Diffuse capillary malformation in association with fetal pleural effusion: report of five patients

The Value of Obstetric Ultrasound in Screening Fetal Nervous System Malformation

BACKGROUND

The article uses ultrasound imaging standard section to examine the fetal central nervous system (CNS) in early pregnancy, combined with ultrasound imaging in the diagnosis of fetal CNS malformation in the middle and late pregnancy, to determine the feasibility of ultrasound imaging in the detection of CNS abnormalities in the first trimester of the fetus.

METHODS

The article selected 2701 pregnant women from the Department of Ultrasound in our hospital from November 2012 to November 2016 to screen for the transparent layer of the fetal neck in early pregnancy, with a total of 2751 cases. The article uses Madison V20 and Madison XG color Doppler ultrasound diagnostic instruments, the probe frequency is measured from 2.0-3.5 MHz, grouped according to gestational age, the statistical section of the case is displayed, and the transparent layer of the neck value is used to count the ultrasound image during early pregnancy. The detection of the CNS malformation by the standard section examination and the sensitivity, specificity, positive predictive value, and negative predictive value of the diagnosis may affect the cause of the CNS display rate.

RESULTS

The sensitivity, specificity, positive predictive value, and negative predictive value of the ultrasound standard section in the diagnosis of fetal CNS malformation in early pregnancy were 85.7%, 100%, 100%, and 99.9%, respectively. Through research, it is found that the use of ultrasound imaging standard section can effectively diagnose fetal CNS severe deformity in early pregnancy, and the detection rate of CNS malformation in early pregnancy is 85.7%. At the same time, the number of positive cases and CNS malformations in this group were few.

CONCLUSIONS

The positive cases detected in early pregnancy were severe malformations of the CNS. The diagnosis of other CNS malformations in the fetus needs further study.

A novel mutation in nuclear prelamin a recognition factor-like causes diffuse pulmonary arteriovenous malformations

Two daughters in a Chinese consanguineous family were diagnosed as diffuse pulmonary arteriovenous malformations (PAVMs) and screened using whole exome sequencing (WES) and copy number variations (CNVs) chips. Though no mutation was found in the established causative genes of capillary malformation-AVMs (CM-AVMs) or PAVMs, Ser161Ile (hg19 NM_022493 c.482G>T) mutation in nuclear prelamin A recognition factor-like (NARFL) was identified. Ser161Ile mutation in NARFL conservation region was predicted to be deleterious and absent in 500 population controls and Exome Aggregation Consortium (ExAC) Database. And there was a dosage effect of the mutation on mRNA levels among family members and population controls, consistent with the instability of mutant mRNA in vitro. Accordingly, in lung tissue of the proband, NARFL protein expression was reduced but Fe3+ was overloaded with vascular endothelial growth factor (VEGF) overexpression. Furthermore, NARFL-knockdown cell lines demonstrated decreased activity of cytosolic aconitase, while NARFL-knockout zebrafish presented ectopic subintestinal vessels sprouts and upregulated VEGF. So we concluded that the Ser161Ile mutant induced NARFL deficiency and eventually diffuse PAVMs probably through VEGF pathway. In a word, we detected a functional mutation in NARFL, which might be the pathogenic gene in this pedigree.