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Nyenga AM, Kayembe Mbuyu A, Lubala TK. Intracerebral Calcifications Associated with Failure to Thrive and Macular Degeneration in an Adolescent: A Case Report. Int Med Case Rep J 2024; 17:627-633. [PMID: 38952481 PMCID: PMC11215278 DOI: 10.2147/imcrj.s469737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 06/23/2024] [Indexed: 07/03/2024] Open
Abstract
Background The clinical picture of intracerebral calcification is so varied that it constitutes an essential element of a wide range of clinical syndromes of variable expression that continue to be described. In this article, we discuss the diagnostic possibilities of basal ganglia calcification considering the association of failure to thrive and macular degeneration in our patient. Case A 17-year-old male patient of Congolese origin consulted us for a pyramidal syndrome consisting of upper limb tremors during mobilization and dysgraphia. The patient also presented with a distance vision disorder for which the ophthalmological examination revealed poor visual acuity in both eyes (2/10) and macular degeneration in the left eye. On physical examination, we noted a short stature with a small head circumference in relation to age. The brain scan revealed the presence of bilateral striato-pallidal calcifications giving the appearance of Fahr's disease. However, the association of delay of stature development with microcrania, macular degeneration with reduced visual acuity and basal ganglia calcifications could suggest a wide range of syndromic hypotheses, the most likely of which is Rajab-type cerebral calcification. Conclusion The association of failure to thrive, macular degeneration, and cerebral calcification of the basal ganglia is revealed as a particular phenotype compared to cases reported in the literature. An in-depth analysis would be necessary to identify a possible genetic basis.
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Affiliation(s)
- Adonis Muganza Nyenga
- Department of Pediatrics, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo
| | - Axel Kayembe Mbuyu
- Department of Medical Imaging, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo
| | - Toni Kasole Lubala
- Department of Pediatrics, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo
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Marques Abramov D, Saad T, Gomes-Junior SC, de Souza E Silva D, Araújo I, Lopes Moreira ME, Lazarev VV. Auditory brainstem function in microcephaly related to Zika virus infection. Neurology 2018; 90:e606-e614. [PMID: 29352094 DOI: 10.1212/wnl.0000000000004974] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Accepted: 11/06/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To study the effect of prenatal Zika virus (ZV) infection on brainstem function reflected in brainstem auditory evoked potentials (BAEPs). METHODS In a cross-sectional study in 19 children (12 girls) with microcephaly related to ZV infection, aged between 12 and 62 weeks, the brainstem function was examined through BAEPs. The latencies of wave peaks I, III, and V of the left and right ears (n = 37) were standardized according to normative data, and compared between them by 2-tailed t test. The confounding variables (cephalic perimeter at the born and chronological age) were correlated with the normalized latencies using Pearson test. RESULTS All patients showed, in general, clear waveforms, with latencies within 3 SDs of the normative values. However, statistically increased latencies of waves I and III (I > III, p = 0.031) were observed, relative to wave V (p < 0.001), the latter being closer to respective normative value. The latency of wave I was observed to increase with age (r = 0.45, p = 0.005). The waves, in turn, did not depend on cephalic perimeter. CONCLUSIONS These results are consistent with the functional normality of the brainstem structure and its lack of correlation with microcephaly, suggesting that the disruption produced by the ZV infection does not act in the cell proliferation phase, but mostly in the processes of neuronal migration and differentiation in the telencephalon.
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Affiliation(s)
- Dimitri Marques Abramov
- From the Laboratory of Neurobiology and Clinical Neurophysiology (D.M.A., T.S., D.d.S.e.S., I.A., V.V.L.) and Unit of Clinical Research (S.-C.G.-J., M.E.L.M.), National Institute of Women, Children and Adolescents, Health Fernandes Figueira, Oswaldo Cruz Foundation (FIOCRUZ), Ministry of Health, Rio de Janeiro, Brazil
| | - Tania Saad
- From the Laboratory of Neurobiology and Clinical Neurophysiology (D.M.A., T.S., D.d.S.e.S., I.A., V.V.L.) and Unit of Clinical Research (S.-C.G.-J., M.E.L.M.), National Institute of Women, Children and Adolescents, Health Fernandes Figueira, Oswaldo Cruz Foundation (FIOCRUZ), Ministry of Health, Rio de Janeiro, Brazil
| | - Saint-Clair Gomes-Junior
- From the Laboratory of Neurobiology and Clinical Neurophysiology (D.M.A., T.S., D.d.S.e.S., I.A., V.V.L.) and Unit of Clinical Research (S.-C.G.-J., M.E.L.M.), National Institute of Women, Children and Adolescents, Health Fernandes Figueira, Oswaldo Cruz Foundation (FIOCRUZ), Ministry of Health, Rio de Janeiro, Brazil
| | - Daniel de Souza E Silva
- From the Laboratory of Neurobiology and Clinical Neurophysiology (D.M.A., T.S., D.d.S.e.S., I.A., V.V.L.) and Unit of Clinical Research (S.-C.G.-J., M.E.L.M.), National Institute of Women, Children and Adolescents, Health Fernandes Figueira, Oswaldo Cruz Foundation (FIOCRUZ), Ministry of Health, Rio de Janeiro, Brazil
| | - Izabel Araújo
- From the Laboratory of Neurobiology and Clinical Neurophysiology (D.M.A., T.S., D.d.S.e.S., I.A., V.V.L.) and Unit of Clinical Research (S.-C.G.-J., M.E.L.M.), National Institute of Women, Children and Adolescents, Health Fernandes Figueira, Oswaldo Cruz Foundation (FIOCRUZ), Ministry of Health, Rio de Janeiro, Brazil
| | - Maria Elizabeth Lopes Moreira
- From the Laboratory of Neurobiology and Clinical Neurophysiology (D.M.A., T.S., D.d.S.e.S., I.A., V.V.L.) and Unit of Clinical Research (S.-C.G.-J., M.E.L.M.), National Institute of Women, Children and Adolescents, Health Fernandes Figueira, Oswaldo Cruz Foundation (FIOCRUZ), Ministry of Health, Rio de Janeiro, Brazil
| | - Vladimir V Lazarev
- From the Laboratory of Neurobiology and Clinical Neurophysiology (D.M.A., T.S., D.d.S.e.S., I.A., V.V.L.) and Unit of Clinical Research (S.-C.G.-J., M.E.L.M.), National Institute of Women, Children and Adolescents, Health Fernandes Figueira, Oswaldo Cruz Foundation (FIOCRUZ), Ministry of Health, Rio de Janeiro, Brazil.
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Dong DY, Binongo JN, Kancherla V. Maternal Chlamydia Infection During Pregnancy and Risk of Cyanotic Congenital Heart Defects in the Offspring. Matern Child Health J 2016; 20:66-76. [PMID: 26156829 DOI: 10.1007/s10995-015-1804-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Genital Chlamydia is a common bacterial sexually-transmitted infection among reproductive aged women, particularly younger populations. Cyanotic congenital heart defects (CCHDs) constitute about one quarter of all cardiac malformations at birth, and are associated with high rate of morbidity and mortality. Epidemiological research on the association between maternal Chlamydia during pregnancy and CCHDs in the offspring is lacking. METHODS Using data from the 2012 United States birth certificates, we examined the association between CCHDs and prenatal exposure to Chlamydia among live singleton births with CCHDs (n = 2487) and unaffected singleton births (n = 3,334,424). We estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) using unconditional logistic regression analysis for all CCHDs combined, and isolated CCHDs (without other major congenital malformations). RESULTS Overall 1.7% of case and 1.7% of control women reported having Chlamydia during their pregnancies. After controlling for potential confounders, we found a weak positive association between maternal Chlamydia during pregnancy and all CCHDs combined (aOR = 1.39; 95% CI 1.02-1.90). The positive association persisted for isolated CCHD cases, but with marginal significance (aOR = 1.34; 95% CI 0.96-1.74). Subgroup analyses for younger women showed an increased risk for CCHDs; however, the associations were not statistically significant. CONCLUSIONS Maternal exposure to Chlamydia during pregnancy was weakly associated with a higher risk of CCHDs in the offspring. The finding should be interpreted with caution due to limitations of birth certificate data. Future studies using more robust data sources are warranted to further study the association between maternal Chlamydia during pregnancy and CCHDs in the offspring.
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Affiliation(s)
- Diane Y Dong
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, USA.,Department of Veterans Affairs, Center for Medication Safety, Hines, IL, USA
| | - José N Binongo
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Vijaya Kancherla
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, USA.
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Livingston JH, Stivaros S, Warren D, Crow YJ. Intracranial calcification in childhood: a review of aetiologies and recognizable phenotypes. Dev Med Child Neurol 2014; 56:612-26. [PMID: 24372060 DOI: 10.1111/dmcn.12359] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/31/2013] [Indexed: 12/24/2022]
Abstract
Intracranial calcification (ICC) is a common finding on neuroimaging in paediatric neurology practice. In approximately half of all cases the calcification occurs in damaged, neoplastic, or malformed brain. For the large number of other disorders in which ICC occurs, no common pathogenetic mechanism can be suggested. Congenital infection, particularly with cytomegalovirus, accounts for a significant proportion of all cases. However, some genetic diseases, in particular Aicardi-Goutières syndrome, Band-like calcification, and RNASET2-related disease, may mimic congenital infection; therefore, a full consideration of the radiological and clinical features is necessary before concluding that congenital infection is the cause. In some disorders calcification is a universal finding, in others it is a frequent occurrence, and in some it is only an occasional finding. Characteristic patterns of calcification are seen in a number of conditions, and a systematic approach to the identification and description of radiological findings, taken together in the context of the clinical scenario, allows a diagnosis to be made in many cases. Nonetheless, there remain a number of presumed genetic disorders associated with ICC for which the underlying molecular cause has not yet been identified.
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Affiliation(s)
- John H Livingston
- Department of Paediatric Neurology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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