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Alsamal M, Zitoun OA, Abdulghani EA, Sula I. Meckel-Gruber syndrome together with Dandy-Walker malformation: an atypical case report of a 2nd recurrence in a consanguine marriage. Childs Nerv Syst 2024; 40:257-261. [PMID: 37530877 DOI: 10.1007/s00381-023-06104-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 07/23/2023] [Indexed: 08/03/2023]
Abstract
Meckel-Gruber syndrome is a lethal disorder characterized by occipital encephalocele, polycystic kidneys, and polydactyly. In most cases, it is identified and terminated antenatally. In this report, the authors present a case of Meckel-Gruber syndrome together with Dandy-Walker malformation. A pregnant woman referred at the 28th week of gestation with an abnormal ultrasound scan showing posterior encephalocele and bilaterally enlarged kidneys. Further imaging also indicated communication between the 4th ventricle and posterior cerebellar cerebrospinal fluid space, after which the fetus was diagnosed with Meckel-Gruber syndrome and Dandy-Walker malformation. Pregnancy termination was refused by the parents and the offspring was prematurely born to be the 2nd recurrence of Meckel-Gruber syndrome in this consanguine family. Remarkably, at the 3 different pregnancies, ultrasound was inconclusive before the 7th month of gestation. Though up to date Meckel-Gruber syndrome is ultimately lethal, the lifespan of affected newborns varied greatly. We suggest developing a severity classification to estimate life expectancy in unterminated cases.
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Affiliation(s)
- Mohamad Alsamal
- College of Medicine, Sulaiman Al Rajhi University, P.O. Box 777, Bukaryiah, 51941, Saudi Arabia.
- Dr. Sulaiman Al Habib Medical Group, Al Qassim, Saudi Arabia.
| | - Osama A Zitoun
- College of Medicine, Sulaiman Al Rajhi University, P.O. Box 777, Bukaryiah, 51941, Saudi Arabia
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | | | - Idris Sula
- College of Medical Applied Sciences, Sulaiman Al Rajhi University, P.O. Box 777, Bukaryiah, 51941, Saudi Arabia
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Prenatal Exome Sequencing in Recurrent Fetal Structural Anomalies: Systematic Review and Meta-Analysis. J Clin Med 2021; 10:jcm10204739. [PMID: 34682862 PMCID: PMC8538791 DOI: 10.3390/jcm10204739] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/04/2021] [Accepted: 10/13/2021] [Indexed: 01/14/2023] Open
Abstract
To determine the diagnostic yield of exome sequencing (ES), a microarray analysis was carried out of fetuses with recurrent fetal structural anomalies (with similar anomalies in consecutive pregnancies). This is a systematic review conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The selected studies describing ES in fetuses with recurrent fetal malformation were assessed using the Standards for Reporting of Diagnostic Accuracy Studies (STARD) criteria for risk of bias. Incidence was used as the pooled effect size by single-proportion analysis using random-effects modeling (weighted by inverse of variance). We identified nine studies on ES diagnostic yield that included 140 fetuses with recurrent structural anomalies. A pathogenic or likely pathogenic variant was found in 57 fetuses, resulting in a 40% (95%CI: 26% to 54%) incremental performance pool of ES. As expected, the vast majority (86%: 36/42) of the newly identified diseases had a recessive inheritance pattern, and among these, 42% (15/36) of variants were found in homozygosity. Meckel syndrome was the monogenic disease most frequently found, although the genes involved were diverse. The ES diagnostic yield in pregnancies with recurrent fetal structural anomalies was 40% (57/140). Homozygous disease-causing variants were found in 36% (15/57) of the newly identified monogenic disorders.
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Ridnõi K, Šois M, Vaidla E, Pajusalu S, Kelder L, Reimand T, Õunap K. A prenatally diagnosed case of Meckel-Gruber syndrome with novel compound heterozygous pathogenic variants in the TXNDC15 gene. Mol Genet Genomic Med 2019; 7:e614. [PMID: 30851085 PMCID: PMC6503012 DOI: 10.1002/mgg3.614] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 01/16/2019] [Accepted: 02/11/2019] [Indexed: 11/10/2022] Open
Abstract
Background Meckel–Gruber syndrome (MKS) is a well‐known rare disease that can be detected on prenatal ultrasound. Meckel–Gruber syndrome has very heterogeneous etiology; at least, 17 genes have been described in association with MKS. The characteristic findings in fetuses affected by MKS are encephalocele (usually occipital), postaxial polydactyly, and polycystic dysplastic kidneys. However, the association of the TXNDC15 gene with MKS has been reported only once before in three consanguineous families. Methods We report a new case of MKS diagnosed at 12 + 1 weeks of gestation with typical ultrasound findings, but with novel compound heterozygous pathogenic variants in the TXNDC15 gene identified by whole‐exome sequencing (WES). Results This is the second clinical report supporting TXNDC15 as a novel causative gene of MKS, and the first describing a case in a non‐consanguineous family with causative compound heterozygous mutations. Conclusions Meckel–Gruber syndrome is a very heterogeneous syndrome in terms of the associated causal genes. In the first‐line diagnosis, we used an next‐generation sequencing (NGS)‐based large gene panel, but only 10 MKS genes were available on the platform used. In the case of prenatal ultrasound findings that are highly suggestive of MKS and a negative NGS MKS gene panel, WES should also be performed to not miss rare gene associations.
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Affiliation(s)
- Konstantin Ridnõi
- Centre for Perinatal Care, Women's Clinic, East-Tallinn Central Hospital, Tallinn, Estonia.,Department of Clinical Genetics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Marek Šois
- Fetal Ultrasound Screening Centre, Tallinn, Estonia
| | - Eve Vaidla
- United Laboratories, Department of Clinical Genetics, Tartu University Hospital, Tartu, Estonia
| | - Sander Pajusalu
- United Laboratories, Department of Clinical Genetics, Tartu University Hospital, Tartu, Estonia.,Department of Genetics, Yale University School of Medicine, New Haven, Connecticut
| | - Larissa Kelder
- Centre of Pathology, Diagnostic Clinic, East-Tallinn Central Hospital, Tallinn, Estonia
| | - Tiia Reimand
- United Laboratories, Department of Clinical Genetics, Tartu University Hospital, Tartu, Estonia.,Department of Biomedicine, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Katrin Õunap
- Department of Clinical Genetics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.,United Laboratories, Department of Clinical Genetics, Tartu University Hospital, Tartu, Estonia
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Cierna Z, Janega P, Grochal F, Ferianec V, Braxatorisova T, Strieskova L, Malova J, Jungova P, Szemes T. The First Reported Case of Meckel-Gruber Syndrome Associated With Abnormal Karyotype Mosaic Trisomy 17. Pediatr Dev Pathol 2017; 20:449-454. [PMID: 28812468 DOI: 10.1177/1093526616689184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Meckel-Gruber syndrome (MKS) is a rare lethal autosomal recessive disorder with typical anomalies including encephalocele, multicystic renal dysplasia, congenital liver fibrosis, and polydactyly. MKS is caused by mutations of genes localized on different chromosomes. Karyotypes of published Meckel-Gruber syndrome cases are without any aberrations. We present a male fetus with meningoencephalocele, multicystic renal dysplasia, congenital liver fibrosis, and other anomalies. Standard cytogenetic examination of cultured fetal skin and muscle fibroblasts showed mosaic trisomy 17. Homozygous deletion in CC2D2A gene was found by Sanger sequencing. This is to our knowledge the first case of genetically confirmed Meckel-Gruber syndrome with incidental cofinding of mosaic trisomy 17. Abnormal karyotype does not exclude diagnosis of MKS with risk of recurrence 25% in next pregnancy. In the case of anomalies typical for Meckel-Gruber syndrome, genetic analysis is indicated.
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Affiliation(s)
- Zuzana Cierna
- 1 Department of Pathology, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic.,2 Medirex group academy, n.o., Bratislava, Slovak Republic
| | - Pavol Janega
- 1 Department of Pathology, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic.,2 Medirex group academy, n.o., Bratislava, Slovak Republic.,3 Institute of Normal and Pathological Physiology, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Frantisek Grochal
- 4 Femicare, s.r.o., Center of prenatal ultrasonographic diagnostics, Martin, Slovak republic.,5 UVN SNP Ruzomberok, Gynecological and Obstetrical Department, Faculty of Health Care, Catholic University in Ruzomberok, Ruzomberok, Slovak Republic
| | - Vladimir Ferianec
- 6 2nd Department of Gynaecology and Obstetrics, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic
| | - Tatiana Braxatorisova
- 7 Institute of Medical biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic
| | - Lucia Strieskova
- 8 Geneton, s.r.o., Bratislava, Slovak Republic.,9 Faculty of Natural Sciences, Comenius University, Bratislava, Slovak Republic
| | - Jana Malova
- 7 Institute of Medical biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic
| | - Petra Jungova
- 7 Institute of Medical biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic
| | - Tomas Szemes
- 8 Geneton, s.r.o., Bratislava, Slovak Republic.,9 Faculty of Natural Sciences, Comenius University, Bratislava, Slovak Republic.,10 Comenius University Science Park, Comenius University, Bratislava, Slovak Republic
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Sawardekar KP. Meckel–Gruber syndrome: prevalence from a hospital-based study in Oman. J Matern Fetal Neonatal Med 2016; 29:3696-8. [DOI: 10.3109/14767058.2016.1141883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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