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J. S, Upadhyay Z, N. VH, Sathyanarayana SO, Palany R, J. S. Clinical Experience from a Single Tertiary Care Center: Neonatal Diabetes Mellitus with Multiple Epiphyseal Dysplasia-Wolcott-Rallison's Syndrome. J Pediatr Genet 2024; 13:185-189. [PMID: 39086446 PMCID: PMC11288704 DOI: 10.1055/s-0043-57005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 03/11/2023] [Indexed: 08/02/2024]
Abstract
Wolcott-Rallison's syndrome (WRS) is a rare nonautoimmune autosomal recessive disorder characterized by neonatal diabetes mellitus, epiphyseal dysplasia, and growth retardation. This is the most common cause of diabetes mellitus in patients with consanguineous parents. WRS is distinguished from other types of neonatal or early-onset diabetes by clinical characteristics and genetic testing. Here, we report four cases of WRS from South India. All four children reported here were born to consanguineous parents and were diagnosed with neonatal diabetes and skeletal dysplasia. Case 1 is a 13-year-old girl with neonatal diabetes and skeletal dysplasia. Case 2 is a 6-month-old male infant who also has primary hypothyroidism. Case 3 was a girl who lived until the age of 4 years before succumbing to liver failure. Case 4 is an 8-month-old female infant born to a third-degree married couple who presented with neonatal diabetes and diabetic ketoacidosis. Genetic testing revealed that she had WRS, which helps us in the anticipation and early treatment of complications.
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Affiliation(s)
- Shantala J.
- Department of Paediatric and Adolescent Endocrinology, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
| | | | - Vani H. N.
- Department of Paediatric and Adolescent Endocrinology, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
| | - Santhosh Olety Sathyanarayana
- Department of Paediatric and Adolescent Endocrinology, Karnataka Institute of Diabetology, Bengaluru, Karnataka, India
| | - Raghupathy Palany
- Department of Paediatric and Adolescent Endocrinology, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
| | - Shruthi J.
- Department of Endocrinology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
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Aldrian D, Bochdansky C, Kavallar AM, Mayerhofer C, Deeb A, Habeb A, Romera Rabasa A, Khadilkar A, Uçar A, Knoppke B, Zafeiriou D, Lang-Muritano M, Miqdady M, Judmaier S, McLin V, Furdela V, Müller T, Vogel GF. Natural history of Wolcott-Rallison syndrome: A systematic review and follow-up study. Liver Int 2024; 44:811-822. [PMID: 38230874 DOI: 10.1111/liv.15834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/19/2023] [Accepted: 12/22/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND AND AIMS To systematically review the literature for reports on Wolcott-Rallison syndrome, focusing on the spectrum and natural history, genotype-phenotype correlations, patient and native liver survival, and long-term outcomes. METHODS PubMed, Livio, Google Scholar, Scopus and Web of Science databases were searched. Data on genotype, phenotype, therapy, cause of death and follow-up were extracted. Survival and correlation analyses were performed. RESULTS Sixty-two studies with 159 patients met the inclusion criteria and additional 30 WRS individuals were collected by personal contact. The median age of presentation was 2.5 months (IQR 2) and of death was 36 months (IQR 50.75). The most frequent clinical feature was neonatal diabetes in all patients, followed by liver impairment in 73%, impaired growth in 72%, skeletal abnormalities in 59.8%, the nervous system in 37.6%, the kidney in 35.4%, insufficient haematopoiesis in 34.4%, hypothyroidism in 14.8% and exocrine pancreas insufficiency in 10.6%. Episodes of acute liver failure were frequently reported. Liver transplantation was performed in six, combined liver-pancreas in one and combined liver-pancreas-kidney transplantation in two individuals. Patient survival was significantly better in the transplant cohort (p = .0057). One-, five- and ten-year patient survival rates were 89.4%, 65.5% and 53.1%, respectively. Liver failure was reported as the leading cause of death in 17.9% of cases. Overall survival was better in individuals with missense mutations (p = .013). CONCLUSION Wolcott-Rallison syndrome has variable clinical courses. Overall survival is better in individuals with missense mutations. Liver- or multi-organ transplantation is a feasible treatment option to improve survival.
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Affiliation(s)
- Denise Aldrian
- Department of Paediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Clemens Bochdansky
- Department of Paediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna M Kavallar
- Department of Paediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Mayerhofer
- Department of Paediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Asma Deeb
- Paediatric Endocrinology Division, Sheikh Shakhbout Medical City, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Abdelhadi Habeb
- Department of Pediatrics, Prince Mohamed bin Abdulaziz Hospital, National Guard Health Affairs, Madinah, Saudi Arabia
| | - Andrea Romera Rabasa
- Department of Pediatric Anesthesia, Gregorio Marañón University Hospital, Madrid, Spain
| | - Anuradha Khadilkar
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India
| | - Ahmet Uçar
- Department of Pediatric Endocrinology & Diabetes, University of Health Sciences, Şişli Hamidiye Etfal Health Practices & Research Centre, Istanbul, Turkey
| | - Birgit Knoppke
- University Children's Hospital Regensburg (KUNO), University Medical Center Regensburg, Regensburg, Germany
| | - Dimitrios Zafeiriou
- 1st Department of Pediatrics, Hippokratio General Hospital, Aristotle University, Thessaloniki, Greece
| | - Mariarosaria Lang-Muritano
- Department of Endocrinology and Diabetology and Children's Research Centre, University Children's Hospital, Zurich, Switzerland
| | - Mohamad Miqdady
- Division of Pediatric Gastroenterology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Sylvia Judmaier
- Department of Paediatrics, LKH Hochsteiermark/Standort Leoben, Leoben, Austria
| | - Valerié McLin
- Department of Pediatrics, Gynecology and Obstetrics, Swiss Pediatric Liver Center, University of Geneva, Geneva, Switzerland
| | - Viktoriya Furdela
- Department of Pediatrics, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Thomas Müller
- Department of Paediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Georg F Vogel
- Department of Paediatrics I, Medical University of Innsbruck, Innsbruck, Austria
- Institute of Cell Biology, Medical University of Innsbruck, Innsbruck, Austria
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Cho S, Shlobin NA, Dahdaleh NS. Os odontoideum: A comprehensive review. JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE 2022; 13:256-264. [PMID: 36263339 PMCID: PMC9574117 DOI: 10.4103/jcvjs.jcvjs_71_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 07/31/2022] [Indexed: 11/10/2022] Open
Abstract
Os odontoideum (OO) is a rare craniocervical anomaly that is characterized by a round ossicle separated from the C2 vertebral body. With a controversial etiology and unknown prevalence in the population, OO may be asymptomatic or present in patients with myelopathic and neurological symptoms. In this literature review, we aimed to investigate epidemiology, embryology, pathophysiology, clinical presentation, and the role of diagnostic radiography in OO. By providing an overview of different management strategies, surgical complications, and postoperative considerations for OO, our findings may guide neurosurgeons in providing proper diagnosis and treatment for OO patients. A literature review was conducted using the PubMed, EMBASE, and Scopus databases. A search using the query "os odontoideum" yielded 4319 results, of which 112 articles were chosen and analyzed for insights on factors such as etiology, clinical presentation, and management of OO. The presentation of OO varies widely from asymptomatic cases to severe neurological deficits. Asymptomatic patients can be managed either conservatively or surgically, while symptomatic patients should undergo operative stabilization. Although multiple studies show different techniques for surgical management involving posterior fusion, the diversity of such cases illustrates how treatment must be tailored to the individual patient to prevent complications. Conflicting studies and the paucity of current literature on OO highlight poor comprehension of the condition. Further understanding of the natural history of OO is critical to form evidence-based guidelines for the management of OO patients. More large-center studies are thus needed to promote accurate management of OO patients with optimal outcomes.
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Affiliation(s)
- Sia Cho
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Nathan A. Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Nader S. Dahdaleh
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Yerramneni VK, Sharma N. Os Odontoideum: A Single-Center Experience with Controversies in Management and Evolution of Treatment Strategies. INDIAN JOURNAL OF NEUROSURGERY 2021. [DOI: 10.1055/s-0039-1686960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
AbstractOs odontoideum is an independent ossicle of variable size and shape separated from the body of C2. There are various theories on the etiology. Different hypothesis on etiology include traumatic and congenital. Because of the laxity of the ligaments associated with the anomalous odontoid, there can be associated instability at the craniovertebral junction. The authors presented their experience of treating these anomalies, their clinical presentations, evolution of the treatment strategies over years, and a brief review of literature on etiopathogenesis.
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Affiliation(s)
- Vamsi Krishna Yerramneni
- Department of Neurosurgery, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India
| | - Neeraj Sharma
- Department of Neurosurgery, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India
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Yang J, Dong C, Duan H, Shu Q, Li H. RDmap: a map for exploring rare diseases. Orphanet J Rare Dis 2021; 16:101. [PMID: 33632281 PMCID: PMC7905868 DOI: 10.1186/s13023-021-01741-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 02/11/2021] [Indexed: 02/01/2023] Open
Abstract
Background The complexity of the phenotypic characteristics and molecular bases of many rare human genetic diseases makes the diagnosis of such diseases a challenge for clinicians. A map for visualizing, locating and navigating rare diseases based on similarity will help clinicians and researchers understand and easily explore these diseases. Methods A distance matrix of rare diseases included in Orphanet was measured by calculating the quantitative distance among phenotypes and pathogenic genes based on Human Phenotype Ontology (HPO) and Gene Ontology (GO), and each disease was mapped into Euclidean space. A rare disease map, enhanced by clustering classes and disease information, was developed based on ECharts. Results A rare disease map called RDmap was published at http://rdmap.nbscn.org. Total 3287 rare diseases are included in the phenotype-based map, and 3789 rare genetic diseases are included in the gene-based map; 1718 overlapping diseases are connected between two maps. RDmap works similarly to the widely used Google Map service and supports zooming and panning. The phenotype similarity base disease location function performed better than traditional keyword searches in an in silico evaluation, and 20 published cases of rare diseases also demonstrated that RDmap can assist clinicians in seeking the rare disease diagnosis. Conclusion RDmap is the first user-interactive map-style rare disease knowledgebase. It will help clinicians and researchers explore the increasingly complicated realm of rare genetic diseases.
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Affiliation(s)
- Jian Yang
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Binsheng Road 3333#, Hangzhou, Zhejiang, 310052, China.,The College of Biomedical Engineering and Instrument Science, Zhejiang University, Zhejiang, China
| | - Cong Dong
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Binsheng Road 3333#, Hangzhou, Zhejiang, 310052, China.,The College of Biomedical Engineering and Instrument Science, Zhejiang University, Zhejiang, China
| | - Huilong Duan
- The College of Biomedical Engineering and Instrument Science, Zhejiang University, Zhejiang, China
| | - Qiang Shu
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Binsheng Road 3333#, Hangzhou, Zhejiang, 310052, China
| | - Haomin Li
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Binsheng Road 3333#, Hangzhou, Zhejiang, 310052, China.
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Zhao N, Yang Y, Li P, Xiong Q, Xiao H, Wu C. Identification of Two Novel Compound Heterozygous EIF2AK3 Mutations Underlying Wolcott-Rallison Syndrome in a Chinese Family. Front Pediatr 2021; 9:679646. [PMID: 34123975 PMCID: PMC8187601 DOI: 10.3389/fped.2021.679646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 04/12/2021] [Indexed: 11/23/2022] Open
Abstract
Objective: Wolcott-Rallison syndrome is a rare autosomal recessive inheritance disorder caused by the defectiveness of eukaryotic translation initiation factor 2 alpha kinase 3 (EIF2AK3), which encodes the PKR-like endoplasmic reticulum kinase (PERK). Defect in EIF2AK3 results in a permanent diabetes in early infancy or newborn period, a tendency to develop skeletal fractures and other associated disorders such as severe liver and renal dysfunction, and central hypothyroidism. Two patients with Wolcott-Rallison syndrome-like manifestations in a Chinese family and family members were genetically analyzed to identify if any variations that occurred in EIF2AK3, which may cause Wolcott-Rallison syndrome. Methods: Whole-exome sequencing (WES) was performed to identify genetic variations, and Sanger sequencing was conducted to verify the identified variations in the family members with Wolcott-Rallison syndrome (WRS) clinical manifestations. Several bioinformatics tools were employed to predict the effect of EIF2AK3 variations on the protein function. The impact on PERK protein was analyzed by sequential analysis and evolution conservation study. Results: Two novel EIF2AK3 heterozygous single base variations (c.2818C>T and c.2980G>C) were detected in the proband. PERK has two functional domains: one is regulatory domain (aa 1-576), and the other is catalytic domain (aa 577-1,115). Both variations are missense mutations and locate in catalytic domain of PERK; c.2818C>T resulted in a residue substitution of proline for serine at amino acid site 940 (p.Pro940Ser), and variation c.2980G>C caused an amino acid change at position 994 from glutamic acid to glutamine (p.Glu994Gln). These novel missense variations may affect the physiological functions of PERK protein. Conclusions: Two novel compound heterozygous EIF2AK3 variations (c.2818C>T, p.Pro940Ser and c.2980G>C, p.Glu994Gln) were found in a Chinese family. The identification of the variations and verification of their pathogenicity extended the variation spectrum of EIF2AK3 variations causing Wolcott-Rallison syndrome and enriched valuable information for precise medical intervention for Wolcott-Rallison syndrome in China.
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Affiliation(s)
- Na Zhao
- Institutes of Biomedical Sciences, Key Laboratory of Chemical Biology and Molecular Engineering of National Ministry of Education, Shanxi University, Taiyuan, China
| | - Yanling Yang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Ping Li
- Institutes of Biomedical Sciences, Key Laboratory of Chemical Biology and Molecular Engineering of National Ministry of Education, Shanxi University, Taiyuan, China
| | - Qiuhong Xiong
- Institutes of Biomedical Sciences, Key Laboratory of Chemical Biology and Molecular Engineering of National Ministry of Education, Shanxi University, Taiyuan, China
| | - Han Xiao
- Institutes of Biomedical Sciences, Key Laboratory of Chemical Biology and Molecular Engineering of National Ministry of Education, Shanxi University, Taiyuan, China
| | - Changxin Wu
- Institutes of Biomedical Sciences, Key Laboratory of Chemical Biology and Molecular Engineering of National Ministry of Education, Shanxi University, Taiyuan, China
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Raj A, Srivastava SK, Marathe N, Bhosale S, Purohit S. Dystopic Os Odontoideum Causing Cervical Myelopathy: A Rare Case Report and Review of Literature. Asian J Neurosurg 2020; 15:236-240. [PMID: 32181211 PMCID: PMC7057904 DOI: 10.4103/ajns.ajns_35_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 01/10/2020] [Indexed: 11/30/2022] Open
Abstract
Os odontoideum (OO) was first described by Giacomini in 1886 as separation of the odontoid process from the body of the axis. Instability can consequently occurs at this level due to the failure of the transverse atlantal ligament (TAL) and this atlantoaxial instability can be a cause of progressive neurological deficits. It is considered a rare anomaly of the odontoid process. It is a disease with controversial etiology, debatable incidence, and only a partly known natural history owing to the paucity of the literature on this topic. There are insufficient demographic data about the occurrence of the disease, and most of the management is dictated by the isolated case reports and few studies which have been carried out at handful of institutes. OO is classified into two types by Fielding et al. based on the anatomic location: orthotopic and dystopic. Orthotopic OO consists of an ossicle that moves with the anterior arch of the atlas, whereas the dystopic type presents as an ossicle near the basion or one that is fused with the clivus. In one magnetic resonance imaging (MRI) study of odontoid morphology, a 0.7% (1 case of 133 patients) incidence was reported. The spectrum of the clinical presentation varies from completely asymptomatic individuals to patients presenting with features of cervical myelopathy. Here, we present a case of 35-year-old-male with dystopic OO who presented to us with features of gradually progressing cervical myelopathy without any obvious history of neck trauma. On investigations, he was found to have atlantoaxial instability with wide atlanto-dens interval. He was treated with the posterior C1-C2 stabilization and reduction of atlantoaxial instability.
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Affiliation(s)
- Aditya Raj
- Department of Orthopaedics, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Sudhir Kumar Srivastava
- Department of Orthopaedics, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Nandan Marathe
- Department of Orthopaedics, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Sunil Bhosale
- Department of Orthopaedics, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Shaligram Purohit
- Department of Orthopaedics, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
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Buntting CS, Dower A, Seghol H, Kohan S. Os odontoideum: a rare cause of syncope. BMJ Case Rep 2019; 12:12/11/e230945. [PMID: 31780615 DOI: 10.1136/bcr-2019-230945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Syncopal events are a concerning presentation and timely evaluation is warranted. Common aetiologies include cardiac and neurological pathology such as arrhythmias, vertebrobasilar arterial disease and vasovagal syncope. We describe the case of a 65-year-old man who presented to our emergency department with symptoms of vertigo and syncope. He was investigated extensively for both cardiac and neurological causes of his symptoms which returned negative results. An outpatient CT scan demonstrated the presence of Os odontoideum and dynamic instability of the atlantoaxial junction, with presumed dynamic obstruction of the vertebral arterial system. This was successfully managed with a posterior atlantoaxial lateral mass fusion with resolution of syncopal symptoms.
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Affiliation(s)
| | - Ashraf Dower
- Neurosurgery, NSW Health, Kogarah, New South Wales, Australia
| | - Haider Seghol
- Neurosurgery, NSW Health, Kogarah, New South Wales, Australia
| | - Saeed Kohan
- Neurosurgery, NSW Health, Kogarah, New South Wales, Australia
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Wang Q, Dong S, Wang F. Os odontoideum: diagnosis and role of imaging. Surg Radiol Anat 2019; 42:155-160. [PMID: 31616983 DOI: 10.1007/s00276-019-02351-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 09/25/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To elucidate the imaging manifestations of os odontoideum, establish the diagnosis and guide surgical therapy. METHODS Clinical and imaging data, including X-ray, CT and MR of 24 patients with os odontoideum, were retrieved and reviewed retrospectively. RESULTS Os odontoideum with intact cortex was divided into round, conical and blunt tooth types. Four cases of orthotopic and 20 cases of dystopic os odontoideum were included. There was anterior displacement of the base of the dens in six cases, posterior displacement in nine cases and no displacement in nine cases. A widening of anterior atlanto-axial space was shown in 14 patients with varying degrees. Thickening of the soft tissue posterior to the dens was observed in 19 patients, spinal canal stenosis in 21 patients, cervical myelopathy in 10 patients and craniocervical junction malformation in 9 patients. Posterior C1-C2 pedicle screw fixation and fusion was performed in 12 patients and 4 patients underwent posterior occipito-cervical fixation and fusion. CONCLUSION Radiographically, os odontoideum is defined as an independent ossicle of variable size with smooth circumferential cortical margins separated from the axis. Imaging can be used to assess atlanto-axial instability, associated normal or abnormal anatomical structures and guide surgical therapy.
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Affiliation(s)
- Qing Wang
- Department of Radiology, QiLu Hospital of ShanDong University, Jinan, Shandong, China
| | - Shuai Dong
- Department of Radiology, ShanDong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Fang Wang
- Department of Radiology, QiLu Hospital of ShanDong University, Jinan, Shandong, China.
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Asl SN, Vakili R, Vakili S, Soheilipour F, Hashemipour M, Ghahramani S, De Franco E, Yaghootkar H. Wolcott-Rallison syndrome in Iran: a common cause of neonatal diabetes. J Pediatr Endocrinol Metab 2019; 32:607-613. [PMID: 31141482 DOI: 10.1515/jpem-2018-0434] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 04/17/2019] [Indexed: 11/15/2022]
Abstract
Background Wolcott-Rallison syndrome is a rare autosomal recessive disorder characterized by neonatal/early-onset non-autoimmune insulin-dependent diabetes, multiple epiphyseal dysphasia and growth retardation. It is caused by mutations in the gene encoding eukaryotic translation initiation factor 2α kinase 3 (EIF2AK3). We aimed to study the clinical characteristics and frequency of the disease in the Iranian population. Methods We recruited 42 patients who referred to the endocrine and metabolism clinic at Mashhad Imam Reza Hospital with neonatal diabetes. Molecular screening of KCNJ11, INS, ABCC8 and EIF2AK3 was performed at the Exeter Molecular Genetics Laboratory, UK. We calculated the frequency of the disease in 124 patients referred from Iran to the Exeter Molecular Genetics Laboratory for genetic screening and compared it to other countries worldwide. Results We identified seven patients as having Wolcott-Rallison syndrome. Genetic testing confirmed the clinical diagnosis and indicated five novel mutations. Only two patients developed clinical features of the syndrome by 6 months of age. Of all 124 cases of Iranian neonatal diabetes referred to the Exeter Molecular Genetics Laboratory for genetic screening, 28 patients (22.58%) had a recessive mutation in EIF2AK3. Conclusions The results of this study raises awareness of the condition and provides further accurate data on the genetic and clinical presentation of Wolcott-Rallison syndrome in the Iranian population. Our study highlights the importance of genetic testing in patients from consanguineous families with diabetes diagnosed within the first 6 months of life.
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Affiliation(s)
- Samaneh Noroozi Asl
- Department of Pediatric Disease, Faulty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Rahim Vakili
- Department of Pediatric Disease, Faulty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saba Vakili
- Department of Pediatric Disease, Faulty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fahimeh Soheilipour
- Minimally Invasive Surgery Research Center, Rasoul-e-Akram Hospital, Iran University of Medical Science, Tehran, Iran
| | - Mahin Hashemipour
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sara Ghahramani
- Department of Pediatric Disease, Faulty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elisa De Franco
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Hanieh Yaghootkar
- Genetics of Complex Traits, University of Exeter Medical School, Medical Research - Level 3, Royal Devon and Exeter Hospital, Barrack Road, Exeter EX2 5DW, UK
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Wolcott-Rallison Syndrome With Different Clinical Presentations and Genetic Patterns in 2 Infants. Health Care Manag (Frederick) 2018; 37:354-357. [DOI: 10.1097/hcm.0000000000000238] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abbasi F, Habibi M, Enayati S, Bitarafan F, Razzaghy-Azar M, Sotodeh A, Omran SP, Maroofian R, Amoli MM. A Genotype-First Approach for Clinical and Genetic Evaluation of Wolcott-Rallison Syndrome in a Large Cohort of Iranian Children With Neonatal Diabetes. Can J Diabetes 2018; 42:272-275. [DOI: 10.1016/j.jcjd.2017.06.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 06/12/2017] [Accepted: 06/21/2017] [Indexed: 11/15/2022]
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Sanchis-Gimeno JA, Llido S, Miquel-Feutch M, Quiles-Guinau L, Rios L, Murillo-Llorente M, Perez-Bermejo M, Nalla S. The Decreasing Prevalence of the Arcuate Foramen. World Neurosurg 2018; 110:521-525. [DOI: 10.1016/j.wneu.2017.10.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 10/03/2017] [Accepted: 10/06/2017] [Indexed: 11/26/2022]
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Jumah F, Alkhdour S, Mansour S, He P, Hroub A, Adeeb N, Hanif R, Mortazavi MM, Tubbs RS, Nanda A. Os Odontoideum: A Comprehensive Clinical and Surgical Review. Cureus 2017; 9:e1551. [PMID: 29018648 PMCID: PMC5630463 DOI: 10.7759/cureus.1551] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Os odontoideum (OO) is a rare anomaly of the odontoid process first described by Giacomini in 1886. There is considerable debate about the origin of this anomaly, whether congenital or acquired, though a growing body of evidence favors the latter. Using PubMed, we reviewed the literature on OO with regards to its etiology, clinical presentations, diagnostic modalities, and management. Manuscripts cited in reviews were also searched manually. Because the medical literature on this condition is limited, our understanding of the natural history and management of OO is still vague. The management guidelines for asymptomatic OO are preliminary. Therefore, we need more large-center studies to investigate this condition further.
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Affiliation(s)
- Fareed Jumah
- School of Medicine, An-najah National University Hospital, Nablus, Palestine
| | - Saja Alkhdour
- School of Medicine, An-najah National University Hospital, Nablus, Palestine
| | - Shaden Mansour
- School of Medicine, An-najah National University Hospital, Nablus, Palestine
| | - Puhan He
- Harvard School of Dental Medicine, Harvard University
| | - Ali Hroub
- School of Medicine, An-najah National University Hospital, Nablus, Palestine
| | - Nimer Adeeb
- Department of Neurosurgery, Louisiana State University, Shreveport, LA
| | - Rimal Hanif
- Department of Neurosurgery, Louisiana State University, Shreveport, LA
| | - Martin M Mortazavi
- California Institute of Neuroscience, Los Robles Hospital and Medical Center
| | | | - Anil Nanda
- Department of Neurosurgery, Louisiana State University, Shreveport, LA
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15
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Mc Kiernan PJ. Recent advances in liver transplantation for metabolic disease. J Inherit Metab Dis 2017; 40:491-495. [PMID: 28168361 DOI: 10.1007/s10545-017-0020-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 01/18/2017] [Accepted: 01/23/2017] [Indexed: 02/07/2023]
Abstract
The indications and outcomes of liver transplantation for metabolic disease have been reviewed recently and this short review concentrates on recent developments and advances. Recently recognized metabolic causes of acute liver failure are reviewed and their implications for transplantation discussed. Newly described indications for liver transplantation in systemic metabolic diseases are described and an update is given on the role of auxiliary and domino liver transplantation.
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MESH Headings
- Amino Acid Metabolism, Inborn Errors/genetics
- Amino Acid Metabolism, Inborn Errors/surgery
- Animals
- Brain Diseases, Metabolic, Inborn/genetics
- Brain Diseases, Metabolic, Inborn/surgery
- Diabetes Mellitus, Type 1/genetics
- Diabetes Mellitus, Type 1/surgery
- Enzyme Replacement Therapy
- Epiphyses/abnormalities
- Epiphyses/surgery
- Glycine N-Methyltransferase/deficiency
- Glycine N-Methyltransferase/genetics
- Humans
- Intestinal Pseudo-Obstruction/genetics
- Intestinal Pseudo-Obstruction/surgery
- Liver Failure, Acute/surgery
- Liver Neoplasms/surgery
- Liver Transplantation/trends
- Metabolic Diseases/surgery
- Mitochondrial Encephalomyopathies/genetics
- Mitochondrial Encephalomyopathies/surgery
- Muscular Dystrophy, Oculopharyngeal
- Neoplasm Proteins/genetics
- Ophthalmoplegia/congenital
- Osteochondrodysplasias/genetics
- Osteochondrodysplasias/surgery
- Purpura/genetics
- Purpura/surgery
- Refsum Disease, Infantile/genetics
- Refsum Disease, Infantile/surgery
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Affiliation(s)
- P J Mc Kiernan
- Division of Gastroenterology/Hepatology/Nutrition Children's Hospital of Pittsburgh of UPMC, Pittsburgh Liver Research Centre, University of Pitttsburgh, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA.
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