi-square test with Yates' correction were used to compare frequencies (P < 0.05 values were considered as significant). RESULTS During the period of evaluation, we identified 50 patients with trisomy 18; 33 (66%) were female and age at the first evaluation ranged from 1 day to 16 years (median 14 days). One cell line with full trisomy 18 was the predominant cytogenetic finding (90%). Three patients (6%) had major neural tube defects, all females. These were two patients (4%) with encephaloceles and one (2%) with myelomeningocele. This last patient undergo to correction surgery on her first day of life. CONCLUSIONS Our data, in accordance with the literature, support the idea that the presence of neural tube defects among patients with trisomy 18 is not coincidental (i.e., these defects are actually part of the spectrum of abnormalities presented in trisomy 18). Thus, the diagnosis of trisomy 18 should be considered in children with major neural tube defects, especially in the presence of other abnormalities or dysmorphisms.
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Rosa RFM, Rosa RCM, Zen PRG, Graziadio C, Paskulin GA. Trissomia 18: revisão dos aspectos clínicos, etiológicos, prognósticos e éticos. Rev paul pediatr 2013; 31:111-20. [DOI: 10.1590/s0103-05822013000100018] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Accepted: 05/21/2012] [Indexed: 12/21/2022]
Abstract
OBJETIVO: Revisar as características clínicas, etiológicas, diagnósticas e prognósticas da trissomia do cromossomo 18 (síndrome de Edwards). FONTES DE DADOS: Foram pesquisados artigos científicos presentes nos portais MedLine, Lilacs e SciELO, utilizando-se os descritores 'trisomy 18' e 'Edwards syndrome'. A pesquisa não se limitou a um período determinado e englobou artigos presentes nestes bancos de dados. SÍNTESE DOS DADOS: A síndrome de Edwards é uma doença caracterizada por um quadro clínico amplo e prognóstico bastante reservado. Há descrição na literatura de mais de 130 anomalias diferentes, as quais podem envolver praticamente todos os órgãos e sistemas. Seus achados são resultantes da presença de três cópias do cromossomo 18. A principal constituição cromossômica observada entre estes pacientes é a trissomia livre do cromossomo 18, que se associa ao fenômeno de não disjunção, especialmente na gametogênese materna. A maioria dos fetos com síndrome de Edwards acaba indo a óbito durante a vida embrionária e fetal. A mediana de sobrevida entre nascidos vivos tem usualmente variado entre 2,5 e 14,5 dias. CONCLUSÕES: O conhecimento do quadro clínico e do prognóstico dos pacientes com a síndrome de Edwards tem grande importância no que diz respeito aos cuidados neonatais e à decisão de instituir ou não tratamentos invasivos. A rapidez na confirmação do diagnóstico é importante para a tomada de decisões referentes às condutas médicas. Muitas vezes, as intervenções são realizadas em condições de emergência, sem muita oportunidade de reflexão ou discussão, e envolvem questões médicas e éticas difíceis.
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Rosa RFM, Rosa RCM, Lorenzen MB, Zen PRG, de Oliveira CAV, Graziadio C, Paskulin GA. Trisomy 18 (Edwards syndrome) and major gastrointestinal malformations. SAO PAULO MED J 2013; 131:133-4. [PMID: 23657517 PMCID: PMC10871733 DOI: 10.1590/s1516-31802013000100025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Revised: 04/25/2012] [Accepted: 07/30/2012] [Indexed: 11/22/2022] Open
Affiliation(s)
- Rafael Fabiano Machado Rosa
- PhD. Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Rosana Cardoso Manique Rosa
- MD. Postgraduate, Postgraduate Program on Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Marina Boff Lorenzen
- Undergraduate Medical Student, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Paulo Ricardo Gazzola Zen
- PhD. Adjunct Professor of Clinical Genetics and Professor of the Postgraduate Program on Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Ceres Andréia Vieira de Oliveira
- MD. Professor, Instituto de Educação e Pesquisa (IEP), Hospital Moinhos de Vento (HMV), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Carla Graziadio
- MD. Postgraduate Student, Postgraduate Program on Pathology, and Assistant Professor of Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Giorgio Adriano Paskulin
- PhD. Associate Professor of Clinical Genetics and Coordinator of the Postgraduate Program on Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
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Rosa RFM, Rosa RCM, Lorenzen MB, Zen PRG, Oliveira CAVD, Graziadio C, Paskulin GA. Limb abnormalities on trisomy 18: evidence for early diagnosis. J Pediatr (Rio J) 2012; 88:401-5. [PMID: 23002079 DOI: 10.2223/jped.2212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2012] [Accepted: 05/28/2012] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE To assess the frequency and types of limb abnormalities observed among patients with trisomy 18, or Edwards syndrome (ES). METHOD The sample consisted of consecutive patients evaluated by a clinical genetics service in the period from 1975 to 2008. The results of the cytogenetic analysis, as well as the clinical data were retrieved from the medical records, with special attention to limb abnormalities findings. All the karyotype analysis was performed at the same laboratory. RESULTS During the study period, 50 patients were identified, 33 (66%) of them females, with ages at the first evaluation ranging from 1 day to 16 years (median 14 days). The single lineage with free trisomy 18 was the most frequent chromosomal disorder (90%). Mosaicism was observed in 10% of the cases. Clenched fist with overlapping fingers was the predominant anomaly of the upper limbs (70%). Other common disorders included the single palmar crease (42%) and hypoplastic nails (36%). Radial abnormalities were found in 11 patients (22%). As for the lower limbs, hypoplastic nails were the most common abnormality (58%), followed by the rocker bottom foot with prominent calcaneus (50%). One patient had unilateral ectrodactyly as well. CONCLUSIONS Despite the classical description, limb anomalies can be much variable in ES. Some patients may show unusual abnormalities, such as radial defects and ectrodactyly. These findings are extremely important for the clinical suspicion and early identification of patients with ES.
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Affiliation(s)
- Rafael F M Rosa
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
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Rosa RF, Rosa RC, Lorenzen MB, de Oliveira CA, Graziadio C, Zen PR, Paskulin GA. Trisomy 18: Frequency, types, and prognosis of congenital heart defects in a Brazilian cohort. Am J Med Genet A 2012; 158A:2358-61. [DOI: 10.1002/ajmg.a.35492] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Accepted: 04/18/2012] [Indexed: 11/11/2022]
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Goetze T, Rosa R, Graziadio C, Almeida S, Zen P, Paskulin G. CRANIOFACIAL ABNORMALITIES IN A PATIENT WITH AMNIOTIC BAND SYNDROME. Int Arch Otorhinolaryngol 2012. [DOI: 10.7162/s1809-977720120s1pf-021] [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: 11/02/2022] Open
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Goetze T, Rosa R, Silva A, Zen P, Graziadio C, Paskulin G. GESTATIONAL EXPOSURE TO MISOPROSTOL AND OCULO-AURICULO-VERTEBRAL SPECTRUM (GOLDENHAR SYNDROME): REPORT OF TWO PATIENTS. Int Arch Otorhinolaryngol 2012. [DOI: 10.7162/s1809-977720120s1pf-020] [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: 11/02/2022] Open
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Graziadio C, Bernardi P, Rosa RFM, Zen PRG, Paskulin GA. Type 1 diabetes in a patient with Ellis-van Creveld syndrome. SAO PAULO MED J 2012; 130:53-6. [PMID: 22344360 PMCID: PMC10906694 DOI: 10.1590/s1516-31802012000100009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Revised: 10/13/2010] [Accepted: 04/18/2011] [Indexed: 11/21/2022] Open
Abstract
CONTEXT Ellis-van Creveld (EVC) syndrome is a rare autosomal recessive disease characterized by disproportionate short stature, narrow thorax, postaxial polydactyly, nail and tooth abnormalities and congenital heart disease. CASE REPORT The patient was a 22-year-old Caucasian man, the third child of consanguineous parents. He received the diagnosis of insulin-dependent diabetes mellitus (DM) at 16 years of age, and around one year later, he underwent surgery to correct a partial atrioventricular septal defect. Upon physical examination, at 22 years of age, he presented stature of 145.5 cm (P3), weight of 49 kg (P3), head circumference of 54 cm (P2-50), high palate, absence of one of the lower lateral incisor teeth, narrow shoulders, narrowing of the upper thorax, scoliosis, rhizomelic shortening of the upper limbs, brachydactyly, postaxial polydactyly and clinodactyly of the second and third fingers. The lower limbs showed rhizomelic shortening with significant genu valgum (knock-knee deformity), small feet with postaxial polydactyly, syndactyly between the second and third toes and hallux valgus. Multiple melanocytic nevi were evident on the face, thorax and limbs. At that time, he was using neutral protamine Hagedorn (NPH) insulin, with poorly controlled DM. The clinical findings presented led to the diagnosis of EVC syndrome. Only one case of this syndrome has been described with DM so far. Attention is drawn to the fact that the genes associated with this syndrome are located close to those of the Wolfram syndrome, a condition that leads to early-onset diabetes.
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Affiliation(s)
- Carla Graziadio
- MD. Assistant Professor and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Pricila Bernardi
- MD. Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Rafael Fabiano Machado Rosa
- PhD. Adjunct Professor of Clinical Genetics and Professor of the Postgraduate Program on Pathology and Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Paulo Ricardo Gazzola Zen
- PhD. Adjunct Professor of Clinical Genetics and Professor of the Postgraduate Program on Pathology and Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Giorgio Adriano Paskulin
- PhD. Associate Professor of Clinical Genetics and professor of the Postgraduate Program on Pathology, Clinical Genetics and Cytogenetics, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
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Graziadio C, Lorenzen MB, Moraes FND, Rosa RFM, Zen PRG, Raupp SF, Paskulin GA. Múltiplas hiperintensidades no sistema nervoso central em uma criança com neurofibromatose do tipo 1. Rev paul pediatr 2011. [DOI: 10.1590/s0103-05822011000400035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Relatar o caso de uma criança com neurofibromatose do tipo 1, apresentando o achado ocasional de múltiplas hiperintensidades e de lesão hamartomatosa pré-quiasmática no sistema nervoso central. DESCRIÇÃO DO CASO: Menino de tez escura de quatro anos, cujo pai apresentava manchas café-com-leite e história de cirurgia de tumor de ouvido. A criança evoluiu com um adequado desenvolvimento neuropsicomotor, sem crises convulsivas ou déficit de aprendizagem. Ao exame físico, possuía múltiplas manchas café-com-leite e efélides. A avaliação pela ressonância nuclear magnética de encéfalo evidenciou múltiplas imagens nodulares hiperintensas em T2 e Flair, com isossinal em T1, localizadas na substância branca dos hemisférios cerebrais, cerebelo e tronco cerebral. Apresentava ainda lesão hamartomatosa pré-quiasmática. A avaliação eletroencefalográfica e o exame neurológico eram normais. COMENTÁRIOS: As imagens hiperintensas verificadas na ressonância nuclear magnética correspondem aos chamados unidentified bright objects (UBOs), observados em de 60 a 70% das crianças com neurofibromatose do tipo 1, sendo raros em adultos. Sua etiologia e significado clínico ainda não são claros. Alguns estudos os têm associado à disfunção cognitiva, déficit neurológico e risco de malignização. Hamartomas localizados próximos ao quiasma óptico são incomuns, mas podem se relacionar à puberdade precoce. A avaliação do sistema nervoso central de crianças assintomáticas com neurofibromatose do tipo 1 é discutível. Contudo, nos casos em que UBOs sejam identificados, é importante considerar seu seguimento radiológico, especialmente diante de lesões múltiplas ou atípicas.
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Zen PRG, Rosa RFM, Rosa RCM, Graziadio C, Paskulin GA. New report of two patients with mosaic trisomy 9 presenting unusual features and longer survival. SAO PAULO MED J 2011; 129:428-32. [PMID: 22249800 PMCID: PMC10868921 DOI: 10.1590/s1516-31802011000600010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [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: 10/04/2010] [Revised: 12/14/2010] [Accepted: 03/10/2011] [Indexed: 11/22/2022] Open
Abstract
CONTEXT Mosaic trisomy 9 is considered to be a rare chromosomal abnormality with limited survival. Our objective was to report on two patients with mosaic trisomy 9 presenting unusual findings and prolonged survival. CASE REPORTS The first patient was a boy aged six years and five months presenting weight of 14.5 kg (< P3), height of 112 cm (P10), head circumference of 49 cm (P2), prominent forehead, triangular and asymmetric face, thin lips, right microtia with overfolded helix, small hands, micropenis (< P10), small testes and hallux valgus. His lymphocyte karyotype was mos 47,XY,+9[4]/46,XY[50]. Additional cytogenetic assessment of the skin showed normal results. The second patient was a two-year-old girl who was initially assessed at five months of age, when she presented weight of 5.3 kg (< P3), height of 61.5 cm (P2-P10), head circumference of 40.5 cm (P25), sparse hair, micrognathia, right ear with overfolded helix and preauricular pit, triphalangeal thumbs and sacral dimple. She also had a history of congenital heart disease, hearing loss, hypotonia, delayed neuropsychomotor development and swallowing disorder. Her lymphocyte karyotype was mos 47,XX,+9[3]/46,XX[69]. Both patients had unusual clinical findings (the first, hemifacial hypoplasia associated with microtia, with a phenotype of oculo-auriculo-vertebral spectrum, and the second, triphalangeal thumbs and hearing loss) and survival greater than what is usually described in the literature (< 1 year). Further reports will be critical for delineating the clinical features and determining the evolution of patients with mosaic trisomy 9.
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Affiliation(s)
- Paulo Ricardo Gazzola Zen
- PhD. Adjunct Professor of Clinical Genetics, Professor of the Postgraduate Pathology Program and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Rafael Fabiano Machado Rosa
- MD. Postgraduate Student and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Rosana Cardoso Manique Rosa
- MD. Pediatrician and Postgraduate Student, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Carla Graziadio
- MD. Assistant Professor of Clinical Genetics and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Giorgio Adriano Paskulin
- PhD. Associated Professor of Clinical Genetics, Professor of the Postgraduate Pathology Program, Clinical Geneticist and Cytogeneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
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Gianfrilli D, Lauretta R, Di Dato C, Graziadio C, Pozza C, De Larichaudy J, Giannetta E, Isidori AM, Lenzi A. Propionyl-L-carnitine, L-arginine and niacin in sexual medicine: a nutraceutical approach to erectile dysfunction. Andrologia 2011; 44 Suppl 1:600-4. [DOI: 10.1111/j.1439-0272.2011.01234.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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Rosa RFM, Mombach R, Zen PRG, Graziadio C, Paskulin GA. Clinical characteristics of a sample of patients with cat eye syndrome. Rev Assoc Med Bras (1992) 2011; 56:462-5. [PMID: 20835645 DOI: 10.1590/s0104-42302010000400021] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Accepted: 05/17/2010] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Cat eye syndrome is considered a rare chromosome disease with a highly variable phenotype. The objective of this paper was to describe the clinical characteristics of a sample of patients with cat eye syndrome who were seen at our service. METHODS This is a retrospective analysis of a sample of six patients with diagnoses of cat eye syndrome. All of these patients’ karyotypes exhibited the presence of an additional marker chromosome, inv dup(22)(pter->q11.2::q11.2->pter). One patient also exhibited mosaicism with a lineage that had a normal chromosomal constitution. Clinical and follow-up data were collected from the patients’ medical records. Fisher’s exact test was used to compare the frequencies observed in our study with figures given in the literature (P<0.05). RESULTS The main abnormalities observed were preauricular tags and/or pits and anal atresia (both observed in 83% of cases). Coloboma of the iris, an important finding with this syndrome, was observed in two cases (33%). Congenital heart disease was detected in four patients (67%) and the main defect found was interatrial communication (75%). Uncommon findings included hemifacial microsomia combined with unilateral microtia and biliary atresia. Just one of these patients died, from chylothorax and sepsis. CONCLUSION The phenotype observed in cat eye syndrome is highly variable and may be superimposed on the phenotype of the oculo-auriculo-vertebral spectrum. Although these patients usually have good prognosis, including from a neurological point of view, we believe that all patients with the syndrome should be assessed very early on for the presence of cardiac, biliary and anorectal malformations, which may avoid possible complications in the future, including patient deaths.
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Affiliation(s)
- Rafael Fabiano Machado Rosa
- Universidade Federal de Ciências da Saúde de Porto Alegre and Complexo Hospitalar Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil
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Abstract
OBJETIVO: Verificar as características clínicas de pacientes com anemia de Fanconi (AF) diagnosticados em um Serviço de Genética Clínica. MÉTODOS: O estudo incluiu todos os pacientes atendidos no Serviço de Genética Clínica da Universidade Federal de Ciências da Saúde de Porto Alegre e Complexo Hospitalar Santa Casa de Porto Alegre, entre 1975 e 2008, com suspeita clínica de AF submetidos ao estudo de quebras cromossômicas com o uso de diepoxi-butano (DEB) a partir do sangue periférico. Realizou-se uma análise retrospectiva das características clínicas dos pacientes, a partir de um levantamento sistemático dos seus prontuários médicos. RESULTADOS: A amostra foi composta de 17 pacientes, sendo que em sete o diagnóstico de AF foi confirmado. Os pacientes com AF caracterizaram-se por um fenótipo amplo, oscilando desde um quadro de pancitopenia sem dismorfias até a presença de múltiplas malformações sem alterações hematológicas. Certos achados, como face triangular, orelhas em abano e manchas café com leite foram frequentes e encontrados apenas nos indivíduos com AF. História de equimoses, hematomas, petéquias, infecções e linfadenopatias foi comum entre os indivíduos desse grupo. Por outro lado, alterações neurológicas foram observadas apenas em pacientes sem AF. Consanguinidade foi verificada em apenas um paciente, que apresentava AF. CONCLUSÕES: Apesar das limitações do estudo, os achados ilustram a grande variabilidade fenotípica observada na AF, o que torna seu diagnóstico clínico um desafio. No entanto, alguns achados específicos podem servir de pistas para sua detecção. A identificação precoce desses indivíduos é fundamental para o seu manejo adequado.
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Zen PRG, Silva APD, O. Filho RL, Rosa RFM, Maia CR, Graziadio C, Paskulin GA. Diagnóstico pré-natal de displasia tanatofórica: papel do ultrassom fetal. Rev paul pediatr 2011. [DOI: 10.1590/s0103-05822011000300024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Relatar o caso de um paciente com displasia tanatofórica, uma forma autossômica dominante e letal de nanismo, diagnosticado ainda no período pré-natal, e revisar a literatura, discutindo os principais diagnósticos diferenciais e ressaltando a importância do ultrassom fetal na identificação de fetos portadores dessa displasia. DESCRIÇÃO DO CASO: O paciente é o segundo filho de pais jovens sem história familiar de doenças genéticas. O ultrassom fetal realizado com 35 semanas de gestação mostrou polidrâmnio, proeminência frontal e desproporção entre crânio e tronco, com hipoplasia torácica e encurtamento dos ossos longos, compatível com o diagnóstico de displasia tanatofórica. Ao nascimento, a criança era pequena e possuía hipotonia, macrocefalia, fontanelas amplas, hipoplasia de face média, olhos protrusos, hemangioma plano no nariz e pálpebras, nariz em sela, micrognatia, pescoço e tórax curtos e encurtamento importante de braços, antebraços, coxas e pernas. A avaliação radiográfica mostrou crânio com grande diâmetro transverso, tórax com costelas curtas e corpos vertebrais reduzidos, importante encurtamento e deformidade dos ossos longos dos membros superiores e inferiores (os fêmures eram curvos) e hipoplasia da bacia. Esses achados confirmaram o diagnóstico pré-natal de displasia tanatofórica. O paciente evoluiu para o óbito poucos dias após o nascimento devido à insuficiência respiratória. COMENTÁRIOS: A ultrassonografia fetal é um método não invasivo capaz de diagnosticar inúmeras displasias ósseas, incluindo a tanatofórica. A importância do diagnóstico intra-útero reside no fato de que auxilia no diagnóstico diferencial, e permite o aconselhamento genético à família.
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Rosa RF, Rosa RC, Flores JA, Chazan DT, Dietrich C, de Barth MB, Carpes VF, da Cunha AC, Graziadio C, Zen PR. Trisomy 13 (Patau syndrome) and craniosynostosis. Am J Med Genet A 2011; 155A:2018-20. [DOI: 10.1002/ajmg.a.34086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Accepted: 04/06/2011] [Indexed: 11/11/2022]
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Rosa RF, Rosa RC, Lorenzen MB, de Moraes FN, Graziadio C, Zen PR, Paskulin GA. Trisomy 18: Experience of a reference hospital from the south of Brazil. Am J Med Genet A 2011; 155A:1529-35. [DOI: 10.1002/ajmg.a.34088] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 04/06/2011] [Indexed: 11/10/2022]
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Affiliation(s)
- Carla Graziadio
- Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
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Abstract
OBJETIVO: Revisar as características clínicas, etiológicas e diagnósticas da síndrome de deleção 22q11 e sua associação com as cardiopatias congênitas. FONTES DOS DADOS: Foram pesquisados artigos científicos presentes nos portais Medline, Lilacs e SciELO, utilizando-se descritores específicos como "22q11", "DiGeorge syndrome", "velocardiofacial syndrome", "congenital heart defects" e "cardio-vascular malformations". O período adotado para a revisão foi de 1980 a 2009. SÍNTESE DOS DADOS: As malformações cardíacas são os defeitos congênitos observados mais frequentemente ao nascimento e representam um problema importante de Saúde Pública. Dentre suas principais causas conhecidas destaca-se a síndrome de deleção 22q11, também chamada de síndrome de DiGeorge, síndrome velocardiofacial e CATCH22. Trata-se de uma doença autossômica domi-nante caracterizada por um fenótipo altamente variável, o que dificulta em muito seu reconhecimento clínico. Além disso, a maior parte dos pacientes apresenta uma microdeleção identificada principalmente por técnicas de citogenética molecular, como a hibridização in situ fluorescente, pouco disponíveis em nosso meio. De forma similar a outras síndromes, a síndrome de deleção 22q11 associa-se a certos defeitos cardíacos específicos, no caso os do tipo conotruncal. Apesar disso, não há ainda na literatura um consenso sobre quais os pacientes com car-diopatia congênita que deveriam ser investigados para a síndrome de deleção 22q11. CONCLUSÕES: Cardiologistas e cirurgiões cardíacos, espe-cialmente pediátricos, devem estar cientes das peculiaridades e dos cuidados dispensados à síndrome de deleção 22q11. Os indivíduos com a síndrome apresentam comumente alterações envolvendo vários sistemas, o que pode levar a dificuldades e a complicações durante seu manejo clínico e cirúrgico.
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Affiliation(s)
| | | | - Carla Graziadio
- Universidade Federal de Ciências da Saúde de Porto Alegre, Brasil
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Graziadio C, Rosa RF, Rosa RC, Zen PR, Flores JA, Paskulin GA. Short-term follow-up of a Brazilian patient with Cantú syndrome. Am J Med Genet A 2011; 155A:1184-8. [DOI: 10.1002/ajmg.a.33904] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Accepted: 12/24/2010] [Indexed: 11/08/2022]
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de Zwart-Storm EA, Rosa RFM, Martin PE, Foelster-Holst R, Frank J, Bau AEK, Zen PRG, Graziadio C, Paskulin GA, Kamps MA, van Geel M, van Steensel MAM. Molecular analysis of connexin26 asparagine14 mutations associated with syndromic skin phenotypes. Exp Dermatol 2011; 20:408-12. [DOI: 10.1111/j.1600-0625.2010.01222.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Paskulin GA, Lorenzen MB, Rosa RFM, Graziadio C, Zen PRG. Importância da análise cromossômica dos fibroblastos em casos suspeitos de mosaicismo: experiência de um serviço de Genética Clínica. Rev paul pediatr 2011. [DOI: 10.1590/s0103-05822011000100012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVOS: Verificar características clínicas e achados citogenéticos de pacientes com suspeita de mosaicismo submetidos à avaliação cromossômica por meio do cariótipo por bandas GTG de linfócitos e fibroblastos. MÉTODOS: Realizou-se uma análise retrospectiva dos pacientes avaliados no Serviço de Genética Clínica do Complexo Hospitalar Santa Casa de Porto Alegre da Universidade Federal de Ciências da Saúde de Porto Alegre, entre 1975 e 2009, por meio da coleta de dados clínicos e resultados da avaliação citogenética. RESULTADOS: A amostra foi composta de 15 pacientes, seis (40%) do sexo masculino, e idades variando de dez dias a 14 anos. Na análise cromossômica do sangue, alterações foram observadas em quatro pacientes (26,7%), incluindo-se um caso de translocação balanceada [t(2;9)pat] e três de mosaicismo [um caso, respectivamente, de mos 45,X/46,X,+mar; mos 46,XY,r(12)/45,XY,-12/47,XY,r(12),+r(12) e mos 46,XY/47,XY,+9]. Com o objetivo de confirmar ou mesmo identificar um mosaicismo cromossômico, os pacientes foram submetidos posteriormente ao cariótipo de pele. Os principais motivos pelos quais os pacientes com cariótipo do sangue sem mosaicismo apresentaram tal suspeita foram a presença de hemi-hipertrofia (n=5) e de manchas hipocrômicas seguindo as linhas de Blaschko (n=4). Mosaicismo foi confirmado em dois casos e identificado em outros dois (dois casos de mos 46,XX/47,XX,+22). O mos 46,XY/47,XY,+9 não foi verificado no estudo dos fibroblastos. CONCLUSÕES: Os resultados ilustram a variabilidade tecidual característica dos casos de mosaicismo cromossômico, bem como confirmam a importância da avaliação de um segundo tecido para a determinação diagnóstica. Achados clínicos, como assimetria de membros e anomalias pigmentares seguindo as linhas de Blaschko, são fortemente indicativos da presença de mosaicismo.
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Graziadio C, Lorenzen MB, Rosa RFM, Pinto LLC, Zen PRG, Travi GM, Valiatti F, Paskulin GA. New report of a familial case of Moebius syndrome presenting skeletal findings. Am J Med Genet A 2010; 152A:2134-8. [PMID: 20635408 DOI: 10.1002/ajmg.a.33548] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Carla Graziadio
- Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre, Rio Grande do Sul, Brazil
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Paskulin GA, Riegel M, Machado Rosa RF, Graziadio C, Gazzola Zen PR. Interstitial deletion of 7q31.32 → q33 secondary to a paracentric inversion of a maternal chromosome 7. Eur J Med Genet 2010; 54:181-5. [PMID: 21056704 DOI: 10.1016/j.ejmg.2010.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Accepted: 10/29/2010] [Indexed: 11/29/2022]
Abstract
Carriers of paracentric inversions (PAIs) are usually asymptomatic. However, such inversions may lead to the formation of recombinant gametes and then to an abnormal gestation. Here we report a girl with a 7q31.32 → q33 deletion secondary to a maternal PAI of chromosome 7. This finding was confirmed through FISH and whole-genome array-CGH analyses. The deficiency of the chromosome 7 observed in our patient was never described before and we did not find any known gene localized within the deficient segment that could be related to her findings of hypoplastic iliac bones, hypoplastic labia minora and postaxial polydactyly. This case highlights the fact that rare viable recombinants can be developed from PAIs, an issue that must be discussed in the genetic counseling.
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Affiliation(s)
- Giorgio Adriano Paskulin
- Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), RS, Brazil
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Rosa RFM, Graziadio C, Lenhardt R, Alves RPM, Paskulin GA, Zen PRG. Central nervous system abnormalities in patients with oculo-auriculo-vertebral spectrum (Goldenhar syndrome). Arq Neuropsiquiatr 2010; 68:98-102. [PMID: 20339662 DOI: 10.1590/s0004-282x2010000100021] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2009] [Accepted: 10/26/2009] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To describe the central nervous system (CNS) alterations present in a sample of oculo-auriculo-vertebral spectrum (OAVS) patients, trying to correlate them with other clinical features. METHOD Seventeen patients with diagnosis of OAVS were evaluated. All presented radiological evaluation of the CNS, normal GTG-Banding karyotype and clinical features involving at least two from the four following areas: oro-cranio-facial, ocular, auricular and vertebral. RESULTS CNS alterations were verified in eight from seventeen patients (47%). Diffuse cerebral hypoplasia, dilated lateral cerebral ventricles (asymptomatic hydrocephalus), corpus callosum dysgenesis and frontal hypodensities were the most frequent abnormalities. Presence of ophthalmologic abnormalities was the only clinical association observed, being significantly more frequent among patients with cerebral alterations (63% versus 11%). CONCLUSION CNS abnormalities are frequent in patients with OAVS, especially in carriers of ophthalmologic alterations. However, the absence of detectable cerebral abnormalities did not exclude the possibility that these subjects will subsequently present neurological symptoms.
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Affiliation(s)
- Rafael Fabiano Machado Rosa
- Santa Casa Hospital Complex of Porto Alegre, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil
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Zen PRG, Rosa RFM, Graziadio C, da Silva AP, Paskulin GA. Omphalocele-exstrophy-imperforate anus-spinal defects (OEIS) complex in a child with nail-patella syndrome. Pediatr Int 2010; 52:847-8. [PMID: 20880310 DOI: 10.1111/j.1442-200x.2010.03216.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rosa RFM, Pfeil JN, Zen PRG, Rosa RCM, Graziadio C, Paskulin GA. Variabilidade fenotípica na síndrome do cromossomo supernumerário der(22)t(11;22) (síndrome de Emanuel). Rev paul pediatr 2010. [DOI: 10.1590/s0103-05822010000300017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Relatar dois pacientes com a síndrome de Emanuel (SE) ou cromossomo supernumerário der(22)t(11;22), secundária a translocações balanceadas familiares, apresentando fenótipos distintos. DESCRIÇÃO DE CASO: O primeiro paciente é uma menina branca de cinco anos de idade, apresentando hipotonia, atraso no desenvolvimento neuropsicomotor, movimentos estereotipados, microcefalia, ptose palpebral, orelhas proeminentes, fossetas e apêndices pré-auriculares, e imperfuração anal. As avaliações adicionais identificaram hipoplasia cerebral e estenose da válvula pulmonar. Possuía história também de laringotraqueomalácia e fenda palatina. O segundo paciente é um menino branco de seis meses de idade com hipotonia, movimentos coreoatetóticos, déficit de crescimento, microcefalia, microssomia hemifacial, fenda palatina, microtia, apêndices pré-auriculares e polegares proximalmente implantados. A ecocardiografia demonstrou estenose da válvula pulmonar, comunicação interatrial e interventricular, persistência do canal arterial e da veia cava superior esquerda. A radiografia de tórax identificou uma costela cervical. O cariótipo por bandas GTG mostrou a presença, em ambos os pacientes, de um cromossomo adicional der(22)t(11;22), secundário a uma translocação balanceada materna no primeiro caso e paterna no segundo caso. COMENTÁRIOS: Apesar de a primeira paciente apresentar achados frequentes da SE, o caso adicional representa a segunda descrição da literatura com um fenótipo de espectro óculo-aurículo-vertebral (EOAV). Assim, ambos salientam a variabilidade clínica observada na SE e a importância da avaliação cariotípica em indivíduos com fenótipo de EOAV.
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Zen PRG, Moraes FND, Lorenzen MB, Rosa RFM, Graziadio C, Franciosi LE, Paskulin GA. Imperfuração anal associada à agenesia parcial do sacro e lipoma pré-sacral: síndrome de Currarino. Rev paul pediatr 2010. [DOI: 10.1590/s0103-05822010000300019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Relatar o caso de uma criança com síndrome de Currarino diagnosticada após avaliação por episódios recorrentes de infecção urinária. DESCRIÇÃO DE CASO: Menina branca de dois anos, única filha de pais hígidos e sem história familiar de defeitos congênitos. A criança nasceu com imperfuração anal e com fístula retovestibular diagnosticadas no primeiro dia de vida. Por volta dos sete meses, começou a apresentar episódios recorrentes de infecção urinária, estabelecendo-se o diagnóstico de bexiga neurogênica. Na mesma ocasião, foi constatada a presença de agenesia parcial do sacro. A avaliação pela tomografia computadorizada e ressonância nuclear magnética de coluna identificou presença de fístula coincidente com a fosseta da transição lombo-sacral, observada ao exame físico; amputação da porção inferior da medula, com diminuição do número de raízes nervosas da cauda equina e massa pré-sacral de aspecto lipomatoso. Esta foi confirmada durante a cirurgia de correção do ânus imperfurado. A criança não apresentava outras dismorfias e a avaliação radiológica dos pais não identificou anormalidades sacrais. COMENTÁRIOS: A síndrome de Currarino é uma doença genética autossômica, dominante e rara caracterizada pela tríade formada por atresia anal, agenesia parcial do sacro e tumoração pré-sacral. Inclui teratomas, meningoceles, cistos entéricos e lipomas, como observado em nossa paciente. Crianças apresentando anormalidades anorretais deveriam ser sempre cuidadosamente avaliadas quanto à presença da síndrome de Currarino. A agenesia parcial do sacro é um forte indicativo da doença.
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Zen PRG, Riegel M, Rosa RFM, Pinto LLC, Graziadio C, Schwartz IVD, Paskulin GA. Esophageal stenosis in a child presenting a de novo 7q terminal deletion. Eur J Med Genet 2010; 53:333-6. [PMID: 20601258 DOI: 10.1016/j.ejmg.2010.06.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Accepted: 06/11/2010] [Indexed: 11/25/2022]
Abstract
We report on the first case of a child with a de novo 7q terminal deletion [46,XX,del(7)(q35 → qter)] presenting esophageal stenosis. This cytogenetic abnormality was confirmed by FISH, using subtelomeric probes, and by a whole-genome array-CGH assay. The child also had phenotypic features previously described in patients with a similar deletion, as growth retardation, microcephaly, coloboma of papilla, ptosis, hearing loss, urinary tract anomalies, partial agenesis of sacrum, hypotonia and neuropsychomotor delay. The odontoid hypoplasia identified, in similarity with the esophageal stenosis, represents an uncommon finding. This report is also the first clinical description of a patient with an abnormality involving the sonic hedgehog gene and an esophageal alteration. It is discussed the possibility of a specific association between them, according to some results observed in studies with animal models.
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Affiliation(s)
- Paulo Ricardo Gazzola Zen
- Clinical Genetics and Postgraduation Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA) and Santa Casa de Porto Alegre Hospital Complex (CHSCPA), Porto Alegre, RS, Brazil
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Bernardi P, Graziadio C, Rosa RFM, Pfeil JN, Zen PRG, Paskulin GA. Fibular dimelia and mirror polydactyly of the foot in a girl presenting additional features of the VACTERL association. SAO PAULO MED J 2010; 128:99-101. [PMID: 20676578 PMCID: PMC10938978 DOI: 10.1590/s1516-31802010000200011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2009] [Revised: 02/26/2009] [Accepted: 02/18/2010] [Indexed: 11/21/2022] Open
Abstract
CONTEXT The association between fibular dimelia and mirror polydactyly of the foot is considered to be a very rare lower-limb abnormality. On the other hand, VACTERL is an acronym for a nonrandom association of congenital anomalies for which the etiology is still poorly understood. CASE REPORT The patient was a seven-month-old white girl whose mother had used misoprostol in the second month of pregnancy to induce abortion. On clinical evaluation, she was small for her age and presented hypotonia, anteverted nares, long philtrum and carp-like mouth. Her left hand had a reduction defect, with absence of the extremities of the second, third and fifth fingers and camptodactyly of the fourth finger. The ipsilateral lower limb presented significant shortening, especially rhizomelic shortening. Her left foot had a mirror configuration with seven toes and no identifiable hallux. The pelvis was hypoplastic. Esophageal atresia with tracheoesophageal fistula and imperforate anus were detected during the neonatal period. Abdominal ultrasound identified agenesis of the right kidney and left pyelocaliceal duplication. Radiographic evaluation on the left side showed iliac and femoral hypoplasia, absence of the tibia with a duplicated fibula and seven metatarsals and toes with no identifiable hallux on the foot. Echocardiography demonstrated an atrial septal defect. Based on the literature, we believe that the spectrum of malformations presented by our patient may be related to the vascular disruptive effect of the misoprostol. However, we cannot rule out the possibility that this association might simply be a coincidence.
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Affiliation(s)
- Pricila Bernardi
- MD. Clinical geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Carla Graziadio
- MD. Assistant professor and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Rafael Fabiano Machado Rosa
- MD. Postgraduate student and clinical geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Juliana Nunes Pfeil
- Medical student, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Paulo Ricardo Gazzola Zen
- PhD. Adjunct professor of Clinical Genetics and professor of the Postgraduate Program on Pathology and Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Giorgio Adriano Paskulin
- PhD. Associate professor of Clinical Genetics and professor of the Postgraduate Program on Pathology, Clinical Genetics and Cytogenetics, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
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Rosa RFM, Dall'Agnol L, Zen PRG, Pereira VLB, Graziadio C, Paskulin GA. Espectro óculo-aurículo-vertebral e malformações cardíacas. Rev Assoc Med Bras (1992) 2010; 56:62-6. [DOI: 10.1590/s0104-42302010000100018] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2009] [Accepted: 10/20/2009] [Indexed: 11/22/2022] Open
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Graziadio C, Rosa RF, Zen PR, Flores JA, Paskulin GA. Richieri-Costa and Pereira form of acrofacial dysostosis: First description of an adult with mesomelic shortness of the lower limbs. Am J Med Genet A 2009; 149A:2886-8. [DOI: 10.1002/ajmg.a.33109] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Koshiyama DB, Rosa RFM, Zen PRG, Pereira VLB, Graziadio C, Cóser VM, Ricachinevsky CP, Varella-Garcia M, Paskulin GA. [22q11.2 deletion syndrome: importance of clinical evaluation and FISH analysis]. Rev Assoc Med Bras (1992) 2009; 55:442-6. [PMID: 19750312 DOI: 10.1590/s0104-42302009000400020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2008] [Accepted: 02/12/2009] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The 22q11.2 deletion syndrome nowadays is considered one of the most often observed genetic diseases in humans. It is clinically characterized by a rather wide phenotypic spectrum, with more than 180 clinical features physical as well as behavioral, already described. However, none is pathognomonic or obligatory which makes diagnosis even more difficult. Thus, this study intended to determine the prevalence and clinical characteristics of patients with 22q11.2 microdeletion in a selected sample of subjects with clinical suspicion of 22q11.2 deletion syndrome and normal karyotype. METHODS A selected sample of 30 patients with clinical suspicion of 22q11.2 deletion syndrome and normal karyotype was evaluated by application of a standard clinical protocol and cytogenetic analysis with fluorescent in situ hybridization. RESULTS 22q11.2 microdeletion was identified in 3 patients (10%), a prevalence similar to the majority of published studies, which ranged from 4 to 21%. The 22q11.2 deletion syndrome patients in this study were characterized by a variable phenotype and shared few clinical features, in agreement with the literature description. CONCLUSIONS These findings strengthen the idea that clinical diagnosis of 22q11.2 deletion syndrome is difficult due to the large phenotypic variability. Therefore a detailed clinical evaluation associated to a sensitive test such as fluorescent in situ hybridization analysis is crucial for the identification of these patients.
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Affiliation(s)
- Dayane Bohn Koshiyama
- Universidade Federal de Ciências da Saúde de Porto Alegre-UFCSPA, Porto Alegre, RS, Brazil
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Rosa RFM, Zen PRG, Rosa RCM, Graziadio C, Paskulin GA. Disostose espôndilo-costal associada a defeitos de fechamento do tubo neural. Rev paul pediatr 2009. [DOI: 10.1590/s0103-05822009000300016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Salientar a relação dos defeitos de fechamento do tubo neural com a disostose espôndilo-costal (DEC) por meio da descrição de três pacientes. DESCRIÇÃO DOS CASOS: Paciente 1: menina branca, 22 meses, nascida com mielomeningocele lombar. Na avaliação, apresentava hipotonia, baixa estatura, dolicocefalia, fendas palpebrais oblíquas para cima, pregas epicânticas e tronco curto com tórax assimétrico. A avaliação radiográfica revelou hemivértebras múltiplas, vértebras em borboleta e fusão e ausência de algumas costelas. Paciente 2: menina branca, 22 meses, com moderado atraso do desenvolvimento neuropsicomotor, baixa estatura, olhos profundos, pregas epicânticas, pescoço e tronco curtos com assimetria do tórax, abdome protruso, hemangioma plano na altura da transição lombossacra e fosseta sacral profunda no dorso. A avaliação radiográfica identificou hemivértebras, fusão incompleta de vértebras e vértebras em borboleta, malformações de costelas e espinha bífida oculta em L5/S1. Paciente 3: menina branca, 9 dias de vida, com fendas palpebrais oblíquas para cima, ponte nasal alargada, orelhas baixo implantadas e rotadas posteriormente, tronco curto, tórax assimétrico e meningocele tóraco-lombar. A avaliação radiográfica evidenciou hemivértebras, malformação e ausência de algumas costelas e agenesia diafragmática à esquerda. A tomografia computadorizada de encéfalo mostrou estenose de aqueduto. COMENTÁRIOS: Vários defeitos de fechamento do tubo neural, de espinha bífida oculta a grandes mielomeningoceles, são observados em pacientes com DEC, indicando que tais pacientes devem ser cuidadosamente avaliados quanto à possível presença desses defeitos.
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Graziadio C, Rosa RFM, Zen PRG, Pinto LLDC, Barea LM, Paskulin GA. Dystonia, autoimmune disease and cerebral white matter abnormalities in a patient with 18p deletion. Arq Neuro-Psiquiatr 2009; 67:689-91. [DOI: 10.1590/s0004-282x2009000400021] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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