Epidemiology and prevalence of pulmonary sequestration in Chinese population, 2010-2019

Patterns of Co-Occurring Birth Defects in Chinese Infants With Congenital Diaphragmatic Hernia: A National Hospital-Based Surveillance Study

BACKGROUND

The landscape of co-occurring birth defects among infants with congenital diaphragmatic hernia (CDH) remains underexplored.

AIMS

This study aims to elucidate the complex patterns of co-occurring defects in Chinese population.

MATERIALS AND METHODS

We analyzed cases from the Chinese Birth Defects Monitoring Network (2007-2019) with CDH that presented along with at least one additional defect but without a syndromic diagnosis. Adjusted observed-to-expected prevalence (O/E) ratios were calculated for all two- to five-way combinations to discern patterns of co-occurring defects with CDH more frequently than expected by chance.

RESULTS

Among 1235 CDH cases associated with other birth defects, the top 30 combinations with the highest adjusted O/E ratios included musculoskeletal, cardiovascular, central nervous system, facial, and renal defects. Cardiovascular defects were involved in 76.7% of the top combinations, followed by central nervous system (23.3%) and musculoskeletal defects (20.0%). The combination of polydactyly and syndactyly anomalies exhibited the highest adjusted O/E ratio of 5963.37 (95% confidence interval: 5960.00-5966.73).

DISCUSSION

The relationship between musculoskeletal malformation and CDH may be explained from the aspects of epidemiology, embryology and pathogenesis. And mechanisms for the co-occurrence of cardiovascular and CDH may involve disruption of common pathways.

CONCLUSION

Our analyses describe the co-occurrence patterns of birth defects in CDH infants and reveal several noteworthy patterns. The observed patterns can guide further study and enhance our comprehension understanding of the developmental mechanisms underlying multiple defects.

Pulmonary Sequestration Masquerading as Pulmonary Abscess

Pulmonary sequestration is a rare congenital condition wherein a nonfunctional lung segment, arising separately from the true lung bud, develops within the chest cavity but lacks communication with the tracheobronchial tree or pulmonary arterial supply. While this condition is typically diagnosed in children, our case highlights its relevance in adults. We present a 37-year-old male who presented with shortness of breath and was initially diagnosed with a pulmonary abscess. A careful review of CT imaging, particularly noting the vascular supply to abnormal pulmonary lesions, led to the diagnosis of infected pulmonary sequestration. This abnormality had been noted previously, but the patient was unaware of the finding, leaving him at risk of infection and subsequent hospitalization. Although this can be a benign and incidental finding on imaging, this case emphasizes the need for appropriate diagnosis, patient education, and appropriate follow-up to avoid future complications.

Pulmonary Sequestration Masquerading as Pulmonary Abscess

Pulmonary sequestration is a rare congenital condition wherein a nonfunctional lung segment, arising separately from the true lung bud, develops within the chest cavity but lacks communication with the tracheobronchial tree or pulmonary arterial supply. While this condition is typically diagnosed in children, our case highlights its relevance in adults. We present a 37-year-old male who presented with shortness of breath and was initially diagnosed with a pulmonary abscess. A careful review of CT imaging, particularly noting the vascular supply to abnormal pulmonary lesions, led to the diagnosis of infected pulmonary sequestration. This abnormality had been noted previously, but the patient was unaware of the finding, leaving him at risk of infection and subsequent hospitalization. Although this can be a benign and incidental finding on imaging, this case emphasizes the need for appropriate diagnosis, patient education, and appropriate follow-up to avoid future complications.

Extralobar pulmonary sequestration in children with abdominal pain: Four case reports

BACKGROUND

Extralobar pulmonary sequestration (ELS) with torsion is extremely rare, consequently, the diagnosis of ELS with torsion in children presents a challenge for clinicians. Herein, we report four cases of ELS with torsion that presented with abdominal pain, and further review the relevant literature to summarize the clinical features.

CASE SUMMARY

Four children presented to our department with abdominal pain. All underwent chest computed tomography, which revealed an intrathoracic soft tissue mass with pleural effusion. All four children underwent thoracoscopic resection of the identified pulmonary sequestration, and the vascular pedicle was clipped and excised. None of the patients experienced any postoperative complications.

CONCLUSION

Clinicians should consider the possibility of ELS with torsion in children presenting with abdominal pain as the chief complaint.

Epidemiology of congenital diaphragmatic hernia among 24 million Chinese births: a hospital-based surveillance study

BACKGROUND

The prevalence of congenital diaphragmatic hernia (CDH) varies across countries, with limited information available on its epidemiology in China. Our study aimed to investigate the prevalence, time trends, and perinatal outcomes of CDH in China, as well as its associated malformations and potential associations with maternal and infant characteristics.

METHODS

This study included all birth and CDH cases from the Chinese Birth Defects Monitoring Network between 2007 and 2019, with CDH cases classified as either isolated or associated. We employed the joinpoint regression model to calculate the trends of prevalence and the annual percent change, with Poisson regression used for adjusted prevalence rate ratios. A P value ≤ 0.05 was considered statistically significant.

RESULTS

A total of 4397 CDH cases were identified among 24,158,029 births in the study period, yielding prevalence rates of 1.82, 1.13 and 0.69 per 10,000 for overall, isolated, and associated CDH, respectively. The prevalence of each type of CDH increased over time. The prevalence of overall CDH varied significantly by infant sex (male vs. female, 1.91/10,000 vs. 1.63/10,000), maternal residence (urban vs. rural, 2.13/10,000 vs. 1.45/10,000), maternal age (< 20 years, 1.31/10,000; 20-24 years, 1.63/10,000; 25-29 years, 1.80/10,000; 30-34 years, 1.87/10,000; ≥ 35 years, 2.22/10,000), and geographic region (central, 1.64/10,000; east, 2.45/10,000; west, 1.37/10,000). Cardiovascular anomalies were the most common malformations associated with CDH. Infants with associated CDH had a higher risk of premature birth and perinatal death than those with isolated CDH.

CONCLUSION

The increasing prevalence and high perinatal mortality rate of CDH highlight the need for further etiological, epidemiological, and clinical studies among the Chinese population. Video Abstract.

Expression, Functional Polymorphism, and Diagnostic Values of MIAT rs2331291 and H19 rs217727 Long Non-Coding RNAs in Cerebral Ischemic Stroke Egyptian Patients

Cerebral ischemic stroke (CIS) is a severe cerebral vascular event. This research aimed to evaluate the role of single-nucleotide polymorphisms (SNPs) of the lncRNAs MIAT rs2331291 and H19 rs217727 and epigenetic methylation in the expression patterns of serum lncRNA H19 in CIS Egyptian patients. It included 80 CIS cases and 40 healthy subjects. Serum MIAT expression levels decreased, whereas serum H19 expression levels increased among CIS compared to controls. For MIAT rs2331291, there were significant differences in the genotypic and allelic frequencies between the CIS and healthy subjects at p = 0.02 and p = 0.0001, respectively. Our findings illustrated a significantly increased MIAT T/T genotype frequency in hypertensive CIS compared to non-hypertensive CIS at p = 0.004. However, H19 rs217727 gene frequency C/C was not significantly higher in non-hypertensive CIS than in hypertensive CIS. The methylation of the H19 gene promoter was significantly higher in CIS patients compared to healthy subjects. The level of MIAT was positively correlated with serum H19 in CIS. Receiver operating characteristics (ROC) analysis revealed that serum MIAT and H19 have a high diagnostic potential for distinguishing CIS subjects from healthy ones. In conclusion, the MIAT-rs2331291 polymorphism might serve as a novel potential indicator of CIS.