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Marchetto A, Leidescher S, van Hoi T, Hirschberger N, Vogel F, Köhler S, Bedei IA, Axt-Fliedner R, Shoukier M, Keil C. Prenatal Diagnosis of Fryns Syndrome through Identification of Two Novel Splice Variants in the PIGN Gene-A Case Series. Life (Basel) 2024; 14:628. [PMID: 38792648 PMCID: PMC11122441 DOI: 10.3390/life14050628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
Fryns syndrome (FS) is a multiple congenital anomaly syndrome with different multisystemic malformations. These include congenital diaphragmatic hernia, pulmonary hypoplasia, and craniofacial dysmorphic features in combination with malformations of the central nervous system such as agenesis of the corpus callosum, cerebellar hypoplasia, and enlarged ventricles. We present a non-consanguineous northern European family with two recurrent cases of FS: a boy with multiple congenital malformations who died at the age of 2.5 months and a female fetus with a complex developmental disorder with similar features in a following pregnancy. Quad whole exome analysis revealed two likely splicing-affecting disease-causing mutations in the PIGN gene: a synonymous mutation c.2619G>A, p.(Leu873=) in the last nucleotide of exon 29 and a 30 bp-deletion c.996_1023+2del (NM_176787.5) protruding into intron 12, with both mutations in trans configuration in the affected patients. Exon skipping resulting from these two variants was confirmed via RNA sequencing. Our molecular and clinical findings identified compound heterozygosity for two novel splice-affecting variants as the underlying pathomechanism for the development of FS in two patients.
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Affiliation(s)
- Aruna Marchetto
- Eurofins Humangenetik und Pränatal-Medizin MVZ GmbH, 80639 Munich, Germany (M.S.)
| | - Susanne Leidescher
- Eurofins Humangenetik und Pränatal-Medizin MVZ GmbH, 80639 Munich, Germany (M.S.)
| | - Theresia van Hoi
- Eurofins Humangenetik und Pränatal-Medizin MVZ GmbH, 80639 Munich, Germany (M.S.)
| | - Niklas Hirschberger
- Eurofins Humangenetik und Pränatal-Medizin MVZ GmbH, 80639 Munich, Germany (M.S.)
| | - Florian Vogel
- Eurofins Humangenetik und Pränatal-Medizin MVZ GmbH, 80639 Munich, Germany (M.S.)
| | - Siegmund Köhler
- Department of Prenatal Medicine and Fetal Therapy, Philipps University, 35043 Marburg, Germany;
| | - Ivonne Alexandra Bedei
- Department of Prenatal Medicine and Fetal Therapy, Justus-Liebig University Giessen, 35392 Giessen, Germany
| | - Roland Axt-Fliedner
- Department of Prenatal Medicine and Fetal Therapy, Justus-Liebig University Giessen, 35392 Giessen, Germany
| | - Moneef Shoukier
- Eurofins Humangenetik und Pränatal-Medizin MVZ GmbH, 80639 Munich, Germany (M.S.)
| | - Corinna Keil
- Department of Prenatal Medicine and Fetal Therapy, Philipps University, 35043 Marburg, Germany;
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2
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PIGN-Related Disease in Two Lithuanian Families: A Report of Two Novel Pathogenic Variants, Molecular and Clinical Characterisation. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58111526. [PMID: 36363484 PMCID: PMC9693321 DOI: 10.3390/medicina58111526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/19/2022] [Accepted: 10/24/2022] [Indexed: 11/05/2022]
Abstract
Background and Objectives: Pathogenic variants of PIGN are a known cause of multiple congenital anomalies-hypotonia-seizures syndrome 1 (MCAHS1). Many affected individuals have clinical features overlapping with Fryns syndrome and are mainly characterised by developmental delay, congenital anomalies, hypotonia, seizures, and specific minor facial anomalies. This study investigates the clinical and molecular data of three individuals from two unrelated families, the clinical features of which were consistent with a diagnosis of MCAHS1. Materials and Methods: Next-generation sequencing (NGS) technology was used to identify the changes in the DNA sequence. Sanger sequencing of gDNA of probands and their parents was used for validation and segregation analysis. Bioinformatics tools were used to investigate the consequences of pathogenic or likely pathogenic PIGN variants at the protein sequence and structure level. Results: The analysis of NGS data and segregation analysis revealed a compound heterozygous NM_176787.5:c.[1942G>T];[1247_1251del] PIGN genotype in family 1 and NG_033144.1(NM_176787.5):c.[932T>G];[1674+1G>C] PIGN genotype in family 2. In silico, c.1942G>T (p.(Glu648Ter)), c.1247_1251del (p.(Glu416GlyfsTer22)), and c.1674+1G>C (p.(Glu525AspfsTer68)) variants are predicted to result in a premature termination codon that leads to truncated and functionally disrupted protein causing the phenotype of MCAHS1 in the affected individuals. Conclusions: PIGN-related disease represents a wide spectrum of phenotypic features, making clinical diagnosis inaccurate and complicated. The genetic testing of every individual with this phenotype provides new insights into the origin and development of the disease.
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3
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Winter-Paquette LM, Al Suwaidi HH, Sajjad Y, Bricker L. Congenital diaphragmatic hernia and early lethality in PIGL-related disorder. Eur J Med Genet 2022; 65:104501. [DOI: 10.1016/j.ejmg.2022.104501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/15/2022] [Accepted: 03/29/2022] [Indexed: 11/03/2022]
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4
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Cannata G, Caporilli C, Grassi F, Perrone S, Esposito S. Management of Congenital Diaphragmatic Hernia (CDH): Role of Molecular Genetics. Int J Mol Sci 2021; 22:ijms22126353. [PMID: 34198563 PMCID: PMC8231903 DOI: 10.3390/ijms22126353] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/04/2021] [Accepted: 06/11/2021] [Indexed: 12/11/2022] Open
Abstract
Congenital diaphragmatic hernia (CDH) is a relatively common major life-threatening birth defect that results in significant mortality and morbidity depending primarily on lung hypoplasia, persistent pulmonary hypertension, and cardiac dysfunction. Despite its clinical relevance, CDH multifactorial etiology is still not completely understood. We reviewed current knowledge on normal diaphragm development and summarized genetic mutations and related pathways as well as cellular mechanisms involved in CDH. Our literature analysis showed that the discovery of harmful de novo variants in the fetus could constitute an important tool for the medical team during pregnancy, counselling, and childbirth. A better insight into the mechanisms regulating diaphragm development and genetic causes leading to CDH appeared essential to the development of new therapeutic strategies and evidence-based genetic counselling to parents. Integrated sequencing, development, and bioinformatics strategies could direct future functional studies on CDH; could be applied to cohorts and consortia for CDH and other birth defects; and could pave the way for potential therapies by providing molecular targets for drug discovery.
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Affiliation(s)
- Giulia Cannata
- Pediatric Clinic, Pietro Barilla Children’s Hospital, University of Parma, Via Gramsci 14, 43126 Parma, Italy; (G.C.); (C.C.); (F.G.)
| | - Chiara Caporilli
- Pediatric Clinic, Pietro Barilla Children’s Hospital, University of Parma, Via Gramsci 14, 43126 Parma, Italy; (G.C.); (C.C.); (F.G.)
| | - Federica Grassi
- Pediatric Clinic, Pietro Barilla Children’s Hospital, University of Parma, Via Gramsci 14, 43126 Parma, Italy; (G.C.); (C.C.); (F.G.)
| | - Serafina Perrone
- Neonatology Unit, Pietro Barilla Children’s Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy;
| | - Susanna Esposito
- Pediatric Clinic, Pietro Barilla Children’s Hospital, University of Parma, Via Gramsci 14, 43126 Parma, Italy; (G.C.); (C.C.); (F.G.)
- Correspondence: ; Tel.: +39-0521-7047
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5
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Kosinski P, Greczan M, Jezela-Stanek A. Diaphragmatic Hernia as a Prenatal Feature of Glycosylphosphatidylinositol Biosynthesis Defects and the Overlap With Fryns Syndrome - Literature Review. Front Genet 2021; 12:674722. [PMID: 34163527 PMCID: PMC8215573 DOI: 10.3389/fgene.2021.674722] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/14/2021] [Indexed: 02/05/2023] Open
Abstract
Fryns syndrome is an autosomal recessive multiple congenital anomaly syndrome, with diaphragmatic defects and secondary lung hypoplasia as cardinal features. Despite it was reported first in 1979, its exact etiology has not been established to date. With this review, we would like to draw attention to the prenatal presentation of multiple congenital anomalies syndromes, resulting from defects in the synthesis of glycosylphosphatidylinositol anchors, to be considered in a prenatal assessment of fetuses with DH and Fryns-like phenotype.
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Affiliation(s)
- Przemyslaw Kosinski
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Milena Greczan
- Department of Pediatrics, Nutrition, and Metabolic Diseases, Children's Memorial Health Institute, Warsaw, Poland
| | - Aleksandra Jezela-Stanek
- Department of Genetics and Clinical Immunology, National Institute of Tuberculosis and Lung Disease, Warsaw, Poland
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6
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Okuda T, Yonekawa T, Murakami Y, Kinoshita T, Ito T, Matsushita K, Koike Y, Inoue M, Uchida K, Yodoya N, Ohashi H, Sawada H, Iwamoto S, Mitani Y, Hirayama M.
PIGO
variants in a boy with features of Mabry syndrome who also exhibits Fryns syndrome with peripheral neuropathy. Am J Med Genet A 2021. [DOI: 10.1002/ajmg.a.62005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Taro Okuda
- Department of Pediatrics Mie University Graduate School of Medicine Tsu Mie Japan
| | - Takahiro Yonekawa
- Department of Pediatrics Mie University Graduate School of Medicine Tsu Mie Japan
| | - Yoshiko Murakami
- Research Institute for Microbial Diseases and World Premier International Immunology Frontier Research Center Osaka University Osaka Japan
| | - Taroh Kinoshita
- Research Institute for Microbial Diseases and World Premier International Immunology Frontier Research Center Osaka University Osaka Japan
| | - Takahiro Ito
- Department of Pediatrics Mie University Graduate School of Medicine Tsu Mie Japan
| | - Kohei Matsushita
- Department of Gastrointestinal and Pediatric Surgery Mie University Graduate School of Medicine Tsu Mie Japan
| | - Yuhki Koike
- Department of Gastrointestinal and Pediatric Surgery Mie University Graduate School of Medicine Tsu Mie Japan
| | - Mikihiro Inoue
- Department of Gastrointestinal and Pediatric Surgery Mie University Graduate School of Medicine Tsu Mie Japan
| | - Keiichi Uchida
- Department of Gastrointestinal and Pediatric Surgery Mie University Graduate School of Medicine Tsu Mie Japan
| | - Noriko Yodoya
- Department of Pediatrics Mie University Graduate School of Medicine Tsu Mie Japan
| | - Hiroyuki Ohashi
- Department of Pediatrics Mie University Graduate School of Medicine Tsu Mie Japan
| | - Hirofumi Sawada
- Department of Pediatrics Mie University Graduate School of Medicine Tsu Mie Japan
| | - Shotaro Iwamoto
- Department of Pediatrics Mie University Graduate School of Medicine Tsu Mie Japan
| | - Yoshihide Mitani
- Department of Pediatrics Mie University Graduate School of Medicine Tsu Mie Japan
| | - Masahiro Hirayama
- Department of Pediatrics Mie University Graduate School of Medicine Tsu Mie Japan
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7
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Aynaoğlu Yıldız G, Özmen S, Yapça ÖE, Topdağı Yılmaz EP, Al RA. What is your diagnosis? J Turk Ger Gynecol Assoc 2021; 22:71-73. [PMID: 33389925 PMCID: PMC7944237 DOI: 10.4274/jtgga.galenos.2020.2019.0208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
| | - Sevilay Özmen
- Department of Pathology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Ömer Erkan Yapça
- Department of Obstetrics and Gynecology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | | | - Ragıp Atakan Al
- Department of Obstetrics and Gynecology, Atatürk University Faculty of Medicine, Erzurum, Turkey
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8
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Salinas-Torres VM, Salinas-Torres RA, Cerda-Flores RM, Gallardo-Blanco HL, Martínez-de-Villarreal LE. A clinical-pathogenetic approach on associated anomalies and chromosomal defects supports novel candidate critical regions and genes for gastroschisis. Pediatr Surg Int 2018; 34:931-943. [PMID: 30094464 DOI: 10.1007/s00383-018-4331-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Gastroschisis has been assumed to have a low rate of syndromic and primary malformations. We aimed to systematically review and explore the frequency and type of malformations/chromosomal syndromes and to identify significant biological/genetic roles in gastroschisis. METHODS Population-based, gastroschisis-associated anomalies/chromosomal defects published 1950-2018 (PubMed/MEDLINE) were independently searched by two reviewers. Associated anomalies/chromosomal defects and selected clinical characteristics were subdivided and pooled by race, system/region, isolated, and associated cases (descriptive analysis and chi-square test were performed). Critical regions/genes from representative chromosomal syndromes including an enrichment analysis using Gene Ontology Consortium/Panther Classification System databases were explored. Fisher's exact test with False Discovery Rate multiple test correction was performed. RESULTS Sixty-eight articles and 18525 cases as a base were identified (prevalence of 17.9 and 3% for associated anomalies/chromosomal defects, respectively). There were 3596 associated anomalies, prevailing those cardiovascular (23.3%) and digestive (20.3%). Co-occurring anomalies were associated with male, female, American Indian, Caucasian, prenatally diagnosed, chromosomal defects, and mortality (P < 0.00001). Gene clusters on 21q22.11 and 21q22.3 (KRTAP), 18q21.33 (SERPINB), 18q22.1 (CDH7, CDH19), 13q12.3 (FLT1), 13q22.1 (KLF5), 13q22.3 (EDNRB), and 13q34 (COL4A1, COL4A2, F7, F10) were significantly related to biological processes: blood pressure regulation and/or vessel integrity, angiogenesis, coagulation, cell-cell and/or cell-matrix adhesion, dermis integrity, and wound healing (P < 0.05). CONCLUSIONS Our findings suggest that gastroschisis may result from the interaction of several chromosomal regions in an additive manner as a pool of candidate genes were identified from critical regions supporting a role for vascular disruption, thrombosis, and mesodermal deficiency in the pathogenesis of gastroschisis.
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Affiliation(s)
- Victor M Salinas-Torres
- Departamento de Genética, Facultad de Medicina y Hospital Universitario José Eleuterio González, Universidad Autónoma de Nuevo León, Ave. Madero y Gonzalitos S/N Col. Mitras Centro, CP 64460, Monterrey, Nuevo León, México.
| | - Rafael A Salinas-Torres
- Departamento de Sistemas y Computación, Instituto Tecnológico de Tijuana, Calzada del Tecnológico S/N Fracc. Tomas Aquino, CP 22414, Tijuana, Baja California, México
| | - Ricardo M Cerda-Flores
- Universidad Autónoma de Nuevo León, Facultad de Enfermería, Dr. José Eleuterio González 1500, Mitras Centro, CP 64460, Monterrey, Nuevo León, México
| | - Hugo L Gallardo-Blanco
- Departamento de Genética, Facultad de Medicina y Hospital Universitario José Eleuterio González, Universidad Autónoma de Nuevo León, Ave. Madero y Gonzalitos S/N Col. Mitras Centro, CP 64460, Monterrey, Nuevo León, México
| | - Laura E Martínez-de-Villarreal
- Departamento de Genética, Facultad de Medicina y Hospital Universitario José Eleuterio González, Universidad Autónoma de Nuevo León, Ave. Madero y Gonzalitos S/N Col. Mitras Centro, CP 64460, Monterrey, Nuevo León, México
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9
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Alessandri JL, Gordon CT, Jacquemont ML, Gruchy N, Ajeawung NF, Benoist G, Oufadem M, Chebil A, Duffourd Y, Dumont C, Gérard M, Kuentz P, Jouan T, Filippini F, Nguyen TTM, Alibeu O, Bole-Feysot C, Nitschké P, Omarjee A, Ramful D, Randrianaivo H, Doray B, Faivre L, Amiel J, Campeau PM, Thevenon J. Recessive loss of function PIGN alleles, including an intragenic deletion with founder effect in La Réunion Island, in patients with Fryns syndrome. Eur J Hum Genet 2018; 26:340-349. [PMID: 29330547 DOI: 10.1038/s41431-017-0087-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 11/12/2017] [Accepted: 12/07/2017] [Indexed: 12/17/2022] Open
Abstract
Fryns syndrome (FS) is a multiple malformations syndrome with major features of congenital diaphragmatic hernia, pulmonary hypoplasia, craniofacial dysmorphic features, distal digit hypoplasia, and a range of other lower frequency malformations. FS is typically lethal in the fetal or neonatal period. Inheritance is presumed autosomal recessive. Although no major genetic cause has been identified for FS, biallelic truncating variants in PIGN, encoding a component of the glycosylphosphatidylinositol (GPI)-anchor biosynthesis pathway, have been identified in a limited number of cases with a phenotype compatible with FS. Biallelic variants in PIGN, typically missense or compound missense with truncating, also cause multiple congenital anomalies-hypotonia-seizures syndrome 1 (MCAHS1). Here we report six further patients with FS with or without congenital diaphragmatic hernia and recessive loss of function PIGN alleles, including an intragenic deletion with a likely founder effect in La Réunion and other Indian Ocean islands. Our results support the hypothesis that a spectrum of phenotypic severity is associated with recessive PIGN variants, ranging from FS at the extreme end, caused by complete loss of function, to MCAHS1, in which some residual PIGN function may remain. Our data add FS resulting from PIGN variants to the catalog of inherited GPI deficiencies caused by the disruption of the GPI-anchor biosynthesis pathway.
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Affiliation(s)
- Jean-Luc Alessandri
- Service de Réanimation Néonatale, Pole Femme-Mère-Enfant, CH Felix Guyon, CHU de La Réunion, Saint-Denis, La Réunion, France.
| | - Christopher T Gordon
- Laboratory of embryology and genetics of congenital malformations, INSERM UMR 1163, Institut Imagine, Paris, France.,Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
| | - Marie-Line Jacquemont
- Unité de Génétique Médicale, Pole Femme-Mère-Enfant, Groupe Hospitalier Sud Réunion, CHU de La Réunion, La Réunion, France
| | | | - Norbert F Ajeawung
- Centre de Recherche du CHU Sainte-Justine et Université de Montréal, Montréal, QC, Canada
| | | | - Myriam Oufadem
- Laboratory of embryology and genetics of congenital malformations, INSERM UMR 1163, Institut Imagine, Paris, France.,Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
| | - Asma Chebil
- Service de Gynécologie-Obstétrique, CH Mamoudzou, Mayotte, France
| | - Yannis Duffourd
- INSERM UMR 1231 GAD team, Genetics of Developmental Anomalies, Université de Bourgogne-Franche Comté, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne/CHU, Dijon, France
| | - Coralie Dumont
- Service de Gynécologie-Obstétrique, Pole Femme-mère-Enfant, Groupe Hospitalier Sud Réunion, CHU de La Réunion, La Réunion, France
| | | | - Paul Kuentz
- INSERM UMR 1231 GAD team, Genetics of Developmental Anomalies, Université de Bourgogne-Franche Comté, Dijon, France
| | - Thibaud Jouan
- INSERM UMR 1231 GAD team, Genetics of Developmental Anomalies, Université de Bourgogne-Franche Comté, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne/CHU, Dijon, France
| | - Francesca Filippini
- Laboratory of embryology and genetics of congenital malformations, INSERM UMR 1163, Institut Imagine, Paris, France.,Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
| | - Thi Tuyet Mai Nguyen
- Centre de Recherche du CHU Sainte-Justine et Université de Montréal, Montréal, QC, Canada
| | - Olivier Alibeu
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France.,Genomic Platform, INSERM UMR 1163, Institut Imagine, Paris, France
| | - Christine Bole-Feysot
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France.,Genomic Platform, INSERM UMR 1163, Institut Imagine, Paris, France
| | - Patrick Nitschké
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France.,Bioinformatic Platform, INSERM UMR 1163, Institut Imagine, Paris, France
| | - Asma Omarjee
- Service de Gynécologie-Obstétrique, Pole Femme-mère-Enfant, Groupe Hospitalier Sud Réunion, CHU de La Réunion, La Réunion, France
| | - Duksha Ramful
- Service de Réanimation Néonatale, Pole Femme-Mère-Enfant, CH Felix Guyon, CHU de La Réunion, Saint-Denis, La Réunion, France
| | - Hanitra Randrianaivo
- Unité de Génétique Médicale, Pole Femme-Mère-Enfant, Groupe Hospitalier Sud Réunion, CHU de La Réunion, La Réunion, France
| | - Bérénice Doray
- Service de Génétique, CH Félix Guyon, CHU de La Réunion, La Réunion, France
| | - Laurence Faivre
- INSERM UMR 1231 GAD team, Genetics of Developmental Anomalies, Université de Bourgogne-Franche Comté, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne/CHU, Dijon, France
| | - Jeanne Amiel
- Laboratory of embryology and genetics of congenital malformations, INSERM UMR 1163, Institut Imagine, Paris, France.,Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France.,Service de Génétique, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Philippe M Campeau
- Centre de Recherche du CHU Sainte-Justine et Université de Montréal, Montréal, QC, Canada
| | - Julien Thevenon
- INSERM UMR 1231 GAD team, Genetics of Developmental Anomalies, Université de Bourgogne-Franche Comté, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne/CHU, Dijon, France.,Centre de Génétique, Hôpital Couple-Enfant, CHU de Grenoble-Alpes, 38700, La Tronche, France
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10
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Reynolds KK, Juusola J, Rice GM, Giampietro PF. Prenatal presentation of Mabry syndrome with congenital diaphragmatic hernia and phenotypic overlap with Fryns syndrome. Am J Med Genet A 2017; 173:2776-2781. [PMID: 28817240 DOI: 10.1002/ajmg.a.38379] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 06/28/2017] [Accepted: 07/01/2017] [Indexed: 12/19/2022]
Abstract
We report on a family in which initial features were compatible with Fryns syndrome. The first sibling was a stillborn female with a left diaphragmatic hernia (DH). Her clinical features overlapped with Fryns syndrome. The second pregnancy, a male fetus, was followed for polyhydramnios, hypoplastic mandible, mild enlargement of the fetal bladder, hydronephrosis, and rocker bottom foot deformities. He had facial features similar to his sibling and a large cleft of the secondary palate, small jaw, and secundum atrial septal defect. He underwent surgical repair of imperforate anus, intestinal malrotation, and placement of mucous fistula for biopsy positive Hirschsprung disease. An elevated alkaline phosphatase level of 1569 U/L was reported. Whole exome sequencing performed on the second child demonstrated compound heterozygosity for the PIGV gene with the p.A341E and p.A418D variants in trans. Hyperphosphatasia with mental retardation syndrome (HPMRS) is caused by mutations in PIGV and includes hyperphosphatasia as a diagnostic hallmark. Our patient exhibited hyperphosphatasia but without any storage material in his skin cells. His features remain similar to his sister's, but includes seizures and lacks diaphragmatic hernia. Until now, HPMRS and Fryns syndrome, despite overlapping features, were considered mutually exclusive as HPMRS involves hyperphosphatasia and Fryns typically exhibits DH. Recent identification of PIGN mutations associated with several cases of Fryns syndrome point to a common pathogenetic etiology involving inborn errors of the glycosylphosphatidylinositiol anchor biosynthetic pathway. A diagnosis of HPMRS should be considered when DH is encountered on prenatal ultrasound.
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11
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Kardon G, Ackerman KG, McCulley DJ, Shen Y, Wynn J, Shang L, Bogenschutz E, Sun X, Chung WK. Congenital diaphragmatic hernias: from genes to mechanisms to therapies. Dis Model Mech 2017; 10:955-970. [PMID: 28768736 PMCID: PMC5560060 DOI: 10.1242/dmm.028365] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Congenital diaphragmatic hernias (CDHs) and structural anomalies of the diaphragm are a common class of congenital birth defects that are associated with significant morbidity and mortality due to associated pulmonary hypoplasia, pulmonary hypertension and heart failure. In ∼30% of CDH patients, genomic analyses have identified a range of genetic defects, including chromosomal anomalies, copy number variants and sequence variants. The affected genes identified in CDH patients include transcription factors, such as GATA4, ZFPM2, NR2F2 and WT1, and signaling pathway components, including members of the retinoic acid pathway. Mutations in these genes affect diaphragm development and can have pleiotropic effects on pulmonary and cardiac development. New therapies, including fetal endoscopic tracheal occlusion and prenatal transplacental fetal treatments, aim to normalize lung development and pulmonary vascular tone to prevent and treat lung hypoplasia and pulmonary hypertension, respectively. Studies of the association between particular genetic mutations and clinical outcomes should allow us to better understand the origin of this birth defect and to improve our ability to predict and identify patients most likely to benefit from specialized treatment strategies.
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Affiliation(s)
- Gabrielle Kardon
- Department of Human Genetics, University of Utah, Salt Lake City, UT 84112, USA
| | - Kate G Ackerman
- Departments of Pediatrics (Critical Care) and Biomedical Genetics, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - David J McCulley
- Department of Pediatrics, University of Wisconsin, Madison, WI 53792, USA
| | - Yufeng Shen
- Department of Systems Biology, Columbia University Medical Center, New York, NY 10032, USA
| | - Julia Wynn
- Departments of Pediatrics, Columbia University Medical Center, New York, NY 10032, USA
| | - Linshan Shang
- Departments of Pediatrics, Columbia University Medical Center, New York, NY 10032, USA
| | - Eric Bogenschutz
- Department of Human Genetics, University of Utah, Salt Lake City, UT 84112, USA
| | - Xin Sun
- Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA
| | - Wendy K Chung
- Department of Human Genetics, University of Utah, Salt Lake City, UT 84112, USA
- Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA
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12
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Bone KM, Chernos JE, Perrier R, Innes AM, Bernier FP, McLeod R, Thomas MA. Mosaic trisomy 1q: a recurring chromosome anomaly that is a diagnostic challenge and is associated with a Fryns-like phenotype. Prenat Diagn 2017; 37:602-610. [DOI: 10.1002/pd.5058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 04/05/2017] [Accepted: 04/18/2017] [Indexed: 01/30/2023]
Affiliation(s)
- Kathleen M. Bone
- Division of Anatomic Pathology and Cytopathology, Cytogenetics Laboratory; Calgary Laboratory Service; Calgary Canada
- Alberta Children's Hospital; Calgary Canada
| | - Judy E. Chernos
- Department of Medical Genetics, Alberta Children's Hospital; University of Calgary; Calgary Canada
- Alberta Children's Hospital Research Institute, Cumming School of Medicine; University of Calgary; Calgary Canada
| | - Renee Perrier
- Department of Medical Genetics, Alberta Children's Hospital; University of Calgary; Calgary Canada
| | - A. Micheil Innes
- Department of Medical Genetics, Alberta Children's Hospital; University of Calgary; Calgary Canada
- Alberta Children's Hospital Research Institute, Cumming School of Medicine; University of Calgary; Calgary Canada
| | - Francois P. Bernier
- Department of Medical Genetics, Alberta Children's Hospital; University of Calgary; Calgary Canada
- Alberta Children's Hospital Research Institute, Cumming School of Medicine; University of Calgary; Calgary Canada
| | - Ross McLeod
- Department of Medical Genetics, Alberta Children's Hospital; University of Calgary; Calgary Canada
| | - Mary Ann Thomas
- Department of Medical Genetics, Alberta Children's Hospital; University of Calgary; Calgary Canada
- Alberta Children's Hospital Research Institute, Cumming School of Medicine; University of Calgary; Calgary Canada
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13
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Ibrahim M, Hunter M, Gugasyan L, Chan Y, Malhotra A, Sehgal A, Tan K. Interstitial deletion of chromosome 1 (1p21.1p12) in an infant with congenital diaphragmatic hernia, hydrops fetalis, and interrupted aortic arch. Clin Case Rep 2017; 5:164-169. [PMID: 28174644 PMCID: PMC5290521 DOI: 10.1002/ccr3.759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 08/28/2016] [Accepted: 11/06/2016] [Indexed: 11/13/2022] Open
Abstract
We report a case of an infant with congenital diaphragmatic hernia (CDH) and hydrops fetalis who died from hypoxic respiratory failure. Autopsy revealed type B interrupted aortic arch (IAA). Microarray revealed a female karyotype with deletion of chromosome 1p21.1p12. There may be an association between 1p microdeletion, CDH, and IAA.
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Affiliation(s)
- Masitah Ibrahim
- Monash Newborn Monash Medical Centre Melbourne Victoria Australia
| | - Matthew Hunter
- Monash Genetics Monash Medical Centre Melbourne Victoria Australia; Department of Paediatrics Monash University Melbourne Victoria Australia
| | - Lucy Gugasyan
- Cytogenetics Laboratory, Pathology Monash Medical Centre Melbourne Victoria Australia
| | - Yuen Chan
- Anatomical Pathology Services Monash Medical Centre Melbourne Victoria Australia
| | - Atul Malhotra
- Monash Newborn Monash Medical Centre Melbourne Victoria Australia; Department of Paediatrics Monash University Melbourne Victoria Australia; The Ritchie Centre Hudson Institute of Medical Research Clayton Victoria Australia
| | - Arvind Sehgal
- Monash Newborn Monash Medical Centre Melbourne Victoria Australia; Department of Paediatrics Monash University Melbourne Victoria Australia; The Ritchie Centre Hudson Institute of Medical Research Clayton Victoria Australia
| | - Kenneth Tan
- Monash Newborn Monash Medical Centre Melbourne Victoria Australia; Department of Paediatrics Monash University Melbourne Victoria Australia; The Ritchie Centre Hudson Institute of Medical Research Clayton Victoria Australia
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14
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Schierz IAM, Pinello G, Giuffrè M, La Placa S, Piro E, Corsello G. Congenital heart defects in newborns with apparently isolated single gastrointestinal malformation: A retrospective study. Early Hum Dev 2016; 103:43-47. [PMID: 27484053 DOI: 10.1016/j.earlhumdev.2016.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 06/07/2016] [Accepted: 07/17/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Congenital gastrointestinal system malformations/abdominal wall defects (GISM) may appear as isolated defects (single or complex), or in association with multiple malformations. The high incidence of association of GISM and congenital heart defects (CHD) in patients with syndromes and malformative sequences is known, but less expected is the association of apparently isolated single GISM and CHD. The aim of this study was to investigate the frequency of CHD in newborns with isolated GISM, and the possibility to modify the diagnostic-therapeutic approach just before the onset of cardiac symptoms or complications. METHODS Anamnestic, clinical, and imaging data of newborns requiring abdominal surgery for GISM, between 2009 and 2014, were compared with a control group of healthy newborns. Distribution of GISM and cardiovascular abnormalities were analyzed, and risk factors for adverse outcomes were identified. RESULTS Seventy-one newborns with isolated GISM were included in this study. More frequent GISM were intestinal rotation and fixation disorders. CHD were observed in 15.5% of patients, augmenting their risk for morbidity. Risk factors for morbidity related to sepsis were identified in central venous catheter, intestinal stoma, and H2-inhibitor-drugs. Moreover, 28.2% of newborns presented only functional cardiac disorders but an unexpectedly higher mortality. CONCLUSIONS The high incidence of congenital heart disease in infants with apparently isolated GISM confirms the need to perform an echocardiographic study before surgery to improve perioperative management and prevent complications such as sepsis and endocarditis.
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Affiliation(s)
- Ingrid Anne Mandy Schierz
- Neonatal Intensive Care Unit, AOUP, Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, Via Alfonso Giordano n. 3, 90127 Palermo, Italy.
| | - Giuseppa Pinello
- Neonatal Intensive Care Unit, AOUP, Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, Via Alfonso Giordano n. 3, 90127 Palermo, Italy.
| | - Mario Giuffrè
- Neonatal Intensive Care Unit, AOUP, Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, Via Alfonso Giordano n. 3, 90127 Palermo, Italy.
| | - Simona La Placa
- Neonatal Intensive Care Unit, AOUP, Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, Via Alfonso Giordano n. 3, 90127 Palermo, Italy.
| | - Ettore Piro
- Neonatal Intensive Care Unit, AOUP, Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, Via Alfonso Giordano n. 3, 90127 Palermo, Italy.
| | - Giovanni Corsello
- Neonatal Intensive Care Unit, AOUP, Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, Via Alfonso Giordano n. 3, 90127 Palermo, Italy.
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15
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Unolt M, DiCairano L, Schlechtweg K, Barry J, Howell L, Kasperski S, Nance M, Adzick NS, Zackai EH, McDonald-McGinn DM. Congenital diaphragmatic hernia in 22q11.2 deletion syndrome. Am J Med Genet A 2016; 173:135-142. [PMID: 27682988 DOI: 10.1002/ajmg.a.37980] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 08/29/2016] [Indexed: 11/10/2022]
Abstract
We report the important association of congenital diaphragmatic hernia (CDH) and 22q11.2 deletion syndrome (22q11.2DS). The prevalence of CDH in our cohort of patients with 22q11.2DS is 0.8% (10/1246), which is greater than in the general population (0.025%). This observation suggests that 22q11.2DS should be considered when a child or fetus presents with CDH, in particular when other clinical findings associated with the 22q11.2DS are present, such as congenital cardiac defects. Furthermore, this finding may lead to the identification of an additional locus for diaphragmatic hernia in the general population. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Marta Unolt
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics and Pediatric Neuropsychiatry, "Sapienza" University of Rome, Philadelphia, Pennsylvania
| | - Lauren DiCairano
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kathryn Schlechtweg
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jessica Barry
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Lori Howell
- Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Stefanie Kasperski
- Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Michael Nance
- Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - N Scott Adzick
- Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Elaine H Zackai
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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16
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McInerney-Leo AM, Harris JE, Gattas M, Peach EE, Sinnott S, Dudding-Byth T, Rajagopalan S, Barnett CP, Anderson LK, Wheeler L, Brown MA, Leo PJ, Wicking C, Duncan EL. Fryns Syndrome Associated with Recessive Mutations in PIGN in two Separate Families. Hum Mutat 2016; 37:695-702. [PMID: 27038415 DOI: 10.1002/humu.22994] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 03/17/2016] [Indexed: 01/08/2023]
Abstract
Fryns syndrome is an autosomal recessive condition characterized by congenital diaphragmatic hernia (CDH), dysmorphic facial features, distal digital hypoplasia, and other associated malformations, and is the most common syndromic form of CDH. No gene has been associated with this condition. Whole-exome sequence data from two siblings and three unrelated individuals with Fryns syndrome were filtered for rare, good quality, coding mutations fitting a recessive inheritance model. Compound heterozygous mutations in PIGN were identified in the siblings, with appropriate parental segregation: a novel STOP mutation (c.1966C>T: p.Glu656X) and a rare (minor allele frequency <0.001) donor splice site mutation (c.1674+1G>C) causing skipping of exon 18 and utilization of a cryptic acceptor site in exon 19. A further novel homozygous STOP mutation in PIGN (c.694A>T: p.Lys232X) was detected in one unrelated case. All three variants affected highly conserved bases. The two remaining cases were negative for PIGN mutations. Mutations in PIGN have been reported in cases with multiple congenital anomalies, including one case with syndromic CDH. Fryns syndrome can be caused by recessive mutations in PIGN. Whether PIGN affects other syndromic and non-syndromic forms of CDH warrants investigation.
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Affiliation(s)
- Aideen M McInerney-Leo
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia.,Queensland University of Technology (QUT), Institute of Health and Biomedical Innovation (IHBI), Brisbane, QLD, Australia
| | - Jessica E Harris
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia.,Queensland University of Technology (QUT), Institute of Health and Biomedical Innovation (IHBI), Brisbane, QLD, Australia
| | - Michael Gattas
- Brisbane Genetics, Wesley Medical Centre, Auchenflower, QLD, Australia
| | - Elizabeth E Peach
- Specialized Obstetric and Gynaecological Imaging, South Bank, QLD, Australia
| | - Stephen Sinnott
- Specialized Obstetric and Gynaecological Imaging, South Bank, QLD, Australia
| | - Tracy Dudding-Byth
- Hunter Genetics, NSW Genetics of Learning Disability (GOLD) Service and GrowUpWell Priority Research Centre, The University of Newcastle, NSW, Australia
| | - Sulekha Rajagopalan
- Department of Clinical Genetics, Liverpool Hospital, Liverpool BC, NSW, Australia
| | - Christopher P Barnett
- Paediatric and Reproductive Genetics Unit, Women's and Children's Hospital/SA Pathology, North Adelaide, South Australia.,School of Medicine, University of Adelaide, North Adelaide, SA, Australia
| | - Lisa K Anderson
- Queensland University of Technology (QUT), Institute of Health and Biomedical Innovation (IHBI), Brisbane, QLD, Australia
| | - Lawrie Wheeler
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia.,Queensland University of Technology (QUT), Institute of Health and Biomedical Innovation (IHBI), Brisbane, QLD, Australia
| | - Matthew A Brown
- Queensland University of Technology (QUT), Institute of Health and Biomedical Innovation (IHBI), Brisbane, QLD, Australia
| | - Paul J Leo
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia.,Queensland University of Technology (QUT), Institute of Health and Biomedical Innovation (IHBI), Brisbane, QLD, Australia
| | - Carol Wicking
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, QLD, Australia
| | - Emma L Duncan
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia.,Queensland University of Technology (QUT), Institute of Health and Biomedical Innovation (IHBI), Brisbane, QLD, Australia.,School of Medicine, Faculty of Medicine and Biomedical Sciences, University of Queensland, Australia.,Department of Endocrinology, James Mayne Building, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, QLD, Australia
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17
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Peron A, Bedeschi MF, Fabietti I, Baffero GM, Fogliani R, Ciralli F, Mosca F, Rizzuti T, Leva E, Lalatta F. Prenatal and postnatal findings in five cases of Fryns syndrome. Prenat Diagn 2014; 34:1227-30. [DOI: 10.1002/pd.4447] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 06/26/2014] [Accepted: 06/27/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Angela Peron
- Clinical Genetics Unit; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico; Milano Italy
| | | | - Isabella Fabietti
- Obstetrics and Gynecology Unit; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Giulia Maria Baffero
- Obstetrics and Gynecology Unit; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Roberto Fogliani
- Obstetrics and Gynecology Unit; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Fabrizio Ciralli
- Neonatal Intensive Care Unit, Department of Clinical Science and Community Health; Università degli Studi di Milano and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Fabio Mosca
- Neonatal Intensive Care Unit, Department of Clinical Science and Community Health; Università degli Studi di Milano and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Tommaso Rizzuti
- Pathology Unit; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Ernesto Leva
- Department of Pediatric Surgery; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Faustina Lalatta
- Clinical Genetics Unit; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico; Milano Italy
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18
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Alessandri JL, Cuillier F, Malan V, Brayer C, Grondard M, Jacquemot-Dekkak L, Kieffer-Traversier M, Pierre F, Laurain C, Samperiz S, Tiran-Rajaofera I, Ramful D. Fryns syndrome without diaphragmatic hernia, DOOR syndrome or Fryns-like syndrome? Report on patients from Indian Ocean islands. Am J Med Genet A 2013; 164A:648-54. [PMID: 24357154 DOI: 10.1002/ajmg.a.36323] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 09/09/2013] [Indexed: 11/06/2022]
Abstract
We report on six patients (five unpublished patients) from the Indian Ocean islands, with coarse face, cleft lip or palate, eye anomalies, brachytelephalangy, nail hypoplasia, various malformations (genitourinary or cerebral), abnormal electroencephalograms with impaired neurological examination and lethal outcome. Massive polyhydramnios was noted in the third trimester of pregnancy and neonatal growth was normal or excessive. The combination of the features is consistent with the diagnosis of Fryns syndrome (FS) without congenital diaphragmatic hernia. Besides chromosomal aberrations and microdeletion syndrome, differential diagnoses include conditions overlapping with FS such as Simpson-Golabi-Behmel, and conditions with hypoplasia/absence of the distal phalanges such as DOOR syndrome, Schinzel-Giedion syndrome, and Rudiger syndrome.
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Affiliation(s)
- Jean-Luc Alessandri
- Service Réanimation Néonatale, Pole Femme-Mère-Enfant, CH Félix Guyon, CHU de La Réunion, Saint-Denis, La Réunion, France
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19
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Asadollahi R, Oneda B, Sheth F, Azzarello-Burri S, Baldinger R, Joset P, Latal B, Knirsch W, Desai S, Baumer A, Houge G, Andrieux J, Rauch A. Dosage changes of MED13L further delineate its role in congenital heart defects and intellectual disability. Eur J Hum Genet 2013; 21:1100-4. [PMID: 23403903 DOI: 10.1038/ejhg.2013.17] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 01/09/2013] [Accepted: 01/16/2013] [Indexed: 01/20/2023] Open
Abstract
A chromosomal balanced translocation disrupting the MED13L (Mediator complex subunit13-like) gene, encoding a subunit of the Mediator complex, was previously associated with transposition of the great arteries (TGA) and intellectual disability (ID), and led to the identification of missense mutations in three patients with isolated TGA. Recently, a homozygous missense mutation in MED13L was found in two siblings with non-syndromic ID from a consanguineous family. Here, we describe for the first time, three patients with copy number changes affecting MED13L and delineate a recognizable MED13L haploinsufficiency syndrome. Using high resolution molecular karyotyping, we identified two intragenic de novo frameshift deletions, likely resulting in haploinsufficiency, in two patients with a similar phenotype of hypotonia, moderate ID, conotruncal heart defect and facial anomalies. In both, Sanger sequencing of MED13L did not reveal any pathogenic mutation and exome sequencing in one patient showed no evidence for a non-allelic second hit. A further patient with hypotonia, learning difficulties and perimembranous VSD showed a 1 Mb de novo triplication in 12q24.2, including MED13L and MAP1LC3B2. Our findings show that MED13L haploinsufficiency in contrast to the previously observed missense mutations cause a distinct syndromic phenotype. Additionally, a MED13L copy number gain results in a milder phenotype. The clinical features suggesting a neurocristopathy may be explained by animal model studies indicating involvement of the Mediator complex subunit 13 in neural crest induction.
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Affiliation(s)
- Reza Asadollahi
- Institute of Medical Genetics, University of Zurich, Zurich, Switzerland
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20
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Briggs LE, Kakarla J, Wessels A. The pathogenesis of atrial and atrioventricular septal defects with special emphasis on the role of the dorsal mesenchymal protrusion. Differentiation 2012; 84:117-30. [PMID: 22709652 PMCID: PMC3389176 DOI: 10.1016/j.diff.2012.05.006] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 04/17/2012] [Accepted: 05/04/2012] [Indexed: 12/22/2022]
Abstract
Partitioning of the four-chambered heart requires the proper formation, interaction and fusion of several mesenchymal tissues derived from different precursor populations that together form the atrioventricular mesenchymal complex. This includes the major endocardial cushions and the mesenchymal cap of the septum primum, which are of endocardial origin, and the dorsal mesenchymal protrusion (DMP), which is derived from the Second Heart Field. Failure of these structures to develop and/or fully mature results in atrial septal defects (ASDs) and atrioventricular septal defects (AVSD). AVSDs are congenital malformations in which the atria are permitted to communicate due to defective septation between the inferior margin of the septum primum and the atrial surface of the common atrioventricular valve. The clinical presentation of AVSDs is variable and depends on both the size and/or type of defect; less severe defects may be asymptomatic while the most severe defect, if untreated, results in infantile heart failure. For many years, maldevelopment of the endocardial cushions was thought to be the sole etiology of AVSDs. More recent work, however, has demonstrated that perturbation of DMP development also results in AVSD. Here, we discuss in detail the formation of the DMP, its contribution to cardiac septation and describe the morphological features as well as potential etiologies of ASDs and AVSDs.
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Affiliation(s)
- Laura E. Briggs
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, 173 Ashley Avenue, Charleston, South Carolina 29425, USA
| | - Jayant Kakarla
- Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Andy Wessels
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, 173 Ashley Avenue, Charleston, South Carolina 29425, USA
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21
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Coulibaly B, Sigaudy S, Girard N, Popovici C, Missirian C, Heckenroth H, Tasei AM, Fernandez C. Coffin-Siris syndrome with multiple congenital malformations and intrauterine death: towards a better delineation of the severe end of the spectrum. Eur J Med Genet 2010; 53:318-21. [PMID: 20624500 DOI: 10.1016/j.ejmg.2010.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Accepted: 07/04/2010] [Indexed: 11/18/2022]
Abstract
Coffine-Siris syndrome or "fifth digit" syndrome is a multiple congenital anomaly-mental retardation syndrome with severe developmental delay, coarse facial features, hirsutism and absent fifth fingernails or toenails or fifth distal phalanges. The etiology of this syndrome remains uncertain. Here we report a stillborn male baby born from consanguineous parents who might represent a very severe form of Coffine-Siris syndrome with cardiac defect and multiple brain malformations including corpus callosum agenesis and Dandy Walker malformation. To the best of our knowledge, it is the first case leading to intrauterine death. Karyotype and array comparative genomic hybridization were normal; these results give additional support to mendelian inheritance for this syndrome. In our family, the most likely mode of inheritance is autosomal recessive and the recurrence is probably as high as 25%.
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Affiliation(s)
- Béma Coulibaly
- Laboratoire d'Anatomie Pathologique et Neuropathologie, Assistance Publique-Hôpitaux de Marseille, Hôpital la Timone, Marseille, France
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22
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Dentici ML, Brancati F, Mingarelli R, Dallapiccola B. A 6-year-old child with Fryns syndrome: Further delineation of the natural history of the condition in survivors. Eur J Med Genet 2009; 52:421-5. [DOI: 10.1016/j.ejmg.2009.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2009] [Accepted: 09/15/2009] [Indexed: 11/24/2022]
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Abstract
Congenital diaphragmatic hernia (CDH) is a common major malformation affecting 1/3000-1/4000 births, which continues to be associated with significant perinatal mortality. Much current research is focused on elucidating the genetics and pathophysiology contributing to CDH to develop more effective therapies. The latest data suggest that many cases of CDH are genetically determined and also indicate that CDH is etiologically heterogeneous. The present review will provide a brief summary of diaphragm development and model organism work most relevant to human CDH and will primarily describe important human phenotypes associated with CDH and also provide recommendations for diagnostic evaluation of a fetus or infant with CDH.
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Affiliation(s)
- B R Pober
- Center for Human Genetics, Massachusetts General Hospital, Boston, MA 02114, USA.
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24
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Yucesoy G, Cakiroglu Y, Caliskan E. Fryns syndrome: case report and review of the literature. JOURNAL OF CLINICAL ULTRASOUND : JCU 2008; 36:315-317. [PMID: 17960800 DOI: 10.1002/jcu.20409] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Fryns syndrome (FS) is a rare malformation. We report a case of FS referred to our clinic at 27 weeks' gestation with a diagnosis of congenital diaphragmatic hernia. Sonographic examination of the fetus revealed a left-sided diaphragmatic hernia, pulmonary hypoplasia, and a median orofacial cleft. The diagnosis of FS was made after exclusion of chromosome aberrations and delivery of the fetus. Macroscopic inspection revealed a coarse face (hypertelorism and broad and flat nasal bridge, anteverted nostrils, median cleft lip/palate, poorly shaped auricles with attached earlobes, facial hirsutism), a narrow thorax, nail hypoplasia, and hypoplastic, widely spaced nipples.
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Affiliation(s)
- Gulseren Yucesoy
- Department of Obstetrics and Gynecology, Kocaeli University, Faculty of Medicine, 41000, Umuttepe, Kocaeli-Turkey
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25
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Lin AE, Pober BR, Adatia I. Congenital diaphragmatic hernia and associated cardiovascular malformations: type, frequency, and impact on management. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2007; 145C:201-16. [PMID: 17436301 PMCID: PMC2891735 DOI: 10.1002/ajmg.c.30131] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The co-occurrence of congenital diaphragmatic hernia (CDH) and cardiovascular malformations (CVMs) has important clinical, genetic, and developmental implications. Previous examinations of this topic often included patients with genetic syndromes. To correct this potential bias, we undertook an extensive review of the literature and obtained new data. The frequency of CVMs associated with isolated CDH was 11-15%. A careful analysis of CVMs indicates that atrial and ventricular septal defects, conotruncal defects, and left ventricular outflow tract obstructive defects were the most common type of CVMs, but proportional to the frequency of occurrence in the general population. The combination of CVM and CDH results in a poorer prognosis than would be expected with either malformation alone. However, the impact on survival from patients with a genetic syndrome has not been consistently evaluated. We encourage researchers to re-analyze existing series and recommend that future studies distinguish isolated CDH from that which is associated with other malformations, especially as part of genetic syndromes. Therapies should be tailored to maximize cardiac output and systemic oxygen delivery rather than systemic oxygen saturation alone. Although there is speculation about the frequency with which isolated left ventricular "hypoplasia" occurs in patients with CDH, we suggest it results from compression of a pre-load deficient left ventricle by the hypertensive right ventricle, and unlike true hypoplasia, is reversible. Irrespective of the type of severity of CVMs in patients with CDH, the degree of pulmonary hypoplasia and pulmonary vascular disease predicts outcome.
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Affiliation(s)
- Angela E Lin
- Genetics Unit, MassGeneral Hospital for Children, Boston, MA 02114, USA.
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26
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Slavotinek AM. Single gene disorders associated with congenital diaphragmatic hernia. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2007; 145C:172-83. [PMID: 17436300 DOI: 10.1002/ajmg.c.30125] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Congenital diaphragmatic hernia (CDH) is a common birth defect with a high pre- and postnatal mortality. Although the majority of diaphragmatic hernias occur as isolated malformations, additional major and minor anomalies are common and are present in more than 40% of patients. There are compelling data for the importance of genetic factors in the etiology of CDH, but the pathogenesis and the causative genes for CDH in humans remain elusive. There are more than 70 syndromes in which diaphragmatic hernias have been described, and several of these syndromes are single gene disorders for which the gene is known. One method for identifying the causative genes in isolated CDH is to study syndromes with known genes in which CDH is a recognized feature, with the rationale that those genes have a role in diaphragm development. This review discusses the syndromes that are most commonly associated with CDH, with greater attention towards syndromes in which the causative genes have been identified, including Simpson-Golabi-Behmel syndrome, Denys-Drash syndrome, spondylocostal dysostosis, craniofrontonasal syndrome, Cornelia de Lange syndrome and Marfan syndrome.
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Affiliation(s)
- Anne M Slavotinek
- Department of Pediatrics, University of California, San Francisco, CA 94143-0748, USA.
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Abstract
AIM This review highlights the relevance of the neural crest (NC) as a developmental control mechanism involved in several pediatric surgical conditions and the investigative interest of following some of its known signaling pathways. METHODS The participation of the NC in facial clefts, ear defects, branchial fistulae and cysts, heart outflow tract and aortic arch anomalies, pigmentary disorders, abnormal enteric innervation, neural tumors, hemangiomas, and vascular anomalies is briefly reviewed. Then, the literature on clinical and experimental esophageal atresia-tracheoesophageal fistula (EA-TEF) and congenital diaphragmatic hernia (CDH) is reviewed for the presence of associated NC defects. Finally, some of the molecular signaling pathways involved in both conditions (sonic hedgehog, Hox genes, and retinoids) are summarized. RESULTS The association of facial, cardiovascular, thymic, parathyroid, and C-cell defects together with anomalies of extrinsic and intrinsic esophageal innervation in babies and/or animals with both EA-TEF and CDH strongly supports the hypothesis that NC is involved in the pathogenesis of these malformative clusters. On the other hand, both EA-TEF and CDH are observed in mice mutant for genes involved in the previously mentioned signaling pathways. CONCLUSIONS The investigation of NC-related molecular pathogenic pathways involved in malformative associations like EA-TEF and CDH that are induced by chromosomal anomalies, chemical teratogens, and engineered mutations is a promising way of clarifying why and how some pediatric surgical conditions occur. Pediatric surgeons should be actively involved in these investigations.
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MESH Headings
- Abnormalities, Multiple/embryology
- Abnormalities, Multiple/physiopathology
- Abnormalities, Multiple/surgery
- Blood Vessels/abnormalities
- Branchial Region/abnormalities
- Cardiovascular Abnormalities/embryology
- Cardiovascular Abnormalities/physiopathology
- Cell Lineage
- Cell Movement
- Child
- Child, Preschool
- Enteric Nervous System/abnormalities
- Esophageal Atresia/embryology
- Esophageal Atresia/physiopathology
- Esophageal Atresia/surgery
- Face/abnormalities
- Genes, Homeobox
- Hedgehog Proteins/physiology
- Hernia, Diaphragmatic/embryology
- Hernia, Diaphragmatic/physiopathology
- Hernia, Diaphragmatic/surgery
- Hernias, Diaphragmatic, Congenital
- Homeodomain Proteins/physiology
- Humans
- Infant
- Infant, Newborn
- Neoplasms/etiology
- Neural Crest/physiopathology
- Patched Receptors
- Pigmentation Disorders/etiology
- Receptors, Cell Surface/physiology
- Receptors, G-Protein-Coupled/physiology
- Receptors, Retinoic Acid/physiology
- Signal Transduction
- Smoothened Receptor
- Syndrome
- Transcription Factors/physiology
- Tretinoin/physiology
- Zinc Finger Protein GLI1
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Affiliation(s)
- Juan A Tovar
- Departamento de Cirugía Pediátrica, Hospital Universitario La Paz, 28046 Madrid, Spain.
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Patel CR, Smith GL, Robinson HB. Prenatal diagnosis of partial anomalous pulmonary venous connection in a patient with Fryns syndrome. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2007; 26:403-6. [PMID: 17324994 DOI: 10.7863/jum.2007.26.3.403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Affiliation(s)
- Chandrakant R Patel
- Department of Pediatrics, Children's Hospital Medical Center of Akron, 2 Perkins Sq, Akron, OH 44308-1062, USA.
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Kantarci S, Casavant D, Prada C, Russell M, Byrne J, Haug LW, Jennings R, Manning S, Boyd T, Fryns J, Holmes L, Donahoe P, Lee C, Kimonis V, Pober B. Findings from aCGH in patients with congenital diaphragmatic hernia (CDH): a possible locus for Fryns syndrome. Am J Med Genet A 2006; 140:17-23. [PMID: 16333846 PMCID: PMC2891730 DOI: 10.1002/ajmg.a.31025] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Congenital diaphragmatic hernia (CDH) is a common and often devastating birth defect that can occur in isolation or as part of a malformation complex. Considerable progress is being made in the identification of genetic causes of CDH. We applied array-based comparative genomic hybridization (aCGH) of approximately 1Mb resolution to 29 CDH patients with prior normal karyotypes who had been recruited into our multi-site study. One patient, clinically diagnosed with Fryns syndrome, demonstrated a de novo 5Mb deletion at chromosome region 1q41-q42.12 that was confirmed by FISH. Given prior reports of CDH in association with cytogenetic abnormalities in this region, we propose that this represents a locus for Fryns syndrome, a Fryns syndrome phenocopy, or CDH.
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MESH Headings
- Abnormalities, Multiple/genetics
- Abnormalities, Multiple/pathology
- Chromosome Deletion
- Chromosomes, Human, Pair 1/genetics
- Cleft Palate/pathology
- Craniofacial Abnormalities/pathology
- Fatal Outcome
- Genetic Predisposition to Disease/genetics
- Genome, Human
- Hernia, Diaphragmatic/genetics
- Hernias, Diaphragmatic, Congenital
- Humans
- In Situ Hybridization, Fluorescence
- Infant
- Infant, Newborn
- Karyotyping
- Limb Deformities, Congenital/pathology
- Nails, Malformed
- Nucleic Acid Hybridization/methods
- Syndrome
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Affiliation(s)
- S. Kantarci
- Pediatric Surgical Research Laboratories, MassGeneral Hospital for Children, Harvard Medical School, Boston, Massachusetts
| | - D. Casavant
- Pediatric Surgical Research Laboratories, MassGeneral Hospital for Children, Harvard Medical School, Boston, Massachusetts
| | - C. Prada
- Division of Genetics, Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - M. Russell
- Pediatric Surgical Research Laboratories, MassGeneral Hospital for Children, Harvard Medical School, Boston, Massachusetts
| | - J. Byrne
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah
| | - L. Wilkins Haug
- Department of Obstetrics and Gynecology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - R. Jennings
- Department of Surgery, Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - S. Manning
- Division of Newborn Medicine, Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - T.K. Boyd
- Department of Pathology, Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - J.P. Fryns
- Department of Genetics, University Hospital of Leuven, Leuven, Belgium
| | - L.B. Holmes
- Genetics and Teratology, MassGeneral Hospital for Children, Harvard Medical School, Boston, Massachusetts
| | - P.K. Donahoe
- Pediatric Surgical Research Laboratories, MassGeneral Hospital for Children, Harvard Medical School, Boston, Massachusetts
| | - C. Lee
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - V. Kimonis
- Division of Genetics, Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - B.R. Pober
- Department of Surgery, Children's Hospital, Harvard Medical School, Boston, Massachusetts
- Genetics and Teratology, MassGeneral Hospital for Children, Harvard Medical School, Boston, Massachusetts
- Correspondence to: Dr. B.R. Pober, Children's Hospital Boston, 300 Longwood Ave., Fegan 325, Boston 02115, MA. or
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Bleyl SB, Botto LD, Carey JC, Young LT, Bamshad MJ, Leppert MF, Ward K. Analysis of a Scottish founder effect narrows the TAPVR-1 gene interval to chromosome 4q12. Am J Med Genet A 2006; 140:2368-73. [PMID: 17036341 DOI: 10.1002/ajmg.a.31471] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Steven B Bleyl
- Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah 84132, USA.
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