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Bolunduț AC, Nazarie F, Lazea C, Șufană C, Miclea D, Lazăr C, Mihu CM. A Pilot Study of Multiplex Ligation-Dependent Probe Amplification Evaluation of Copy Number Variations in Romanian Children with Congenital Heart Defects. Genes (Basel) 2024; 15:207. [PMID: 38397197 PMCID: PMC10887610 DOI: 10.3390/genes15020207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 01/31/2024] [Accepted: 02/04/2024] [Indexed: 02/25/2024] Open
Abstract
Congenital heart defects (CHDs) have had an increasing prevalence over the last decades, being one of the most common congenital defects. Their etiopathogenesis is multifactorial in origin. About 10-15% of all CHD can be attributed to copy number variations (CNVs), a type of submicroscopic structural genetic alterations. The aim of this study was to evaluate the involvement of CNVs in the development of congenital heart defects. We performed a cohort study investigating the presence of CNVs in the 22q11.2 region and GATA4, TBX5, NKX2-5, BMP4, and CRELD1 genes in patients with syndromic and isolated CHDs. A total of 56 patients were included in the study, half of them (28 subjects) being classified as syndromic. The most common heart defect in our study population was ventricular septal defect (VSD) at 39.28%. There were no statistically significant differences between the two groups in terms of CHD-type distribution, demographical, and clinical features, with the exceptions of birth length, weight, and length at the time of blood sampling, that were significantly lower in the syndromic group. Through multiplex ligation-dependent probe amplification (MLPA) analysis, we found two heterozygous deletions in the 22q11.2 region, both in patients from the syndromic group. No CNVs involving GATA4, NKX2-5, TBX5, BMP4, and CRELD1 genes were identified in our study. We conclude that the MLPA assay may be used as a first genetic test in patients with syndromic CHD and that the 22q11.2 region may be included in the panels used for screening these patients.
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Affiliation(s)
- Alexandru Cristian Bolunduț
- 1st Department of Pediatrics, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400370 Cluj-Napoca, Romania
| | - Florina Nazarie
- Department of Medical Genetics, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Cecilia Lazea
- 1st Department of Pediatrics, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400370 Cluj-Napoca, Romania
- 1st Pediatrics Clinic, Emergency Pediatric Clinical Hospital, 400370 Cluj-Napoca, Romania
| | - Crina Șufană
- 1st Pediatrics Clinic, Emergency Pediatric Clinical Hospital, 400370 Cluj-Napoca, Romania
| | - Diana Miclea
- 1st Department of Pediatrics, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400370 Cluj-Napoca, Romania
- Medical Genetics Compartment, Emergency Pediatric Clinical Hospital, 400370 Cluj-Napoca, Romania
| | - Călin Lazăr
- 1st Department of Pediatrics, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400370 Cluj-Napoca, Romania
- 1st Pediatrics Clinic, Emergency Pediatric Clinical Hospital, 400370 Cluj-Napoca, Romania
| | - Carmen Mihaela Mihu
- Department of Histology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
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Miclea D, Osan S, Bucerzan S, Stefan D, Popp R, Mager M, Puiu M, Zimbru C, Chirita-Emandi A, Alkhzouz C. Copy number variation analysis in 189 Romanian patients with global developmental delay/intellectual disability. Ital J Pediatr 2022; 48:207. [PMID: 36585697 PMCID: PMC9801529 DOI: 10.1186/s13052-022-01397-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 12/13/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Developmental delay and intellectual disability represent a common pathology in general population, involving about 3% of the pediatric age population, the genetic etiology being often involved. The aim of this study was to determine the clinically relevant copy number variants in patients diagnosed with global developmental delay/intellectual disability in our population, using the chromosomal microarray analysis. METHODS We analyzed 189 patients diagnosed with global developmental delay/intellectual disability, presented in Clinical Emergency Hospital for Children, Cluj-Napoca. The patients were completely clinically investigated, including dysmorphic and internal malformations evaluation, psychiatric, neuropsychological and metabolic evaluation, standard karyotyping. Genomic analysis was done using chromosomal microarray analysis. RESULTS Pathogenic findings (including uniparental disomy) and variants of unknown significance were detected in 53 of 189 patients (28.04%). Pathogenic copy number variants and uniparental disomy were observed in 35 of 189 patients (18.51%). Two patients presented uniparental disomy for chromosome 15, one with clinical phenotype of Prader-Willi syndrome and the other with clinical phenotype with Angelman syndrome. Within the category of pathogenic findings, the recurrent copy number variants were seen in 21 of 35 patients (60%). CONCLUSIONS The increased percentage of pathogenic structural variants observed in patients with global developmental delay/intellectual disability analyzed by chromosomal microarray technique supports its use in patients with a non-specific phenotype such as these neurodevelopmental disorders. The high percentage of recurrent pathogenic variants between these findings is a finding that support their initial evaluation when a genetic testing algorithm could be a useful option.
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Affiliation(s)
- Diana Miclea
- grid.411040.00000 0004 0571 5814Department of Molecular Sciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, Pasteur Street, No 6, 400349 Cluj-Napoca, Romania ,Emergency Clinical Hospital for Children, Pasteur Street, No 6, 400349 Cluj-Napoca, Romania
| | - Sergiu Osan
- grid.411040.00000 0004 0571 5814Department of Molecular Sciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, Pasteur Street, No 6, 400349 Cluj-Napoca, Romania
| | - Simona Bucerzan
- Emergency Clinical Hospital for Children, Pasteur Street, No 6, 400349 Cluj-Napoca, Romania ,grid.411040.00000 0004 0571 5814Department of Mother and Child, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Delia Stefan
- grid.411040.00000 0004 0571 5814Department of Molecular Sciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, Pasteur Street, No 6, 400349 Cluj-Napoca, Romania
| | - Radu Popp
- grid.411040.00000 0004 0571 5814Department of Molecular Sciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, Pasteur Street, No 6, 400349 Cluj-Napoca, Romania
| | - Monica Mager
- Emergency Clinical Hospital for Children, Pasteur Street, No 6, 400349 Cluj-Napoca, Romania ,grid.411040.00000 0004 0571 5814Department of Neuroscience, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Maria Puiu
- grid.22248.3e0000 0001 0504 4027“Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Cristian Zimbru
- grid.6992.40000 0001 1148 0861Polytechnic University, Timisoara, Romania
| | - Adela Chirita-Emandi
- grid.22248.3e0000 0001 0504 4027“Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Camelia Alkhzouz
- Emergency Clinical Hospital for Children, Pasteur Street, No 6, 400349 Cluj-Napoca, Romania ,grid.411040.00000 0004 0571 5814Department of Mother and Child, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Riza AL, Alkhzouz C, Farcaș M, Pîrvu A, Miclea D, Mihuț G, Pleșea RM, Ștefan D, Drodar M, Lazăr C, Study OBOTHINT, Study OBOTFUSE, Ioana M, Popp R. Non-Syndromic Hearing Loss in a Romanian Population: Carrier Status and Frequent Variants in the GJB2 Gene. Genes (Basel) 2022; 14:69. [PMID: 36672810 PMCID: PMC9858611 DOI: 10.3390/genes14010069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/16/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
The genetic causes of autosomal recessive nonsyndromic hearing loss (ARNSHL) are heterogeneous and highly ethnic-specific. We describe GJB2 (connexin 26) variants and carrier frequencies as part of our study and summarize previously reported ones for the Romanian population. In total, 284 unrelated children with bilateral congenital NSHL were enrolled between 2009 and 2018 in northwestern Romania. A tiered diagnostic approach was used: all subjects were tested for c.35delG, c.71G>A and deletions in GJB6 (connexin 30) using PCR-based methods. Furthermore, 124 cases undiagnosed at this stage were analyzed by multiplex-ligation-dependent probe amplifications (MLPA), probe mix P163, and sequencing of GJB2 exon 2. Targeted allele-specific PCR/restriction fragment length polymorphism (RFLP) established definite ethio-pathogenical diagnosis for 72/284 (25.35%) of the cohort. Out of the 124 further analyzed, in 12 cases (9.67%), we found compound heterozygous point mutations in GJB2. We identified one case of deletion of exon 1 of the WFS1 (wolframin) gene. Carrier status evaluation used Illumina Infinium Global Screening Array (GSA) genotyping: the HINT cohort-416 individuals in northwest Romania, and the FUSE cohort-472 individuals in southwest Romania. GSA variants yielded a cumulated risk allele presence of 0.0284. A tiered diagnostic approach may be efficient in diagnosing ARNSHL. The summarized contributions to Romanian descriptive epidemiology of ARNSHL shows that pathogenic variants in the GJB2 gene are frequent among NSHL cases and have high carrier rates, especially for c.35delG and c.71G>A. These findings may serve in health strategy development.
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Affiliation(s)
- Anca-Lelia Riza
- Regional Centre of Medical Genetics Dolj, Emergency County Hospital Craiova, 200642 Craiova, Romania
- Laboratory of Human Genomics, University of Medicine and Pharmacy of Craiova, 200638 Craiova, Romania
| | - Camelia Alkhzouz
- First Pediatric Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Clinical Emergency Hospital for Children, 400394 Cluj-Napoca, Romania
| | - Marius Farcaș
- Molecular Sciences Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Andrei Pîrvu
- Regional Centre of Medical Genetics Dolj, Emergency County Hospital Craiova, 200642 Craiova, Romania
- Laboratory of Human Genomics, University of Medicine and Pharmacy of Craiova, 200638 Craiova, Romania
| | - Diana Miclea
- First Pediatric Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Clinical Emergency Hospital for Children, 400394 Cluj-Napoca, Romania
| | - Gheorghe Mihuț
- ENT Department, Clinical Emergency Hospital for Children, 400394 Cluj-Napoca, Romania
| | - Răzvan-Mihail Pleșea
- Regional Centre of Medical Genetics Dolj, Emergency County Hospital Craiova, 200642 Craiova, Romania
- Laboratory of Human Genomics, University of Medicine and Pharmacy of Craiova, 200638 Craiova, Romania
| | - Delia Ștefan
- Molecular Sciences Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Mihaela Drodar
- Laboratory of Human Genomics, University of Medicine and Pharmacy of Craiova, 200638 Craiova, Romania
| | - Călin Lazăr
- First Pediatric Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Clinical Emergency Hospital for Children, 400394 Cluj-Napoca, Romania
| | | | | | - Mihai Ioana
- Regional Centre of Medical Genetics Dolj, Emergency County Hospital Craiova, 200642 Craiova, Romania
- Laboratory of Human Genomics, University of Medicine and Pharmacy of Craiova, 200638 Craiova, Romania
| | - Radu Popp
- Molecular Sciences Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
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Fãgãrãşan A, Gozar L, Ghiragosian SER, Murariu M, Pop M, Crauciuc A, Miclea D, Şuteu CC. Severe early-onset manifestations of generalized arterial calcification of infancy (mimicking severe coarctation of the aorta) with ABCC6 gene variant - Case report and literature review. Front Cardiovasc Med 2022; 9:1032519. [PMID: 36606277 PMCID: PMC9807665 DOI: 10.3389/fcvm.2022.1032519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/24/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Generalized arterial calcification of infancy (GACI) is a rare cause of infantile heart failure and systemic hypertension with a poor prognosis, characterized by extensive calcification and proliferation of the intimal layer of large and medium sized arteries. Case report We present the first case report of successful surgical treatment of severe aortic arch obstruction by calcified plaques mimicking severe coarctation of the aorta and the outcome (of bisphosphonate therapy) in a newborn with GACI. Furthermore, we report the identification of a variant in ATP Binding Cassette Subfamily C, Member 6 (ABCC6) gene, possibly associated with severe early-onset manifestations of GACI. Conclusion This case report highlights the importance of considering GACI in an infant with heart failure, systemic hypertension, and evidence of increased echogenicity of the arterial vessels. We noted the favorable outcome in improving the aortic calcification in our patient after surgical treatment and bisphosphonates therapy. Early diagnosis and treatment improve the long-term prognosis. A better understanding of this rare genetic disease could lead to new therapeutic strategies.
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Affiliation(s)
- Amalia Fãgãrãşan
- Clinic of Pediatric Cardiology, Emergency Institute of Cardiovascular Diseases and Transplantation, Târgu Mureş, Romania,Department of Pediatrics III, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, Târgu Mureş, Romania
| | - Liliana Gozar
- Clinic of Pediatric Cardiology, Emergency Institute of Cardiovascular Diseases and Transplantation, Târgu Mureş, Romania,Department of Pediatrics III, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, Târgu Mureş, Romania,*Correspondence: Liliana Gozar,
| | - Simina-Elena Rusu Ghiragosian
- Department of Pediatrics III, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, Târgu Mureş, Romania,Simina-Elena Rusu Ghiragosian,
| | - Mircea Murariu
- Clinic of Pediatric Cardiology, Emergency Institute of Cardiovascular Diseases and Transplantation, Târgu Mureş, Romania
| | - Marian Pop
- ME1 Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, Târgu Mureş, Romania,Department of Radiology, Emergency Institute for Cardiovascular Diseases and Heart Transplant, Târgu Mureş, Romania
| | - Andrei Crauciuc
- Clinic of Pediatric Cardiology, Emergency Institute of Cardiovascular Diseases and Transplantation, Târgu Mureş, Romania
| | - Diana Miclea
- Department of Medical Genetics, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Carmen Corina Şuteu
- Clinic of Pediatric Cardiology, Emergency Institute of Cardiovascular Diseases and Transplantation, Târgu Mureş, Romania
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Damian LO, Miclea D, Vulturar R, Crăciun A. Osteogenesis imperfecta and rheumatoid arthritis: connective issues. Osteoporos Int 2022; 33:2237-2239. [PMID: 35984463 DOI: 10.1007/s00198-022-06530-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The coexistence of osteogenesis imperfecta and inflammatory arthritis has been very rarely described. Nevertheless, systemic inflammation has been found in osteogenesis imperfecta. The COL1A1 mutations may affect collagen synthesis as well as post-translational modifications, extracellular matrix interactions, and receptor-mediated signaling. Major collagen binding ligands forming the interactome, such as cytokines, cell adhesion molecules, matrix metalloproteinases, proteoglycans, and other molecules, are autoimmunity targets involved in rheumatoid arthritis pathogenesis. Cross-talk between bone remodeling and inflammatory pathways involving osteoclasts is important in osteogenesis imperfecta and rheumatoid arthritis. In osteogenesis imperfecta, the structural abnormalities and repeated traumatism, including fractures, could activate locally the innate immunity and trigger arthritis, similar to post-traumatic arthritis. Currently, the therapy of osteogenesis imperfecta is a suboptimally met need. Understanding the complex putative pathogenic links between osteogenesis imperfecta and inflammatory arthritis could hopefully lead to new therapeutic targets. Raising awareness regarding a possible association between osteogenesis imperfecta and arthritis could help improve the quality of life in these patients.
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Affiliation(s)
- Laura Otilia Damian
- Rheumatology Dept, Emergency Clinical County Hospital Cluj, 2-4 Clinicilor St, 400006, Cluj-Napoca-Napoca, Romania.
- CMI Reumatologie Dr Damian, 6-8 Petru Maior St, 400002, Cluj-Napoca-Napoca, Romania.
| | - Diana Miclea
- Department of Medical Genetics, Emergency Pediatric Hospital, Cluj-Napoca-Napoca, Romania
- Department of Molecular Sciences, University of Medicine and Pharmacy "Iuliu Hatieganu, " 6 Pasteur St, 400349, Cluj-Napoca-Napoca, Romania
| | - Romana Vulturar
- Department of Molecular Sciences, University of Medicine and Pharmacy "Iuliu Hatieganu, " 6 Pasteur St, 400349, Cluj-Napoca-Napoca, Romania
- Cognitive Neuroscience Laboratory, University Babes-Bolyai, 30 Fântânele St, 400294, Cluj-Napoca-Napoca, Romania
| | - Alexandra Crăciun
- Department of Molecular Sciences, University of Medicine and Pharmacy "Iuliu Hatieganu, " 6 Pasteur St, 400349, Cluj-Napoca-Napoca, Romania
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Țaranu I, Iancu M, Lazea C, Alkhzouz C, Răcătăianu N, Cătană CS, Mirea AM, Miclea D, Bolboacă SD, Drugan C. Evaluation of Circulating Chitotriosidase Activity in Children with Obesity. J Clin Med 2022; 11:jcm11133634. [PMID: 35806923 PMCID: PMC9267881 DOI: 10.3390/jcm11133634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/14/2022] [Accepted: 06/14/2022] [Indexed: 11/16/2022] Open
Abstract
Childhood obesity progresses to metabolic disturbances via low-grade inflammation. Identifying novel molecules that reflect the activity of the immune responses is critical in understanding its underlying pathogenesis. Our exploratory study aimed to evaluate the change of chitotriosidase (CHIT1) plasma activity according to Body Mass Index (BMI)-for-age z score in pediatric patients. The study evaluated 68 children consisting of 47.1% girls with a mean age of 12.47 ± 3.71 years and 52.9% boys with a mean age of 11.93 ± 3.18 years. The effect of the most frequent CHIT1 gene variants, the 24 base pair duplication (dup24) and G102S polymorphism, upon the association between circulating CHIT1 activity and the obesity level, was also investigated. A significantly higher logCHIT1 plasma activity was found in children with extreme obesity than in children with overweight (p = 0.048 for the uncorrected CHIT1 and 0.026 for the corrected CHIT1). The BMI-for-age z score significantly (p = 0.031) predicts increased CHIT1 activity in children with overweight, obesity, and extreme obesity after controlling for the two gene variants, age, gender, and time since weight gain. Dup24 and G102S polymorphism were significant independent predictors (p-values < 0.002) for the change of CHIT1 plasma activity. Circulating CHIT1 might be an accurate indicator of inflammation in children with obesity. Its role and the effect of the dup24 and G102S variants on the CHIT1 activity should be validated in a larger cohort.
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Affiliation(s)
- Ioana Țaranu
- Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy, Louis Pasteur Str., No. 6, 400349 Cluj-Napoca, Romania; (I.Ț.); (M.I.); (S.D.B.)
- Pediatric Clinic 1, Emergency Pediatric Hospital, Calea Moților, No. 68, 400370 Cluj-Napoca, Romania;
| | - Mihaela Iancu
- Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy, Louis Pasteur Str., No. 6, 400349 Cluj-Napoca, Romania; (I.Ț.); (M.I.); (S.D.B.)
| | - Cecilia Lazea
- Pediatric Clinic 1, Emergency Pediatric Hospital, Calea Moților, No. 68, 400370 Cluj-Napoca, Romania;
- Department Mother and Child, Iuliu Hațieganu University of Medicine and Pharmacy, Calea Moților, No. 68, 400370 Cluj-Napoca, Romania;
- Correspondence: ; Tel.: +40-744353764
| | - Camelia Alkhzouz
- Department Mother and Child, Iuliu Hațieganu University of Medicine and Pharmacy, Calea Moților, No. 68, 400370 Cluj-Napoca, Romania;
| | - Nicoleta Răcătăianu
- Integrated Ambulatory of Endocrinology, Infectious Diseases Clinical Hospital, Calea Moților, No. 19, 400000 Cluj-Napoca, Romania;
| | - Cristina-Sorina Cătană
- Department of Medical Biochemistry, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Str., No. 6, 400349 Cluj-Napoca, Romania; (C.-S.C.); (C.D.)
| | - Andreea-Manuela Mirea
- Pediatric Clinic 1, Emergency Pediatric Hospital, Calea Moților, No. 68, 400370 Cluj-Napoca, Romania;
| | - Diana Miclea
- Department of Molecular Sciences, Iuliu Hațieganu University of Medicine and Pharmacy, Louis Pasteur Str., No. 6, 400349 Cluj-Napoca, Romania;
| | - Sorana D. Bolboacă
- Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy, Louis Pasteur Str., No. 6, 400349 Cluj-Napoca, Romania; (I.Ț.); (M.I.); (S.D.B.)
| | - Cristina Drugan
- Department of Medical Biochemistry, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Str., No. 6, 400349 Cluj-Napoca, Romania; (C.-S.C.); (C.D.)
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Lazea C, Al-Khzouz C, Sufana C, Miclea D, Asavoaie C, Filimon I, Fufezan O. Diagnosis and Management of Genetic Causes of Middle Aortic Syndrome in Children: A Comprehensive Literature Review. Ther Clin Risk Manag 2022; 18:233-248. [PMID: 35330917 PMCID: PMC8938167 DOI: 10.2147/tcrm.s348366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/21/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Cecilia Lazea
- Department Mother and Child, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania
- Department of Pediatrics I, Emergency Pediatric Hospital, Cluj-Napoca, Romania
- Correspondence: Cecilia Lazea, Department Mother and Child, University of Medicine and Pharmacy “Iuliu Hatieganu”, 68, Motilor Street, Cluj-Napoca, 400370, Romania, Tel +40 744353764, Email ;
| | - Camelia Al-Khzouz
- Department Mother and Child, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania
- Department of Medical Genetics, Emergency Pediatric Hospital, Cluj-Napoca, Romania
| | - Crina Sufana
- Department of Pediatrics I, Emergency Pediatric Hospital, Cluj-Napoca, Romania
| | - Diana Miclea
- Department of Medical Genetics, Emergency Pediatric Hospital, Cluj-Napoca, Romania
- Department of Molecular Sciences, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania
| | - Carmen Asavoaie
- Department of Radiology and Medical Imaging, Emergency Pediatric Hospital, Cluj-Napoca, Romania
| | - Ioana Filimon
- Department of Radiology and Medical Imaging, Emergency Pediatric Hospital, Cluj-Napoca, Romania
| | - Otilia Fufezan
- Department of Radiology and Medical Imaging, Emergency Pediatric Hospital, Cluj-Napoca, Romania
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Manole S, Pintican R, Palade E, Duma MM, Dadarlat-Pop A, Schiau C, Bene I, Rancea R, Miclea D, Manole V, Molnar A, Solomon C. Primary Pericardial Synovial Sarcoma: A Case Report and Literature Review. Diagnostics (Basel) 2022; 12:diagnostics12010158. [PMID: 35054325 PMCID: PMC8774691 DOI: 10.3390/diagnostics12010158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 12/30/2021] [Accepted: 01/03/2022] [Indexed: 11/16/2022] Open
Abstract
We report a case of a 52-year-old woman who was referred to our institution with a superior vena cava syndrome and was investigated through echocardiography, CT and MRI revealing a well-defined, encapsulated pericardial mass. The pathology, correlated with the immunohistochemical analysis, concluded it was an extremely rare primary pericardial synovial sarcoma. The patient underwent surgery and chemotherapy with a 16-month disease-free survival and passed away after a contralateral aggressive relapse. Moreover, we discuss the role of each imaging modality together with their pericardial synovial sarcoma reported features.
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Affiliation(s)
- Simona Manole
- Department of Radiology, “Niculae Stancioiu” Heart Institute, 400001 Cluj-Napoca, Romania;
- Department of Radiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.S.); (I.B.)
| | - Roxana Pintican
- Department of Radiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.S.); (I.B.)
- Correspondence: (R.P.); (C.S.)
| | - Emanuel Palade
- Department of Cardiovascular and Thoracic Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (E.P.); (A.M.)
- Department of Thoracic Surgery, Leon Daniello“ Pneumophtysiology Hospital Cluj-Napoca, 400332 Cluj-Napoca, Romania
| | | | - Alexandra Dadarlat-Pop
- Cardiology Department, Heart Institute “N. Stăncioiu”, 400001 Cluj-Napoca, Romania; (A.D.-P.); (R.R.)
- Department of Internal Medicine, Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Calin Schiau
- Department of Radiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.S.); (I.B.)
| | - Ioana Bene
- Department of Radiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.S.); (I.B.)
| | - Raluca Rancea
- Cardiology Department, Heart Institute “N. Stăncioiu”, 400001 Cluj-Napoca, Romania; (A.D.-P.); (R.R.)
| | - Diana Miclea
- Department of Medical Genetics, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Viorel Manole
- Department of Cardiovascular Surgery, Heart Institute “N. Stăncioiu”, 400001 Cluj-Napoca, Romania;
| | - Adrian Molnar
- Department of Cardiovascular and Thoracic Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (E.P.); (A.M.)
- Department of Cardiovascular Surgery, Heart Institute “N. Stăncioiu”, 400001 Cluj-Napoca, Romania;
| | - Carolina Solomon
- Department of Radiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.S.); (I.B.)
- Correspondence: (R.P.); (C.S.)
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9
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Lazea C, Bucerzan S, Crisan M, Al-Khzouz C, Miclea D, Şufană C, Cismaru G, Grigorescu-Sido P. Cardiovascular manifestations in Marfan syndrome. Med Pharm Rep 2021; 94:S25-S27. [PMID: 34527904 DOI: 10.15386/mpr-2223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Marfan syndrome (MFS) is an autosomal dominant inherited disease of the connective tissue with multiorgan involvement (skeleton, cardiovascular, eyes, skin, lungs). Cardiovascular involvement is variable and represents the major cause of morbidity and mortality in Marfan syndrome. We provide a comprehensive description of cardiovascular manifestations in Marfan syndrome, genotype-phenotype correlations and assessment of cardiovascular abnormalities and complications.
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Affiliation(s)
- Cecilia Lazea
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Emergency Pediatric Hospital, Cluj-Napoca, Romania
| | - Simona Bucerzan
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Emergency Pediatric Hospital, Cluj-Napoca, Romania
| | | | - Camelia Al-Khzouz
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Emergency Pediatric Hospital, Cluj-Napoca, Romania
| | - Diana Miclea
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Emergency Pediatric Hospital, Cluj-Napoca, Romania
| | - Crina Şufană
- Emergency Pediatric Hospital, Cluj-Napoca, Romania
| | - Gabriel Cismaru
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Cardiology Rehabilitation Department, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania
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10
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Abstract
Background and aim The lysosomal storage diseases are a group of monogenic diseases with multisystemic impairment and chronic progression induced by the deficiency of lysosomal acid hydrolases involved in the breakdown of various macromolecules. The accumulation occurs in the macrophages of the reticule-endothelial system and causes enlargement and functional impairment. The mainly involved organs are the brain, liver, spleen, bones, joints, airways, lungs, and heart. The aim of this study was to evaluate early symptoms, signs and the delay in the diagnosis of different lysosomal diseases. Methods The medical documentation of 188 patients with lysosomal storage disorders, aged 1-70 years, were analyzed. All these patients were specifically diagnosed, by enzyme and molecular assay. Results The age of clinical signs onset varies in different type of lysosomal diseases, from the first months of life or early childhood in severe form, to adulthood in attenuated forms. The delay between the clinical signs onset and specific diagnosis ranged from 0.5 months to 57.91 years. Conclusions The lysosomal storage diseases are rare diseases with childhood onset, but these early signs and symptoms are not recognized and are often taken into account when the vital organs damage becomes manifest.
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Affiliation(s)
- Camelia Alkhzouz
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Center of Expertise for Rare Diseases Lysosomal Diseases, Clinical Emergency Hospital for Children, Cluj, Romania
| | - Diana Miclea
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Center of Expertise for Rare Diseases Lysosomal Diseases, Clinical Emergency Hospital for Children, Cluj, Romania
| | - Simona Bucerzan
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Center of Expertise for Rare Diseases Lysosomal Diseases, Clinical Emergency Hospital for Children, Cluj, Romania
| | - Cecilia Lazea
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Center of Expertise for Rare Diseases Lysosomal Diseases, Clinical Emergency Hospital for Children, Cluj, Romania
| | - Ioana Nascu
- Center of Expertise for Rare Diseases Lysosomal Diseases, Clinical Emergency Hospital for Children, Cluj, Romania
| | - Paula Grigorescu Sido
- Center of Expertise for Rare Diseases Lysosomal Diseases, Clinical Emergency Hospital for Children, Cluj, Romania
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11
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Bucerzan S, Alkhzouz C, Crisan M, Miclea D, Asavoaie C, Ilies R, Grigorescu-Sido P. Diagnostic, treatment and outcome possibilities in achondroplasia. Med Pharm Rep 2021; 94:S22-S24. [PMID: 34527903 DOI: 10.15386/mpr-2222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Achondroplasia is a common form of chondrodysplasia. It is transmitted by autosomal dominant trait. The disease is determined by mutations in receptor-3 gene of the fibroblast growth factor. The most frequent mutations are c.1138G>A and c.1183G>C; c.1138A. The diagnosis can usually be made on the basis of clinical characteristics and specific features on radiographs. It is not necessary to perform molecular testing in every child with a clinical diagnosis of achondroplasia.The aim of this study is to establish the diagnostic, treatment and outcome possibilities in patients with achondroplasia in our care. Method The study group consisted of 27 patients with achondroplasia. The method consisted of: clinical and radiological examinations. The DNA analasys was performed by PCR-RFLP technique. Results 80 patients were diagnosed with bone dysplasia; 24 of them were diagnosed (on clinical and radiological basis) with achondroplasia. Out of this group, 16 patients were identified as heterozygotes for G1138A mutation in FGFR3 gene; 3 patients undergoing treatment with somatotropic hormone; the growth rate is improving from 0.1 cm/month to 0.5 cm/month. Conclusions In achondroplasia diagnosis is based on clinical and radiological criteria. It is the first study that reports the prevelance of this mutation in Romania.
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Affiliation(s)
- Simona Bucerzan
- First Pediatric Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Camelia Alkhzouz
- First Pediatric Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mirela Crisan
- Emergency Clinical Hospital for Children, First Pediatric Clinic Cluj-Napoca, Romania
| | - Diana Miclea
- Medical Genetic Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Carmen Asavoaie
- Emergency Clinical Hospital for Children, Cluj-Napoca, Romania
| | - Roxana Ilies
- Emergency Clinical Hospital for Children, Cluj-Napoca, Romania
| | - Paula Grigorescu-Sido
- First Pediatric Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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12
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Pop TL, Grama A, Miclea D, Vulturar R, Benţa G, Grigore M, Simu C. Challenges in the diagnosis and management of urea cycle disorders in Romanian children. Med Pharm Rep 2021; 94:S36-S39. [PMID: 34527907 DOI: 10.15386/mpr-2226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Pediatricians should be aware of the clinical presentation, emergency intervention, and long-term management of hyperammonemia. In Romania, there are many challenges regarding hyperammonemia: low awareness of the need for prompt diagnosis and adequate management, communication problems between different physicians, lack of knowledge and availability of diagnostic tools and medications, lack of dietitians trained in metabolic diseases. Urea cycle disorders (UCD) are severe diseases, with high mortality in neonates and possible neurologic complications in the survivors. Clinical presentation is variable, with the onset at any age. It is crucial for a correct and early diagnosis that the first physician sees a patient with symptoms of hyperammonemia to think of it. Pediatricians should suspect UCD in neonates or children with hyperammonemia without metabolic acidosis and hypoglycemia. Neonatal sepsis is the most frequent misdiagnosis. Pediatricians and parents of a child with UCD should be aware of the potential triggers of hyperammonemia. Emergency treatment to reduce the ammonia level should be initiated as quickly as possible. Long-term treatment aims to obtain metabolic control and achieve normal development and growth. A multidisciplinary approach in managing these children improves survival chances and the long-term quality of life.
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Affiliation(s)
- Tudor Lucian Pop
- 2 Pediatric Clinic, Department of Mother and Child, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Center of Expertise in Pediatric Rare Liver Disorders, 2nd Pediatric Clinic, Emergency Clinical Hospital for Children Cluj-Napoca, Romania
| | - Alina Grama
- 2 Pediatric Clinic, Department of Mother and Child, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Center of Expertise in Pediatric Rare Liver Disorders, 2nd Pediatric Clinic, Emergency Clinical Hospital for Children Cluj-Napoca, Romania
| | - Diana Miclea
- Center of Expertise in Pediatric Rare Liver Disorders, 2nd Pediatric Clinic, Emergency Clinical Hospital for Children Cluj-Napoca, Romania.,Department of Medical Genetics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Romana Vulturar
- Center of Expertise in Pediatric Rare Liver Disorders, 2nd Pediatric Clinic, Emergency Clinical Hospital for Children Cluj-Napoca, Romania.,Department of Molecular Sciences, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Gabriel Benţa
- 2 Pediatric Clinic, Department of Mother and Child, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mădălina Grigore
- 2 Pediatric Clinic, Department of Mother and Child, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Claudia Simu
- 2 Pediatric Clinic, Department of Mother and Child, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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13
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Miclea D, Alkhzouz C, Bucerzan S, Grigorescu-Sido P. Genetic testing in pediatric endocrine pathology. Med Pharm Rep 2021; 94:S15-S18. [PMID: 34527901 DOI: 10.15386/mpr-2220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In genetic endocrine diseases, genetic testing is necessary for a precise diagnosis, which will provide a better knowledge of the evolution and prognosis and also indicate the adequate therapy, targeting the precise etiopathogenesis of the disease. Genetic testing in endocrinology is often based on classical cytogenetic techniques, molecular cytogenetic analysis or molecular biology techniques. Genetic testing in disorders of sex development includes the karyotype and SRY gene analysis and depending on the presence of associated clinical signs and on the observations at paraclinical examination, these tests will be followed by chromosomal array techniques and NGS sequencing. In short stature, the decision to perform a genetic test is taken depending on clinical, paraclinical and imaging signs. In case of a short stature associated with a low weight/length for gestational age, genetic testing is proposed to evaluate a Russell-Silver syndrome or if the short stature is associated with other clinical signs (e.g. intellectual disability), chromosomal analysis by microarray is proposed. If the short stature is disproportionate, it is indicated to perform a next generation sequencing (NGS) of a panel of genes involved in skeletal dysplasia. If an endocrine cause for short stature is observed at the hormonal evaluation, it is indicated to test a panel of genes involved in these pathways. In genetic obesity, depending on clinical signs associated to obesity, it will be a more targeted genetic testing. If obesity is associated with intellectual disability or other nonspecific neurological changes, a chromosomal analysis by microarray will be indicated. If monogenic obesity is suspected, NGS testing will be indicated (as genes panel or whole exome or genome analysis). Genetic testing in endocrine diseases brings an etiological diagnosis, but a favorable cost-benefit ratio derives from an adequate indication of these tests, generally proposed in expert centers for rare endocrine diseases.
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Affiliation(s)
- Diana Miclea
- Molecular Sciences Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Medical Genetics Department, Clinical Emergency Hospital for Children, Cluj-Napoca, Romania
| | - Camelia Alkhzouz
- Medical Genetics Department, Clinical Emergency Hospital for Children, Cluj-Napoca, Romania.,Mother and Child Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simona Bucerzan
- Medical Genetics Department, Clinical Emergency Hospital for Children, Cluj-Napoca, Romania.,Mother and Child Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Paula Grigorescu-Sido
- Mother and Child Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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14
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Miclea D, Szucs A, Mirea A, Stefan DM, Nazarie F, Bucerzan S, Lazea C, Grama A, Pop TL, Farcas M, Zaharie G, Matyas M, Mager M, Vintan M, Popp R, Alkhzouz C. Diagnostic Usefulness of MLPA Techniques for Recurrent Copy Number Variants Detection in Global Developmental Delay/Intellectual Disability. Int J Gen Med 2021; 14:4511-4515. [PMID: 34429637 PMCID: PMC8378908 DOI: 10.2147/ijgm.s320033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/15/2021] [Indexed: 02/05/2023] Open
Abstract
Background Genetic testing has become a standardized practice in the diagnosis of patients with global developmental delay/intellectual disability (GDD/ID). The aim of this study is to observe the frequency of recurrent copy number variations (CNVs) in patients diagnosed with GDD/ID, using MLPA technique. Methods A total of 501 paediatric patients with GDD/ID were analysed using SALSA MLPA probemix P245 Microdeletion Syndromes-1A, and the technical steps were performed according to the MRC Holland MLPA general protocol. Results Twenty-five of 501 patients (5%) were diagnosed with a microdeletion/microduplication syndrome. Amongst them, 7 of 25 (30%) with clinical suggestion have a confirmed diagnosis, for the other cases the clinical features were not evocative for a specific syndrome. Conclusion This study showed that in cases with a specific clinical diagnosis the MLPA technique could be a useful alternative, less expensive and more efficient to indicate as first intention of a targeted diagnostic test, as it is the case of Williams syndrome, Prader–Willi syndrome or DiGeorge syndrome.
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Affiliation(s)
- Diana Miclea
- Department of Molecular Sciences, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Emergency Clinical Hospital for Children, Cluj-Napoca, Romania
| | - Adriana Szucs
- Department of Molecular Sciences, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Emergency Clinical Hospital for Children, Cluj-Napoca, Romania
| | - Andreea Mirea
- Department of Molecular Sciences, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Emergency Clinical Hospital for Children, Cluj-Napoca, Romania
| | - Delia-Maria Stefan
- Department of Molecular Sciences, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Emergency Clinical Hospital for Children, Cluj-Napoca, Romania
| | - Florina Nazarie
- Department of Molecular Sciences, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Emergency Clinical Hospital for Children, Cluj-Napoca, Romania
| | - Simona Bucerzan
- Emergency Clinical Hospital for Children, Cluj-Napoca, Romania.,Department of Mother and Child, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cecilia Lazea
- Emergency Clinical Hospital for Children, Cluj-Napoca, Romania.,Department of Mother and Child, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alina Grama
- Emergency Clinical Hospital for Children, Cluj-Napoca, Romania.,Department of Mother and Child, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Tudor Lucian Pop
- Emergency Clinical Hospital for Children, Cluj-Napoca, Romania.,Department of Mother and Child, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Marius Farcas
- County Emergency Clinical Hospital, Cluj-Napoca, Romania
| | - Gabriela Zaharie
- Department of Mother and Child, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,County Emergency Clinical Hospital, Cluj-Napoca, Romania
| | - Melinda Matyas
- Department of Mother and Child, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,County Emergency Clinical Hospital, Cluj-Napoca, Romania
| | - Monica Mager
- Emergency Clinical Hospital for Children, Cluj-Napoca, Romania.,Department of Mother and Child, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Vintan
- Emergency Clinical Hospital for Children, Cluj-Napoca, Romania.,Department of Mother and Child, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Radu Popp
- Department of Molecular Sciences, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Camelia Alkhzouz
- Emergency Clinical Hospital for Children, Cluj-Napoca, Romania.,Department of Mother and Child, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
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15
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Alkhzouz C, Bucerzan S, Miclaus M, Mirea AM, Miclea D. 46,XX DSD: Developmental, Clinical and Genetic Aspects. Diagnostics (Basel) 2021; 11:1379. [PMID: 34441313 PMCID: PMC8392837 DOI: 10.3390/diagnostics11081379] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/19/2021] [Accepted: 07/27/2021] [Indexed: 11/17/2022] Open
Abstract
Differences in sex development (DSD) in patients with 46,XX karyotype occur by foetal or postnatal exposure to an increased amount of androgens. These disorders are usually diagnosed at birth, in newborns with abnormal genitalia, or later, due to postnatal virilization, usually at puberty. Proper diagnosis and therapy are mostly based on the knowledge of normal development and molecular etiopathogenesis of the gonadal and adrenal structures. This review aims to describe the most relevant data that are correlated with the normal and abnormal development of adrenal and gonadal structures in direct correlation with their utility in clinical practice, mainly in patients with 46,XX karyotype. We described the prenatal development of structures together with the main molecules and pathways that are involved in sex development. The second part of the review described the physical, imaging, hormonal and genetic evaluation in a patient with a disorder of sex development, insisting more on patients with 46,XX karyotype. Further, 95% of the etiology in 46,XX patients with disorders of sex development is due to congenital adrenal hyperplasia, by enzyme deficiencies that are involved in the hormonal synthesis pathway. The other cases are explained by genetic abnormalities that are involved in the development of the genital system. The phenotypic variability is very important in 46,XX disorders of sex development and the knowledge of each sign, even the most discreet, which could reveal such disorders, mainly in the neonatal period, could influence the evolution, prognosis and life quality long term.
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Affiliation(s)
- Camelia Alkhzouz
- Mother and Child Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.A.); (S.B.)
- Genetic Department, Clinical Emergency Hospital for Children Cluj-Napoca, 400370 Cluj-Napoca, Romania; (M.M.); (A.-M.M.)
| | - Simona Bucerzan
- Mother and Child Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.A.); (S.B.)
- Genetic Department, Clinical Emergency Hospital for Children Cluj-Napoca, 400370 Cluj-Napoca, Romania; (M.M.); (A.-M.M.)
| | - Maria Miclaus
- Genetic Department, Clinical Emergency Hospital for Children Cluj-Napoca, 400370 Cluj-Napoca, Romania; (M.M.); (A.-M.M.)
| | - Andreea-Manuela Mirea
- Genetic Department, Clinical Emergency Hospital for Children Cluj-Napoca, 400370 Cluj-Napoca, Romania; (M.M.); (A.-M.M.)
| | - Diana Miclea
- Mother and Child Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.A.); (S.B.)
- Molecular Science Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
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Matyas M, Miclea D, Zaharie G. Case Report: Uncommon Association of ITGB4 and KRT10 Gene Mutation in a Case of Epidermolysis Bullosa With Pyloric Atresia and Aplasia Cutis Congenita. Front Genet 2021; 12:641977. [PMID: 34306001 PMCID: PMC8296908 DOI: 10.3389/fgene.2021.641977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 06/07/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Epidermolysis bullosa is a rare form of genodermatosis produced by different gene mutations. The junctional form of the disease (JEB-PA) can associate pyloric atresia, renal abnormalities, and aplasia cutis congenita. Case Description: A case of a male preterm newborn with suspicion of digestive tube malformation at fetal ultrasound and who was born by cesarian section. At birth, he presented extensive cutaneous aplasia on the lower limbs and bilaterally under ears; outer ear agenesis; nasal septum hypoplasia; micrognathia; multiple blisters on the face, trunk, and limbs; lower limb deformities and absence of toe nails. Pathological examination following a surgical procedure with unfavorable outcome showed pyloric atresia, junctional form of epidermolysis bullosa and aplasia cutis congenita. Homozygous variants in two genes were identified: c.3111+1G>A in ITGB4 (class 5) and c.1498G>T in KRT10 (class 3). Conclusion: The particularity of our case is the novel finding of a coincidental occurrence in the context of consaguinity of two mutations in the ITGB4 and KRT10 genes, and clinical characteristics of epidermolysis bullosa.
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Affiliation(s)
- Melinda Matyas
- Neonatology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Diana Miclea
- Genetics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Gabriela Zaharie
- Neonatology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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17
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Cismaru AC, Soritau O, Jurj AM, Raduly LZ, Pop B, Bocean C, Miclea D, Baldasici O, Moldovan C, Urian L, Braicu C, Chira S, Cojocneanu R, Pop LA, Burz C, Berindan Neagoe I. Human Chorionic Gonadotropin Improves the Proliferation and Regenerative Potential of Bone Marrow Adherent Stem Cells and the Immune Tolerance of Fetal Microchimeric Stem Cells In Vitro. Stem Cell Rev Rep 2021; 16:524-540. [PMID: 32020407 DOI: 10.1007/s12015-020-09957-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Nongonadal tissues express luteinizing hormone-chorionic gonadotropin receptors (LHCG-R) which are essential for their growth during fetal development. Adult mesenchymal stem/stromal cells (MSCs) have been shown to express functional LHCG-R outside pregnancy conditions, making them susceptible to hCG stimulation. In the present study we tested the effect of hCG treatment on bone marrow (BM) derived adherent stem cells in vitro, isolated from a parous women, mother of male sons, in order to evaluate its effect on maternal MSCs and in the same time on fetal microchimeric stem cells (FMSCs), to better understand the outcomes of this safe and affordable treatment on cell proliferation and expression of pluripotency genes. Our study highlights the beneficial effects of hCG exposure on gene regulation in bone marrow adherent stem cells through the upregulation of pluripotency genes and selection of more primitive mesenchymal stem cells with a better differentiation potential. Validation of these effects on MSCs and FMSCs long after parturition in vivo represents a close perspective as it could set the premises of a new mobilization strategy for the stem cell transplantation procedures in the clinical setting.
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Affiliation(s)
- Andrei Cosmin Cismaru
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Olga Soritau
- Radiotherapy, Radio-biology and Tumor Biology Laboratory, The Oncology Institute "Prof. dr. Ion Chiricuta", Cluj-Napoca, Romania
| | - Ancuta Maria Jurj
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Lajos-Zsolt Raduly
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Bogdan Pop
- Pathology Department, The Oncology Institute "Prof. dr. Ion Chiricuta", Cluj-Napoca, Romania
| | - Cosmina Bocean
- Pathology Department, The Oncology Institute "Prof. dr. Ion Chiricuta", Cluj-Napoca, Romania
| | - Diana Miclea
- Genetics Department, "Iuliu Hatieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Oana Baldasici
- Functional Genomics, Proteomics and Experimental Pathology Laboratory, The Oncology Institute "Prof. dr. Ion Chiricuta", Cluj-Napoca, Romania
| | - Cristian Moldovan
- MedFUTURE, the Research Center for Advanced Medicine, "Iuliu Hatieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Laura Urian
- Hematology Department, "Iuliu Hatieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cornelia Braicu
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sergiu Chira
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Roxana Cojocneanu
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Laura Ancuta Pop
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Claudia Burz
- Immunology Department, "Iuliu Hatieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioana Berindan Neagoe
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Lazea C, Bucerzan S, Al-Khzouz C, Zimmermann A, Vesa ȘC, Nașcu I, Creț V, Crișan M, Asăvoaie C, Miclea D, Grigorescu-Sido P. Cardiac Manifestations in a Group of Romanian Patients with Gaucher Disease Type 1 (a Monocentric Study). Diagnostics (Basel) 2021; 11:diagnostics11060989. [PMID: 34072542 PMCID: PMC8227770 DOI: 10.3390/diagnostics11060989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/20/2021] [Accepted: 05/24/2021] [Indexed: 11/17/2022] Open
Abstract
Gaucher disease (GD), one of the most common lysosomal disorders, is characterised by clinical heterogeneity. Cardiac involvement is rare and refers to pulmonary hypertension (PH), valvular abnormalities and myocardial infiltrative damage. The aim of this study was to evaluate cardiac involvement in a group of Romanian GD patients. Phenotypic and genotypic characterisation was carried out in 69 patients with GD type 1. Annual echocardiography and electrocardiography were performed to assess pulmonary pressure, morphology and function of the valves and electrocardiographic changes. Nine patients (13%) exhibited baseline echocardiographic signs suggesting PH. Mitral regurgitation was present in 33 patients (48%) and aortic regurgitation in 11 patients (16%). One patient presented aortic stenosis. Significant valvular dysfunction was diagnosed in 10% of patients. PH was associated with greater age (p < 0.001), longer time since splenectomy (p = 0.045) and longer time between clinical onset and the start of enzyme replacing therapy (p < 0.001). Electrocardiographic changes were present in five patients (7%).
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Affiliation(s)
- Cecilia Lazea
- 1st Pediatric Discipline, Mother and Child Department, “Iuliu Hațieganu” University of Medicine and Pharmacy, Clinic Pediatrics I, Emergency Pediatric Hospital, 400370 Cluj-Napoca, Romania; (S.B.); (C.A.-K.)
- Correspondence: ; Tel.: +40-744-353-764
| | - Simona Bucerzan
- 1st Pediatric Discipline, Mother and Child Department, “Iuliu Hațieganu” University of Medicine and Pharmacy, Clinic Pediatrics I, Emergency Pediatric Hospital, 400370 Cluj-Napoca, Romania; (S.B.); (C.A.-K.)
- Department of Genetic Diseases, Emergency Pediatric Hospital, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400370 Cluj-Napoca, Romania
| | - Camelia Al-Khzouz
- 1st Pediatric Discipline, Mother and Child Department, “Iuliu Hațieganu” University of Medicine and Pharmacy, Clinic Pediatrics I, Emergency Pediatric Hospital, 400370 Cluj-Napoca, Romania; (S.B.); (C.A.-K.)
- Department of Genetic Diseases, Emergency Pediatric Hospital, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400370 Cluj-Napoca, Romania
| | - Anca Zimmermann
- 1st Clinic and Polyclinic of Internal Medicine, Medical Clinic 2, Clinic of Worms, Department of Diabetology and Endocrinology, University Medical Center, 55131 Mainz, Germany;
| | - Ștefan Cristian Vesa
- Department of Pharmacology, Toxicology and Clinical Pharmacology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Ioana Nașcu
- Emergency Pediatric Hospital, 400370 Cluj-Napoca, Romania; (I.N.); (V.C.); (M.C.); (C.A.)
| | - Victoria Creț
- Emergency Pediatric Hospital, 400370 Cluj-Napoca, Romania; (I.N.); (V.C.); (M.C.); (C.A.)
| | - Mirela Crișan
- Emergency Pediatric Hospital, 400370 Cluj-Napoca, Romania; (I.N.); (V.C.); (M.C.); (C.A.)
| | - Carmen Asăvoaie
- Emergency Pediatric Hospital, 400370 Cluj-Napoca, Romania; (I.N.); (V.C.); (M.C.); (C.A.)
| | - Diana Miclea
- Department of Medical Genetics, “Iuliu Hațieganu” University of Medicine and Pharmacy, Emergency Pediatric Hospital, 400012 Cluj-Napoca, Romania;
| | - Paula Grigorescu-Sido
- Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
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Alkhzouz C, Cabau G, Lazea C, Asavoaie C, Bucerzan S, Mirea AM, Farcas M, Miclaus Jnr M, Popp R, Miclea D. Skeletal Abnormalities and VDR1 Gene Polymorphisms in Mucopolysaccharidosis Patients. Pharmgenomics Pers Med 2021; 14:349-358. [PMID: 33889011 PMCID: PMC8056862 DOI: 10.2147/pgpm.s295241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 02/22/2021] [Indexed: 11/23/2022]
Abstract
Introduction Articular and bone damage, which is so disabling in Mucopolysaccharidosis (MPS), requires attention as to the explanatory bias of the pathogenetic mechanisms identified to date. The vitamin D receptor (VDR) has been investigated in many studies in correlation with bone metabolism, osteoporosis, and the impaired bone mineral density associated with certain polymorphisms of the VDR gene. Aim This study aims to observe whether there is an association between clinical features, phospho-calcium metabolism parameters and the VDR gene polymorphisms in patients with MPS. Patients and Method We evaluated six patients with MPS type I, 20 patients with MPS type II, two patients with MPS types IIIA and IIIB and three patients with MPS type IVB. In these patients, phospho-calcium metabolism, markers of bone formation, bone radiographs and bone densitometry were evaluated, as were four polymorphisms of the VDR gene (ApaI, BsmI, FokI and TaqI). Results There was a deficiency in 25 hydroxy vitamin D in MPS type I patients at the final evaluation and in MPS type II patients, both at ERT initiation and at the last evaluation. The analysed polymorphisms were not associated with modified calcium-phosphor levels, but some differences were observed regarding the level of 25 OH vitamin D. Thus, in the case of AA polymorphism, all patients have a 25 OH vitamin D deficiency, and one patient with the AA genotype and three with Aa have a 25 OH vitamin D deficiency and secondary hyperparathyroidism due to this deficiency (four patients), all of them having the Bb phenotype. Conclusion In MPS patients, vitamin D deficiency is observed, as it is in some patients with secondary hyperparathyroidism, which indicates vitamin D supplementation to protect bone metabolism. There are no obvious correlations between VDR polymorphism and bone metabolism in MPS patients.
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Affiliation(s)
- Camelia Alkhzouz
- Department of Medical Genetics, Clinical Emergency Hospital for Children, Cluj-Napoca, Romania.,"Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Georgiana Cabau
- "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cecilia Lazea
- "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,First Pediatric Clinic, Clinical Emergency Hospital for Children, Cluj-Napoca, Romania
| | - Carmen Asavoaie
- First Pediatric Clinic, Clinical Emergency Hospital for Children, Cluj-Napoca, Romania
| | - Simona Bucerzan
- Department of Medical Genetics, Clinical Emergency Hospital for Children, Cluj-Napoca, Romania.,"Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Marius Farcas
- "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Maria Miclaus Jnr
- "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Radu Popp
- "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Diana Miclea
- Department of Medical Genetics, Clinical Emergency Hospital for Children, Cluj-Napoca, Romania.,"Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
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20
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Abstract
Potocki-Lupski syndrome (PTLS) is a rare developmental disorder resulting from the partial duplication of the short arm of chromosome 17. Affected children may have hypotonia, facial dysmorphism, or neurological abnormalities. PTLS is also frequently associated with failure to thrive due to swallowing difficulties or growth hormone deficiency. We report the first Romanian family (a mother and her five children) diagnosed with PTLS (17p11.2 microduplication). Fortunately, they present a less severe form of the disease. The neurological manifestations (speech delay, mild intellectual disability) are associated with craniofacial dysmorphism (microcephaly, micrognathia, triangular face, broad forehead, long chin, prominent ears, dolichocephaly, down slanting palpebral fissures). The diagnostic was established using a multiplex ligation-dependent probe amplification technique (MLPA) test, which detected the duplication of three regions of the 17p11.2 chromosome (RAI1, DRC3-6, LLGL1-4RA). Children with PTLS have specific phenotypes (craniofacial dysmorphism or neurological manifestations), which must draw the pediatrician's attention to a possible genetic condition. However, every child with this disease is unique and may have a different clinical presentation. A multi-disciplinary team is needed for the management of these patients. The parent's counseling and genetic advice are essential for a family with children with PTLS.
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Affiliation(s)
- Alina Grama
- Second Pediatric Discipline, Department of Mother and Child, University of Medicine and Pharmacy Iuliu Hațieganu, Cluj-Napoca, Romania.,Second Pediatric Clinic, Emergency Clinical Hospital for Children, Cluj-Napoca, Romania
| | - Claudia Sîrbe
- Second Pediatric Discipline, Department of Mother and Child, University of Medicine and Pharmacy Iuliu Hațieganu, Cluj-Napoca, Romania.,Second Pediatric Clinic, Emergency Clinical Hospital for Children, Cluj-Napoca, Romania
| | - Diana Miclea
- Discipline of Medical Genetics, Department of Molecular Sciences, University of Medicine and Pharmacy Iuliu Hațieganu, Cluj-Napoca, Romania
| | - Simona Sorana Cǎinap
- Second Pediatric Discipline, Department of Mother and Child, University of Medicine and Pharmacy Iuliu Hațieganu, Cluj-Napoca, Romania.,Second Pediatric Clinic, Emergency Clinical Hospital for Children, Cluj-Napoca, Romania
| | - Delia Huniadi
- Discipline of Neurology, University of Medicine and Pharmacy Iuliu Hațieganu, Cluj-Napoca, Romania
| | - Bogdan Bulata
- Pediatric Nephrology, Dialysis and Toxicology Clinic, Emergency Clinical Hospital for Children, Cluj-Napoca, Romania
| | - Tudor Lucian Pop
- Second Pediatric Discipline, Department of Mother and Child, University of Medicine and Pharmacy Iuliu Hațieganu, Cluj-Napoca, Romania.,Second Pediatric Clinic, Emergency Clinical Hospital for Children, Cluj-Napoca, Romania
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Bucerzan S, Miclea D, Lazea C, Asavoaie C, Kulcsar A, Grigorescu-Sido P. 16q24.3 Microduplication in a Patient With Developmental Delay, Intellectual Disability, Short Stature, and Nonspecific Dysmorphic Features: Case Report and Review of the Literature. Front Pediatr 2020; 8:390. [PMID: 32760686 PMCID: PMC7373721 DOI: 10.3389/fped.2020.00390] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 06/08/2020] [Indexed: 11/13/2022] Open
Abstract
We describe the case of a seven-year-old female patient who presented in our service with severe developmental delay, intellectual disability, facial dysmorphism, and femur fracture, observed in the context of very low bone mineral density. Array-based single nucleotide polymorphism (SNP array) analysis identified a 113 kb duplication involving the morbid OMIM genes: ANKRD11 (exon1), RPL13, and PGN genes. ANKRD11 deletions are frequently described in association with KBG syndrome, the duplications being less frequent (one case described before). The exome sequencing was negative for pathogenic variants or of uncertain significance in genes possibly associated with this phenotype. The patient presented subtle signs of KBG syndrome. It is known that the phenotype of KBG syndrome has a wide clinical spectrum, this syndrome being often underdiagnosed due to overlapping features with other conditions, also characterized by multiple congenital anomalies and intellectual disability. The particularity of this case is represented by the very low bone mineral density in a patient with 16q24.3 duplication. ANKRD11 haploinsufficiency is known to be associated with skeletal involvement, such as short stature, or delayed bone age. An effect on bone density has been observed only in experimental studies on mice with induced missense mutations in the ANKRD11 gene. This CNV also involved the duplication of the very conserved RPL13 gene, which could have a role for the skeletal phenotype of this patient, knowing the high level of gene expression in bone tissue and also the association with spondyloepimetaphyseal dysplasia Isidor Toutain type, in case of splicing mutations.
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Affiliation(s)
- Simona Bucerzan
- Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Children's Emergency Clinical Hospital Cluj-Napoca, Cluj-Napoca, Romania
| | - Diana Miclea
- Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Children's Emergency Clinical Hospital Cluj-Napoca, Cluj-Napoca, Romania
| | - Cecilia Lazea
- Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Children's Emergency Clinical Hospital Cluj-Napoca, Cluj-Napoca, Romania
| | - Carmen Asavoaie
- Children's Emergency Clinical Hospital Cluj-Napoca, Cluj-Napoca, Romania
| | - Andrea Kulcsar
- Children's Emergency Clinical Hospital Cluj-Napoca, Cluj-Napoca, Romania
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Chirita Emandi A, Dobrescu AI, Doros G, Hyon C, Miclea D, Popoiu C, Puiu M, Arghirescu S. A Novel 3q29 Deletion in Association With Developmental Delay and Heart Malformation-Case Report With Literature Review. Front Pediatr 2019; 7:270. [PMID: 31338352 PMCID: PMC6628938 DOI: 10.3389/fped.2019.00270] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 06/14/2019] [Indexed: 01/16/2023] Open
Abstract
3q29 deletion syndrome is a rare disorder, causing a complex phenotype. Clinical features are variable and relatively non-specific. Our report aims to present an atypical, de novo deletion in chromosome band 3q29 in a preschool boy, first child of healthy non-consanguineous parents, presenting a particular phenotype (microcephaly, "full moon" face, flattened facial profile, large ears, auricular polyp, and dental dystrophies), motor and cognitive delay, characteristics of autism spectrum disorder and aggressive behavior. He also presented intrauterine growth restriction (birth weight 2,400 g) and a ventricular septal defect. SNP Array revealed a 962 kb copy number loss, on the chromosome 3q29 band (195519857-196482211), consistent with 3q29 microdeletion syndrome. FISH analysis using a RP11-252K11 probe confirmed the deletion in the proband, which was not present in the parents. Although the patient's deletion is relatively small, it partly overlaps the canonical 3q29 deletion (defined between TFRC and DLG1 gene) and extends upstream, associating a different facial phenotype compared to the classic 3q29 deletion, nonetheless showing a similar psychiatric disorder. This deletion is different from the canonical region, as it does not include the PAK2 and DLG1 genes, considered as candidates for causing intellectual disability. Thus, narrowing the genotype-phenotype correlation for the 3q29 band, FBX045 is suggested as a candidate gene for the neuropsychiatric phenotype.
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Affiliation(s)
- Adela Chirita Emandi
- Discipline of Genetics, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania.,"Louis Turcanu" Clinical Emergency Hospital for Children, Timișoara, Romania
| | - Andreea Iulia Dobrescu
- Discipline of Genetics, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania.,"Louis Turcanu" Clinical Emergency Hospital for Children, Timișoara, Romania
| | - Gabriela Doros
- "Louis Turcanu" Clinical Emergency Hospital for Children, Timișoara, Romania.,IIIrd Pediatric Clinic, Pediatric Cardiology, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania
| | - Capucine Hyon
- Département de Génétique Médicale, AP-HP, GHUEP, Hôpital Armand Trousseau, Paris, France.,INSERM, UMRS 933, Hôpital Armand Trousseau, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, Paris, France
| | - Diana Miclea
- Genetics Department Cluj-Napoca, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Calin Popoiu
- "Louis Turcanu" Clinical Emergency Hospital for Children, Timișoara, Romania.,Discipline of Pediatric Surgery, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania
| | - Maria Puiu
- Discipline of Genetics, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania.,"Louis Turcanu" Clinical Emergency Hospital for Children, Timișoara, Romania
| | - Smaranda Arghirescu
- "Louis Turcanu" Clinical Emergency Hospital for Children, Timișoara, Romania.,IIIrd Pediatric Clinic, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania
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Bucerzan S, Miclea D, Popp R, Alkhzouz C, Lazea C, Pop IV, Grigorescu-Sido P. Clinical and genetic characteristics in a group of 45 patients with Turner syndrome (monocentric study). Ther Clin Risk Manag 2017; 13:613-622. [PMID: 28496331 PMCID: PMC5422538 DOI: 10.2147/tcrm.s126301] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Introduction Recent years have seen a shift in perspective on Turner syndrome, as it is no longer considered a significant disability due to therapeutic advances. The delay of diagnosis and the underdiagnosis are common in Turner syndrome, especially because of the great phenotypic variability and lack of firm diagnostic criteria. Aim Our first aim was to assess the clinical and the cytogenetic characteristics and growth rate in growth hormone (GH)-treated patients as compared to those with spontaneous growth. The second aim was to analyze the Y chromosomal sequences. Materials and methods We analyzed 45 patients diagnosed with Turner syndrome in Genetic Pathology Centre of Cluj Emergency Children’s Hospital. We carried out a study of the clinical features, the correlations between the karyotype and the phenotype, and we also made a research of Y chromosome sequences. Results The average age at diagnosis was 8.9±5.4 years. A significant association was observed between the number of external phenotypical abnormalities and internal malformations (r=0.45), particularly the cardiovascular ones (r=0.44). Patients treated with GH showed improvement in growth rate, with final stature significantly better than in untreated patients; benefits following treatment were greater if diagnosis was made before the age of 5 years. Thirteen percent of patients experienced spontaneous and complete puberty, whereas 30% experienced incomplete puberty. Patients with the 45,X genotype had a greater stature deficit and a higher incidence of cardiac malformations, compared with patients with 45,X/46,XX mosaic karyotype. Y chromosome sequences were found in only one patient, who subsequently underwent gonadectomy. Conclusion The importance of this study resides, to the best of our knowledge, in the fact that the largest group of patients in Romania was analyzed and assessed. To draw firm conclusions on the most valuable clinical indicators for Turner syndrome diagnosis in clinical practice, studies on large groups of patients should be conducted.
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Affiliation(s)
- Simona Bucerzan
- Emergency Hospital for Children, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Diana Miclea
- Emergency Hospital for Children, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Molecular Sciences, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Radu Popp
- Department of Molecular Sciences, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Camelia Alkhzouz
- Emergency Hospital for Children, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cecilia Lazea
- Emergency Hospital for Children, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioan Victor Pop
- Department of Molecular Sciences, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Paula Grigorescu-Sido
- Emergency Hospital for Children, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Miclea D, Peca L, Cuzmici Z, Pop IV. Genetic testing in patients with global developmental delay / intellectual disabilities. A review. ACTA ACUST UNITED AC 2015; 88:288-92. [PMID: 26609258 PMCID: PMC4632884 DOI: 10.15386/cjmed-461] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 05/15/2015] [Indexed: 12/28/2022]
Abstract
Genetic factors are responsible for up to 40% developmental disability cases, such as global developmental delay/intellectual disability (GDD/DI). The American and more recently the European guidelines on this group of diseases state that genetic testing is essential and should become a standardized diagnostic practice. The main arguments for the necessity of implementing such a practice are: (1) the high prevalence of developmental disabilities (3% of the population); (2) the high genetic contribution to this type of pathology; (3) insufficient referral for genetic consultation. In an attempt to address these issues, the purpose of this paper is to present the genetic etiology of global developmental delay / intellectual disability with emphasis on the need to implement a genetic testing protocol for the patients with GDD/DI, as indicated by the current guidelines. Chromosomal abnormalities and fragile X syndrome are the most frequent causes of developmental disabilities and the techniques employed to detect such genetic disorders should be used as first line investigations of GDD/DI.
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Affiliation(s)
- Diana Miclea
- Department of Molecular Sciences, Medical Genetics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Loredana Peca
- Faculty of Psychology and Educational Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Zina Cuzmici
- Department of Molecular Sciences, Medical Genetics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioan Victor Pop
- Department of Molecular Sciences, Medical Genetics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Zubicki A, Gostin X, Miclea D, Riou B, Buy E, Richer C, Coriat P. Comparison of the haemodynamic actions of desflurane/N2O and isoflurane/N2O anaesthesia in vascular surgical patients. Acta Anaesthesiol Scand 1998; 42:1057-62. [PMID: 9809088 DOI: 10.1111/j.1399-6576.1998.tb05376.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The purpose of this study was to compare heart rate and arterial blood pressure response to desflurane/N2O vs isoflurane/N2O anaesthesia in a randomized clinical trial performed in patients before vascular surgery. METHODS To evaluate associated changes in the autonomic nervous system with maintenance of anaesthesia, we used power spectral analysis (PSA) of heart rate and blood pressure and measured plasma catecholamine concentrations. Twenty-five patients whose trachea had been intubated after propofol induction were given either desflurane or isoflurane at 1 and 1.5 MAC in N2O (60%) in a random manner. RESULTS At an anaesthetic depth of up to 1.5 MAC, arterial blood pressure, indices of sympathetic activity derived from PSA, decreased with both anaesthetics, while heart rate and plasma catecholamine concentrations did not significantly change. Plasma renin activity significantly increased at 1.5 MAC anaesthesia in both groups. CONCLUSIONS We conclude that sympathetic hyperactivity previously reported during desflurane anaesthesia in healthy volunteers is not frequent in clinical practice in elderly vascular surgical patients under desflurane/N2O anaesthesia, since it occurs at an anaesthetic depth which cannot be reached in these patients because of the lowering arterial blood pressure effects of desflurane, which are similar to those of isoflurane.
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Affiliation(s)
- A Zubicki
- Department of Anesthesiology and Intensive Care, Hôpital de la Pitié-Salpétrière, Paris, France
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