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Bhutani J, Rengan V, Pansari V, Kannan D. Sacral Agenesis: Late Presentation and the Psychological Impact of Delayed Diagnosis. Cureus 2023; 15:e47456. [PMID: 38021544 PMCID: PMC10660888 DOI: 10.7759/cureus.47456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2023] [Indexed: 12/01/2023] Open
Abstract
Sacral agenesis (SA) is a rare condition characterized by the absence of one or more lower sacral vertebral bodies. In India, children with this condition often present late with symptoms primarily related to urinary and bowel dysfunction. Maternal diabetes is the only confirmed risk factor, significantly elevating the incidence rate. We discuss a case of a nine-year-old female who presented to the pediatric outpatient department (OPD) with chronic constipation and urinary retention, having experienced symptoms since infancy. Initial investigations at peripheral hospitals had yielded no clear diagnosis, leading to undue psychological distress to the child and family. The child had been born to a mother with diabetes mellitus during pregnancy. Physical examination revealed mild dehydration, anemia, and sacral dimpling. Further evaluation showed renal injury and SA confirmed by MRI, along with other associated findings. This case report highlights the importance of early diagnosis and intervention in pediatric SA, especially given the risk of renal disease progression. The treatment in this case included clean intermittent self-catheterization (CIC), dietary management, and counseling on renal health. Crucially, uncovering the root cause provided immense psychological relief to the child and her family. Pediatric SA remains a diagnostic challenge, often leading to psychological distress in affected individuals who present late. Early recognition and comprehensive management are crucial, especially in cases associated with maternal diabetes, to mitigate the risk of renal complications and improve the overall quality of life for affected children.
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2
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Jasiewicz B, Kacki W. Caudal Regression Syndrome-A Narrative Review: An Orthopedic Point of View. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10030589. [PMID: 36980147 PMCID: PMC10047641 DOI: 10.3390/children10030589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/13/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023]
Abstract
Abnormalities in cellular differentiation during embryo-fetal period may lead to various malformations of the spine. Caudal regression syndrome (CRS) is a group of defects with premature growth/development termination of the vertebral column. CRS can be divided into three types: sirenomelia, complete absence of the sacrum and partial absence of the sacrum. Genitourinary and gastrointestinal anomalies are common, with neurogenic bladder and bowel incontinence. Treatment of patients with CRS is complex and multidisciplinary and should be comprehensive. The most common orthopedic problems are: spinal deformity (kyphosis and scoliosis), spinopelvic instability and lower limbs deformities.
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Affiliation(s)
- Barbara Jasiewicz
- Department of Orthopedics and Rehabilitation, Jagiellonian University Collegium Medicum, Balzera 15, 34-500 Zakopane, Poland
| | - Wojciech Kacki
- Department of Orthopedics and Rehabilitation, Jagiellonian University Collegium Medicum, Balzera 15, 34-500 Zakopane, Poland
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3
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Schierz IAM, Piro E, Giuffrè M, Pinello G, Angelini A, Antona V, Cimador M, Corsello G. Clinical and genetic approach in the characterization of newborns with anorectal malformation. J Matern Fetal Neonatal Med 2022; 35:4513-4520. [DOI: 10.1080/14767058.2020.1854213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Ingrid Anne Mandy Schierz
- Department of Health Promotion, Mother-Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, Neonatal Intensive Care Unit, University Hospital “P. Giaccone”, Palermo, Italy
| | - Ettore Piro
- Department of Health Promotion, Mother-Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, Neonatal Intensive Care Unit, University Hospital “P. Giaccone”, Palermo, Italy
| | - Mario Giuffrè
- Department of Health Promotion, Mother-Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, Neonatal Intensive Care Unit, University Hospital “P. Giaccone”, Palermo, Italy
| | - Giuseppa Pinello
- Department of Health Promotion, Mother-Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, Neonatal Intensive Care Unit, University Hospital “P. Giaccone”, Palermo, Italy
| | - Alice Angelini
- Department of Health Promotion, Mother-Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, Neonatal Intensive Care Unit, University Hospital “P. Giaccone”, Palermo, Italy
| | - Vincenzo Antona
- Department of Health Promotion, Mother-Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, Neonatal Intensive Care Unit, University Hospital “P. Giaccone”, Palermo, Italy
| | - Marcello Cimador
- Department of Health Promotion, Mother-Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, Pediatric Surgery Unit, University Hospital “P. Giaccone”, Palermo, Italy
| | - Giovanni Corsello
- Department of Health Promotion, Mother-Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, Neonatal Intensive Care Unit, University Hospital “P. Giaccone”, Palermo, Italy
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4
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Gajagowni S, Nair P, Bapat AC, Vachharajani AJ. Diabetic Embryopathies. Neoreviews 2022; 23:e677-e688. [PMID: 36180736 DOI: 10.1542/neo.23-10-e677] [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
Diabetic embryopathy is defined as congenital anomalies that are linked to maternal diabetes. The association between diabetes and fetal, neonatal, and long-term complications is well-established. These complications include organ or structural maldevelopment, fetal growth abnormalities, and learning/psychiatric comorbidities. Recent studies have elucidated the pathophysiology behind these conditions and outlined new management approaches. Caudal regression syndrome, also known as sacral agenesis, is a well-known but less described complication of maternal diabetes. The purpose of this review is to summarize existing research on common neonatal morbidities in infants of mothers with diabetes with a focus on caudal regression syndrome and its long-term associations.
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Affiliation(s)
| | - Pooja Nair
- University of Missouri School of Medicine, Columbia, MO
| | - Alka C Bapat
- Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, New York, NY
| | - Akshaya J Vachharajani
- Division of Neonatology, Department of Child Health, University of Missouri School of Medicine, Columbia, MO
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5
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Xu Z, Gu Y, Chen J, Chen X, Song Y, Fan J, Ji X, Li Y, Zhang W, Zhang R. Epigenome-wide gene–age interaction study reveals reversed effects of MORN1 DNA methylation on survival between young and elderly oral squamous cell carcinoma patients. Front Oncol 2022; 12:941731. [PMID: 35965572 PMCID: PMC9366171 DOI: 10.3389/fonc.2022.941731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/28/2022] [Indexed: 12/04/2022] Open
Abstract
DNA methylation serves as a reversible and prognostic biomarker for oral squamous cell carcinoma (OSCC) patients. It is unclear whether the effect of DNA methylation on OSCC overall survival varies with age. As a result, we performed a two-phase gene–age interaction study of OSCC prognosis on an epigenome-wide scale using the Cox proportional hazards model. We identified one CpG probe, cg11676291MORN1, whose effect was significantly modified by age (HRdiscovery = 1.018, p = 4.07 × 10−07, FDR-q = 3.67 × 10−02; HRvalidation = 1.058, p = 8.09 × 10−03; HRcombined = 1.019, p = 7.36 × 10−10). Moreover, there was an antagonistic interaction between hypomethylation of cg11676291MORN1 and age (HRinteraction = 0.284; 95% CI, 0.135–0.597; p = 9.04 × 10−04). The prognosis of OSCC patients was well discriminated by the prognostic score incorporating cg11676291MORN1–age interaction (HRhigh vs. low = 3.66, 95% CI: 2.40–5.60, p = 1.93 × 10−09). By adding 24 significant gene–age interactions using a looser criterion, we significantly improved the area under the receiver operating characteristic curve (AUC) of the model at 3- and 5-year prognostic prediction (AUC3-year = 0.80, AUC5-year = 0.79, C-index = 0.75). Our study identified a significant interaction between cg11676291MORN1 and age on OSCC survival, providing a potential therapeutic target for OSCC patients.
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Affiliation(s)
- Ziang Xu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Department of Oral Special Consultation, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
| | - Yan Gu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Department of Orthodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Nanjing, China
| | - Jiajin Chen
- Department of Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xinlei Chen
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Department of Oral Special Consultation, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
| | - Yunjie Song
- Department of Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Juanjuan Fan
- Department of Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xinyu Ji
- Department of Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yanyan Li
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Department of Oral Special Consultation, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
| | - Wei Zhang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Department of Oral Special Consultation, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Ruyang Zhang, ; Wei Zhang,
| | - Ruyang Zhang
- Department of Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- China International Cooperation Center for Environment and Human Health, Nanjing Medical University, Nanjing, China
- *Correspondence: Ruyang Zhang, ; Wei Zhang,
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Pitsava G, Feldkamp ML, Pankratz N, Lane J, Kay DM, Conway KM, Hobbs C, Shaw GM, Reefhuis J, Jenkins MM, Almli LM, Moore C, Werler M, Browne ML, Cunniff C, Olshan AF, Pangilinan F, Brody LC, Sicko RJ, Finnell RH, Bamshad MJ, McGoldrick D, Nickerson DA, Mullikin JC, Romitti PA, Mills JL. Exome sequencing identifies variants in infants with sacral agenesis. Birth Defects Res 2022; 114:215-227. [PMID: 35274497 PMCID: PMC9338687 DOI: 10.1002/bdr2.1987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 01/22/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Sacral agenesis (SA) consists of partial or complete absence of the caudal end of the spine and often presents with additional birth defects. Several studies have examined gene variants for syndromic forms of SA, but only one has examined exomes of children with non-syndromic SA. METHODS Using buccal cell specimens from families of children with non-syndromic SA, exomes of 28 child-parent trios (eight with and 20 without a maternal diagnosis of pregestational diabetes) and two child-father duos (neither with diagnosis of maternal pregestational diabetes) were exome sequenced. RESULTS Three children had heterozygous missense variants in ID1 (Inhibitor of DNA Binding 1), with CADD scores >20 (top 1% of deleterious variants in the genome); two children inherited the variant from their fathers and one from the child's mother. Rare missense variants were also detected in PDZD2 (PDZ Domain Containing 2; N = 1) and SPTBN5 (Spectrin Beta, Non-erythrocytic 5; N = 2), two genes previously suggested to be associated with SA etiology. Examination of variants with autosomal recessive and X-linked recessive inheritance identified five and two missense variants, respectively. Compound heterozygous variants were identified in several genes. In addition, 12 de novo variants were identified, all in different genes in different children. CONCLUSIONS To our knowledge, this is the first study reporting a possible association between ID1 and non-syndromic SA. Although maternal pregestational diabetes has been strongly associated with SA, the missense variants in ID1 identified in two of three children were paternally inherited. These findings add to the knowledge of gene variants associated with non-syndromic SA and provide data for future studies.
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Affiliation(s)
- Georgia Pitsava
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - Marcia L. Feldkamp
- Division of Medical Genetics, Department of Pediatrics, 295 Chipeta Way, Suite 2S010, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Nathan Pankratz
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN, USA
| | - John Lane
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Denise M. Kay
- Division of Genetics, Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Kristin M. Conway
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA
| | - Charlotte Hobbs
- Rady Children’s Institute for Genomic Medicine, San Diego, California, USA
| | - Gary M. Shaw
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Jennita Reefhuis
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mary M. Jenkins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lynn M. Almli
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Cynthia Moore
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Martha Werler
- Slone Epidemiology Center at Boston University, Boston, MA
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA
| | - Marilyn L. Browne
- New York State Department of Health, Birth Defects Registry, Albany, New York, USA
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, New York, USA
| | - Chris Cunniff
- Department of Pediatrics, Weill Cornell Medical College, New York, NY, USA
| | - Andrew F. Olshan
- Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Faith Pangilinan
- Gene and Environment Interaction Section, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Lawrence C. Brody
- Gene and Environment Interaction Section, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Robert J. Sicko
- Division of Genetics, Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Richard H. Finnell
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, Texas, USA
| | - Michael J. Bamshad
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Daniel McGoldrick
- Department of Genome Sciences, University of Washington, Seattle, Washington, USA
| | - Deborah A. Nickerson
- Department of Genome Sciences, University of Washington, Seattle, Washington, USA
| | - James C. Mullikin
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Paul A. Romitti
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA
| | - James L. Mills
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
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Barber AM, Helms A, Thompson R, Whitlock BK, Steffen DJ, Petersen JL. Whole-genome sequencing to investigate a possible genetic basis of perosomus elumbis in a calf resulting from a consanguineous mating. Transl Anim Sci 2021. [DOI: 10.1093/tas/txab171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Alexa M Barber
- Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE 68503, USA
| | - Alyssa Helms
- Department of Large Animal Clinical Sciences, Virginia Tech, Blacksburg, VA 24061, USA
| | - Riley Thompson
- College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA
| | - Brian K Whitlock
- Department of Large Animal Clinical Sciences, University of Tennessee, Knoxville, TN 37996, USA
| | - David J Steffen
- School of Veterinary Medicine and Biomedical Science, University of Nebraska – Lincoln, Lincoln, NE 68503, USA
| | - Jessica L Petersen
- Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE 68503, USA
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8
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Kylat RI, Bader M. Caudal Regression Syndrome. CHILDREN (BASEL, SWITZERLAND) 2020; 7:children7110211. [PMID: 33158301 PMCID: PMC7694368 DOI: 10.3390/children7110211] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/20/2020] [Accepted: 10/29/2020] [Indexed: 01/27/2023]
Abstract
Caudal Regression Syndrome (CRS) or Caudal dysgenesis syndrome (CDS) is characterized by maldevelopment of the caudal half of the body with variable involvement of the gastrointestinal, genitourinary, skeletal, and nervous systems. CRS affects 1–3 newborn infants per 100,000 live births. The prevalence in infants of diabetic mothers is reported at 1 in 350 live births which includes all the variants. A related condition is sirenomelia sequence or mermaid syndrome or symmelia and is characterized by fusion of the legs and a variable combination of the other abnormalities. The Currarino triad is a related anomaly that includes anorectal atresia, coccygeal and partial sacral agenesis, and a pre-sacral lesion such as anterior meningocele, lipoma or dermoid cyst. A multidisciplinary management approach is needed that includes rehabilitative services, and patients need a staged surgical approach.
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Warner T, Scullen TA, Iwanaga J, Loukas M, Bui CJ, Dumont AS, Tubbs RS. Caudal Regression Syndrome-A Review Focusing on Genetic Associations. World Neurosurg 2020; 138:461-467. [PMID: 32200015 DOI: 10.1016/j.wneu.2020.03.057] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/09/2020] [Accepted: 03/10/2020] [Indexed: 12/31/2022]
Abstract
Caudal regression syndrome (CRS) represents a spectrum of clinical phenotypes with varying degrees of malformation of the lower body with involvement of structures deriving from all 3 layers of the trilaminar embryo. We review areas of active investigation in the diagnosis, etiology, epidemiology, and treatment of the disease with a focus on underlying genetics. CRS pathobiology is complex and multifactorial with a significant contribution from environmental factors as evidenced in twin studies. Contemporary genomic and genetic investigations in both human primary tissue and murine in vitro and in vivo models implicate various genes associated with caudal differentiation and neural cell migration in embryogenesis. A large number of identified targets center around the metabolic regulation of retinoic acid and its derivatives. Dysregulation of retinoic acid homeostasis has been associated with abnormal embryonic cell migration, differentiation, and organogenesis with resulting malformations and agenesis in both a laboratory and a clinical setting. There appears to be a significant overlap in potential genetic targets with CRS and other developmental syndromes with similar presentations, such as VACTERL (vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities) association. CRS represents a spectrum of caudal developmental abnormalities with treatment options limited to mild and moderate expressions of disease. Continued research is necessary to further clarify mechanisms of disease pathobiology and complex polygenetic and environmental interaction. Despite this, progress has been made in identifying genetic targets and downstream effectors contributing to preclinical and clinical progression.
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Affiliation(s)
- Tyler Warner
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
| | - Tyler A Scullen
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
| | - C J Bui
- Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA; Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA
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Wu H, Qi P, Dai R, Li Z, Feng H. Urine retention as the first presentation of congenital absence of the sacrum: A case report of a rare clinical phenomenon. Medicine (Baltimore) 2018; 97:e11623. [PMID: 30075539 PMCID: PMC6081139 DOI: 10.1097/md.0000000000011623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
RATIONALE Congenital absence of either a part of or the entire sacrum is rare, and only a few such cases have been reported until now. Most cases showed vertebral, pelvic, neurological, and visceral abnormalities, and the cases were usually quite serious. Only in rare cases was there urine retention without other symptoms. PATIENT CONCERNS We describe the case of a 28-years-old man who presented with urine retention. DIAGNOSES Urodynamic study confirmed that he had urinary retention, and magnetic resonance imaging (MRI) showed the absence of the sacrum. INTERVENTIONS He was treated with electro-acupuncture and medications to improve nerve function. OUTCOMES His symptoms showed clear improvement. LESSONS Although this case is rare, it indicates that the spine and pelvis may need to be examined when unexplained urinary retention occurs.
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Affiliation(s)
| | - Peng Qi
- Department of General Surgery
| | - Ruoheng Dai
- Department of Pediatrics, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital
| | - Ze Li
- Department of Emergency, Hebei Medical University Second Affiliated Hospital, Shijiazhuang, Hebei, China
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11
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Mottet N, Chaussy Y, Auber F, Guimiot F, Arbez-Gindre F, Riethmuller D, Cretolle C, Benachi A. How to Explore Fetal Sacral Agenesis Without Open Dysraphism: Key Prenatal Imaging and Clinical Implications. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:1807-1820. [PMID: 29377253 DOI: 10.1002/jum.14522] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 10/01/2017] [Accepted: 10/02/2017] [Indexed: 06/07/2023]
Abstract
The estimated prevalence of fetal caudal dysgenesis is 1 per 100,000 births. The functional prognosis of sacral agenesis is dominated by the large spectrum of associated caudal malformations. Except for cases associated with hydrocephalus secondary to open spinal dysraphism or chromosomal anomalies, association with mental deficiency is rare. We propose a systematic prenatal approach to cases of fetal sacral agenesis based on 9 etiologic items: clinical context, type of sacral dysgenesis, associated spinal cord malformations, mobility of lower limbs, investigation of the presacral region, analysis of the gastrointestinal tract, analysis of the genitourinary tract, associated vertebral defects, and cytogenetic analysis.
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Affiliation(s)
- Nicolas Mottet
- Departments of Obstetrics and Gynecology, Jean Minjoz Besançon University Hospital, Université de Franche Comté, Besançon, France
- Department of Obstetrics and Gynecology, Hospital Antoine Béclère, Assistance Publique-Hôpitaux de Paris, Université Paris Sud, Paris, France
| | - Yann Chaussy
- Department of Pediatric Surgery, Jean Minjoz Besançon University Hospital, Université de Franche Comté, Besançon, France
| | - Frederic Auber
- Department of Pediatric Surgery, Jean Minjoz Besançon University Hospital, Université de Franche Comté, Besançon, France
| | - Fabien Guimiot
- Department of Developmental Biology, Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Denis Diderot University, Paris, France
| | - Francine Arbez-Gindre
- Unit of Fetal Pathology, Jean Minjoz Besançon University Hospital, Université de Franche Comté, Besançon, France
| | - Didier Riethmuller
- Departments of Obstetrics and Gynecology, Jean Minjoz Besançon University Hospital, Université de Franche Comté, Besançon, France
| | - Célia Cretolle
- National Reference Centre for Rare Diseases on Anorectal Malformations and Rare Pelvic Anomalies, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Université René Descartes, Paris, France
| | - Alexandra Benachi
- Department of Obstetrics and Gynecology, Hospital Antoine Béclère, Assistance Publique-Hôpitaux de Paris, Université Paris Sud, Paris, France
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