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Geroldi A, Ponti C, Mammi A, Patrone S, Gotta F, Trevisan L, Sanguineri F, Origone P, Gaudio A, La Barbera A, Cataldi M, Gemelli C, Massucco S, Schenone A, Lanteri P, Fiorillo C, Grandis M, Mandich P, Bellone E. Early Onset Inherited Peripheral Neuropathies: The Experience of a Specialized Referral Center for Genetic Diagnosis Achievement. Pediatr Neurol 2024; 154:4-8. [PMID: 38428336 DOI: 10.1016/j.pediatrneurol.2024.02.002] [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] [Received: 09/05/2022] [Revised: 01/26/2024] [Accepted: 02/05/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Charcot-Marie-Tooth disease (CMT) is a heterogeneous group of inherited peripheral neuropathies. Although the typical disease onset is reported in the second decade, earlier onsets are not uncommon. To date, few studies on pediatric populations have been conducted and the achievement of molecular diagnosis remains challenging. METHODS During the last 24 years we recruited 223 patients with early-onset hereditary peripheral neuropathies (EOHPN), negative for PMP22 duplication, 72 of them referred by a specialized pediatric hospital. Genetic testing for CMT-associated genes has been carried out with a range of different techniques. RESULTS Of the 223 EOHPN cases, 43% were classified as CMT1 (demyelinating), 49% as CMT2 (axonal), and 8% as CMTi (intermediate). Genetic diagnosis was reached in 51% of patients, but the diagnostic yield increased to 67% when focusing only on cases from the specialized pediatric neuromuscular centers. Excluding PMP22 rearrangements, no significant difference in diagnostic rate between demyelinating and axonal forms was identified. De novo mutations account for 38% of cases. CONCLUSIONS This study describes an exhaustive picture of EOHPN in an Italian referral genetic center and analyzes the molecular diagnostic rate of a heterogeneous cohort compared with one referred by a specialized pediatric center. Our data identify MPZ, MFN2, GDAP1, and SH3TC2 genes as the most frequent players in EOHPN. Our study underlines the relevance of a specific neurological pediatric expertise to address the genetic testing and highlights its importance to clarify possible unexpected results when neuropathy is only a secondary clinical sign of a more complex phenotype.
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Affiliation(s)
- Alessandro Geroldi
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy.
| | - Clarissa Ponti
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, UOC Genetica Medica, Genoa, Italy
| | - Alessia Mammi
- IRCCS Ospedale Policlinico San Martino, UOC Genetica Medica, Genoa, Italy
| | - Serena Patrone
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy
| | - Fabio Gotta
- IRCCS Ospedale Policlinico San Martino, UOC Genetica Medica, Genoa, Italy
| | - Lucia Trevisan
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, UOC Genetica Medica, Genoa, Italy
| | - Francesca Sanguineri
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, UOC Genetica Medica, Genoa, Italy
| | - Paola Origone
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, UOC Genetica Medica, Genoa, Italy
| | - Andrea Gaudio
- IRCCS Ospedale Policlinico San Martino, UOC Genetica Medica, Genoa, Italy
| | - Andrea La Barbera
- IRCCS Ospedale Policlinico San Martino, UOC Genetica Medica, Genoa, Italy
| | - Matteo Cataldi
- Pediatric Neuropsychiatric Unit, IRCCS Institute "G. Gaslini", Genoa, Italy
| | - Chiara Gemelli
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, UOC Clinica Neurologica, Genoa, Italy
| | - Sara Massucco
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, UOC Clinica Neurologica, Genoa, Italy
| | - Angelo Schenone
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, UOC Clinica Neurologica, Genoa, Italy
| | - Paola Lanteri
- Pediatric Neuropsychiatric Unit, IRCCS Institute "G. Gaslini", Genoa, Italy
| | - Chiara Fiorillo
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy; Unit of Paediatric Neurology and Neuromuscular Disorders, IRCCS Institute "G. Gaslini", Genoa, Italy
| | - Marina Grandis
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, UOC Clinica Neurologica, Genoa, Italy
| | - Paola Mandich
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, UOC Genetica Medica, Genoa, Italy
| | - Emilia Bellone
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, UOC Genetica Medica, Genoa, Italy
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2
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Giardina E, Mandich P, Ghidoni R, Ticozzi N, Rossi G, Fenoglio C, Tiziano FD, Esposito F, Capellari S, Nacmias B, Mineri R, Campopiano R, Di Pilla L, Sammarone F, Zampatti S, Peconi C, De Angelis F, Palmieri I, Galandra C, Nicodemo E, Origone P, Gotta F, Ponti C, Nicsanu R, Benussi L, Peverelli S, Ratti A, Ricci M, Di Fede G, Magri S, Serpente M, Lattante S, Domi T, Carrera P, Saltimbanco E, Bagnoli S, Ingannato A, Albanese A, Tagliavini F, Lodi R, Caltagirone C, Gambardella S, Valente EM, Silani V. Distribution of the C9orf72 hexanucleotide repeat expansion in healthy subjects: a multicenter study promoted by the Italian IRCCS network of neuroscience and neurorehabilitation. Front Neurol 2024; 15:1284459. [PMID: 38356886 PMCID: PMC10865370 DOI: 10.3389/fneur.2024.1284459] [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: 08/28/2023] [Accepted: 01/05/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction High repeat expansion (HRE) alleles in C9orf72 have been linked to both amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD); ranges for intermediate allelic expansions have not been defined yet, and clinical interpretation of molecular data lacks a defined genotype-phenotype association. In this study, we provide results from a large multicenter epidemiological study reporting the distribution of C9orf72 repeats in healthy elderly from the Italian population. Methods A total of 967 samples were collected from neurologically evaluated healthy individuals over 70 years of age in the 13 institutes participating in the RIN (IRCCS Network of Neuroscience and Neurorehabilitation) based in Italy. All samples were genotyped using the AmplideXPCR/CE C9orf72 Kit (Asuragen, Inc.), using standardized protocols that have been validated through blind proficiency testing. Results All samples carried hexanucleotide G4C2 expansion alleles in the normal range. All samples were characterized by alleles with less than 25 repeats. In particular, 93.7% of samples showed a number of repeats ≤10, 99.9% ≤20 repeats, and 100% ≤25 repeats. Conclusion This study describes the distribution of hexanucleotide G4C2 expansion alleles in an Italian healthy population, providing a definition of alleles associated with the neurological healthy phenotype. Moreover, this study provides an effective model of federation between institutes, highlighting the importance of sharing genomic data and standardizing analysis techniques, promoting translational research. Data derived from the study may improve genetic counseling and future studies on ALS/FTD.
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Affiliation(s)
- Emiliano Giardina
- Genomic Medicine Laboratory UILDM, IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Paola Mandich
- IRCCS Ospedale Policlinico San Martino – UOC Genetica Medica, Genova, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genova, Genova, Italy
| | - Roberta Ghidoni
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Nicola Ticozzi
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, “Dino Ferrari” Center, Università degli Studi di Milano, Milan, Italy
| | - Giacomina Rossi
- Unit of Neurology V – Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Chiara Fenoglio
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Francesco Danilo Tiziano
- Section of Genomic Medicine, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Unit of Medical Genetics, Department of Laboratory Science and Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Federica Esposito
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Laboratory of Human Genetics of Neurological Disorders, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sabina Capellari
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- DIBINEM Università di Bologna, Bologna, Italy
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Rossana Mineri
- Laboratory Medicine, Department of Cytogenetics and Molecular Genetics, IRCCS Humanitas Research Hospital, Milan, Italy
| | | | | | | | - Stefania Zampatti
- Genomic Medicine Laboratory UILDM, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Cristina Peconi
- Genomic Medicine Laboratory UILDM, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Flavio De Angelis
- Department of Mental, Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
- Department of Biology, California State University, Northridge, Northridge, CA, United States
| | | | | | | | - Paola Origone
- IRCCS Ospedale Policlinico San Martino – UOC Genetica Medica, Genova, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genova, Genova, Italy
| | - Fabio Gotta
- IRCCS Ospedale Policlinico San Martino – UOC Genetica Medica, Genova, Italy
| | - Clarissa Ponti
- IRCCS Ospedale Policlinico San Martino – UOC Genetica Medica, Genova, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genova, Genova, Italy
| | - Roland Nicsanu
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Luisa Benussi
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Silvia Peverelli
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Antonia Ratti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Medical Biotechnology and Molecular Medicine, Università degli Studi di Milano, Milan, Italy
| | - Martina Ricci
- Unit of Neurology V – Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Giuseppe Di Fede
- Unit of Neurology V – Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Stefania Magri
- Unit of Medical Genetics and Neurogenetics Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Maria Serpente
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Serena Lattante
- Section of Genomic Medicine, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Biological and Environmental Sciences and Technologies, University of Salento, Lecce, Italy
| | - Teuta Domi
- Experimental Neuropathology Unit, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola Carrera
- Laboratory of Clinical Molecular Biology, Unit of Genomics for Human Disease Diagnosis, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisa Saltimbanco
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Silvia Bagnoli
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Assunta Ingannato
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Alberto Albanese
- Department of Neurology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | | | - Raffaele Lodi
- Policlinico S. Orsola-Malpighi, Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Bologna, Italy
| | - Carlo Caltagirone
- Department of Clinical and Behavioral Neurology, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Stefano Gambardella
- IRCCS Neuromed, Pozzilli, Italy
- Department of Biomolecular Sciences, University of Urbino "Carlo Bo", Urbino, Italy
| | - Enza Maria Valente
- IRCCS Mondino Foundation, Pavia, Italy
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, “Dino Ferrari” Center, Università degli Studi di Milano, Milan, Italy
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3
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Geroldi A, Tozza S, Fiorillo C, Nolano M, Fossa P, Vitale F, Domi R, Gaudio A, Mammi A, Patrone S, Barbera AL, Origone P, Ponti C, Sanguineri F, Zara F, Cataldi M, Salpietro V, Venturi CB, Massucco S, Schenone A, Manganelli F, Mandich P, Bellone E, Gotta F. A novel de novo variant in POLR3B gene associated with a primary axonal involvement of the largest nerve fibers. J Peripher Nerv Syst 2023; 28:620-628. [PMID: 37897416 DOI: 10.1111/jns.12602] [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] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND AND AIMS POLR3B gene encodes a subunit of RNA polymerase III (Pol III). Biallelic mutations in POLR3B are associated with leukodystrophies, but recently de novo heterozygous mutations have been described in early onset peripheral demyelinating neuropathies with or without central involvement. Here, we report the first Italian case carrying a de novo variant in POLR3B with a pure neuropathy phenotype and primary axonal involvement of the largest nerve fibers. METHODS Nerve conduction studies, sympathetic skin response, dynamic sweat test, tactile and thermal quantitative sensory testing and brain magnetic resonance imaging were performed according to standard procedures. Histopathological examination was performed on skin and sural nerve biopsies. Molecular analysis of the proband and his relatives was performed with Next Generation Sequencing. The impact of the identified variant on the overall protein structure was evaluated through rotamers method. RESULTS Since his early adolescence, the patient presented with signs of polyneuropathy with severe distal weakness, atrophy, and reduced sensation. Neurophysiological studies showed a sensory-motor axonal polyneuropathy, with confirmed small fiber involvement. In addition, skin biopsy and sural nerve biopsy showed predominant large fibers involvement. A trio's whole exome sequencing revealed a novel de novo variant p.(Arg1046Cys) in POLR3B, which was classified as Probably Pathogenic. Molecular modeling data confirmed a deleterious effect of the variant on protein structure. INTERPRETATION Neurophysiological and morphological findings suggest a primary axonal involvement of the largest nerve fibers in POLR3B-related neuropathies. A partial loss of function mechanism is proposed for both neuropathy and leukodystrophy phenotypes.
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Affiliation(s)
- Alessandro Geroldi
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy
| | - Stefano Tozza
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Chiara Fiorillo
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy
- Child Neuropsychiatric Unit, IRCCS Institute G. Gaslini, Genoa, Italy
| | - Maria Nolano
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Paola Fossa
- Department of Pharmacy, University of Genoa, Genoa, Italy
| | - Floriana Vitale
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Regi Domi
- Department of Pharmacy, University of Genoa, Genoa, Italy
| | - Andrea Gaudio
- OU Medical Genetics, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Alessia Mammi
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy
| | - Serena Patrone
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy
| | - Andrea La Barbera
- OU Medical Genetics, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Paola Origone
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy
- OU Medical Genetics, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Clarissa Ponti
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy
- OU Medical Genetics, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesca Sanguineri
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy
- OU Medical Genetics, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Federico Zara
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy
- Medical Genetic Unit, IRCCS Institute G. Gaslini, Genoa, Italy
| | - Matteo Cataldi
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy
- Child Neuropsychiatric Unit, IRCCS Institute G. Gaslini, Genoa, Italy
| | - Vincenzo Salpietro
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy
- Medical Genetic Unit, IRCCS Institute G. Gaslini, Genoa, Italy
| | | | - Sara Massucco
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy
- OU Neurology Clinic, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Angelo Schenone
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy
- OU Neurology Clinic, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Paola Mandich
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy
- OU Medical Genetics, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Emilia Bellone
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences, University of Genoa, Genoa, Italy
- OU Medical Genetics, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Fabio Gotta
- OU Medical Genetics, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Gaudio A, Gotta F, Ponti C, Sanguineri F, Trevisan L, Geroldi A, Patrone S, Gemelli C, Cabona C, Astrea G, Fiorillo C, Gustincich S, Grandis M, Mandich P. Case report: Episodic ataxia without ataxia? Front Neurol 2023; 14:1224241. [PMID: 37965175 PMCID: PMC10640972 DOI: 10.3389/fneur.2023.1224241] [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: 05/17/2023] [Accepted: 10/03/2023] [Indexed: 11/16/2023] Open
Abstract
Hereditary myopathies represent a clinically and genetically heterogeneous group of neuromuscular disorders, characterized by highly variable clinical presentations and frequently overlapping phenotypes with other neuromuscular disorders, likely influenced by genetic and environmental modifiers. Genetic testing is often challenging due to ambiguous clinical diagnosis. Here, we present the case of a family with clinical and Electromyography (EMG) features resembling a myotonia-like disorder in which Whole Exome Sequencing (WES) analysis revealed the co-segregation of two rare missense variants in UBR4 and HSPG2, genes previously associated with episodic ataxia 8 (EA8). A review of the literature highlighted a striking overlap between the clinical and the molecular features of our family and the previously described episodic ataxias (EAs), which raises concerns about the genotype-phenotype correlation, clinical variability, and the confounding overlap in these groups of disorders. This emphasizes the importance of thoroughly framing the patient's phenotype. The more clear-cut the diagnosis, the easier the identification of a genetic determinant, and the better the prognosis and the treatment of patients.
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Affiliation(s)
- Andrea Gaudio
- IRCCS Ospedale Policlinico San Martino—UOC Genetica Medica, Genova, Italy
| | - Fabio Gotta
- IRCCS Ospedale Policlinico San Martino—UOC Genetica Medica, Genova, Italy
| | - Clarissa Ponti
- IRCCS Ospedale Policlinico San Martino—UOC Genetica Medica, Genova, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genova, Genova, Italy
| | - Francesca Sanguineri
- IRCCS Ospedale Policlinico San Martino—UOC Genetica Medica, Genova, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genova, Genova, Italy
| | - Lucia Trevisan
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genova, Genova, Italy
- IRCCS Ospedale Policlinico San Martino—SS Centro Tumori Ereditari, Genova, Italy
| | - Alessandro Geroldi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genova, Genova, Italy
| | - Serena Patrone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genova, Genova, Italy
| | - Chiara Gemelli
- IRCCS-Ospedale Policlinico San Martino—UOC Clinica Neurologica, Genova, Italy
| | - Corrado Cabona
- IRCCS-Ospedale Policlinico San Martino—UOC Neurofisiopatologia, Genova, Italy
| | | | - Chiara Fiorillo
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genova, Genova, Italy
- IRCCS Istituto Giannina Gaslini—UOC Neuropsichiatria Infantile, Genova, Italy
| | - Stefano Gustincich
- Department of Neuroscience and Brain Technologies, Istituto Italiano di Tecnologia, Genova, Italy
| | - Marina Grandis
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genova, Genova, Italy
- IRCCS-Ospedale Policlinico San Martino—UOC Clinica Neurologica, Genova, Italy
| | - Paola Mandich
- IRCCS Ospedale Policlinico San Martino—UOC Genetica Medica, Genova, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genova, Genova, Italy
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5
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Geroldi A, Trevisan L, Gaudio A, Gotta F, Patrone S, Origone P, Grandis M, Gemelli C, Schenone A, Accogli A, Zara F, Mandich P, Bellone E. A misleading presentation of Mohr-Tranebjaerg syndrome: What is hidden behind an axonal neuropathy? Parkinsonism Relat Disord 2022; 102:54-56. [PMID: 35947939 DOI: 10.1016/j.parkreldis.2022.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/21/2022] [Accepted: 07/24/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Alessandro Geroldi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Largo P. Daneo 3, 16132, Genova, Italy.
| | - Lucia Trevisan
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Largo P. Daneo 3, 16132, Genova, Italy; IRCCS Ospedale Policlinico San Martino - UOC Genetica Medica, Largo R. Benzi 10, 16132, Genova, Italy.
| | - Andrea Gaudio
- IRCCS Ospedale Policlinico San Martino - UOC Genetica Medica, Largo R. Benzi 10, 16132, Genova, Italy.
| | - Fabio Gotta
- IRCCS Ospedale Policlinico San Martino - UOC Genetica Medica, Largo R. Benzi 10, 16132, Genova, Italy.
| | - Serena Patrone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Largo P. Daneo 3, 16132, Genova, Italy.
| | - Paola Origone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Largo P. Daneo 3, 16132, Genova, Italy; IRCCS Ospedale Policlinico San Martino - UOC Genetica Medica, Largo R. Benzi 10, 16132, Genova, Italy.
| | - Marina Grandis
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Largo P. Daneo 3, 16132, Genova, Italy; IRCCS-Ospedale Policlinico San Martino - UOC Clinica Neurologica, Largo R. Benzi 10, 16132, Genova, Italy.
| | - Chiara Gemelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Largo P. Daneo 3, 16132, Genova, Italy.
| | - Angelo Schenone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Largo P. Daneo 3, 16132, Genova, Italy; IRCCS-Ospedale Policlinico San Martino - UOC Clinica Neurologica, Largo R. Benzi 10, 16132, Genova, Italy.
| | - Andrea Accogli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Largo P. Daneo 3, 16132, Genova, Italy; IRCCS Ospedale Policlinico San Martino - UOC Genetica Medica, Largo R. Benzi 10, 16132, Genova, Italy.
| | - Federico Zara
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Largo P. Daneo 3, 16132, Genova, Italy; IRCCS Istituto Giannina Gaslini - UOC Genetica Medica, Via Gerolamo Gaslini 5, 16147, Genova, Italy.
| | - Paola Mandich
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Largo P. Daneo 3, 16132, Genova, Italy; IRCCS Ospedale Policlinico San Martino - UOC Genetica Medica, Largo R. Benzi 10, 16132, Genova, Italy.
| | - Emilia Bellone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Largo P. Daneo 3, 16132, Genova, Italy; IRCCS Ospedale Policlinico San Martino - UOC Genetica Medica, Largo R. Benzi 10, 16132, Genova, Italy.
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6
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Ebrille E, Lucciola MT, Amellone C, Ballocca F, Suppo M, Antonacci G, Gotta F, Birolo M, Orlando F, Favro E, Giammaria M. Deep sedation with dexmedetomidine administered by electrophysiologists during COVID-19 pandemic compared with propofol administered by anesthesiologists for ablation of atrial fibrillation. Europace 2022. [PMCID: PMC9384089 DOI: 10.1093/europace/euac053.098] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Funding Acknowledgements Type of funding sources: None. Background COVID-19 pandemic, limiting the availability of anesthesiologists, has impacted heavily on the organization of invasive cardiac procedures such as transcatheter atrial fibrillation (AF) ablation. Purpose We compared the safety and efficacy of deep sedation with dexmedetomidine administered by electrophysiologists without anesthesiologist supervision, against the standard protocol performed with propofol. Methods We retrospectively included all AF ablation procedures performed in 2020: 23 patients sedated with 1% propofol (2 ml bolus followed by infusion starting at 1 mg/Kg/h), 26 patients with dexmedetomidine (infusion starting at 0.7 mcg/Kg/h). Both groups additionally received 1 mcg/Kg of midazolam as a single bolus and 0.05 mg single boluses of fentanyl prior to ablation on each pair of pulmonary veins (PV). Primary outcomes were oxygen desaturation (< 90%) or need for assisted ventilation/intubation, bradycardia (heart rate < 45 bpm) and persistent hypotension (systolic blood pressure < 90 mmHg). Results Baseline characteristics and hemodynamic variables did not differ between the two groups (all p > 0.05). In 8/23 (35%) patients propofol infusion velocity reduction was necessary to maintain the hemodynamic values, compared to 7/26 (27%) with dexmedetomidine. Inter-group comparison of hemodynamic variables during the procedure showed no statistically significant difference, despite a trend in favor of dexmedetomidine (3 respiratory depressions and 3 persistent hypotension episodes with propofol vs. 0 with dexmedetomidine; p = 0.057). Conclusion Deep sedation with dexmedetomidine administered by electrophysiologists without anesthesiologist supervision is safe and effective for AF transcatheter ablation. A trend towards a lower incidence of hypotension and respiratory depression was noted when compared to propofol.
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Affiliation(s)
- E Ebrille
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - MT Lucciola
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - C Amellone
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - F Ballocca
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - M Suppo
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - G Antonacci
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - F Gotta
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - M Birolo
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - F Orlando
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - E Favro
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - M Giammaria
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
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7
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Ebrille E, Amellone C, Lucciola M, Suppo M, Antonacci G, Gotta F, Birolo M, Favro E, Orlando F, Giammaria M. HeartLogic algorithm for heart failure monitoring in the era of CoViD-19 pandemic and remote monitoring/telemedicine. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0712] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Due to the current CoViD-19 pandemic, the number of outpatient hospital visits has significantly decreased, creating a fundamental need for telemedicine. Remote monitoring of implantable cardiac devices has emerged as a powerful and well-validated tool to follow patients with heart failure (HF) and cardiac resynchronization therapy (CRTs) devices.
Purpose
The aim of our study was to evaluate the CRT HeartLogic algorithm performance in the detection of HF episodes in a real-life population followed with remote monitoring.
Methods
Fifty-four patient (mean age 73±7 years, 72% males) with HF and reduced left ventricular ejection fraction were implanted with a HeartLogic-enabled CRT device and were enrolled in the Boston Scientific Latitude remote monitoring platform. Remote data were reviewed every month and at the time of an alert. The HeartLogic nominal value of 16 was used to trigger an alert episode. Patients were then contacted by phone and actions were taken to manage the potential HF condition detected by the alert.
Results
During a median follow-up of 12 (6–18) months, the HeartLogic alert was triggered in 9 patients (9/54, 17%). The median time between threshold crossing and a HF clinical event was 11 (2–19) days. The maximum HeartLogic index value was 43 (mean 29±8). Three events occurred after inappropriate discontinuation of HF therapy. All the events required clinical action. Four out of 9 patients required diuretic dosage increase, 1/9 electrical cardioversion for new onset atrial fibrillation, 3/9 hospitalization for i.v. therapy. One patient showed only mild HF symptoms but was found to have concomitant CoViD-19 infection.
Conclusion
The HeartLogic algorithm is useful to detect HF worsening and undertake appropriate clinical actions. Telemedicine and device remote monitoring are very helpful tools allowing early detection of HF-related clinical conditions. This is of utmost importance in the era of CoViD-19 pandemic, when scheduled access to the hospital for routine follow-up appointments might be limited.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- E Ebrille
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - C Amellone
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - M.T Lucciola
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - M Suppo
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - G Antonacci
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - F Gotta
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - M Birolo
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - E Favro
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - F Orlando
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - M Giammaria
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
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8
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Ruscitti F, Trevisan L, Rosti G, Gotta F, Cianflone A, Geroldi A, Origone P, Pichiecchio A, Viglio S, Iascone M, Mandich P. A novel mutation in COL3A1 associates to vascular Ehlers-Danlos syndrome with predominant musculoskeletal involvement. Mol Genet Genomic Med 2021; 9:e1753. [PMID: 34318601 PMCID: PMC8457703 DOI: 10.1002/mgg3.1753] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 09/02/2020] [Revised: 04/15/2021] [Accepted: 07/08/2021] [Indexed: 11/21/2022] Open
Abstract
Background Vascular Ehlers–Danlos syndrome (vEDS) is a heritable connective tissue disorder caused by defects in the type III collagen protein. It is generally considered the most severe form of Ehlers–Danlos syndrome (EDS) due to an increased risk of spontaneous artery or organ rupture. vEDS has an extremely heterogeneous presentation and muscle rupture is considered a minor diagnostic criterium. Methods A patient with a long history of inconclusive examinations and investigations was referred to our unit. The clinical picture was mainly characterized by muscle ruptures, whereas the cardiovascular involvement was limited to mitral regurgitation. We performed a panel analysis of genes associated with inheritable heart diseases using the TruSight Cardio kit (Illumina). A skin biopsy was then performed for functional studies to analyze the different forms of collagen molecules produced in vitro by cutaneous fibroblasts. Results The patient presented the novel variant c.3478A>G (p.Ile1160Val) in COL3A1 (NM_000090.3), whose pathogenicity was supported by biochemical analysis of type III collagen. Conclusion In this report, we describe a case of vEDS with predominant and severe musculoskeletal involvement. Our findings provide insight into genetic variants and clinical expression of vEDS, broadening the clinical scenario of the syndrome.
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Affiliation(s)
- Federica Ruscitti
- DINOGMI Department, University of Genoa, Genoa, Italy.,Medical Genetics Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lucia Trevisan
- DINOGMI Department, University of Genoa, Genoa, Italy.,Medical Genetics Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giulia Rosti
- DINOGMI Department, University of Genoa, Genoa, Italy.,Medical Genetics Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Fabio Gotta
- Medical Genetics Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Annalia Cianflone
- DINOGMI Department, University of Genoa, Genoa, Italy.,Medical Genetics Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Paola Origone
- DINOGMI Department, University of Genoa, Genoa, Italy.,Medical Genetics Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Anna Pichiecchio
- Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Simona Viglio
- Biochemistry Unit, Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Maria Iascone
- Medical Genetics Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Paola Mandich
- DINOGMI Department, University of Genoa, Genoa, Italy.,Medical Genetics Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Ebrille E, Amellone C, Lucciola M, Orlando F, Suppo M, Antonacci G, Gotta F, Giammaria M. Implantable cardiac monitor after cryptogenic stroke: atrial fibrillation detection and predictors. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0382] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
The main objective of our study was to analyze the incidence and predictors of atrial fibrillation (AF) in patients with cryptogenic stroke (CS) who received an implantable cardiac monitor (ICM) at our Institution.
Methods
From November 2013 to October 2017, a total of 133 patients who had suffered a CS were implanted with an ICM after a thorough screening process. The median time between the thromboembolic event and ICM implantation was 64 days [IQ range: 16–111]. All implanted patients were followed with remote monitoring until the first detected episode of AF or up to December 2018. Every remote monitoring transmission and related electrograms were analyzed by the dedicated Electrophysiology Nursing team and confirmed by experienced Electrophysiologists. AF was defined by any episode lasting greater than or equal to 2 minutes.
Results
During a median follow-up of 14.8 months [IQ range: 3.0–31.2], AF was detected in 65 out of 133 patients (48.9%). The median time from ICM implantation and AF detection was 3.5 months [IQ range: 0.9–6.7]. The prevalence of AF was 22.6%, 34.4%, 40.8% and 48.3% at 3, 6, 12 and 24 months respectively. At the multivariate analysis, high premature atrial contractions (PAC) burden and left atrium (LA) dilation were the only independent predictors of AF detection (HR 2.82, 95% CI 1.64–4.83, p<0.001 for PAC; HR 1.75, 95% CI 1.03–2.97, p=0.038 for LA dimension). Patients were dived into categories based on the probability of AF detection (low, intermediate and high risk) and a new risk stratification algorithm was implemented (Figure 1).
Conclusion
After a thorough screening process, AF detection in patients with CS and ILM was quite high. Having a high PAC burden and LA dilation predicted AF episodes at the multivariate analysis. A new risk stratification algorithm was developed.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- E Ebrille
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - C Amellone
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - M.T Lucciola
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - F Orlando
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - M Suppo
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - G Antonacci
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - F Gotta
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
| | - M Giammaria
- Maria Vittoria Hospital, Cardiology Department, Turin, Italy
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10
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Gotta F, Lamp M, Geroldi A, Trevisan L, Origone P, Fugazza G, Fabbri S, Nesti C, Rubegni A, Morani F, Santorelli FM, Bellone E, Mandich P. A novel mutation of Twinkle in Perrault syndrome: A not rare diagnosis? Ann Hum Genet 2020; 84:417-422. [PMID: 32281099 DOI: 10.1111/ahg.12384] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/27/2020] [Accepted: 03/02/2020] [Indexed: 01/26/2023]
Abstract
Perrault syndrome is a rare disorder characterized by ovarian dysgenesis, bilateral sensorineural hearing loss and associated with mutations in six mitochondrial proteins. Additional neurological features were also described. Herein, we report on a 27-year-old woman with Perrault syndrome (PS), moderate ataxia and axonal sensory-motor peripheral neuropathy in whom we identified compound heterozygous mutations in the TWNK gene (p.Val507Ile and the novel p.Phe248Ser variant). Fewer than 30 patients with PS have been reported worldwide. Neurological involvement is more frequently associated with mutations in TWNK and indicates possible genotype-phenotype correlations. TWNK mutations should be searched in patients with sensory ataxia, early onset bilateral sensorineural hearing loss, and ovarian dysfunction in women.
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Affiliation(s)
- Fabio Gotta
- Clinical Genetics Unit, Ospedale Policlinico IRCCS San Martino, Genoa, Italy
| | - Merit Lamp
- Clinical Genetics Unit, Ospedale Policlinico IRCCS San Martino, Genoa, Italy
| | - Alessandro Geroldi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Child Sciences, University of Genoa, Genoa, Italy
| | - Lucia Trevisan
- Clinical Genetics Unit, Ospedale Policlinico IRCCS San Martino, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Child Sciences, University of Genoa, Genoa, Italy
| | - Paola Origone
- Clinical Genetics Unit, Ospedale Policlinico IRCCS San Martino, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Child Sciences, University of Genoa, Genoa, Italy
| | | | - Sabrina Fabbri
- Neurology, Ospedale Policlinico IRCCS San Martino, Genoa, Italy
| | - Claudia Nesti
- Molecular Medicine, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Anna Rubegni
- Molecular Medicine, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Federica Morani
- Molecular Medicine, IRCCS Fondazione Stella Maris, Pisa, Italy
| | | | - Emilia Bellone
- Clinical Genetics Unit, Ospedale Policlinico IRCCS San Martino, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Child Sciences, University of Genoa, Genoa, Italy
| | - Paola Mandich
- Clinical Genetics Unit, Ospedale Policlinico IRCCS San Martino, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Child Sciences, University of Genoa, Genoa, Italy
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11
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Origone P, Geroldi A, Lamp M, Sanguineri F, Caponnetto C, Cabona C, Gotta F, Trevisan L, Bellone E, Manganelli F, Devigili G, Mandich P. Role of MAPT in Pure Motor Neuron Disease: Report of a Recurrent Mutation in Italian Patients. NEURODEGENER DIS 2019; 18:310-314. [PMID: 30893702 DOI: 10.1159/000497820] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 02/11/2019] [Indexed: 11/19/2022] Open
Abstract
The aim of our study was to evaluate the role of mutations in the MAPT gene in patients with pure amyotrophic lateral sclerosis (ALS). A cohort of 120 ALS patients, both sporadic and familial, without cognitive impairment was analyzed by next-generation sequencing with a multiple-gene panel comprising 23 genes, including MAPT, known to be associated with ALS and frontotemporal dementia. The presence of the C9orf72 expansion was also investigated. Twelve patients had mutations in the SOD1, TARDBP, MATR3, and FUS genes, while 10 patients carried the C9orf72 expansion. One female patient was found to carry the D348G mutation in MAPT, previously reported in an Italian family with lower motor neuron disease. Our patient presented both upper and lower motor neuron signs, early development of dyspnea, resting and kinetic tremor, and a slow disease course (> 11 years). The present case further broadens the clinical phenotype associated with MAPT mutations and suggests that, although rarely, MAPT mutations can cause ALS and, therefore, should be analyzed in ALS patients, especially in those with early breathing difficulties and long-lasting disease.
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Affiliation(s)
- Paola Origone
- Deptartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy, .,Medical Genetics Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy,
| | - Alessandro Geroldi
- Deptartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Merit Lamp
- Deptartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy.,Medical Genetics Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesca Sanguineri
- Deptartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Claudia Caponnetto
- Neurological Clinic, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Corrado Cabona
- Deptartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy.,Neurological Clinic, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Fabio Gotta
- Deptartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy.,Medical Genetics Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lucia Trevisan
- Deptartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy.,Medical Genetics Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Emilia Bellone
- Deptartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy.,Medical Genetics Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Fiore Manganelli
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Grazia Devigili
- 1st Neurology Unit, Department of Clinical Neurosciences, IRCCS "Carlo Besta" Neurological Institute, Milan, Italy
| | - Paola Mandich
- Deptartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy.,Medical Genetics Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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12
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Grandis M, Geroldi A, Gulli R, Manganelli F, Gotta F, Lamp M, Origone P, Trevisan L, Gemelli C, Fabbri S, Schenone A, Tozza S, Santoro L, Bellone E, Mandich P. Autosomal-dominant transthyretin (TTR)-related amyloidosis is not a frequent CMT2 neuropathy "in disguise". Orphanet J Rare Dis 2018; 13:177. [PMID: 30286783 PMCID: PMC6172830 DOI: 10.1186/s13023-018-0917-0] [Citation(s) in RCA: 2] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 09/21/2018] [Indexed: 11/25/2022] Open
Abstract
Transthyretin (TTR)-related familial amyloid polyneuropathy (TTR-FAP) is a life-threatening autosomal dominant, systemic disease. First symptoms usually occur from the second to over sixth decade of life with a length-dependent axonal neuropathy with prominent involvement of the small fibers and multi-organ systemic failure. Early diagnosis is pivotal for effective therapeutic options, but it is hampered by the heterogeneity of the clinical spectrum which can lead to misdiagnosis with other neurological condition/disorder such as axonal sensory-motor neuropathy (CMT2) as described in literature. The aim of our study was to search for TTR mutations in a large cohort of selected undiagnosed axonal sensory-motor neuropathy patients to establish if misdiagnosis is frequent or rare in the Italian population. No TTR pathogenic variants were found in our cohort. In conclusion, our study shows that TTR testing not should be straightforward recommended in CMT2 patients but only when “red flags” TTR’s features are present.
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Affiliation(s)
- Marina Grandis
- Dept. of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genoa, Viale Benedetto XV, Largo P. Daneo 3, 16132, Genoa, Italy.,Ospedale Policlinico San Martino IRCCS-Neurological Unit, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Alessandro Geroldi
- Dept. of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genoa, Viale Benedetto XV, Largo P. Daneo 3, 16132, Genoa, Italy.
| | - Rossella Gulli
- Ospedale Policlinico San Martino IRCCS-Medical Genetic Unit, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Fiore Manganelli
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Via S. Pansini, 5, 80131, Naples, Italy
| | - Fabio Gotta
- Dept. of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genoa, Viale Benedetto XV, Largo P. Daneo 3, 16132, Genoa, Italy.,Ospedale Policlinico San Martino IRCCS-Medical Genetic Unit, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Merit Lamp
- Dept. of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genoa, Viale Benedetto XV, Largo P. Daneo 3, 16132, Genoa, Italy.,Ospedale Policlinico San Martino IRCCS-Medical Genetic Unit, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Paola Origone
- Dept. of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genoa, Viale Benedetto XV, Largo P. Daneo 3, 16132, Genoa, Italy.,Ospedale Policlinico San Martino IRCCS-Medical Genetic Unit, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Lucia Trevisan
- Dept. of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genoa, Viale Benedetto XV, Largo P. Daneo 3, 16132, Genoa, Italy.,Ospedale Policlinico San Martino IRCCS-Medical Genetic Unit, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Chiara Gemelli
- Dept. of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genoa, Viale Benedetto XV, Largo P. Daneo 3, 16132, Genoa, Italy.,Ospedale Policlinico San Martino IRCCS-Neurological Unit, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Sabrina Fabbri
- Dept. of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genoa, Viale Benedetto XV, Largo P. Daneo 3, 16132, Genoa, Italy
| | - Angelo Schenone
- Dept. of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genoa, Viale Benedetto XV, Largo P. Daneo 3, 16132, Genoa, Italy.,Ospedale Policlinico San Martino IRCCS-Neurological Unit, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Stefano Tozza
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Via S. Pansini, 5, 80131, Naples, Italy
| | - Lucio Santoro
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Via S. Pansini, 5, 80131, Naples, Italy
| | - Emilia Bellone
- Dept. of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genoa, Viale Benedetto XV, Largo P. Daneo 3, 16132, Genoa, Italy.,Ospedale Policlinico San Martino IRCCS-Medical Genetic Unit, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Paola Mandich
- Dept. of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genoa, Viale Benedetto XV, Largo P. Daneo 3, 16132, Genoa, Italy.,Ospedale Policlinico San Martino IRCCS-Medical Genetic Unit, Largo R. Benzi 10, 16132, Genoa, Italy
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Lamp M, Origone P, Geroldi A, Verdiani S, Gotta F, Caponnetto C, Devigili G, Verriello L, Scialò C, Cabona C, Canosa A, Vanni I, Bellone E, Eleopra R, Mandich P. Twenty years of molecular analyses in amyotrophic lateral sclerosis: genetic landscape of Italian patients. Neurobiol Aging 2018. [DOI: 10.1016/j.neurobiolaging.2018.01.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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14
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Mandich P, Lamp M, Gotta F, Gulli R, Iacometti A, Marchese R, Bellone E, Abbruzzese G, Ferrandes G. 1993-2014: two decades of predictive testing for Huntington's disease at the Medical Genetics Unit of the University of Genoa. Mol Genet Genomic Med 2017; 5:473-480. [PMID: 28944231 PMCID: PMC5606876 DOI: 10.1002/mgg3.238] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 04/13/2016] [Revised: 07/26/2016] [Accepted: 08/05/2016] [Indexed: 11/10/2022] Open
Abstract
Background Predictive testing for Huntington's disease has been available at the Medical Genetics Unit of the University of Genoa from 1987. In 1989, an integrated counseling protocol (geneticist, psychologist, and neurologist) was developed following International Guidelines. Methods This is a retrospective analysis of the clinical charts and motivation questionnaires of persons seeking predictive testing through direct DNA analysis from 1993 until 2014, with the aim to evaluate their individual characteristics, motivations, and the outcomes of the counseling protocol. Results A total of 299 persons (164 women, 135 men) applied for predictive testing. Most applicants’ features and motivations were similar to those previously described, but surprisingly the percentage of completed protocols was higher among men, 68.5% versus 53.5% (P = 0.011). Likewise, persons over 25 years of age were more likely to take the test than younger applicants (18–25 years): 63.4% versus 48.1% (P = 0.043). In addition, relationship status, having children, and the gender of the affected parent showed different effects on the decision about testing in males and females. No catastrophic reactions were reported during the study period. Conclusions We observed that factors influencing the decision‐making process might differ between males and females, and that predictive testing appears a safe procedure if framed within an integrated counseling protocol.
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Affiliation(s)
- Paola Mandich
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Child SciencesUniversity of GenoaGenoaItaly.,Medical Genetics UnitIRCCS AOU San Martino-ISTGenoaItaly
| | - Merit Lamp
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Child SciencesUniversity of GenoaGenoaItaly.,Medical Genetics UnitIRCCS AOU San Martino-ISTGenoaItaly
| | - Fabio Gotta
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Child SciencesUniversity of GenoaGenoaItaly.,Medical Genetics UnitIRCCS AOU San Martino-ISTGenoaItaly
| | - Rossella Gulli
- Medical Genetics UnitIRCCS AOU San Martino-ISTGenoaItaly
| | - Ariela Iacometti
- Unit of Clinical Psychology and PsychotherapyIRCCS AOU San Martino-ISTGenoaItaly
| | | | - Emilia Bellone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Child SciencesUniversity of GenoaGenoaItaly.,Medical Genetics UnitIRCCS AOU San Martino-ISTGenoaItaly
| | - Giovanni Abbruzzese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Child SciencesUniversity of GenoaGenoaItaly.,Clinical Neurology UnitIRCCS AOU San Martino-ISTGenoaItaly
| | - Giovanna Ferrandes
- Unit of Clinical Psychology and PsychotherapyIRCCS AOU San Martino-ISTGenoaItaly
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Geroldi A, Lastella P, Patruno M, Gotta F, Resta N, Devigili G, Sabbà C, Gulli R, Lamp M, Origone P, Mandich P, Bellone E. Two novel cases of compound heterozygous mutations in mitofusin2: Finding out the inheritance. Neuromuscul Disord 2017; 27:377-381. [PMID: 28215760 DOI: 10.1016/j.nmd.2017.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 12/16/2016] [Accepted: 01/15/2017] [Indexed: 11/28/2022]
Abstract
MFN2 is the major gene involved in the axonal form of Charcot-Marie-Tooth disease. It usually has an autosomal dominant pattern of inheritance, but a few cases of homozygous or compound heterozygous mutations have been described. These patients usually present an earlier onset, more severe phenotype and their inheritance pattern can span from autosomal recessive to semidominant. Here we report two unrelated patients carrying two compound heterozygous MFN2 mutations. Both present a pure axonal neuropathy without any additional features. The first patient presents a mild clinical phenotype with onset in the 2nd decade, while the second patient shows a severe, early onset phenotype with loss of independent ambulation. Only a careful clinical examination as well as neurophysiological and genetic studies allowed us to establish the role and the transmission pattern of the identified variants. We discuss practical consequences of this finding in genetic counseling.
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Affiliation(s)
- Alessandro Geroldi
- Dept. of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Medical Genetics, University of Genoa, 16132 Genoa, Italy.
| | - Patrizia Lastella
- UOC Medicina Interna Universitaria "Cesare Frugoni", Centro Sovraziendale Malattie Rare, AOU Consorziale Policlinico Giovanni XXIII, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Margherita Patruno
- UOC Laboratorio di Genetica Medica Universitaria, D.A.I. di Patologia Diagnostica, Bioimmagini e Sanità Pubblica, AOU Consorziale Policlinico di Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Fabio Gotta
- Dept. of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Medical Genetics, University of Genoa, 16132 Genoa, Italy; COU Medical Genetics, IRCCS AOU San Martino IST - Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy
| | - Nicoletta Resta
- UOC Laboratorio di Genetica Medica Universitaria, D.A.I. di Patologia Diagnostica, Bioimmagini e Sanità Pubblica, AOU Consorziale Policlinico di Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Grazia Devigili
- Neurological Unit, Dept of Neuroscience, University Hospital "Santa Maria della Misericordia", Udine, Italy
| | - Carlo Sabbà
- UOC Medicina Interna Universitaria "Cesare Frugoni", Centro Sovraziendale Malattie Rare, AOU Consorziale Policlinico Giovanni XXIII, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Rossella Gulli
- COU Medical Genetics, IRCCS AOU San Martino IST - Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy
| | - Merit Lamp
- Dept. of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Medical Genetics, University of Genoa, 16132 Genoa, Italy; COU Medical Genetics, IRCCS AOU San Martino IST - Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy
| | - Paola Origone
- Dept. of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Medical Genetics, University of Genoa, 16132 Genoa, Italy; COU Medical Genetics, IRCCS AOU San Martino IST - Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy
| | - Paola Mandich
- Dept. of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Medical Genetics, University of Genoa, 16132 Genoa, Italy; COU Medical Genetics, IRCCS AOU San Martino IST - Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy
| | - Emilia Bellone
- Dept. of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Medical Genetics, University of Genoa, 16132 Genoa, Italy; COU Medical Genetics, IRCCS AOU San Martino IST - Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy
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16
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Mandich P, Mantero V, Verdiani S, Gotta F, Caponnetto C, Bellone E, Ferrandes G, Origone P. Complexities of Genetic Counseling for ALS: A Case of Two Siblings with Discordant Genetic Test Results. J Genet Couns 2015; 24:553-7. [PMID: 25843563 DOI: 10.1007/s10897-015-9831-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 03/03/2015] [Indexed: 10/23/2022]
Abstract
Rapid advances in the genetics of amyotrophic lateral sclerosis (ALS) have dramatically changed the approach of clinicians and researchers to the motor neuron diseases. We report two siblings in whom the genetic study provided conflicting results, hence raising a number of issues which deserve to be considered by clinicians involved in genetic testing for ALS. The first patient died within 2 years of ALS onset, while her brother still manages to walk unaided, 7 years into onset. Genetic analyses, performed on the first patient as part of a research protocol, and as clinical genetic testing on the brother, provided different results. Results for Patient 1 were negative for all investigated genes, thus suggesting that her disease may be a phenocopy, while her brother carried an autosomal dominant TARDBP mutation (p.A382T). A multidisciplinary approach may help patients and clinicians face the emerging dilemmas in such a complex field. Sharing and updating of advances, not to mention uncertainties inherent to current knowledge, with patients and families may prove to be an effective way to support them and to make them aware of the present limits of our knowledge and of the blurred border between research and clinical practice.
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Affiliation(s)
- Paola Mandich
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genova, Viale Benedetto XV, 6, 16132, Genoa, Italy
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Piccoli GB, Cimmino MA, Lamp M, Gotta F, Vigotti FN, Priola AM, Veltri A, Mandich P. Quiz Page February 2015. Am J Kidney Dis 2015; 65:A17-9. [DOI: 10.1053/j.ajkd.2014.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 10/01/2014] [Indexed: 11/11/2022]
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Mandich P, Lamp M, Gulli R, Iacometti A, Marchese R, Gotta F, Abbruzzese G, Ferrandes G. K08 1993-2013: Two Decades of Predictive HD Testing at the Medical Genetics Service of the University Of Genoa. Journal of Neurology, Neurosurgery & Psychiatry 2014. [DOI: 10.1136/jnnp-2014-309032.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Gotta F, Kassaniou S, Gnagne Y, Gnanazan G. [Internal iliac artery: functional anastomosis value and pelvic surgery application]. Morphologie 2003; 87:39-45. [PMID: 15146746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
The vascularization of the intra and extra pelvic organs of adults, children and neonates (male and female) is studied in 17 pelvis, in which the vascular system has been injected with colored Altufix p10 and gelatinous india ink. The pelvic region constitute a true vascular crossroad of two anastomotic networks, one arterial, originate from the visceral and parietal branches of iliac internal and external arteries, femoral and abdominal aorta by inferior mesenteric artery; the other one, which morphology is incompletely superposable in diameter. Each organ is tributary of characteristic vascular system from adventitious to mucosa with direct or recurrential manner between striated muscle fibers and mucosal layers. This duality of two systems, vascular and anastomotic provides the anatomic direction of vascular suppliance after troncular iliac artery binding and determines the vitality of the organ.
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Affiliation(s)
- F Gotta
- Laboratoire d'Anatomie, BpV 166, Abidjan, Côte d'Ivoire
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Gotta F, N'Guessan G, Gnagne Y, Kassandou S, Kokoua A. [The left renal retro-aortic vein: report of three cases]. Morphologie 1999; 83:47-50. [PMID: 10546236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
This study investigated the congenital retro-aortic left renal vein in three subjects, observed in dissection practice. Comparative morphometric analysis is made about vein and artery and their collaterals. The importance and the contribution of this left retro-aortic renal vein are discussed with reference to his embryologic and clinical aspect implication.
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Affiliation(s)
- F Gotta
- Laboratoire d'Anatomie, Abidjan, Côte d'Ivoire
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N'Guessan G, Gotta F, Gnagne Y, Kokoua A, Honde M. [The musculo-fascial graft from the elevator muscle of the anus. Importance for plastic surgery of the bladder in the treatment of obstetric vesico-vaginal fistulas]. Morphologie 1999; 83:51-5. [PMID: 10546237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
The levator ano-muscle and fascia are studied by females pelvis. The muscle is composed of three groups of fibres: the puborectalis muscle, the ilococcygeus and the ischiococcygeus muscles. The muscular fascial graft is dissected from the superior fibers of puborectalis muscle and placed in front of the lateral face of the bladder. In this regard, the anatomical and clinical knowledges are provided and morphometric and morphologic studies proposed this graft as the inter-vesico-vaginal plasty in treatment of vesico-vaginal fistulae.
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Affiliation(s)
- G N'Guessan
- Laboratoire d'Anatomie, Abidjan, Côte d'Ivoire
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