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Kokhanov A. Congenital Abnormalities in the Infant of a Diabetic Mother. Neoreviews 2022; 23:e319-e327. [PMID: 35490182 DOI: 10.1542/neo.23-5-e319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Diabetes mellitus is among the most common chronic diseases worldwide. Infants of diabetic mothers are at increased risk of having congenital abnormalities. Tremendous progress has been achieved in the pregnancy care of diabetic women; however, the risk of birth defects associated with maternal diabetes still exists. These anomalies might arise in many organs and systems of the developing fetus. Many mechanisms have been implicated in the teratogenicity of maternal diabetes and it is critical to achieve good glycemic control before conception in women with diabetes. Neonatal clinicians must be able to identify patients at risk and recognize the signs of diabetic embryopathy. This article presents a review of congenital anomalies associated with maternal diabetes.
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Affiliation(s)
- Artemiy Kokhanov
- Department of Neonatology, Memorial Care Miller Children's and Women's Hospital Long Beach, Long Beach, CA
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Reyes CA, Young JN, Torres PR. First Reported Case of Femoral Facial Syndrome in an Adult: Esophageal Adenocarcinoma as a Progressive Gastrointestinal Manifestation. Cureus 2022; 14:e24285. [PMID: 35607579 PMCID: PMC9123342 DOI: 10.7759/cureus.24285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 11/17/2022] Open
Abstract
A 42-year-old female with a past medical history of femoral facial syndrome (FFS) and years of gastroesophageal reflux disease presented to our clinic with symptoms of dysphagia and iron deficiency anemia. On upper endoscopy, esophageal stricture and adenocarcinoma were detected. Unfortunately, the patient developed coronavirus disease 2019 (COVID-19) multi-organ failure prior to cancer treatment and died with dignity after choosing comfort care measures. To the best of our knowledge, we report the first case of FFS in an adult patient. This case also uniquely highlights the rare gastrointestinal manifestations of FFS.
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The Clinical Manifestations of Femoral-Facial Syndrome in an Orthopaedic Patient. Case Rep Orthop 2021; 2021:6684757. [PMID: 34221528 PMCID: PMC8219463 DOI: 10.1155/2021/6684757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/02/2021] [Indexed: 11/17/2022] Open
Abstract
Femoral-facial syndrome (FFS) is an exceedingly rare congenital disorder of unknown etiology related to maternal diabetes during pregnancy. It is characterized by variations of bilateral femoral hypoplasia and facial anomalies. We discuss an interesting case of a 3-year-old girl with FFS with an extensive surgical history who presented to a pediatric orthopaedic clinic with ankle pains and absent femurs. As this disease process is not frequently encountered, it is imperative for the practicing clinician to be aware of the various presentations. In this study, we discuss the different orthopaedic presentations in the literature and discuss various management recommendations.
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Lacarrubba-Flores MDJ, Carvalho DR, Ribeiro EM, Moreno CA, Esposito AC, Marson FAL, Loureiro T, Cavalcanti DP. Femoral-facial syndrome: A review of the literature and 14 additional patients including a monozygotic discordant twin pair. Am J Med Genet A 2018; 176:1917-1928. [PMID: 30070764 DOI: 10.1002/ajmg.a.40425] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 06/04/2018] [Accepted: 06/06/2018] [Indexed: 01/31/2023]
Abstract
Femoral-facial syndrome (FFS, OMIM 134780), also known as femoral hypoplasia-unusual face syndrome, is a rare sporadic syndrome associated with maternal diabetes, and comprising femoral hypoplasia/agenesis and a distinct facies characterized by micrognathia, cleft palate, and other minor dysmorphisms. The evaluation of 14 unpublished Brazilian patients, prompted us to make an extensive literature review comparing both sets of data. From 120 previously reported individuals with FFS, 66 were excluded due to: not meeting the inclusion criteria (n = 21); not providing sufficient data to ascertain the diagnosis (n = 29); were better assigned to another diagnosis (n = 3); and, being fetuses of the second trimester (n = 13) due to the obvious difficult to confirm a typical facies. Clinical-radiological and family information from 54 typical patients were collected and compared with the 14 new Brazilian patients. The comparison between the two sets of patients did not show any relevant differences. Femoral involvement was most frequently hypoplasia, observed in 91.2% of patients, and the typical facies was characterized by micrognathia (97%), cleft palate (61.8%), and minor dysmorphisms (frontal bossing 63.6%, short nose 91.7%, long philtrum 94.9%, and thin upper lip 92.3%). Clubfoot (55.9%) was commonly observed. Other observed findings may be part of FFS or may be simply concurrent anomalies since maternal diabetes is a common risk factor. While maternal diabetes was the only common feature observed during pregnancy (50.8%), no evidence for a monogenic basis was found. Moreover, a monozygotic discordant twin pair was described reinforcing the absence of a major genetic factor associated with FFS.
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Affiliation(s)
- Maria Dora Jazmin Lacarrubba-Flores
- Skeletal Dysplasia Group, Department of Medical Genetics, Faculty of Medical Sciences, University of Campinas [Unicamp], Campinas, São Paulo, Brazil.,Perinatal Genetic Program, Department of Medical Genetics, Faculty of Medical Sciences, University of Campinas [Unicamp], Campinas, São Paulo, Brazil
| | - Daniel Rocha Carvalho
- Genetic Unit, SARAH Network of Rehabilitation Hospital, Federal District, Brasilia, Brazil
| | | | - Carolina Araujo Moreno
- Skeletal Dysplasia Group, Department of Medical Genetics, Faculty of Medical Sciences, University of Campinas [Unicamp], Campinas, São Paulo, Brazil.,Perinatal Genetic Program, Department of Medical Genetics, Faculty of Medical Sciences, University of Campinas [Unicamp], Campinas, São Paulo, Brazil
| | - Ana Carolina Esposito
- Pediatric Division, Hospital Municipal Nossa Senhora do Loreto, Rio de Janeiro, Brazil
| | - Fernando Augusto Lima Marson
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas [Unicamp], Campinas, São Paulo, Brazil
| | - Thereza Loureiro
- Unit of Medical Genetics, Department of Genetics, Faculty of Medicine, University of São Paulo, Riberão Preto, São Paulo, Brazil
| | - Denise Pontes Cavalcanti
- Skeletal Dysplasia Group, Department of Medical Genetics, Faculty of Medical Sciences, University of Campinas [Unicamp], Campinas, São Paulo, Brazil.,Perinatal Genetic Program, Department of Medical Genetics, Faculty of Medical Sciences, University of Campinas [Unicamp], Campinas, São Paulo, Brazil
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