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Ricciardi G, Cammisa L, Bove R, Picchiotti G, Spaziani M, Isidori AM, Aceti F, Giacchetti N, Romani M, Sogos C. Clinical, Cognitive and Neurodevelopmental Profile in Tetrasomies and Pentasomies: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1719. [PMID: 36360447 PMCID: PMC9688827 DOI: 10.3390/children9111719] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/28/2022] [Accepted: 11/05/2022] [Indexed: 10/23/2023]
Abstract
Background: Sex chromosome aneuploidies (SCAs) are a group of disorders characterised by an abnormal number of sex chromosomes. Collective prevalence rate of SCAs is estimated to be around 1 in 400-500 live births; sex chromosome trisomies (e.g., XXX, XXY, XYY) are most frequent, while tetra- and pentasomies (e.g., XXXX, XXXXX, XXXY, XXXXY) are rarer, and the most common is 48, XXYY syndrome. The presence of additional X and/or Y chromosomes is believed to cause neurodevelopmental differences, with increased risk for developmental delays, language-based learning disabilities, cognitive impairments, executive dysfunction, and behavioural and psychological disorders. Aim of the Study: Our review has the purpose of analysing the neurocognitive, linguistical and behavioural profile of patients affected by sex chromosomes supernumerary aneuploidies (tetrasomy and pentasomy) to better understand the specific areas of weakness, in order to provide specific rehabilitation therapy. Methods: The literature search was performed by two authors independently. We used MEDLINE, PubMed, and PsycINFO search engines to identify sources of interest, without year or language restrictions. At the end of an accurate selection, 16 articles fulfilled the inclusion and exclusion criteria. Results and Conclusions: International literature has described single aspects of the neuropsychological profile of 48, XXYY and 49, XXXXY patients. In 48, XXYY patients, various degrees of psychosocial/executive functioning issues have been reported and there is an increased frequency of behavioural problems in childhood. Developmental delay and behavioural problems are the most common presenting problems, even if anxiety, depression and oppositional defiant disorder are also reported. They also show generalized difficulties with socialization and communication. Cognitive abilities are lower in measures of verbal IQ than in measures of performance IQ. Visuospatial skills are a relative strength compared to verbal skills. In patients with 49, XXXXY, both intellectual and adaptive functioning skills fall into the disability range, with better non-verbal cognitive performance. Speech and language testing reveals more deficits in expressive language than receptive language and comprehension. Anxiety, thought problems, internalizing and externalizing problems, and deficits in social cognition and communication are reported. Behavioural symptoms lessen from school age to adolescence, with the exception of thought problems and anxiety. Individuals affected by sex chromosome aneuploidies show testosterone deficiency, microorchidism, lack of pubertal progression and infertility. Hormone replacement therapy (HRT) is usually recommended for these patients: different studies have found that testosterone-based HRT benefit a wide range of areas initiated in these disorders, affecting not only neuromotor, cognitive and behavioural profile but also structural anomalies of the brain (i.e., increase of volume of grey temporal lobe matter). In conclusion, further studies are needed to better understand the neuropsychological profile with a complete evaluation, including neurocognitive and psychosocial aspects and to establish the real impact of HRT on improving the cognitive and behavioural profile of these patients.
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Affiliation(s)
- Giacomina Ricciardi
- Section of Child and Adolescents Neuropsychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Luca Cammisa
- Section of Child and Adolescents Neuropsychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Rossella Bove
- Section of Child and Adolescents Neuropsychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Giorgia Picchiotti
- Section of Child and Adolescents Neuropsychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Matteo Spaziani
- Advanced Endocrine Diagnostics Unit, Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy
| | - Andrea M. Isidori
- Advanced Endocrine Diagnostics Unit, Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy
| | - Franca Aceti
- Post-Partum Disorders Unit, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Nicoletta Giacchetti
- Post-Partum Disorders Unit, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Maria Romani
- Section of Child and Adolescents Neuropsychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Carla Sogos
- Section of Child and Adolescents Neuropsychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
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Rajabzadeh M, Taheri N, Jazayeri O. 49,XXXXY syndrome: A case study and a systematic review of clinical features among the Iranian population. Clin Case Rep 2022; 10:e6342. [PMID: 36188049 PMCID: PMC9508802 DOI: 10.1002/ccr3.6342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 05/05/2022] [Accepted: 08/31/2022] [Indexed: 11/11/2022] Open
Abstract
The present study describes the clinical, biochemical, hormonal, and developmental characteristics of a patient affected 49,XXXXY syndrome with routine Fraccaro syndrome features accompanied by sexual masturbation behavior. This study summarized the clinical features and also maternal age on birth time of so far 49,XXXXY reported patients among the Iranian population.
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Affiliation(s)
| | - Nafiseh Taheri
- Razi Pathobiology Diagnostic LaboratoryDepartment of GeneticsBabolIran
| | - Omid Jazayeri
- Department of Molecular and Cell Biology, Faculty of ScienceUniversity of MazandaranBabolsarIran
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Samango-Sprouse CA, Lasutschinkow PC, McLeod M, Porter GF, Powell S, St Laurent J, Sadeghin T, Gropman AL. Speech and language development in children with 49,XXXXY syndrome. Am J Med Genet A 2020; 185:3567-3575. [PMID: 32725750 DOI: 10.1002/ajmg.a.61767] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 01/27/2023]
Abstract
49,XXXXY is the rarest X and Y chromosomal variation and is frequently characterized by expressive and receptive language dysfunction, low muscle tonus, and intellectual deficits. Due to the low incidence of this disorder, comprehensive studies analyzing the specific aspects of the speech and language phenotype in these boys have been uncommon. This is the first in-depth investigation of the speech and language profiles in a large cohort of boys with 49,XXXXY. Based on the clinical judgment of speech and language pathologists, there was an increased incidence (91.8%) of Childhood Apraxia of Speech (CAS), which has not been previously described in this disorder. In preschool boys, some significant differences were demonstrated between boys who received early hormonal treatment (n = 16) and untreated boys (n = 4) on the language scales (p = .047) on the Bayley Scales of Infants and Toddlers, as well as significant differences between treated (n = 13) and untreated boys (n = 8) on the Expressive One Word Picture Vocabulary Test (p = .008). No significant differences between treatment groups were found in school age children, however, treated groups demonstrated less discrepancies between expressive and receptive language. More research and larger samples are needed to determine the extent of the impact of testosterone treatment on boys with 49,XXXXY. This study identifies CAS as a potential explanation for the significant expressive language dysfunction and subsequent behavioral dysfunction. These findings may assist in facilitating more targeted treatment and improved outcomes for boys with 49,XXXXY.
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Affiliation(s)
- Carole A Samango-Sprouse
- Department of Pediatrics, George Washington University, Washington, District of Columbia, USA.,Department of Human and Molecular Genetics, Florida International University, Miami, Florida, USA.,The Focus Foundation, Davidsonville, Maryland, USA
| | | | | | | | - Sherida Powell
- Department of Economics, George Washington University, Washington, District of Columbia, USA
| | | | | | - Andrea L Gropman
- Division of Neurogenetics and Developments Pediatrics, Children's National Health System, Washington, District of Columbia, USA.,Department of Neurology, George Washington University, Washington, District of Columbia, USA
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Gropman AL, Porter GF, Lasutschinkow PC, Sadeghin T, Tipton ES, Powell S, Samango-Sprouse CA. Neurocognitive development and capabilities in boys with 49,XXXXY syndrome. Am J Med Genet A 2020; 185:3541-3546. [PMID: 32662248 DOI: 10.1002/ajmg.a.61736] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 06/05/2020] [Indexed: 01/25/2023]
Abstract
49,XXXXY was previously associated with profound to severe intellectual deficits. However, prior research papers on the cognitive profiles of this population were confounded by small samples sizes, wide age spreads, and incomplete histories of testosterone replacement therapy. This study is the first comprehensive, international investigation of the neurocognitive aspects of 49,XXXXY, and the potential effects of biological treatment on this profile. Sixty-seven boys from infancy to 11 years of age were enrolled in this longitudinal study, with the majority of boys postnatally diagnosed though chromosomal analysis. These boys received a comprehensive neurocognitive evaluation tailored to specific language-based deficits and cognitive challenges. Results revealed higher neurocognitive capacities, both verbally and nonverbally, than previously reported in this disorder. Infant boys with 49,XXXXY who received early hormonal therapy (EHT) had significantly higher scores on the cognitive domain of the Bayley Scales of Infant Development than untreated infants (p = .013). In addition, treated school-aged participants had significantly better scaled scores than untreated boys in form completion (p = .042), a task that requires deductive reasoning, on nonverbal testing on the Leiter International Performance Scales. This study indicates greater cognitive capacities with a wide range of abilities in the child with 49,XXXXY, thus warranting further investigation to identify and understand the critical influences on the etiology and the variability of those capacities.
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Affiliation(s)
- Andrea L Gropman
- Division of Neurogenetics and Developments Pediatrics, Children's National Health System, Washington, District of Columbia, USA.,Department of Neurology, George Washington University, Washington, District of Columbia, USA
| | - Grace F Porter
- Research Department, The Focus Foundation, Davidsonville, Maryland, USA
| | | | - Teresa Sadeghin
- Research Department, The Focus Foundation, Davidsonville, Maryland, USA
| | | | - Sherida Powell
- Department of Economics, George Washington University, Washington, District of Columbia, USA
| | - Carole A Samango-Sprouse
- Research Department, The Focus Foundation, Davidsonville, Maryland, USA.,Department of Pediatrics, George Washington University, Washington, District of Columbia, USA.,Department of Human and Molecular Genetics, Florida International University, Miami, Florida, USA
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Samango‐Sprouse C, Lasutschinkow PC, Mitchell F, Porter GF, Hendrie P, Powell S, Sadeghin T, Gropman A. 49,
XXXXY
syndrome: A study of neurological function in this uncommon X and Y chromosomal disorder. Am J Med Genet A 2020; 185:3557-3566. [DOI: 10.1002/ajmg.a.61742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/31/2020] [Accepted: 06/10/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Carole Samango‐Sprouse
- Department of PediatricsGeorge Washington University Washington District of Columbia USA
- Department of Human and Molecular GeneticsFlorida International University Miami Florida USA
- ResearchThe Focus Foundation Maryland USA
| | | | | | | | | | - Sherida Powell
- Department of EconomicsGeorge Washington University Washington District of Columbia USA
| | | | - Andrea Gropman
- Division of Neurogenetics and Developments PediatricsChildren's National Health System Washington District of Columbia USA
- Department of NeurologyGeorge Washington University Washington District of Columbia USA
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Yang ZY, Ni JD, Long Z, Kuang LT, Tao SB. Unusual presentation of congenital radioulnar synostosis with osteoporosis, fragility fracture and nonunion: A case report and review of literature. World J Clin Cases 2020; 8:1538-1546. [PMID: 32368548 PMCID: PMC7190948 DOI: 10.12998/wjcc.v8.i8.1538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/26/2020] [Accepted: 04/09/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Congenital radioulnar synostosis (CRUS) is a rare deformity of the upper extremity. It is characterized by loss of rotation of the involved forearm and functional limitations in daily activities. No studies on CRUS with osteoporosis have been reported to date, and osteoporosis is usually recognized as an important dimension of genetic disorder in children. We discuss the possible relationship among this disorder, osteoporosis and fracture nonunion, investigate the strict surgical indications and recommended treatments.
CASE SUMMARY A 14-year-old male patient with bilateral CRUS with osteoporosis, fragility fracture and nonunion of fractures in ulna and radius presented our institution for further treatment, complaining of limitation in rotation. The bone mineral density of the hip and lumbar spine was 0.687 g/cm2 and 0.705 g/cm2, respectively, and the Z-score for both was -2.1, which revealed osteoporosis and a high risk of fracture. Tow serum bone turnover markers indicated an imbalance of bone metabolism. Reoperation for ulna fracture with autogenous bone grafting and a postoperative physiotherapy program were adopted rather than the separation of pathological synostosis. Radiological examination, observational posture assessment and limb function scale were evaluated before and 1 year after surgery. At 1 year, the fracture nonunion had almost recovered, forearm movement function on the fracture side was restored, and function on the healthy side was significantly improved compared with that before rehabilitation.
CONCLUSION Surgical indications for CRUS vary from person to person. Surgery should not be the first choice of treatment, and physiotherapy is not inferior to surgical treatment.
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Affiliation(s)
- Zhan-Yu Yang
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha 410000, Hunan Province, China
| | - Jiang-Dong Ni
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha 410000, Hunan Province, China
| | - Ze Long
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha 410000, Hunan Province, China
| | - Le-Tian Kuang
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha 410000, Hunan Province, China
| | - Shi-Bin Tao
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha 410000, Hunan Province, China
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Tosi L, Mitchell F, Porter GF, Ruland L, Gropman A, Lasutschinkow PC, Tran SL, Rajah EN, Gillies AP, Hendrie P, Peret R, Sadeghin T, Samango-Sprouse CA. Musculoskeletal abnormalities in a large international cohort of boys with 49,XXXXY. Am J Med Genet A 2020; 185:3531-3540. [PMID: 32243688 DOI: 10.1002/ajmg.a.61578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/23/2019] [Accepted: 03/16/2020] [Indexed: 11/09/2022]
Abstract
49,XXXXY is the rarest X and Y chromosomal variation, with an incidence of 1 in 80,000-100,000 live male births and has been associated with numerous musculoskeletal abnormalities. Data was collected from an international cohort of boys with 49,XXXXY over 10 years. Children were evaluated by a multidisciplinary team consisting of a pediatric orthopedist, a neurogeneticist, a neurodevelopmentalist, and two physical therapists. Increased rates of torticollis (32.4%), hamstring tightness (42%), radioulnar synostosis (67.6%), pes planus (65.2%), and other foot abnormalities (86.9%) were observed. Several anomalies increased with age, specifically hamstring tightness, kyphosis, and scoliosis. The elucidation of the orthopedic profile of this population is necessary in order to provide healthcare providers with current medical information. This research further supports the necessity for the comprehensive multidisciplinary treatment of boys with 49,XXXXY.
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Affiliation(s)
- Laura Tosi
- Children's National Hospital, Washington, District of Columbia, USA.,The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | | | | | - Leigh Ruland
- The Focus Foundation, Davidsonville, Maryland, USA
| | - Andrea Gropman
- Children's National Hospital, Washington, District of Columbia, USA.,The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | | | | | - Elmer N Rajah
- Children's National Hospital, Washington, District of Columbia, USA
| | - Austin P Gillies
- Children's National Hospital, Washington, District of Columbia, USA
| | | | - Rick Peret
- The Focus Foundation, Davidsonville, Maryland, USA
| | | | - Carole A Samango-Sprouse
- The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.,The Focus Foundation, Davidsonville, Maryland, USA.,Florida International University, Miami, Florida, USA
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8
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Samango‐Sprouse CA, Porter GF, Lasutschinkow PC, Tran SL, Sadeghin T, Gropman AL. Impact of early diagnosis and noninvasive prenatal testing (NIPT): Knowledge, attitudes, and experiences of parents of children with sex chromosome aneuploidies (SCAs). Prenat Diagn 2020; 40:470-480. [DOI: 10.1002/pd.5580] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 09/19/2019] [Accepted: 09/21/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Carole A. Samango‐Sprouse
- Department of PediatricsGeorge Washington University Washington District of Columbia USA
- Department of Human and Molecular GeneticsFlorida International University Miami Florida USA
- The Focus Foundation Davidsonville Maryland USA
| | | | | | | | | | - Andrea L. Gropman
- Department of NeurologyGeorge Washington University Washington District of Columbia
- Division of Neurogenetics and Developmental Pediatrics, Children's National Hospital Washington District of Columbia USA
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9
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Lasutschinkow PC, Gropman AL, Porter GF, Sadeghin T, Samango-Sprouse CA. Behavioral phenotype of 49,XXXXY syndrome: Presence of anxiety-related symptoms and intact social awareness. Am J Med Genet A 2020; 182:974-986. [PMID: 32083381 DOI: 10.1002/ajmg.a.61507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/02/2020] [Accepted: 01/23/2020] [Indexed: 11/10/2022]
Abstract
49,XXXXY is a rare X and Y chromosome variation that occurs in 1:85,000 to 1:100,000 live male births and is notable for variable motor, speech, and behavioral deficits. Case studies have described boys with this disorder as shy, impulsive, and aggressive with low frustration tolerances; however, previous studies have been limited due to cohort size. This study reports on the largest cohort of boys with 49,XXXXY to date with an emphasis on the prevalence of anxiety-related symptoms and sociability from preschool to adolescence. The Child Behavior Checklist, Behavior Rating Inventory of Executive Function, 2nd edition, and Social Responsiveness Scale, 2nd edition were completed by parents on a cohort of 69. The cohort demonstrated deficits in social cognition and communication beginning in preschool, however, presented with consistent social awareness and motivation for social activities not previously appreciated in this disorder. In addition, signs of anxiety presented during preschool years and increased in severity with age, particularly in internalizing problems. Boys with 49,XXXXY presented with wide behavioral variability across all ages and domains. Further research into the potential influences of culture, birth order, biological treatment, and frequency of services is needed to better define the behavioral phenotype of children with this disorder.
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Affiliation(s)
| | - Andrea L Gropman
- Department of Neurology, George Washington University, Washington, District of Columbia.,Division of Neurogenetics and Developmental Pediatrics, Children's National Health System, Washington, District of Columbia
| | - Grace F Porter
- Research Department, The Focus Foundation, Davidsonville, Maryland
| | - Teresa Sadeghin
- Research Department, The Focus Foundation, Davidsonville, Maryland
| | - Carole A Samango-Sprouse
- Research Department, The Focus Foundation, Davidsonville, Maryland.,Department of Human and Molecular Genetics, Florida International University, Miami, Florida.,Department of Pediatrics, George Washington University, Washington, District of Columbia
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10
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Stoll C, Dott B, Roth MP. Associated anomalies in cases with agenesis of the corpus callosum. Am J Med Genet A 2019; 179:2101-2111. [PMID: 31444900 DOI: 10.1002/ajmg.a.61330] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 07/19/2019] [Accepted: 08/01/2019] [Indexed: 12/11/2022]
Abstract
Agenesis of corpus callosum (ACC) is an uncommon congenital anomaly, its etiology is unclear and its pathogenesis is controversial. Cases with ACC often have other non-ACC associated congenital anomalies. The purpose of this study was to assess the prevalence and the types of these associated anomalies in a defined population. The associated anomalies in cases with ACC were collected in all live births, stillbirths, and terminations of pregnancy during 29 years in 387,067 consecutive births in the area covered by our population-based registry of congenital malformations. Of the 99 cases with ACC, representing a prevalence of 2.56 per 10,000, 73 (73.7%) had associated anomalies. There were 16 (16.2%) cases with chromosomal abnormalities, and 13 (13.2%) nonchromosomal recognized dysmorphic conditions including syndromes two each: Aicardi, Dandy-Walker, and fetal alcoholism. Forty-four (44.4%) of the cases had nonsyndromic multiple congenital anomalies (MCA). Anomalies in the musculoskeletal, the urogenital, the central nervous, the cardiovascular, and the digestive systems were the most common other anomalies in the cases with MCA. The anomalies associated with ACC could be classified into a recognizable malformation syndrome in 29 out of the 73 cases (39.7%) with associated anomalies. This study included special strengths: it is population-based, each affected child was examined by a geneticist, all elective terminations were ascertained, and the surveillance for anomalies was continued until 2 years of age. In conclusion the overall prevalence of associated anomalies, three of four cases, emphasizes the need for a screening for other anomalies in cases with ACC.
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Affiliation(s)
- Claude Stoll
- Laboratoire de Génétique Médicale, Faculté de Médecine, Strasbourg Cedex, France
| | - Beatrice Dott
- Laboratoire de Génétique Médicale, Faculté de Médecine, Strasbourg Cedex, France
| | - Marie-Paule Roth
- Laboratoire de Génétique Médicale, Faculté de Médecine, Strasbourg Cedex, France
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