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Srinivasarangan M, Jagadeesh S, Bheemanna A, Sivasankar A, Patil A, Basavaraju B, Sattur A. A Randomised Controlled Trial Comparing Ketamine versus Fentanyl for Procedural Sedation in the Emergency Department for Adults with Isolated Extremity Injury. Malays Orthop J 2024; 18:116-124. [PMID: 38638669 PMCID: PMC11023337 DOI: 10.5704/moj.2403.015] [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: 02/18/2022] [Accepted: 07/07/2023] [Indexed: 04/20/2024] Open
Abstract
Introduction Alleviating pain and anxiety of patients during procedures is an essential skill for an Emergency Physician (EP). Several sedatives and dissociative agents are used for PSA (Procedural Sedation and Analgesia). In this study, we aimed to compare two drugs that is, ketamine and fentanyl for procedural sedation in adults with isolated limb injuries in the Emergency Department (ED). Materials and methods In this prospective, randomised controlled interventional trial, patients aged between 18 to 65 years with isolated extremity injury requiring PSA in the ED were recruited. A total of 200 subjects were included in the study and randomly allocated to either the fentanyl (n=100) or the ketamine (n=100) group. Patients were blinded to the intervention and subsequently premedicated with Midazolam. Following this, they received either ketamine or fentanyl based on the group they were allocated to. Vital signs, including but not limited to the level of sedation, were measured at predetermined time intervals. A Modified Aldrete Score of >8 was used as a criterion for disposition from the ED. Data were collected in a pre-designed proforma. We aimed to compare the effectiveness as well as ascertain the safety profile of the two drugs for PSA in the ED. Results There was no significant difference between the two groups when age, gender, mechanism of injury and comorbidities were compared. We found that there was no statistically significant difference between the two groups when blood pressure, respiratory rate and depth of sedation were compared. In both groups, there was a significant decrease in pain on the Numerical Rating Scale (NRS) following drug administration from 8 to 3 (p<0.001). Patients in the fentanyl group had an increased incidence of transient oxygen desaturation (p<0.001). Vomiting was more common in the ketamine group (p<0.001). Conclusion PSA is a safe and efficacious procedure for patients undergoing painful procedures in ED. Patients in both the groups maintained hemodynamic stability throughout the procedure. From our study, we were able to conclude that both ketamine and fentanyl are similar in efficacy for PSA in the ED for adults with isolated limb injuries. In addition, no significant cardiovascular adverse events were noted in either group in our study.
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Affiliation(s)
- M Srinivasarangan
- Department of Emergency Medicine, JSS Medical College, Mysuru, India
| | - S Jagadeesh
- Department of Emergency Medicine, JSS Medical College, Mysuru, India
| | - A Bheemanna
- Department of Emergency Medicine, JSS Medical College, Mysuru, India
| | - A Sivasankar
- Department of Emergency Medicine, JSS Medical College, Mysuru, India
| | - A Patil
- Department of Anesthesiology, Dr Moopen's Medical College, Wayanad, India
| | - B Basavaraju
- Department of Emergency Medicine, JSS Medical College, Mysuru, India
| | - A Sattur
- Department of Emergency Medicine, JSS Medical College, Mysuru, India
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Liang M, Suresh B, Bareke E, Choufani S, Jagadeesh S, Weksberg R, Majewski J, Slim R. A homozygous stop codon in HORMAD2 in a patient with recurrent digynic triploid miscarriage. Mol Genet Genomic Med 2024; 12:e2402. [PMID: 38400599 PMCID: PMC10891434 DOI: 10.1002/mgg3.2402] [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: 08/13/2023] [Revised: 01/19/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Recurrent miscarriage (RM) affects 1% to 5% of couples trying to conceive. Despite extensive clinical and laboratory testing, half of the RM cases remain unexplained. We report the genetic analysis of a couple with eight miscarriages and the search for their potential genetic etiology. METHODS Short tandem repeat (STR) markers, single nucleotide polymorphic (SNP) microarray, and human DNA methylation microarray were used to analyze the genotypes of two miscarriages. Exomes sequencing was performed on DNA from the two partners and identified variants were validated by Sanger sequencing. RESULTS STR marker genotyping demonstrated that the two available miscarriages are triploid digynic and resulted from the failure of Meiosis II. SNP microarray analysis revealed an additional Meiosis I abnormality that is the segregation of the two maternal homologous chromosomes in one triploid miscarriage. Whole-exome sequencing on DNA from the two partners identified candidate variants only in the female partner in two genes with roles in female reproduction, a missense in EIF4ENIF1 (OMIM 607445) and a stop gain in HORMAD2 (OMIM 618842). EIF4ENIF1 is a eukaryotic translation initiation factor 4E nuclear import factor required for the oocyte germinal vesicle breakdown, and HORMAD2 is part of the synaptonemal complex that was hypothesized to act as a checkpoint mechanism to eliminate oocytes with asynapsis during meiotic prophase I in mice. CONCLUSION While both genes may contribute to the phenotype, the Meiosis I abnormalities in the conceptions favor the causal role of HORMAD2 in the etiology of RM in this couple. This report illustrates the importance of comprehensively analyzing the products of conception to guide the search for the genetic causation of RM.
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Affiliation(s)
- Manqi Liang
- Department of Human GeneticsResearch Institute of the McGill University Health CentreMontrealQuebecCanada
| | - Beena Suresh
- Department of Clinical Genetics & Genetic CounsellingMediscan SystemsChennaiIndia
| | - Eric Bareke
- Department of Human GeneticsMcGill UniversityMontrealQuebecCanada
| | - Sanaa Choufani
- Genetics and Genome Biology Program, Research InstituteThe Hospital for Sick ChildrenTorontoOntarioCanada
| | - Sujatha Jagadeesh
- Department of Clinical Genetics & Genetic CounsellingMediscan SystemsChennaiIndia
| | - Rosanna Weksberg
- Genetics and Genome Biology Program, Research InstituteThe Hospital for Sick ChildrenTorontoOntarioCanada
- Division of Clinical & Metabolic Genetics, Department of PaediatricsThe Hospital for Sick ChildrenTorontoOntarioCanada
- Institute of Medical SciencesUniversity of TorontoTorontoOntarioCanada
| | - Jacek Majewski
- Department of Human GeneticsMcGill UniversityMontrealQuebecCanada
| | - Rima Slim
- Department of Human GeneticsResearch Institute of the McGill University Health CentreMontrealQuebecCanada
- Department of Obstetrics and GynecologyMcGill University Health CentreMontrealQuebecCanada
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3
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Lischka A, Eggermann K, Record CJ, Dohrn MF, Laššuthová P, Kraft F, Begemann M, Dey D, Eggermann T, Beijer D, Šoukalová J, Laura M, Rossor AM, Mazanec R, Van Lent J, Tomaselli PJ, Ungelenk M, Debus KY, Feely SME, Gläser D, Jagadeesh S, Martin M, Govindaraj GM, Singhi P, Baineni R, Biswal N, Ibarra-Ramírez M, Bonduelle M, Gess B, Romero Sánchez J, Suthar R, Udani V, Nalini A, Unnikrishnan G, Marques W, Mercier S, Procaccio V, Bris C, Suresh B, Reddy V, Skorupinska M, Bonello-Palot N, Mochel F, Dahl G, Sasidharan K, Devassikutty FM, Nampoothiri S, Rodovalho Doriqui MJ, Müller-Felber W, Vill K, Haack TB, Dufke A, Abele M, Stucka R, Siddiqi S, Ullah N, Spranger S, Chiabrando D, Bolgül BS, Parman Y, Seeman P, Lampert A, Schulz JB, Wood JN, Cox JJ, Auer-Grumbach M, Timmerman V, de Winter J, Themistocleous AC, Shy M, Bennett DL, Baets J, Hübner CA, Leipold E, Züchner S, Elbracht M, Çakar A, Senderek J, Hornemann T, Woods CG, Reilly MM, Kurth I. Genetic landscape of congenital insensitivity to pain and hereditary sensory and autonomic neuropathies. Brain 2023; 146:4880-4890. [PMID: 37769650 PMCID: PMC10689924 DOI: 10.1093/brain/awad328] [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: 04/26/2023] [Revised: 08/16/2023] [Accepted: 09/03/2023] [Indexed: 10/02/2023] Open
Abstract
Congenital insensitivity to pain (CIP) and hereditary sensory and autonomic neuropathies (HSAN) are clinically and genetically heterogeneous disorders exclusively or predominantly affecting the sensory and autonomic neurons. Due to the rarity of the diseases and findings based mainly on single case reports or small case series, knowledge about these disorders is limited. Here, we describe the molecular workup of a large international cohort of CIP/HSAN patients including patients from normally under-represented countries. We identify 80 previously unreported pathogenic or likely pathogenic variants in a total of 73 families in the >20 known CIP/HSAN-associated genes. The data expand the spectrum of disease-relevant alterations in CIP/HSAN, including novel variants in previously rarely recognized entities such as ATL3-, FLVCR1- and NGF-associated neuropathies and previously under-recognized mutation types such as larger deletions. In silico predictions, heterologous expression studies, segregation analyses and metabolic tests helped to overcome limitations of current variant classification schemes that often fail to categorize a variant as disease-related or benign. The study sheds light on the genetic causes and disease-relevant changes within individual genes in CIP/HSAN. This is becoming increasingly important with emerging clinical trials investigating subtype or gene-specific treatment strategies.
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Affiliation(s)
- Annette Lischka
- Institute for Human Genetics and Genomic Medicine, Medical Faculty, RWTH Aachen University Hospital, 52074 Aachen, Germany
| | - Katja Eggermann
- Institute for Human Genetics and Genomic Medicine, Medical Faculty, RWTH Aachen University Hospital, 52074 Aachen, Germany
| | - Christopher J Record
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Maike F Dohrn
- Department of Neurology, Medical Faculty of the RWTH Aachen University, 52074 Aachen, Germany
- Dr. John T. Macdonald Foundation, Department of Human Genetics and John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, FL 33136, USA
| | - Petra Laššuthová
- Department of Paediatric Neurology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, 150 06 Praha, Czechia
| | - Florian Kraft
- Institute for Human Genetics and Genomic Medicine, Medical Faculty, RWTH Aachen University Hospital, 52074 Aachen, Germany
| | - Matthias Begemann
- Institute for Human Genetics and Genomic Medicine, Medical Faculty, RWTH Aachen University Hospital, 52074 Aachen, Germany
| | - Daniela Dey
- Institute for Human Genetics and Genomic Medicine, Medical Faculty, RWTH Aachen University Hospital, 52074 Aachen, Germany
| | - Thomas Eggermann
- Institute for Human Genetics and Genomic Medicine, Medical Faculty, RWTH Aachen University Hospital, 52074 Aachen, Germany
| | - Danique Beijer
- Dr. John T. Macdonald Foundation, Department of Human Genetics and John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, FL 33136, USA
| | - Jana Šoukalová
- Department of Medical Genetics, University Hospital Brno, 625 00 Brno, Czechia
| | - Matilde Laura
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Alexander M Rossor
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Radim Mazanec
- Department of Neurology, Faculty of Medicine, Charles University in Prague and Motol University Hospital, 150 06 Prague, Czechia
| | - Jonas Van Lent
- Peripheral Neuropathy Research Group, Department of Biomedical Sciences, Institute Born Bunge, University of Antwerp, 2160 Antwerp, Belgium
| | - Pedro J Tomaselli
- Department of Neurosciences and Behaviour Sciences, Clinical Hospital of Ribeirão Preto, University of São Paulo, Ribeirão Preto, 14015-130, Brazil
| | - Martin Ungelenk
- Institute of Human Genetics, University Hospital Jena, 07747 Jena, Germany
| | - Karlien Y Debus
- Center for Molecular Biomedicine Institute for Biophysics, Friedrich-Schiller Universität Jena, 07745 Jena, Germany
| | - Shawna M E Feely
- Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
- Division of Pediatric Neurology, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, WA 98105, USA
| | - Dieter Gläser
- Center for Human Genetics, Genetikum®, 89231 Neu-Ulm, Germany
| | - Sujatha Jagadeesh
- Department of Clinical Genetics and Genetic Counselling, Mediscan Systems, Chennai 600032, Tamilnadu, India
| | - Madelena Martin
- Davis and Davis Children's Hospital, University of California, Sacramento, CA 95817, USA
| | - Geeta M Govindaraj
- Department of Pediatrics, Government Medical College, Kozhikode, Kerala 673 008, India
| | - Pratibha Singhi
- Pediatric Neurology and Neurodevelopment, Medanta, The Medicity, Gurgaon, Haryana 122 001, India
| | - Revanth Baineni
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605 006, India
| | - Niranjan Biswal
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605 006, India
| | - Marisol Ibarra-Ramírez
- Genetics Department, Hospital Universitario Dr. José Eleuterio González Universidad Autónoma de Nuevo León, 64460 Monterrey, Nuevo León, México
| | - Maryse Bonduelle
- Centre for Medical Genetics, Universitair Ziekenhuis Brussel, 1090 Jette, Brussels, Belgium
| | - Burkhard Gess
- Department of Neurology, Medical Faculty of the RWTH Aachen University, 52074 Aachen, Germany
- Department of Neurology, University Hospital, Evangelisches Klinikum Bethel, University of Bielefeld, 33617 Bielefeld, Germany
| | | | - Renu Suthar
- Pediatric Neurology and Neurodevelopment Unit, Department of Pediatrics, Advanced Pediatric Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh 160 012, India
| | - Vrajesh Udani
- Department of Child Neurology, PD Hinduja Hospital and Medical Research Centre, Mumbai, Maharashtra 400 016, India
| | - Atchayaram Nalini
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru 560 029, India
| | - Gopikrishnan Unnikrishnan
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru 560 029, India
| | - Wilson Marques
- Department of Neurosciences and Behaviour Sciences, Clinical Hospital of Ribeirão Preto, University of São Paulo, Ribeirão Preto, 14015-130, Brazil
| | - Sandra Mercier
- CHU Nantes, Service de Génétique Médicale, Centre de Référence des Maladies Neuromusculaires AOC, 44000 Nantes, France
| | - Vincent Procaccio
- Department of Biochemistry and Genetics, MitoVasc Institute, UMR CNRS 6015- INSERM U1083, CHU Angers, 49055 Angers, France
| | - Céline Bris
- Department of Biochemistry and Genetics, MitoVasc Institute, UMR CNRS 6015- INSERM U1083, CHU Angers, 49055 Angers, France
| | - Beena Suresh
- Department of Clinical Genetics and Genetic Counselling, Mediscan Systems, Chennai 600032, Tamilnadu, India
| | - Vaishnavi Reddy
- Department of Clinical Genetics and Genetic Counselling, Mediscan Systems, Chennai 600032, Tamilnadu, India
| | - Mariola Skorupinska
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | | | - Fanny Mochel
- Genetics Department, Sorbonne Université, Paris Brain Institute, APHP, INSERM, CNRS, 75013 Paris, France
| | - Georg Dahl
- Pediatric Neurology, Children’s Hospital of the King’s Daughters in Norfolk, Norfolk, VA 23507, USA
| | - Karthika Sasidharan
- Department of Pediatrics, Government Medical College, Kozhikode, Kerala 673 008, India
| | - Fiji M Devassikutty
- Department of Pediatrics, Government Medical College, Kozhikode, Kerala 673 008, India
| | - Sheela Nampoothiri
- Department of Pediatric Genetics, Amrita Institute of Medical Sciences and Research Center, Cochin, Kerala 682 041, India
| | - Maria J Rodovalho Doriqui
- Department of Genetics, Hospital Infantil Doutor Juvêncio Mattos, São Luis, Maranhão 65015-460, Brazil
| | - Wolfgang Müller-Felber
- Department of Neuropediatrics, Developmental Neurology and Social Pediatrics, LMU Campus Innenstadt, University of Munich, 80337 Munich, Germany
| | - Katharina Vill
- Department of Pediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, 80337 Munich, Germany
- Institute of Human Genetics, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Tobias B Haack
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, 72076 Tübingen, Germany
| | - Andreas Dufke
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, 72076 Tübingen, Germany
| | - Michael Abele
- Neurologie, Praxis für Neurologie und Schlafmedizin, 53359 Rheinbach, Germany
| | - Rolf Stucka
- Friedrich Baur Institute at the Department of Neurology, LMU University Hospital, LMU Munich, 80336 Munich, Germany
| | - Saima Siddiqi
- Genomics Group, Institute of Biomedical and Genetic Engineering (IBGE), Islamabad 44000, Pakistan
| | - Noor Ullah
- Institute for Paramedical Sciences, Khyber Medical University, Peshawar, KPK 25100, Pakistan
| | | | - Deborah Chiabrando
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center ‘Guido Tarone’, University of Torino, 10124 Turin, Italy
| | - Behiye S Bolgül
- Department of Pedodontics, Faculty of Dentistry, Dicle University, 21200 Diyarbakir, Turkey
| | - Yesim Parman
- Neuromuscular Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey
| | - Pavel Seeman
- Department of Paediatric Neurology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, 150 06 Praha, Czechia
| | - Angelika Lampert
- Institute of Neurophysiology, Medical Faculty, Uniklinik RWTH Aachen University, 52074 Aachen, Germany
| | - Jörg B Schulz
- Department of Neurology, Medical Faculty of the RWTH Aachen University, 52074 Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Research Centre Jülich GmbH, and RWTH Aachen University, 52056 Aachen, Germany
| | - John N Wood
- Molecular Nociception Group, Wolfson Institute for Biomedical Research, University College London, London WC1E 6BT, UK
| | - James J Cox
- Molecular Nociception Group, Wolfson Institute for Biomedical Research, University College London, London WC1E 6BT, UK
| | - Michaela Auer-Grumbach
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | - Vincent Timmerman
- Peripheral Neuropathy Research Group, Department of Biomedical Sciences, Institute Born Bunge, University of Antwerp, 2160 Antwerp, Belgium
| | - Jonathan de Winter
- Translational Neurosciences and Institute Born Bunge, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
- Neuromuscular Reference Centre, Department of Neurology, Antwerp University Hospital, 2610 Antwerp, Belgium
| | | | - Michael Shy
- Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
| | - David L Bennett
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford OX3 9DU, UK
| | - Jonathan Baets
- Translational Neurosciences and Institute Born Bunge, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
- Neuromuscular Reference Centre, Department of Neurology, Antwerp University Hospital, 2610 Antwerp, Belgium
| | - Christian A Hübner
- Institute of Human Genetics, University Hospital Jena, 07747 Jena, Germany
| | - Enrico Leipold
- Department of Anesthesiology and Intensive Care and CBBM—Center of Brain, Behavior and Metabolism, University of Luebeck, 23562 Luebeck, Germany
| | - Stephan Züchner
- Dr. John T. Macdonald Foundation, Department of Human Genetics and John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, FL 33136, USA
| | - Miriam Elbracht
- Institute for Human Genetics and Genomic Medicine, Medical Faculty, RWTH Aachen University Hospital, 52074 Aachen, Germany
| | - Arman Çakar
- Neuromuscular Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey
| | - Jan Senderek
- Friedrich Baur Institute at the Department of Neurology, LMU University Hospital, LMU Munich, 80336 Munich, Germany
| | - Thorsten Hornemann
- Department of Clinical Chemistry, University Hospital Zurich, University of Zurich, 8006 Zurich, Switzerland
| | - C Geoffrey Woods
- Cambridge Institute for Medical Research, Keith Peters Building, Cambridge Biomedical Campus, Cambridge CB2 0XY, UK
| | - Mary M Reilly
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Ingo Kurth
- Institute for Human Genetics and Genomic Medicine, Medical Faculty, RWTH Aachen University Hospital, 52074 Aachen, Germany
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Cogal AG, Arroyo J, Shah RJ, Reese KJ, Walton BN, Reynolds LM, Kennedy GN, Seide BM, Senum SR, Baum M, Erickson SB, Jagadeesh S, Soliman NA, Goldfarb DS, Beara-Lasic L, Edvardsson VO, Palsson R, Milliner DS, Sas DJ, Lieske JC, Harris PC. Comprehensive Genetic Analysis Reveals Complexity of Monogenic Urinary Stone Disease. Kidney Int Rep 2021; 6:2862-2884. [PMID: 34805638 PMCID: PMC8589729 DOI: 10.1016/j.ekir.2021.08.033] [Citation(s) in RCA: 5] [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: 07/27/2021] [Revised: 08/24/2021] [Accepted: 08/30/2021] [Indexed: 01/06/2023] Open
Abstract
Introduction Because of phenotypic overlap between monogenic urinary stone diseases (USD), gene-specific analyses can result in missed diagnoses. We used targeted next generation sequencing (tNGS), including known and candidate monogenic USD genes, to analyze suspected primary hyperoxaluria (PH) or Dent disease (DD) patients genetically unresolved (negative; N) after Sanger analysis of the known genes. Cohorts consisted of 285 PH (PHN) and 59 DD (DDN) families. Methods Variants were assessed using disease-specific and population databases plus variant assessment tools and categorized using the American College of Medical Genetics (ACMG) guidelines. Prior Sanger analysis identified 47 novel PH or DD gene pathogenic variants. Results Screening by tNGS revealed pathogenic variants in 14 known monogenic USD genes, accounting for 45 families (13.1%), 27 biallelic and 18 monoallelic, including 1 family with a copy number variant (CNV). Recurrent genes included the following: SLC34A3 (n = 13), CLDN16 (n = 8), CYP24A1 (n = 4), SLC34A1 (n = 3), SLC4A1 (n = 3), APRT (n = 2), CLDN19 (n = 2), HNF4A1 (n = 2), and KCNJ1 (n = 2), whereas ATP6V1B1, CASR, and SLC12A1 and missed CNVs in the PH genes AGXT and GRHPR accounted for 1 pedigree each. Of the 48 defined pathogenic variants, 27.1% were truncating and 39.6% were novel. Most patients were diagnosed before 18 years of age (76.1%), and 70.3% of biallelic patients were homozygous, mainly from consanguineous families. Conclusion Overall, in patients suspected of DD or PH, 23.9% and 7.3% of cases, respectively, were caused by pathogenic variants in other genes. This study shows the value of a tNGS screening approach to increase the diagnosis of monogenic USD, which can optimize therapies and facilitate enrollment in clinical trials.
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Affiliation(s)
- Andrea G Cogal
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA
| | - Jennifer Arroyo
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA
| | - Ronak Jagdeep Shah
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA
| | - Kalina J Reese
- Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota, USA
| | - Brenna N Walton
- Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota, USA
| | - Laura M Reynolds
- Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota, USA
| | - Gabrielle N Kennedy
- Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota, USA
| | - Barbara M Seide
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA
| | - Sarah R Senum
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Stephen B Erickson
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Neveen A Soliman
- Department of Pediatrics, Center of Pediatric Nephrology and Transplantation, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - David S Goldfarb
- Nephrology Division, New York University Langone Health and New York University School of Medicine, New York, New York, USA
| | - Lada Beara-Lasic
- Nephrology Division, New York University Langone Health and New York University School of Medicine, New York, New York, USA
| | - Vidar O Edvardsson
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Children's Medical Center, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Runolfur Palsson
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Division of Nephrology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Dawn S Milliner
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA
| | - David J Sas
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.,Division of Pediatric Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.,Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - John C Lieske
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.,Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Peter C Harris
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.,Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota, USA
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Jagadeesh S, MV R, Rajan S. Remembering Professor P. K. Appukuttan. Indian J Plast Surg 2021. [PMCID: PMC8515305 DOI: 10.1055/s-0041-1736683] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- S. Jagadeesh
- Department of Plastic Surgery, GMC Kozhikode, Kozhikode, Kerala, India
| | - Raman MV
- Department of Plastic Surgery, GMC Kozhikode, Kozhikode, Kerala, India
| | - Sheeja Rajan
- Department of Plastic Surgery, GMC Kozhikode, Kozhikode, Kerala, India
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Rezaei M, Suresh B, Bereke E, Hadipour Z, Aguinaga M, Qian J, Bagga R, Fardaei M, Hemida R, Jagadeesh S, Majewski J, Slim R. Featured Cover. Clin Genet 2021. [DOI: 10.1111/cge.13971] [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] [Indexed: 11/28/2022]
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7
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Puri RD, Setia N, N V, Jagadeesh S, Nampoothiri S, Gupta N, Muranjan M, Bhat M, Girisha KM, Kabra M, Verma J, Thomas DC, Biji I, Raja J, Makkar R, Verma IC, Kishnani PS. Late onset Pompe Disease in India - Beyond the Caucasian phenotype. Neuromuscul Disord 2021; 31:431-441. [PMID: 33741225 DOI: 10.1016/j.nmd.2021.02.013] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 01/14/2023]
Abstract
We evaluated the clinical histories, motor and pulmonary functions, cardiac phenotypes and GAA genotypes of an Indian cohort of twenty patients with late onset Pompe disease (LOPD) in this multi-centre study. A mean age at onset of symptoms and diagnosis of 9.9 ± 9.7 years and 15.8 ± 12.1 years respectively was identified. All patients had lower extremity limb-girdle muscle weakness. Seven required ventilatory support and seven used mobility assists. Of the four who used both assists, two received ventilatory support prior to wheelchair use. Cardiac involvement was seen in eight patients with various combinations of left ventricular hypertrophy, tricuspid regurgitation, cardiomyopathy, dilated ventricles with biventricular dysfunction and aortic regurgitation. Amongst 20 biochemically diagnosed patients (low residual GAA enzyme activity) GAA genotypes of 19 patients identified homozygous variants in eight and compound heterozygous in 11: 27 missense, 3 nonsense, 2 initiator codon, 3 splice site and one deletion. Nine variants in 7 patients were novel. The leaky Caucasian, splice site LOPD variant, c.-32-13T>G mutation was absent. This first study from India provides an insight into a more severe LOPD phenotype with earlier disease onset at 9.9 years compared to 33.3 years in Caucasian patients, and cardiac involvement more than previously reported. The need for improvement in awareness and diagnosis of LOPD in India is highlighted.
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Affiliation(s)
- Ratna Dua Puri
- Institute of Medical Genetics and Genomics, Sir Ganga Ram Hospital, New Delhi, India.
| | - Nitika Setia
- Institute of Medical Genetics and Genomics, Sir Ganga Ram Hospital, New Delhi, India
| | - Vinu N
- Institute of Medical Genetics and Genomics, Sir Ganga Ram Hospital, New Delhi, India
| | - Sujatha Jagadeesh
- Department of Clinical Genetics & Genetic Counselling, Mediscan Systems, Chennai, India
| | - Sheela Nampoothiri
- Department of Pediatric Genetics, Amrita Institute of Medical Sciences, Kerala, India
| | - Neerja Gupta
- Division of Genetics, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Mamta Muranjan
- Department of Pediatrics, King Edward Memorial Hospital, Mumbai, India
| | - Meenakshi Bhat
- Department of Clinical Genetics, Centre for Human Genetics, Bangalore, India
| | - Katta M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Madhulika Kabra
- Division of Genetics, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Jyotsna Verma
- Institute of Medical Genetics and Genomics, Sir Ganga Ram Hospital, New Delhi, India
| | - Divya C Thomas
- Institute of Medical Genetics and Genomics, Sir Ganga Ram Hospital, New Delhi, India
| | - Ishpreet Biji
- Institute of Medical Genetics and Genomics, Sir Ganga Ram Hospital, New Delhi, India
| | - Jayarekha Raja
- Department of Clinical Genetics & Genetic Counselling, Mediscan Systems, Chennai, India
| | | | - Ishwar C Verma
- Institute of Medical Genetics and Genomics, Sir Ganga Ram Hospital, New Delhi, India
| | - Priya S Kishnani
- Division of Medical Genetics, Department of Pediatrics, Duke University Medical Center, Durham, NC, USA
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8
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Rezaei M, Suresh B, Bereke E, Hadipour Z, Aguinaga M, Qian J, Bagga R, Fardaei M, Hemida R, Jagadeesh S, Majewski J, Slim R. Novel pathogenic variants in NLRP7, NLRP5, and PADI6 in patients with recurrent hydatidiform moles and reproductive failure. Clin Genet 2021; 99:823-828. [PMID: 33583041 DOI: 10.1111/cge.13941] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 01/25/2021] [Revised: 02/07/2021] [Accepted: 02/10/2021] [Indexed: 12/26/2022]
Abstract
Recurrent hydatidiform moles (RHMs) are human pregnancies with abnormal embryonic development and hyperproliferating trophoblast. Biallelic mutations in NLRP7 and KHDC3L, members of the subcortical maternal complex (SCMC), explain the etiology of RHMs in only 60% of patients. Here we report the identification of seven functional variants in a recessive state in three SCMC members, five in NLRP7, one in NLRP5, and one in PADI6. In NLRP5, we report the first patient with RHMs and biallelic mutations. In PADI6, the patient had four molar pregnancies, two of which had fetuses with various abnormalities including placental mesenchymal dysplasia and intra-uterine growth restriction, which are features of Beckwith-Wiedemann syndrome and Silver Russell syndrome, respectively. Our findings corroborate recent studies and highlight the common oocyte origin of all these conditions and the continuous spectrum of abnormalities associated with deficiencies in the SCMC genes.
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Affiliation(s)
- Maryam Rezaei
- Department of Human Genetics, McGill University Health Centre Research Institute, Montreal, Quebec, Canada
| | - Beena Suresh
- Department of Clinical Genetics & Genetic counselling, Mediscan Systems, Chennai, India
| | - Eric Bereke
- Department of Human Genetics, McGill University Health Centre Research Institute, Montreal, Quebec, Canada.,Genome Quebec Innovation Centre, Montreal, Quebec, Canada
| | - Zahra Hadipour
- Medical Genetics Department, Atieh Research Center and Hospital, Tehran, Iran
| | - Monica Aguinaga
- Genetics and Genomics Department, Instituto Nacional de Perinatologia, Mexico City, Mexico
| | - Jianhua Qian
- Department of Gynecology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Rashmi Bagga
- Department of Obstetrics & Gynecology, Post Graduate Institute of Medical, Education and Research, PGIMER, Chandigarh, India
| | - Majid Fardaei
- Department of Medical Genetics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reda Hemida
- Obstetrics and Gynecology, Mansoura University, Mansoura, Egypt
| | - Sujatha Jagadeesh
- Department of Clinical Genetics & Genetic counselling, Mediscan Systems, Chennai, India
| | - Jacek Majewski
- Department of Human Genetics, McGill University Health Centre Research Institute, Montreal, Quebec, Canada.,Genome Quebec Innovation Centre, Montreal, Quebec, Canada
| | - Rima Slim
- Department of Human Genetics, McGill University Health Centre Research Institute, Montreal, Quebec, Canada.,Departments of Obstetrics and Gynecology, McGill University Health Centre, Montreal, Quebec, Canada
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9
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Gangodkar P, Khadilkar V, Raghupathy P, Kumar R, Dayal AA, Dayal D, Ayyavoo A, Godbole T, Jahagirdar R, Bhat K, Gupta N, Kamalanathan S, Jagadeesh S, Ranade S, Lohiya N, Oke RL, Ganesan K, Khatod K, Agarwal M, Phadke N, Khadilkar A. Clinical application of a novel next generation sequencing assay for CYP21A2 gene in 310 cases of 21- hydroxylase congenital adrenal hyperplasia from India. Endocrine 2021; 71:189-198. [PMID: 32948948 DOI: 10.1007/s12020-020-02494-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 05/02/2020] [Accepted: 09/07/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Accurate diagnosis is required for management of Congenital adrenal hyperplasia (CAH). The conventional method for detection of mutations in the CYP21A2 gene is targeted capillary sequencing which is labor intensive and has limited multiplexing capability. Next generation sequencing (NGS) provides data with high sequence coverage and depth. Our objective was to develop an accurate NGS-based assay to characterize the mutation spectrum in CYP21A2 gene in Indian patients suspected to have 21-OH CAH. METHODS Cases with 21-OH CAH from 12 endocrine units across India were studied. DNA was extracted from proband's and parent's(subset) blood. Locus-specific long-range PCR and gel electrophoresis of amplicons was followed by NGS where no visible 30 kb homozygous/whole gene deletion was observed. Orthogonal confirmation was performed by capillary sequencing (ABI 3500) and Multiplex Ligation-dependent Probe Amplification (MLPA, MRC-Holland). PCR products were purified and individual libraries were pooled and sequenced (Illumina). RESULTS Of the 310 CAH cases, biallelic mutations (pathogenic/ likely pathogenic variants involving both CYP21A2 gene copies) were detected in 256 (82.6%), heterozygous mutations in 13 (4.2 %), and none in 41 (13.2%). Most common mutation was c.293-13A/C>G (29.03%), followed by 30 kb deletion (18.24%). Thirty samples tested orthogonally (by capillary sequencing or MLPA) showed 100% concordance with NGS assay. Nine novel variants were identified. CONCLUSIONS We have developed and validated a comprehensive NGS-based assay for detection of variants in CYP21A2 gene in patients with 21-OH CAH. We describe CYP21A2 mutation spectrum and novel variants in a large cohort of Indian patients with CAH.
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Affiliation(s)
- Priyanka Gangodkar
- Research Scientist, GenePath Diagnostics India Private Limited, Pune, Maharashtra, India
| | - Vaman Khadilkar
- Consultant Pediatric Endocrinologist, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir hospital, Pune, Maharashtra, India
| | - P Raghupathy
- Pediatric Endocrinologist, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
| | - Rakesh Kumar
- Endocrinology and Diabetes Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, India
| | - Archana Arya Dayal
- Consultant Pediatric Endocrinologist, Sir Gangaram Hospital, Delhi, India
| | - Devi Dayal
- Pediatric Endocrinology & Diabetes Unit, PGIMER, Chandigarh, India
| | - Ahila Ayyavoo
- Consultant Pediatric Endocrinologist and Diabetologist, GKNM hospital, Coimbatore, Tamil Nadu, India
| | - Tushar Godbole
- Consultant Pediatric Endocrinologist, Harmony Health Hub, Nashik, Maharashtra, India
| | - Rahul Jahagirdar
- Professor and Pediatric Endocrinologist, Bharati Vidyapeeth University Medical College, Pune, Maharashtra, India
| | - Kavitha Bhat
- Chief Pediatric Endocrinologist, Rainbow Children's Hospital, Bengaluru, Karnataka, India
| | - Neerja Gupta
- Division of Genetics, Department of Pediatrics, AIIMS, New Delhi, India
| | | | - Sujatha Jagadeesh
- Consultant, Medical Geneticist & dysmorphologist, Mediscan, Chennai, Tamil Nadu, India
| | - Shatakshi Ranade
- Senior Research Scientist, GenePath Diagnostics india Private Limited, Pune, Maharashtra, India
| | - Nikhil Lohiya
- Fellow in Pediatric Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir hospital, Pune, Maharashtra, India
| | - Rashmi Lote Oke
- Research Scientist, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir hospital, Pune, Maharashtra, India
| | - Karthik Ganesan
- Chief Technology Officer, GenePath Diagnostics Inc., Pune, India
| | - Kavita Khatod
- Head of Lab operations, GenePath Diagnostics India Private Limited, Pune, Maharashtra, India
| | - Meenal Agarwal
- Chief Clinical Officer, GenePath Diagnostics India Private Limited, Pune, Maharashtra, India
| | - Nikhil Phadke
- Chief Scientific Officer, GenePath Diagnostics India Private Limited, Pune, Maharashtra, India
| | - Anuradha Khadilkar
- Consultant Pediatrician and Deputy Director, Hirabai Cowasji Jehangir medical research Institute, Jehangir Hospital, Pune, Maharashtra, India.
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10
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Dongerdiye R, Jagadeesh S, Suresh B, Rajendran A, Devendra R, Warang P, Kedar PS. Novel pathogenic variant c.2714C>A (p. Thr905Lys) in the HK1 gene causing severe haemolytic anaemia with developmental delay in an Indian family. J Clin Pathol 2020; 74:620-624. [PMID: 33361148 DOI: 10.1136/jclinpath-2020-206960] [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] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 12/01/2020] [Accepted: 12/01/2020] [Indexed: 11/04/2022]
Abstract
Hexokinase (EC 2.7.1.1, Adenosine Tri Phosphate (ATP): D-hexose-6-phosphotransferase) is a crucial regulatory enzyme of the glycolytic pathway (Embden-Meyerhof pathway). Hexokinase deficiency is associated with chronic non-spherocytic haemolytic anaemia (HA) with some exceptional cases showing psychomotor/mental retardation and fetus death. The proband is a four-and-half-year-old female child born of a four-degree consanguineous marriage hailing from South India with autosomal recessive congenital HA associated with developmental delay. She was well till 3 months of her age post an episode of diarrhoea when she was noted to be severely anaemic and requiring regular transfusions. The common causes of HA, haemoglobinopathies, red cell membranopathies and common red cell enzymopathies (G6PD, GPI, PK and P5N) were ruled out. Targeted analysis of whole exome sequencing (WES) using an insilico gene panel for hereditary anaemia was performed to identify pathogenic variants in the patient. Next-generation sequencing revealed a novel homozygous variant in hexokinase gene c.2714C>A (p. Thr905Lys) in exon-18. The pathogenic nature of the variant p. Thr905Lys in the HK1 gene was confirmed collectively by biochemical and molecular studies. Insilico analysis (PolyPhen-2, Provean, Mutation Taster) predicted the variant to be severe disease causing. Multiple sequence alignment demonstrated the conservation of p. Thr905 across the species. The impact of the mutation on the protein structure was studied by PyMOL and Swiss Protein databank viewer.
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Affiliation(s)
- Rashmi Dongerdiye
- Hematogenetics, National Institute of Immunohaematology, Mumbai, Maharashtra, India
| | - Sujatha Jagadeesh
- Department of Clinical Genetics and Genetic Counseling Department, MediScan Systems, Chennai, Tamil Nadu, India
| | - Beena Suresh
- Department of Clinical Genetics and Genetic Counseling Department, MediScan Systems, Chennai, Tamil Nadu, India
| | - Aruna Rajendran
- Department of Hematology, Institute of Child Health and Hospital for Children, Chennai, Tamil Nadu, India
| | - Rati Devendra
- Hematogenetics, National Institute of Immunohaematology, Mumbai, Maharashtra, India
| | - Prashant Warang
- Hematogenetics, National Institute of Immunohaematology, Mumbai, Maharashtra, India
| | - Prabhakar S Kedar
- Hematogenetics, National Institute of Immunohaematology, Mumbai, Maharashtra, India
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11
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Yadav RM, Gupta M, Dalvi A, Bargir UA, Hule G, Shabrish S, Aluri J, Kulkarni M, Kambli P, Uppuluri R, Seshadri S, Jagadeesh S, Suresh B, Raja J, Taur P, Malaischamy S, Ghosh P, Mahalingam S, Kadam P, Lashkari HP, Tamhankar P, Tamhankar V, Mithbawkar S, Bhattad S, Jhawar P, Makam A, Bansal V, Prasad M, Govindaraj G, Guhan B, Bharadwaj Tallapaka K, Desai M, Raj R, Madkaikar MR. Prenatal Diagnosis for Primary Immunodeficiency Disorders-An Overview of the Indian Scenario. Front Immunol 2020; 11:612316. [PMID: 33365035 PMCID: PMC7750517 DOI: 10.3389/fimmu.2020.612316] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/04/2020] [Indexed: 01/13/2023] Open
Abstract
Prenatal Diagnosis (PND) forms an important part of primary preventive management for families having a child affected with primary immunodeficiency. Although individually sparse, collectively this group of genetic disorders represents a significant burden of disease. This paper discusses the prenatal services available for affected families at various centers across the country and the challenges and ethical considerations associated with genetic counseling. Mutation detection in the index case and analysis of chorionic villous sampling or amniocentesis remain the preferred procedures for PND and phenotypic analysis of cordocentesis sample is reserved for families with well-characterized index case seeking PND in the latter part of the second trimester of pregnancy. A total of 112 families were provided PND services in the last decade and the presence of an affected fetus was confirmed in 32 families. Post-test genetic counseling enabled the affected families to make an informed decision about the current pregnancy.
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Affiliation(s)
- Reetika Malik Yadav
- Center of Excellence for PIDs, Department of Pediatric Immunology and Leucocyte Biology, ICMR-National Institute of Immunohaematology, Mumbai, India
| | - Maya Gupta
- Center of Excellence for PIDs, Department of Pediatric Immunology and Leucocyte Biology, ICMR-National Institute of Immunohaematology, Mumbai, India
| | - Aparna Dalvi
- Center of Excellence for PIDs, Department of Pediatric Immunology and Leucocyte Biology, ICMR-National Institute of Immunohaematology, Mumbai, India
| | - Umair Ahmed Bargir
- Center of Excellence for PIDs, Department of Pediatric Immunology and Leucocyte Biology, ICMR-National Institute of Immunohaematology, Mumbai, India
| | - Gouri Hule
- Center of Excellence for PIDs, Department of Pediatric Immunology and Leucocyte Biology, ICMR-National Institute of Immunohaematology, Mumbai, India
| | - Snehal Shabrish
- Center of Excellence for PIDs, Department of Pediatric Immunology and Leucocyte Biology, ICMR-National Institute of Immunohaematology, Mumbai, India
| | - Jahnavi Aluri
- Center of Excellence for PIDs, Department of Pediatric Immunology and Leucocyte Biology, ICMR-National Institute of Immunohaematology, Mumbai, India
| | - Manasi Kulkarni
- Center of Excellence for PIDs, Department of Pediatric Immunology and Leucocyte Biology, ICMR-National Institute of Immunohaematology, Mumbai, India
| | - Priyanka Kambli
- Center of Excellence for PIDs, Department of Pediatric Immunology and Leucocyte Biology, ICMR-National Institute of Immunohaematology, Mumbai, India
| | - Ramya Uppuluri
- Department of Pediatric Hematology-Oncology, Blood Marrow Transplantation, Apollo Hospitals, Chennai, India
| | - Suresh Seshadri
- Department of Clinical Genetics & Genetic Counseling, Mediscan Systems, Chennai, India
| | - Sujatha Jagadeesh
- Department of Clinical Genetics & Genetic Counseling, Mediscan Systems, Chennai, India
| | - Beena Suresh
- Department of Clinical Genetics & Genetic Counseling, Mediscan Systems, Chennai, India
| | - Jayarekha Raja
- Department of Clinical Genetics & Genetic Counseling, Mediscan Systems, Chennai, India
| | - Prasad Taur
- Department of Immunology and Department of Pediatric Hemato-Oncology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | | | | | | | - Priya Kadam
- MedGenome Labs Private Limited, Bangalore, India
| | - Harsha Prasada Lashkari
- Department of Pediatrics, Kasturba Medical College Hospital, Manipal Academy of Higher Education, Mangalore, India
| | | | | | | | - Sagar Bhattad
- Division of Pediatric Immunology and Rheumatology, Department of Pediatrics, Aster CMI Hospital, Bangalore, India
| | - Prerna Jhawar
- Department of Fetal Medicine, Motherhood Hospital, Bangalore, India
| | - Adinarayan Makam
- Department of Fetal Medicine, Adi Advanced Centre for Fetal Care, Bangalore, India
| | - Vandana Bansal
- Fetal Medicine Department Surya Hospitals, Mumbai, India
| | | | - Geeta Govindaraj
- Department of Pediatrics, Government Medical College, Kozhikode, Calicut, India
| | - Beena Guhan
- Department of Pediatrics, Government Medical College, Kozhikode, Calicut, India
| | | | - Mukesh Desai
- Department of Immunology and Department of Pediatric Hemato-Oncology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Revathi Raj
- Department of Pediatric Hematology-Oncology, Blood Marrow Transplantation, Apollo Hospitals, Chennai, India
| | - Manisha Rajan Madkaikar
- Center of Excellence for PIDs, Department of Pediatric Immunology and Leucocyte Biology, ICMR-National Institute of Immunohaematology, Mumbai, India
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12
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Nampoothiri S, Yesodharan D, Bhattacherjee A, Ahamed H, Puri RD, Gupta N, Kabra M, Ranganath P, Bhat M, Phadke S, Radha Rama Devi A, Jagadeesh S, Danda S, Sylaja PN, Mandal K, Bijarnia‐Mahay S, Makkar R, Verma IC, Dalal A, Ramaswami U. Fabry disease in India: A multicenter study of the clinical and mutation spectrum in 54 patients. JIMD Rep 2020; 56:82-94. [PMID: 33204599 PMCID: PMC7653245 DOI: 10.1002/jmd2.12156] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/14/2020] [Accepted: 07/20/2020] [Indexed: 11/18/2022] Open
Abstract
Fabry disease (FD) is a treatable X linked lysosomal storage disorder with a wide phenotypic spectrum. There is a scarcity of published data on the burden of FD in India. This study evaluates the clinical and molecular spectrum of Indian patients with FD. In this multicentric study involving 10 tertiary referral centers in India, we analyzed the clinical course and genotype of 54 patients from 37 families. Family screening identified 19 new patients (35%) from 12 index cases. Then, 33 GLA gene variants were identified in 49/54 (90.7%) which included 11 novel and 22 known pathogenic variants. Of the 54 patients in our cohort, 40 patients had "classical" and 10 patients had a "nonclassical" presentation. The symptoms and signs included kidney dysfunction in 38/54 (70.3%), neuropathic pain in 34/54 (62.9%), left ventricular hypertrophy in 22/49 (44.8%) and stroke in 5/54 (9.2%). Female heterozygotes were 10/54 (18.5%) of whom 2 were index cases. There was a significant delay in reaching the diagnosis of 11.7 years. Enzyme replacement therapy was initiated in 28/54 (51.8%) patients with significant improvement of neuropathic pain and gastrointestinal symptoms. This study highlights the clinical presentation and mutational spectrum of FD in India and suggests that family screening and screening of high-risk groups (hypertrophic cardiomyopathy, idiopathic chronic renal failure and cryptogenic stroke) could be the most cost-effective strategies for early identification of FD.
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Affiliation(s)
- Sheela Nampoothiri
- Department of Pediatric GeneticsAmrita Institute of Medical Sciences and Research CentreCochinKeralaIndia
| | - Dhanya Yesodharan
- Department of Pediatric GeneticsAmrita Institute of Medical Sciences and Research CentreCochinKeralaIndia
| | - Amrita Bhattacherjee
- Diagnostics DivisionCentre for DNA Fingerprinting and Diagnostics (CDFD)HyderabadIndia
| | - Hisham Ahamed
- Department of CardiologyAmrita Institute of Medical Sciences and Research CentreCochinKeralaIndia
| | - Ratna Dua Puri
- Institute of Genetics and GenomicsSir Ganga Ram HospitalNew DelhiIndia
| | - Neerja Gupta
- Division of Genetics, Department of PediatricsAll India Institute of Medical SciencesNew DelhiIndia
| | - Madhulika Kabra
- Division of Genetics, Department of PediatricsAll India Institute of Medical SciencesNew DelhiIndia
| | - Prajnya Ranganath
- Department of Medical GeneticsNizam's Institute of Medical SciencesHyderabadIndia
| | - Meenakshi Bhat
- Department of Clinical GeneticsCentre for Human GeneticsBangaloreIndia
| | - Shubha Phadke
- Department of Medical GeneticsSanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia
| | | | - Sujatha Jagadeesh
- Department of Clinical Genetics and Genetic CounselingMediscan SystemsChennaiIndia
| | - Sumita Danda
- Department of Clinical GeneticsChristian Medical College and HospitalVelloreIndia
| | - Padmavathy Narayana Sylaja
- Comprehensive Stroke Care Program, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST)TrivandrumKeralaIndia
| | - Kausik Mandal
- Department of Medical GeneticsSanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia
| | | | | | | | - Ashwin Dalal
- Diagnostics DivisionCentre for DNA Fingerprinting and Diagnostics (CDFD)HyderabadIndia
| | - Uma Ramaswami
- Lysosomal Disorders Unit, Institute of Immunity and TransplantationRoyal Free London NHS Foundation TrustLondonUK
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13
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Karthik RC, Radhakrishnan A, Vikram A, Arumugam B, Jagadeesh S. Self-care practices among type II diabetics in rural area of Kancheepuram district, Tamil Nadu. J Family Med Prim Care 2020; 9:2912-2918. [PMID: 32984148 PMCID: PMC7491818 DOI: 10.4103/jfmpc.jfmpc_356_20] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 03/28/2020] [Accepted: 04/22/2020] [Indexed: 11/29/2022] Open
Abstract
Introduction: Type 2 diabetes mellitus is one of the most prevalent noncommunicable diseases in India. The acute and chronic complications of diabetes impact the physical, mental, and social well-being of the patients, thereby, placing a major burden on the health care system. Studies have shown that adequate self-care practices among the patients will facilitate good glycemic control and prevent complications. Objectives: To study the patterns of self-care practice among diabetic patients and the factors associated with them. Methods: This descriptive cross-sectional study was carried out among 250 diabetics in the rural field practice area of a Tertiary Medical College and Hospital in Chennai. The participants were interviewed on their diabetic status and various components of self-care practices adopted from The Summary of Diabetes Self-care Activities (SDSCA) Measure. Adherence to medication was assessed by using Morisky Medication Adherence Scale-4 (MMAS-4). Results: Our study observed that the overall prevalence of good self-care practices was very low (5.6%). Moderate self-care practices were prevalent in 42% of the study participants whereas the majority (52.4%) of the study population had poor self-care practices. In our study, the association between self-care activity with educational status and occupation was found to be statistically significant. Adherence was high for blood sugar testing (75.2%) and medication (70.4%) in the study population whereas adherence for foot care was poor (17.6%). Conclusion: Our study emphasized on the need for knowledge and awareness to be provided in rural areas regarding diabetes care management and self-care practices. Structured programs need to be planned to improve the attitude and practices of diabetic patients to promote better compliance towards diet, exercise, adherence to drugs, and appropriate foot care.
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Affiliation(s)
- Recharla Chenchu Karthik
- Department of Community Medicine, Tagore Medical College and Hospital, Rathinamangalam, Chennai, Tamil Nadu, India
| | - A Radhakrishnan
- Department of Community Medicine, Tagore Medical College and Hospital, Rathinamangalam, Chennai, Tamil Nadu, India
| | - A Vikram
- Department of Community Medicine, Tagore Medical College and Hospital, Rathinamangalam, Chennai, Tamil Nadu, India
| | - Balaji Arumugam
- Department of Community Medicine, Tagore Medical College and Hospital, Rathinamangalam, Chennai, Tamil Nadu, India
| | - S Jagadeesh
- 3rd year MBBS, Tagore Medical College and Hospital, Rathinamangalam, Chennai, Tamil Nadu, India
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14
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Chevarin M, Duffourd Y, A Barnard R, Moutton S, Lecoquierre F, Daoud F, Kuentz P, Cabret C, Thevenon J, Gautier E, Callier P, St-Onge J, Jouan T, Lacombe D, Delrue MA, Goizet C, Morice-Picard F, Van-Gils J, Munnich A, Lyonnet S, Cormier-Daire V, Baujat G, Holder M, Petit F, Leheup B, Odent S, Jouk PS, Lopez G, Geneviève D, Collignon P, Martin-Coignard D, Jacquette A, Perrin L, Putoux A, Sarrazin E, Amarof K, Missotte I, Coubes C, Jagadeesh S, Lapi E, Demurger F, Goldenberg A, Doco-Fenzy M, Mignot C, Héron D, Jean-Marçais N, Masurel A, El Chehadeh S, Marle N, Huet F, Binquet C, Collod-Beroud G, Arnaud P, Hanna N, Boileau C, Jondeau G, Olaso R, Lechner D, Poe C, Assoum M, Carmignac V, Duplomb L, Tran Mau-Them F, Philippe C, Vitobello A, Bruel AL, Boland A, Deleuze JF, Thauvin-Robinet C, Rivière JB, O'Roak BJ, Faivre L. Excess of de novo variants in genes involved in chromatin remodelling in patients with marfanoid habitus and intellectual disability. J Med Genet 2020; 57:466-474. [PMID: 32277047 DOI: 10.1136/jmedgenet-2019-106425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 07/16/2019] [Revised: 11/22/2019] [Accepted: 12/21/2019] [Indexed: 01/10/2023]
Abstract
PURPOSE Marfanoid habitus (MH) combined with intellectual disability (ID) (MHID) is a clinically and genetically heterogeneous presentation. The combination of array CGH and targeted sequencing of genes responsible for Marfan or Lujan-Fryns syndrome explain no more than 20% of subjects. METHODS To further decipher the genetic basis of MHID, we performed exome sequencing on a combination of trio-based (33 subjects) or single probands (31 subjects), of which 61 were sporadic. RESULTS We identified eight genes with de novo variants (DNVs) in at least two unrelated individuals (ARID1B, ATP1A1, DLG4, EHMT1, NFIX, NSD1, NUP205 and ZEB2). Using simulation models, we showed that five genes (DLG4, NFIX, EHMT1, ZEB2 and ATP1A1) met conservative Bonferroni genomewide significance for an excess of the observed de novo point variants. Overall, at least one pathogenic or likely pathogenic variant was identified in 54.7% of subjects (35/64). These variants fell within 27 genes previously associated with Mendelian disorders, including NSD1 and NFIX, which are known to be mutated in overgrowth syndromes. CONCLUSION We demonstrated that DNVs were enriched in chromatin remodelling (p=2×10-4) and genes regulated by the fragile X mental retardation protein (p=3×10-8), highlighting overlapping genetic mechanisms between MHID and related neurodevelopmental disorders.
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Affiliation(s)
- Martin Chevarin
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France
| | - Yannis Duffourd
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France.,FHU TRANSLAD, CHU Dijon, Dijon, France
| | - Rebecca A Barnard
- Department of Molecular & Medical Genetics, Oregon Health & Science University, Portland, Oregon, USA
| | - Sébastien Moutton
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France.,Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'interrégion Est, Centre Hospitalier Universitaire Dijon, Dijon, France.,Centre de Référence Anomalies du Développement et Syndromes Malformatifs Sud-Ouest, Centre Hospitalier Universitaire Bordeaux, Bordeaux, France
| | - François Lecoquierre
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France
| | - Fatma Daoud
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France
| | - Paul Kuentz
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France.,FHU TRANSLAD, CHU Dijon, Dijon, France
| | - Caroline Cabret
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France
| | - Julien Thevenon
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France.,Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'interrégion Est, Centre Hospitalier Universitaire Dijon, Dijon, France
| | | | - Patrick Callier
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France.,FHU TRANSLAD, CHU Dijon, Dijon, France
| | - Judith St-Onge
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France
| | - Thibaud Jouan
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France
| | - Didier Lacombe
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs Sud-Ouest, Centre Hospitalier Universitaire Bordeaux, Bordeaux, France
| | - Marie Ange Delrue
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs Sud-Ouest, Centre Hospitalier Universitaire Bordeaux, Bordeaux, France
| | - Cyril Goizet
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs Sud-Ouest, Centre Hospitalier Universitaire Bordeaux, Bordeaux, France
| | - Fanny Morice-Picard
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs Sud-Ouest, Centre Hospitalier Universitaire Bordeaux, Bordeaux, France
| | - Julien Van-Gils
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs Sud-Ouest, Centre Hospitalier Universitaire Bordeaux, Bordeaux, France
| | - Arnold Munnich
- IHU Imagine, Département de Génétique, APHP, Hôpital Necker Enfants Malades, Paris, France
| | - Stanislas Lyonnet
- IHU Imagine, Département de Génétique, APHP, Hôpital Necker Enfants Malades, Paris, France
| | - Valérie Cormier-Daire
- IHU Imagine, Département de Génétique, APHP, Hôpital Necker Enfants Malades, Paris, France
| | - Geneviève Baujat
- IHU Imagine, Département de Génétique, APHP, Hôpital Necker Enfants Malades, Paris, France
| | - Muriel Holder
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs Nord, Centre Hospitalier Universitaire Lille, Lille, France
| | - Florence Petit
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs Nord, Centre Hospitalier Universitaire Lille, Lille, France
| | - Bruno Leheup
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'interrégion Ouest, Centre Hospitalier Universitaire Nancy, Nancy, France
| | - Sylvie Odent
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'interrégion Est, Centre Hospitalier Universitaire Rennes, Rennes, France
| | - Pierre-Simon Jouk
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs Centre Est, Centre Hospitalier Universitaire Grenoble, Grenoble, France
| | - Gipsy Lopez
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs Centre Est, Centre Hospitalier Universitaire Grenoble, Grenoble, France
| | - David Geneviève
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs Sud-Languedoc Roussillon, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - Patrick Collignon
- Centre de Compétence Anomalies du Développement et Syndromes Malformatifs Sud-Est, CHI de Toulon - La Seyne-sur-Mer, France
| | - Dominique Martin-Coignard
- Centre de compétence Anomalies du Développement et Syndromes Malformatifs, CH Le Mans, Le Mans, France
| | - Aurélia Jacquette
- Département de Génétique et Centre de Référence Déficiences intellectuelles de causes rares, APHP, La Pitié Salpêtrière, Paris, France
| | - Laurence Perrin
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs Ile de France, APHP, Hôpital Robert Debré, Paris, France
| | - Audrey Putoux
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs Centre Est, Hospices Civils de Lyon, Lyon, France
| | - Elisabeth Sarrazin
- Centre de Référence Caribéen des Maladies Rares Neurologiques et Neuromusculaires, CHU de Fort de France, Hôpital Pierre Zobda-Quitman, La Martinique, France
| | - Khadija Amarof
- Centre de Référence Caribéen des Maladies Rares Neurologiques et Neuromusculaires, CHU de Fort de France, Hôpital Pierre Zobda-Quitman, La Martinique, France
| | - Isabelle Missotte
- Service de Pédiatrie, Centre Hospitalier Territorial, Nouvelle Calédonie, France
| | - Christine Coubes
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs Sud-Languedoc Roussillon, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | | | - Elisabetta Lapi
- Genetica Medica, Azienda Ospedaliera Universitaria Anna Meyer, Firenze, Italia
| | | | - Alice Goldenberg
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHU Rouen, Rouen, France
| | - Martine Doco-Fenzy
- EA3801, Centre de Référence Anomalies du Développement et Syndromes Malformatifs et service de génétique, CHU Reims et UFR de médecine de Reims, Reims, France
| | - Cyril Mignot
- Département de Génétique et Centre de Référence Déficiences intellectuelles de causes rares, APHP, La Pitié Salpêtrière, Paris, France
| | - Delphine Héron
- Département de Génétique et Centre de Référence Déficiences intellectuelles de causes rares, APHP, La Pitié Salpêtrière, Paris, France
| | | | - Alice Masurel
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'interrégion Est, Centre Hospitalier Universitaire Dijon, Dijon, France
| | - Salima El Chehadeh
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'interrégion Est, Centre Hospitalier Universitaire Dijon, Dijon, France
| | - Nathalie Marle
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France.,FHU TRANSLAD, CHU Dijon, Dijon, France
| | - Frédéric Huet
- FHU TRANSLAD, CHU Dijon, Dijon, France.,Service de Pédiatrie 1, Centre Hospitalier Universitaire Dijon, Dijon, France
| | - Christine Binquet
- Centre d'Investigation Clinique - Epidémiologie Clinique, Centre Hospitalier Universitaire Dijon, Dijon, France
| | | | - Pauline Arnaud
- Centre de référence syndromes de Marfan et syndromes apparentés, APHP, Hôpital Bichat, Paris, France
| | - Nadine Hanna
- Centre de référence syndromes de Marfan et syndromes apparentés, APHP, Hôpital Bichat, Paris, France
| | - Catherine Boileau
- Centre de référence syndromes de Marfan et syndromes apparentés, APHP, Hôpital Bichat, Paris, France
| | - Guillaume Jondeau
- Centre de référence syndromes de Marfan et syndromes apparentés, APHP, Hôpital Bichat, Paris, France
| | - Robert Olaso
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, Evry, France
| | - Doris Lechner
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, Evry, France
| | - Charlotte Poe
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France
| | - Mirna Assoum
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France
| | - Virginie Carmignac
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France
| | - Laurence Duplomb
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France
| | - Frédéric Tran Mau-Them
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France
| | - Christophe Philippe
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France
| | - Antonio Vitobello
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France
| | - Ange-Line Bruel
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France
| | - Anne Boland
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, Evry, France
| | - Jean-François Deleuze
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, Evry, France
| | - Christel Thauvin-Robinet
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France.,FHU TRANSLAD, CHU Dijon, Dijon, France.,Centre de Référence Déficience intellectuelle, Centre Hospitalier Universitaire Dijon, Dijon, France
| | - Jean-Baptiste Rivière
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France.,FHU TRANSLAD, CHU Dijon, Dijon, France
| | - Brian J O'Roak
- Department of Molecular & Medical Genetics, Oregon Health & Science University, Portland, Oregon, USA
| | - Laurence Faivre
- INSERM, U1231, Génétique des Anomalies du Développement, Université de Bourgogne Franche-Comté, UMR Lipides, Nutrition, Dijon, France .,FHU TRANSLAD, CHU Dijon, Dijon, France.,Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'interrégion Est, Centre Hospitalier Universitaire Dijon, Dijon, France.,Centre de Référence Déficience intellectuelle, Centre Hospitalier Universitaire Dijon, Dijon, France
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15
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Somashekar PH, Narayanan DL, Jagadeesh S, Suresh B, Vaishnavi RD, Bielas S, Girisha KM, Shukla A. Bain type of X-linked syndromic mental retardation in a male with a pathogenic variant in HNRNPH2. Am J Med Genet A 2019; 182:183-188. [PMID: 31670473 PMCID: PMC10052778 DOI: 10.1002/ajmg.a.61388] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 02/19/2019] [Revised: 07/25/2019] [Accepted: 10/04/2019] [Indexed: 11/09/2022]
Abstract
Heterogeneous nuclear ribonucleoproteins (hnRNPs) are RNA binding proteins, which aid in maturation, stabilization, and transport of mRNA. They have a significant role in cellular nucleic acid metabolism. The hnRNPs alter gene expression and are linked to various neurodegenerative disorders and cancers. Previously, six unrelated girls with developmental delay, intellectual disability, and hypotonia were found to have de novo heterozygous pathogenic missense variants in HNRNPH2, located on the X chromosome. A gain-of-function effect was proposed for the variant and it was thought to be lethal in males as no surviving males were identified. We describe a family with two affected siblings, one male and one female, with a known pathogenic variant in HNRNPH2, possibly due to maternal germline mosaicism.
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Affiliation(s)
- Puneeth H Somashekar
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Dhanya L Narayanan
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | - Beena Suresh
- Department of Genetics, Mediscan Systems, Chennai, India
| | | | - Stephanie Bielas
- Department of Human Genetics, University of Michigan, Ann Arbor, Michigan
| | - Katta M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anju Shukla
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Suresh B, Reddy V, Kurth I, Jagadeesh S. A Child Presenting with Recurrent Corneal Ulcers: Hereditary Sensory and Autonomic Neuropathy IV (HSAN IV). Neuroophthalmology 2019; 43:310-312. [DOI: 10.1080/01658107.2018.1506937] [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] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 07/24/2018] [Accepted: 07/28/2018] [Indexed: 10/28/2022] Open
Affiliation(s)
- Beena Suresh
- Department of Clinical Genetics, Mediscan Systems, Chennai, India
| | - Vaishnavi Reddy
- Department of Clinical Genetics, Mediscan Systems, Chennai, India
| | - Ingo Kurth
- Institut für Humangenetik, der RWTH Aachen, Germany
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17
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Nampoothiri S, Guillemyn B, Elcioglu N, Jagadeesh S, Yesodharan D, Suresh B, Turan S, Symoens S, Malfait F. Ptosis as a unique hallmark for autosomal recessive WNT1-associated osteogenesis imperfecta. Am J Med Genet A 2019; 179:908-914. [PMID: 30896082 DOI: 10.1002/ajmg.a.61119] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 10/19/2018] [Revised: 02/07/2019] [Accepted: 02/15/2019] [Indexed: 01/22/2023]
Abstract
Osteogenesis imperfecta (OI) is a heritable connective tissue disorder, mainly characterized by bone fragility and low bone mass. Defects in the type I procollagen-encoding genes account for the majority of OI, but increasingly more rare autosomal recessive (AR) forms are being identified, which are caused by defects in genes involved in collagen metabolism, bone mineralization, or osteoblast differentiation. Bi-allelic mutations in WNT1 have been associated with a rare form of AR OI, characterized by severe osteoporosis, vertebral compression, scoliosis, fractures, short stature, and variable neurological problems. Heterozygous WNT1 mutations have been linked to autosomal dominant early-onset osteoporosis. In this study, we describe the clinical and molecular findings in 10 new patients with AR WNT1-related OI. Thorough revision of the clinical symptoms of these 10 novel patients and previously published AR WNT1 OI cases highlight ptosis as a unique hallmark in the diagnosis of this OI subtype.
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Affiliation(s)
- Sheela Nampoothiri
- Department of Pediatric Genetics, Amrita Institute of Medical Sciences & Research Centre, Cochin, Kerala, India
| | - Brecht Guillemyn
- Department of Biomolecular Medicine, Center for Medical Genetics Ghent, Ghent University Hospital, Ghent, Belgium
| | - Nursel Elcioglu
- Department of Pediatric Genetics, Marmara University Medical School, Istanbul, Turkey.,Department of Medicine, Eastern Mediterranean University Medical School, Mersin, Turkey
| | - Sujatha Jagadeesh
- Department of Clinical Genetics, Mediscan Systems, Chennai, Tamil Nadu, India
| | - Dhanya Yesodharan
- Department of Pediatric Genetics, Amrita Institute of Medical Sciences & Research Centre, Cochin, Kerala, India
| | - Beena Suresh
- Department of Clinical Genetics, Mediscan Systems, Chennai, Tamil Nadu, India
| | - Serap Turan
- Department of Pediatric Endocrinology, Marmara University Medical School, Istanbul, Turkey
| | - Sofie Symoens
- Department of Biomolecular Medicine, Center for Medical Genetics Ghent, Ghent University Hospital, Ghent, Belgium
| | - Fransiska Malfait
- Department of Biomolecular Medicine, Center for Medical Genetics Ghent, Ghent University Hospital, Ghent, Belgium
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18
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Prabhu SR, Mahadevan S, Jagadeesh S, Dharan D, Ganesh C, Suresh S, Suresh I. Normative Data of Thyroid Gland Volume in South Indian Neonates and Infants. Indian J Pediatr 2018; 85:1045-1049. [PMID: 29423669 DOI: 10.1007/s12098-017-2528-5] [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: 05/15/2017] [Accepted: 10/04/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To establish normative ultrasound data for thyroid gland volume in South Indian neonates and infants and compare with abnormal sonological features of thyroid in congenital hypothyroidism (CH) to explore thyroid ultrasound utility as a supportive screening tool to newborn screening programs for early detection of CH. METHODS In view of impact of geo ethnic factors, varying growth velocities and body mass indices of human population worldwide, specific regional, age and gender related reference data for thyroid gland size and volume are vital. This study was an offshoot of ICMR pilot New Born Screening (NBS) project for CH. Formula used for thyroid volume estimation was ellipsoidal formula D1 x D2 x D3 × 0.523. It was a prospective observational study. The neonates who screened negative for Thyroid Stimulating Hormone (TSH) with repeat normal serum TSH and free thyroxine were selected. One hundred fifty seven infants were enrolled which included 99 boys and 58 girls. The study population included children in age groups from 3 d to 1 y six months. RESULTS Data analysis was done by descriptive method and unpaired t test. Mean thyroid volume was 0.26 ml with 0.27 ml in boys and 0.24 ml in girls. Statistically significant "p value" was noted in single lobe measurements among boys and girls. CONCLUSIONS Thyroid gland volume normative data play a key role in evaluation of thyroid sonological abnormalities in CH and there is effective utility of ultrasound as a supportive diagnostic and prognostic screening tool for early detection of CH.
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Affiliation(s)
- Sudha Rathna Prabhu
- MediScan, No 197, Dr Natesan Road, Mylapore, Chennai, Tamil Nadu, 600004, India.
| | - Shriraam Mahadevan
- MediScan, No 197, Dr Natesan Road, Mylapore, Chennai, Tamil Nadu, 600004, India
| | - Sujatha Jagadeesh
- MediScan, No 197, Dr Natesan Road, Mylapore, Chennai, Tamil Nadu, 600004, India
| | - Dharani Dharan
- MediScan, No 197, Dr Natesan Road, Mylapore, Chennai, Tamil Nadu, 600004, India
| | - Chandra Ganesh
- MediScan, No 197, Dr Natesan Road, Mylapore, Chennai, Tamil Nadu, 600004, India
| | - Seshadri Suresh
- MediScan, No 197, Dr Natesan Road, Mylapore, Chennai, Tamil Nadu, 600004, India
| | - Indrani Suresh
- MediScan, No 197, Dr Natesan Road, Mylapore, Chennai, Tamil Nadu, 600004, India
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19
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Somashekar PH, Girisha KM, Nampoothiri S, Gowrishankar K, Devi RR, Gupta N, Narayanan DL, Kaur A, Bajaj S, Jagadeesh S, Lewis LES, Shailaja S, Shukla A. Locus and allelic heterogeneity and phenotypic variability in Waardenburg syndrome. Clin Genet 2018; 95:398-402. [PMID: 30394532 DOI: 10.1111/cge.13468] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 08/09/2018] [Revised: 10/03/2018] [Accepted: 10/25/2018] [Indexed: 02/02/2023]
Abstract
Waardenburg syndrome (WS) is a disorder of neural crest cell migration characterized by auditory and pigmentary abnormalities. We investigated a cohort of 14 families (16 subjects) either by targeted sequencing or whole-exome sequencing. Thirteen of these families were clinically diagnosed with WS and one family with isolated non-syndromic hearing loss (NSHL). Intra-familial phenotypic variability and non-penetrance were observed in families diagnosed with WS1, WS2 and WS4 with pathogenic variants in PAX3, MITF and EDNRB, respectively. We observed gonosomal mosaicism for a variant in PAX3 in an asymptomatic father of two affected siblings. For the first time, we report a biallelic pathogenic variant in MITF in a subject with WS2 and a biallelic variant in EDNRB was noted in a subject with WS2. An individual with isolated NSHL carried a pathogenic variant in MITF. Blended phenotype of NSHL and albinism was observed in a subject clinically diagnosed to have WS2. A phenocopy of WS1 was observed in a subject with a reported pathogenic variant in GJB2, known to cause isolated NSHL. These novel and infrequently reported observations exemplify the allelic and genetic heterogeneity and show phenotypic diversity of WS.
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Affiliation(s)
- Puneeth H Somashekar
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Katta M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sheela Nampoothiri
- Department of Pediatric Genetics, Amrita Institute of Medical Sciences and Research Centre, Cochin, India
| | | | - Radha R Devi
- Rainbow Children Hospital and Sandor Life Sciences Pvt. Ltd., Hyderabad, India
| | - Neerja Gupta
- Genetics Unit, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Dhanya L Narayanan
- Department of Medical Genetics, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Anupriya Kaur
- Genetics Metabolic Unit, Department of Pediatrics, Advanced Pediatrics Center, PGIMER, Chandigarh, India
| | - Shruti Bajaj
- Department of Pediatrics, Seth GS Medical College and KEM Hospital, Mumbai, India
| | | | - Leslie E S Lewis
- Department of Pediatrics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shenoy Shailaja
- Department of Ophthalmology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anju Shukla
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Colaco SM, Chidambarathanu S, Raja V, Murlidhar L, Jagadeesh S, Suresh I, Seshadri S. Idiopathic Arterial Calcification: Experience from a Single Center in South India. J Fetal Med 2018. [DOI: 10.1007/s40556-018-0176-0] [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] [Indexed: 10/16/2022]
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21
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Ramakrishnan D, Chidambarathanu S, Murli L, Micheal J, Jagadeesh S, Suresh I, Seshadri S. Persistent Left Superior Vena Cava in Fetuses: An Autopsy Series. Fetal Pediatr Pathol 2017; 36:304-310. [PMID: 28569558 DOI: 10.1080/15513815.2017.1324546] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To review fetal autopsy reports with persistent left superior vena cava (PLSVC) and identify its associations. MATERIALS AND METHODS Autopsy reports of all fetuses diagnosed with PLSVC in our center from January 2011 to December 2015 were reviewed. Fetuses less than 15 weeks gestational age along with autolyzed and damaged hearts were excluded from the study. The study group was compared with controls during this period. RESULTS Prenatal ultrasound detection rate of PLSVC was 13.06%. All the cases had associated anomalies of which 96% had extra cardiac anomalies and 67% had intrinsic cardiac defects among which septal defects were most common (39.6%). Anomalies of cardiovascular, respiratory, genitourinary and musculoskeletal, hypoplastic thymus and single umbilical artery were significantly higher in the study group. CONCLUSION This study emphasizes on the importance of improving the technical skill for imaging the three-vessel view as PLSVC seems to have significant associations.
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Salian S, Cho TJ, Phadke SR, Gowrishankar K, Bhavani GS, Shukla A, Jagadeesh S, Kim OH, Nishimura G, Girisha KM. Cover Image, Volume 173A, Number 3, March 2017. Am J Med Genet A 2017. [DOI: 10.1002/ajmg.a.38197] [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] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Smrithi Salian
- Department of Medical Genetics, Kasturba Medical College; Manipal University; Manipal India
| | - Tae-Joon Cho
- Division of Pediatric Orthopedics; Seoul National University Children's Hospital; Seoul Korea
| | - Shubha R. Phadke
- Department of Medical Genetics; Sanjay Gandhi Postgraduate Institute of Medical Sciences; Lucknow India
| | - Kalpana Gowrishankar
- Department of Medical Genetics; Apollo Children's Hospital; Chennai Tamilnadu India
| | | | - Anju Shukla
- Department of Medical Genetics, Kasturba Medical College; Manipal University; Manipal India
| | | | - Ok-Hwa Kim
- Department of Radiology; Woorisoa Children's Hospital; Seoul Korea
| | - Gen Nishimura
- Department of Pediatric Imaging; Tokyo Metropolitan Children's Medical Center; Tokyo Japan
| | - Katta M. Girisha
- Department of Medical Genetics, Kasturba Medical College; Manipal University; Manipal India
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Salian S, Cho TJ, Phadke SR, Gowrishankar K, Bhavani GS, Shukla A, Jagadeesh S, Kim OH, Nishimura G, Girisha KM. Additional three patients with Smith-McCort dysplasia due to novel RAB33B mutations. Am J Med Genet A 2017; 173:588-595. [PMID: 28127940 DOI: 10.1002/ajmg.a.38064] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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: 07/01/2016] [Accepted: 11/14/2016] [Indexed: 11/06/2022]
Abstract
Smith-McCort dysplasia (SMC OMIM 615222) and Dyggve-Melchior-Clausen dysplasia (DMC OMIM 223800) are allelic skeletal dysplasias caused by homozygous or compound heterozygous mutations in DYM (OMIM 607461). Both disorders share the same skeletal phenotypes characterized by spondylo-epi-metaphyseal dysplasia with distinctive lacy ilia. The difference rests on the presence or absence of intellectual disability, that is, intellectual disability in DMC and normal cognition in SMC. However, genetic heterogeneity was suspected in SMC. Recently, RAB33B (OMIM 605950) has been identified as the second gene for SMC. Nevertheless, only two affected families have been reported so far. Here we present three SMC patients with four novel pathogenic variants in RAB33B, including homozygosity for c.211C>T (p.R71*), homozygosity for c.365T>C (p.F122S), and compound heterozygosity for c.48delCGGGGCAG (p.G17Vfs*58) and c.490C>T (p.Q164*). We also summarize the clinical, radiological, and mutation profile of RAB33B after literature mining. This report ascertains the pathogenic relationship between RAB33B and SMC. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Smrithi Salian
- Department of Medical Genetics, Kasturba Medical College, Manipal University, Manipal, India
| | - Tae-Joon Cho
- Division of Pediatric Orthopedics, Seoul National University Children's Hospital, Seoul, Korea
| | - Shubha R Phadke
- Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Kalpana Gowrishankar
- Department of Medical Genetics, Apollo Children's Hospital, Chennai, Tamilnadu, India
| | | | - Anju Shukla
- Department of Medical Genetics, Kasturba Medical College, Manipal University, Manipal, India
| | | | - Ok-Hwa Kim
- Department of Radiology, Woorisoa Children's Hospital, Seoul, Korea
| | - Gen Nishimura
- Department of Pediatric Imaging, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Katta M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal University, Manipal, India
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24
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Beena S, Murlidhar L, Seshadri S, Jagadeesh S, Suresh I. Usefulness of fetal autopsy in the diagnosis of blomstrand chondrodysplasia: a report of three cases. J Matern Fetal Neonatal Med 2016; 30:1041-1044. [PMID: 27353973 DOI: 10.1080/14767058.2016.1199675] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Blomstrand osteochondrodysplasia (BOCD) is a rare autosomal recessive sclerosing skeletal dysplasia characterized by accelerated chondrocyte differentiation. In this article, we discuss three cases where lethal skeletal dysplasia was suspected and Blomstrand dysplasia was diagnosed by autopsy. Antenatal ultrasound findings include increased nuchal translucency, tetramicromelia and polyhydramnios. Radiological hallmark is advanced skeletal maturation and bone sclerosis. Histology of long bones revealed narrow cartilagenous cap and changes in the physeal growth zone which showed severe hypoplasia and disorganization of proliferative phase and hypertrophic phase. Homozygous and compound heterozygous mutations in PTHR1 gene have been implicated in the pathogenesis of this chondrodysplasia.
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Affiliation(s)
- Suresh Beena
- a Department of Clinical Genetics and Genetic Counseling
| | | | | | | | - Indrani Suresh
- e Department of Fetal Medicine , Mediscan Systems , Chennai , India
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Affiliation(s)
- Sudha Rathna Prabhu
- Department of Genetics, Mediscans and Fetal Care and Research Foundation, Chennai, Tamil Nadu, India
| | - Shriraam Mahadevan
- Department of Genetics, Mediscans and Fetal Care and Research Foundation, Chennai, Tamil Nadu, India
| | - Sujatha Jagadeesh
- Department of Genetics, Mediscans and Fetal Care and Research Foundation, Chennai, Tamil Nadu, India
| | - Seshadri Suresh
- Department of Genetics, Mediscans and Fetal Care and Research Foundation, Chennai, Tamil Nadu, India
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Abstract
AIM To establish normative data for stretched penile length (SPL) in term male neonates born in Tamil Nadu. MATERIALS AND METHODS All live term male neonates delivered in a hospital during a given period were included. SPL was measured from the pubic ramus to the tip of the glans. Two consecutive measurements were taken and average was recorded. RESULTS The mean SPL observed in our study was 2.83 ± 0.49 cm. CONCLUSION This study helps establish normative values for SPL in neonates of Tamil Nadu origin.
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Affiliation(s)
| | - Shriraam Mahadevan
- Consultant Endocrinologist, Madras Medical College, Chennai, Tamil Nadu, India
| | - R. Bharath
- Consultant Endocrinologist, Madras Medical College, Chennai, Tamil Nadu, India
| | - Sujatha Jagadeesh
- Geneticist and Dysmorphologist, Madras Medical College, Chennai, Tamil Nadu, India
| | - J. Kumutha
- Department of Neonatology, Madras Medical College, Chennai, Tamil Nadu, India
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27
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Gardeitchik T, Mohamed M, Fischer B, Lammens M, Lefeber D, Lace B, Parker M, Kim KJ, Lim BC, Häberle J, Garavelli L, Jagadeesh S, Kariminejad A, Guerra D, Leão M, Keski-Filppula R, Brunner H, Nijtmans L, van den Heuvel B, Wevers R, Kornak U, Morava E. Clinical and biochemical features guiding the diagnostics in neurometabolic cutis laxa. Eur J Hum Genet 2014; 22:888-95. [PMID: 23963297 PMCID: PMC4060105 DOI: 10.1038/ejhg.2013.154] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [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: 11/17/2012] [Revised: 06/11/2013] [Accepted: 06/12/2013] [Indexed: 01/01/2023] Open
Abstract
Patients with cutis laxa (CL) have wrinkled, sagging skin with decreased elasticity. Skin symptoms are associated with variable systemic involvement. The most common, genetically highly heterogeneous form of autosomal recessive CL, ARCL2, is frequently associated with variable metabolic and neurological symptoms. Progeroid symptoms, dysmorphic features, hypotonia and psychomotor retardation are highly overlapping in the early phase of these disorders. This makes the genetic diagnosis often challenging. In search for discriminatory symptoms, we prospectively evaluated clinical, neurologic, metabolic and genetic features in our patient cohort referred for suspected ARCL. From a cohort of 26 children, we confirmed mutations in genes associated with ARCL in 16 children (14 probands), including 12 novel mutations. Abnormal glycosylation and gyration abnormalities were mostly, but not always associated with ATP6V0A2 mutations. Epilepsy was most common in ATP6V0A2 defects. Corpus callosum dysgenesis was associated with PYCR1 and ALDH18A1 mutations. Dystonic posturing was discriminatory for PYCR1 and ALDH18A1 defects. Metabolic markers of mitochondrial dysfunction were found in one patient with PYCR1 mutations. So far unreported white matter abnormalities were found associated with GORAB and RIN2 mutations. We describe a large cohort of CL patients with neurologic involvement. Migration defects and corpus callosum hypoplasia were not always diagnostic for a specific genetic defect in CL. All patients with ATP6V0A2 defects had abnormal glycosylation. To conclude, central nervous system and metabolic abnormalities were discriminatory in this genetically heterogeneous group, although not always diagnostic for a certain genetic defect in CL.
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Affiliation(s)
- Thatjana Gardeitchik
- Department of Pediatrics, Institute for Metabolic and Genetic Disease, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Miski Mohamed
- Department of Pediatrics, Institute for Metabolic and Genetic Disease, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Björn Fischer
- Institute of Medical Genetics and Human Genetics, Charité Universitätsmedizin, Berlin, Germany
| | - Martin Lammens
- Department of Pathology, Institute for Metabolic and Genetic Disease, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Dirk Lefeber
- Department of Neurology, Institute for Metabolic and Genetic Disease, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Baiba Lace
- Medical Genetics Clinic, Children's Clinical University Hospital, Riga, Latvia
| | - Michael Parker
- Sheffield Clinical Genetics Service, Sheffield Children's Hospital, Sheffield, UK
| | - Ki-Joong Kim
- Department of Pediatrics, Seoul National University Hospital, Seoul, South Korea
| | - Bing C Lim
- Department of Pediatrics, Seoul National University Hospital, Seoul, South Korea
| | - Johannes Häberle
- Department of Pediatrics, University Children's Hospital, Zürich, Switzerland
| | - Livia Garavelli
- Clinical Genetics Unit, Obstetric and Pediatric Department, Santa Maria Nuova Hospital IRCCS, Reggio Emilia, Italy
| | | | | | - Deanna Guerra
- Department of Biomedical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Michel Leão
- Pediatric Neurology Unit and Neurogenetics Unit, Hospital S João, Porto, Portugal
| | | | - Han Brunner
- Department of Human Genetics, Institute for Metabolic and Genetic Disease, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Leo Nijtmans
- Department of Pediatrics, Institute for Metabolic and Genetic Disease, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Bert van den Heuvel
- Department of Pediatrics, Institute for Metabolic and Genetic Disease, Radboud University Medical Centre, Nijmegen, The Netherlands
- Laboratory for Genetic Endocrine and Metabolic Diseases, Institute for Metabolic and Genetic Disease, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ron Wevers
- Department of Pediatrics, Institute for Metabolic and Genetic Disease, Radboud University Medical Centre, Nijmegen, The Netherlands
- Laboratory for Genetic Endocrine and Metabolic Diseases, Institute for Metabolic and Genetic Disease, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Uwe Kornak
- Institute of Medical Genetics and Human Genetics, Charité Universitätsmedizin, Berlin, Germany
- FG Development and Disease, Max Planck Institute for Molecular Genetics, Berlin, Germany
| | - Eva Morava
- Department of Pediatrics, Institute for Metabolic and Genetic Disease, Radboud University Medical Centre, Nijmegen, The Netherlands
- Hayward Genetics Center, Tulane University Medical Center, New Orleans, LA, USA
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28
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Karthikeyan G, Jagadeesh S, Seshadri S, Häberle J. Citrullinemia type 1: genetic diagnosis and prenatal diagnosis in subsequent pregnancy. Indian Pediatr 2014; 50:965-6. [PMID: 24222285 DOI: 10.1007/s13312-013-0239-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Citrullinemia type 1 was diagnosed by tandem mass spectrometry in a full term male neonate who presented with an acute catastrophic collapse on the 3rd day of life. Both parents were identified to be carriers for the exon 15 p Gly390Arg mutation in the argininosuccinate synthetase gene located at chromosome 9q34.1. Chorionic villus sampling and prenatal genetic testing in the subsequent pregnancy revealed an affected fetus resulting in termination of pregnancy.
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Affiliation(s)
- G Karthikeyan
- Womens Center, Coimbatore; Mediscan systems, Chennai, India; and Division of Metabolism, University Childrens Hospital, Steinweiesstrasse, Switzerland. Correspondence to: Dr G Karthikeyan, GK Baby Clinic, 472, Muniappan Koil Street, Coimbatore 641 003, India.
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29
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Suresh I, Raja V, Sriram V, Ravulapalli S, Balusamy SL, Sairam S, Jagadeesh S, Murlidhar L. Prenatal Sonographic Features and Postnatal Outcome of Congenital Posteromedial Bowing of Tibia: An Experience from a Tertiary Fetal Medicine Center. J Fetal Med 2014. [DOI: 10.1007/s40556-014-0004-0] [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] [Indexed: 12/01/2022]
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30
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Tuz K, Bachmann-Gagescu R, O’Day D, Hua K, Isabella C, Phelps I, Stolarski A, O’Roak B, Dempsey J, Lourenco C, Alswaid A, Bönnemann C, Medne L, Nampoothiri S, Stark Z, Leventer R, Topçu M, Cansu A, Jagadeesh S, Done S, Ishak G, Glass I, Shendure J, Neuhauss S, Haldeman-Englert C, Doherty D, Ferland R. Mutations in CSPP1 Cause Primary Cilia Abnormalities and Joubert Syndrome with or without Jeune Asphyxiating Thoracic Dystrophy. Am J Hum Genet 2014. [DOI: 10.1016/j.ajhg.2014.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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31
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Tuz K, Bachmann-Gagescu R, O'Day DR, Hua K, Isabella CR, Phelps IG, Stolarski AE, O'Roak BJ, Dempsey JC, Lourenco C, Alswaid A, Bönnemann CG, Medne L, Nampoothiri S, Stark Z, Leventer RJ, Topçu M, Cansu A, Jagadeesh S, Done S, Ishak GE, Glass IA, Shendure J, Neuhauss SCF, Haldeman-Englert CR, Doherty D, Ferland RJ. Mutations in CSPP1 cause primary cilia abnormalities and Joubert syndrome with or without Jeune asphyxiating thoracic dystrophy. Am J Hum Genet 2014; 94:62-72. [PMID: 24360808 DOI: 10.1016/j.ajhg.2013.11.019] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 11/13/2013] [Indexed: 12/26/2022] Open
Abstract
Joubert syndrome (JBTS) is a recessive ciliopathy in which a subset of affected individuals also have the skeletal dysplasia Jeune asphyxiating thoracic dystrophy (JATD). Here, we have identified biallelic truncating CSPP1 (centrosome and spindle pole associated protein 1) mutations in 19 JBTS-affected individuals, four of whom also have features of JATD. CSPP1 mutations explain ∼5% of JBTS in our cohort, and despite truncating mutations in all affected individuals, the range of phenotypic severity is broad. Morpholino knockdown of cspp1 in zebrafish caused phenotypes reported in other zebrafish models of JBTS (curved body shape, pronephric cysts, and cerebellar abnormalities) and reduced ciliary localization of Arl13b, further supporting loss of CSPP1 function as a cause of JBTS. Fibroblasts from affected individuals with CSPP1 mutations showed reduced numbers of primary cilia and/or short primary cilia, as well as reduced axonemal localization of ciliary proteins ARL13B and adenylyl cyclase III. In summary, CSPP1 mutations are a major cause of the Joubert-Jeune phenotype in humans; however, the mechanism by which these mutations lead to both JBTS and JATD remains unknown.
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Affiliation(s)
- Karina Tuz
- Center for Neuropharmacology and Neuroscience, Albany Medical College, Albany, NY 12208, USA
| | - Ruxandra Bachmann-Gagescu
- Institute of Molecular Life Sciences, University of Zurich, 8057 Zurich, Switzerland; Institute of Medical Genetics, University of Zurich, 8603 Zurich, Switzerland
| | - Diana R O'Day
- Divisions of Genetic Medicine and Developmental Medicine, Department of Pediatrics, University of Washington, Seattle, WA 98195, USA
| | - Kiet Hua
- Center for Neuropharmacology and Neuroscience, Albany Medical College, Albany, NY 12208, USA
| | - Christine R Isabella
- Divisions of Genetic Medicine and Developmental Medicine, Department of Pediatrics, University of Washington, Seattle, WA 98195, USA
| | - Ian G Phelps
- Divisions of Genetic Medicine and Developmental Medicine, Department of Pediatrics, University of Washington, Seattle, WA 98195, USA
| | - Allan E Stolarski
- Center for Neuropharmacology and Neuroscience, Albany Medical College, Albany, NY 12208, USA
| | - Brian J O'Roak
- Department of Molecular & Medical Genetics, Oregon Health Sciences University, Portland, OR 97239, USA
| | - Jennifer C Dempsey
- Divisions of Genetic Medicine and Developmental Medicine, Department of Pediatrics, University of Washington, Seattle, WA 98195, USA
| | - Charles Lourenco
- Neurogenetics Division, Clinics Hospital, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo 14049-900, Brazil
| | - Abdulrahman Alswaid
- Department of Pediatrics, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia
| | - Carsten G Bönnemann
- Neuromuscular and Neurogenetic Disorders of Childhood Section, John Edward Porter Neuroscience Research Center, National Institutes of Health, Bethesda, MD 20892, USA
| | - Livija Medne
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Sheela Nampoothiri
- Department of Pediatric Genetics, Amrita Institute of Medical Sciences and Research Center, AIMS Ponekkara Post Office, Kochi, Kerala 682041, India
| | - Zornitza Stark
- Victorian Clinical Genetics Services, Murdoch Childrens Research Institute, Parkville, VIC 3052, Australia
| | - Richard J Leventer
- Departments of Neurology and Pediatrics, Murdoch Childrens Research Institute, Royal Children's Hospital and University of Melbourne, Parkville, VIC 3052, Australia
| | - Meral Topçu
- Department of Child Neurology, Hacettepe University Medical Faculty, Ihsan Dogramacı Children's Hospital, Ankara 06100, Turkey
| | - Ali Cansu
- Pediatric Neurology Unit, De Karadeniz Technical University, Trabzon 61080, Turkey
| | | | - Stephen Done
- Department of Radiology, University of Washington and Seattle Children's Hospital, Seattle, WA 98105, USA
| | - Gisele E Ishak
- Department of Radiology, University of Washington and Seattle Children's Hospital, Seattle, WA 98105, USA
| | - Ian A Glass
- Divisions of Genetic Medicine and Developmental Medicine, Department of Pediatrics, University of Washington, Seattle, WA 98195, USA; Center for Integrative Brain Research, Seattle Children's Hospital Research Institute, Seattle, WA 98105, USA
| | - Jay Shendure
- Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA
| | - Stephan C F Neuhauss
- Institute of Molecular Life Sciences, University of Zurich, 8057 Zurich, Switzerland
| | - Chad R Haldeman-Englert
- Department of Pediatrics, Section on Medical Genetics, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Dan Doherty
- Divisions of Genetic Medicine and Developmental Medicine, Department of Pediatrics, University of Washington, Seattle, WA 98195, USA; Center for Integrative Brain Research, Seattle Children's Hospital Research Institute, Seattle, WA 98105, USA.
| | - Russell J Ferland
- Center for Neuropharmacology and Neuroscience, Albany Medical College, Albany, NY 12208, USA; Department of Neurology, Albany Medical College, Albany, NY 12208, USA.
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Jagadeesh S, Suresh B, Murugan V, Suresh S, Salomans GS, Struys EA, Jacobs C. Pyridoxine-dependent epilepsy owing to antiquitin deficiency--mutation in the ALDH7A1 gene. Paediatr Int Child Health 2013; 33:113-5. [PMID: 23925287 DOI: 10.1179/2046905512y.0000000028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 10/31/2022]
Abstract
Pyridoxine-dependent epilepsy (PDE) is an inborn error of metabolism resulting from antiquitin deficiency. There is marked elevation of α-amino adipic semi-aldehyde (αAASA), piperidine-6-carboxylate (P6C) and pipecolic acid. The diagnosis can be confirmed by identifying the mutation in the ALDH7A1 gene in chromosome 5q3l. An 8-year-old Indian girl presented with severe developmental delay and seizures and was found to have pyridoxine-dependent epilepsy owing to an antiquitin mutation. Genetic evaluation of the parents allowed antenatal diagnosis to be made during the next pregnancy.
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33
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Jagadeesh S, Suresh B, Seshadri S, Suzuki Y. Biotinidase deficiency: an atypical presentation. Natl Med J India 2013; 26:29-30. [PMID: 24066991] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Biotinidase deficiency is a rare metabolic disorder which can cause dermatological manifestations and lead to severe neurological sequelae if untreated. Holocarboxylase synthetase deficiency also has similar manifestations and needs to be differentiated. We present a neonate who had atypical early onset symptoms and was diagnosed to have biotinidase deficiency.
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Affiliation(s)
- Sujatha Jagadeesh
- Mediscan Systems, 197 Dr Natesan Road, Mylapore, Chennai 600004, Tamil Nadu, India - Department of Genetics
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34
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Alders M, Mendola A, Adès L, Al Gazali L, Bellini C, Dallapiccola B, Edery P, Frank U, Hornshuh F, Huisman SA, Jagadeesh S, Kayserili H, Keng WT, Lev D, Prada CE, Sampson JR, Schmidtke J, Shashi V, van Bever Y, Van der Aa N, Verhagen JM, Verheij JB, Vikkula M, Hennekam RC. Evaluation of Clinical Manifestations in Patients with Severe Lymphedema with and without CCBE1 Mutations. Mol Syndromol 2012; 4:107-13. [PMID: 23653581 DOI: 10.1159/000342486] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2012] [Indexed: 11/19/2022] Open
Abstract
The lymphedema-lymphangiectasia-intellectual disability (Hennekam) syndrome (HS) is characterised by a widespread congenital lymph vessel dysplasia manifesting as congenital lymphedema of the limbs and intestinal lymphangiectasia, accompanied by unusual facial morphology, variable intellectual disabilities and infrequently malformations. The syndrome is heterogeneous as mutations in the gene CCBE1 have been found responsible for the syndrome in only a subset of patients. We investigated whether it would be possible to predict the presence of a CCBE1 mutation based on phenotype by collecting clinical data of patients diagnosed with HS, with or without a CCBE1 mutation. We report here the results of 13 CCBE1 positive patients, 16 CCBE1 negative patients, who were clinically found to have classical HS, and 8 patients in whom the diagnosis was considered possible, but not certain, and in whom no CCBE1 mutation was identified. We found no statistically significant phenotypic differences between the 2 groups with the clinical HS phenotype, although the degree of lymphatic dysplasia tended to be more pronounced in the mutation positive group. We also screened 158 patients with less widespread and less pronounced forms of lymphatic dysplasia for CCBE1 mutations, and no mutation was detected in this group. Our results suggest that (1) CCBE1 mutations are present only in patients with a likely clinical diagnosis of HS, and not in patients with less marked forms of lymphatic dysplasia, and (2) that there are no major phenotypic differences between HS patients with or without CCBE1 mutations.
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Affiliation(s)
- M Alders
- Department of Clinical Genetics, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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35
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Abstract
Cartilage-hair hypoplasia is a rare, autosomal recessive skeletal dysplasia, caused by mutations in the RMRP gene. The skeletal abnormalities include irregular metaphyses and cone shaped epiphyses of the hands. Molecular diagnosis confirmed two novel RMRP mutations in a compound heterozygous state in two siblings with this condition.
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Affiliation(s)
- Kerstin Reicherter
- Center for Pediatrics and Adolescent Medicine and Faculty of Biology, University of Freiburg, Freiburg, Germany
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36
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Abstract
We present the first mutation proven case of Fanconi-Bickel syndrome, a rare type of glycogen storage disease, from India. A four-year-old girl presented with severe growth retardation, genu varum and hepatomegaly. Investigations confirmed severe hypophosphatemic rickets and Fanconi syndrome. Molecular analysis confirmed a homozygous deletion insertion mutation in Glut 2 gene.
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Affiliation(s)
- Mohandas Nair K
- Department of Pediatrics, Medical College, Calicut, Kerala, India
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37
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Abstract
Mucopolysaccharidoses (MPS) are a family of inherited metabolic diseases that results from the deficiency of lysosomal enzymes involved in the degradation of the glycosaminoglycans (mucopolysaccharides). Despite the well-documented oral and dental findings of MPS type IV, there is not much literature documented about the incidence of this disorder among siblings in the same family. This report outlines the clinical and radiographic findings found in three siblings with Morquio syndrome.
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Affiliation(s)
- P Rekka
- Department of Pediatric and Preventive Dentistry, Meenakshi Ammal Dental College and Hospital, Meenakshi University, Maduravoyal, India
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38
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Jagadeesh S, Bhat L, Suresh I, Muralidhar SL. Prenatal diagnosis of restrictive dermopathy. Indian Pediatr 2009; 46:349-351. [PMID: 19383993] [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: 05/27/2023]
Abstract
We report three cases of Restrictive dermopathy from unrelated families. All were small for gestational age with small eyes and open mouth. Taut, stretched skin caused restriction of movements. Clavicular hypoplasia was a consistent radiological feature. Molecular diagnosis in the parents facilitated prenatal diagnosis from chorionic villous sample (CVS) in the subsequent pregnancy.
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39
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Jagadeesh S, Jabeen G, Bhat L, Vasikarla M, Suresh A, Seshadri S, Lata S. Triple X syndrome with rare phenotypic presentation. Indian J Pediatr 2008; 75:629-31. [PMID: 18759093 DOI: 10.1007/s12098-008-0120-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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] [Received: 03/07/2007] [Accepted: 02/29/2008] [Indexed: 10/21/2022]
Abstract
Triple X syndrome is a rare numerical chromosomal anomaly, occurring as a result of non dysjunction in meiosis I. Most cases have neurodevelopmental defects and functional problems. We report two cases diagnosed in our centre. The first was a fetus with cleft lip and palate, 47, XXX was identified by Fetal Blood Sampling. The second was a child with multisystem anomaly including cleft lip and palate, whose karyotype also revealed 47, XXX. Though isolated cases of associated abnormalities have been reported there have not been consistent phenotypic changes reported with this condition.
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Affiliation(s)
- Sujatha Jagadeesh
- Department of Genetics, A Unit of Mediscan Systems, 197, Dr Natesan Road, Mylapore, Chennai, India.
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40
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Appukuttan A, Mathew J, Varghese S, Jagadeesh S. The reverse sural artery neurocutaneous flap under combined sciatic and femoral nerve block for lower limb defects: a series of ten cases. Eur J Plast Surg 2007. [DOI: 10.1007/s00238-007-0181-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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41
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Aswin A, Jagadeesh S. Bipolar cautery forceps: An economical version. Indian J Plast Surg 2007. [DOI: 10.1055/s-0039-1699182] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
ABSTRACT
Context:Bipolar cautery forceps are an expensive instrument and especially in Government Medical colleges and Government Hospitals, getting a pair is a very tedious and prolonged task due to official reasons.Aims:To make a cheap and easily obtainable bipolar cautery forceps.Settings and Design: The reason for innovation was that the cautery forceps in the department were out of order and we were not getting replacements.Materials and Methods:Made from condemned and damaged forceps or from stainless steel nonsurgical forceps which are very low-cost, very cheap and easy to get hold of, especially in a Government institution with limited resources.Results: It has been used for the past one and a half years in our Department for plastic surgical procedures, including microvascular surgery. Initially, it was designed when the cautery forceps in the department were out of order and we were not getting replacements and later on, it became part of the routine set as it was found to be equally good.Conclusions: A very cheap and useful alternative to the commercially available bipolar cautery forceps has been made.
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Affiliation(s)
- Appukuttan Aswin
- Dept. of Plastic Surgery, Medical College Calicut, Kerala, India
| | - S. Jagadeesh
- Dept. of Plastic Surgery, Medical College Calicut, Kerala, India
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42
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Appukuttan A, Jagadeesh S. Bipolar cautery forceps: An economical version. Indian J Plast Surg 2007. [DOI: 10.4103/0970-0358.32668] [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] [Indexed: 11/04/2022] Open
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43
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Abstract
Calmodulin is a Ca2+ binding protein found in many eukaryotic cells. It is one of the most important intracellular mediators of Ca2+-dependant signaling in eukaryotic cells. It regulates diverse processes including mitosis, muscle contraction and nucleotide metabolism by modulating the activity of at least 30 different target enzymes in a calcium-dependant manner. Calmodulin plays an important role in the regulation of processes, such as the assembly and disassembly of microtubules by controlling protein kinase activities, by exerting an indirect influence upon a wide variety of cellular processes. It is observed that multi-drug resistant cells have a greater intracellular concentration of calcium than non-resistant cells which contributes to their increased sensitivity to calmodulin antagonism compared with that of non resistant cells. Calmodulin mediated processes can be effectively inhibited by a variety of pharmacological agents of different chemical structures, eg:The calcium channel blocker verapamil and antipsychotic drugs like the Phenothiazines. Many bioisosteres of phenothiazines like phenoxazines and acridones have been prepared and these have also shown very good calmodulin antagonism. These calmodulin antagonists have been shown to modulate multi-drug resistance (MDR) in cancer cells. This review highlights concepts of identification and optimization of new inhibitors of calmodulin in reversing MDR in cancer cells.
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Affiliation(s)
- Y C Mayur
- Department of Medicinal Chemistry, V.L. College of Pharmacy, Raichur, India.
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44
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Mayur YC, Padma T, Parimala BH, Chandramouli KH, Jagadeesh S, Gowda NMM, Thimmaiah KN. Sensitization of multidrug resistant (MDR) cancer cells to vinblastine by novel acridones: correlation between anti-calmodulin activity and anti-MDR activity. Med Chem 2006; 2:63-77. [PMID: 16787357 DOI: 10.2174/157340606775197732] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [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: 11/22/2022]
Abstract
Multidrug resistance (MDR) of cancer cells remains to be an important cause of chemotherapy failure. Search for the new MDR reversal agents is still an unceasing challenge for the scientists. In an attempt to find clinically useful modulators of MDR, a series of 19 N(10)-substituted-2-bromoacridones has been synthesized. Parent compound 1, prepared by the Ullmann condensation of o-chlorobenzoic acid and p-bromoaniline, undergoes N-alkylation in the presence of a phase transfer catalyst. N-(omega-Chloroalkyl) analogues were subjected to iodide catalyzed nucleophilic substitution reaction with various secondary amines to get the products 3-10 and 12-19, which increased the uptake of vinblastine (VLB) in MDR KBCh(R)-8-5 cells to a greater extent (1.25 to 1.9-fold) than did a similar concentration of the standard modulator, verapamil (VRP). Results of the efflux experiment showed that each modulator significantly inhibited the efflux of VLB, suggesting that they may be competitors for P-gp. All the compounds effectively compete with [(3)H] azidopine for binding to P-gp, pointed out this transport membrane protein as their likely site of action. Compounds at IC(10) were evaluated for their efficacy to modulate the cytotoxicity of VLB in KBCh(R)-8-5 cells and found that the modulators enhanced the cytotoxicity of VLB by 3.8 to 34-fold. The study on the structure-activity relationship revealed that substitution of hydrogen atom at position C-2 in acridone nucleus by a bromine atom increased the cytotoxic and anti-MDR activities. The ability of acridones to inhibit calmodulin-dependent cyclic AMP phosphodiesterase has been determined and the results have shown a strong positive correlation between anti-calmodulin activity and cytotoxicity in KBCh(R)-8-5 cells or anti-MDR activity.
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Affiliation(s)
- Y C Mayur
- Department of Chemistry, Western Illinois University, 1 University Circle, Currens Hall, Macomb, IL 61455, USA
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45
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Rajan TS, Varughese S, Jagadeesh S. Fan flaps for Cheiloplasty (lower lip reconstruction): A two year experience. Indian J Plast Surg 2006. [DOI: 10.1055/s-0039-1699149] [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] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
ABSTRACT
Aim:To evaluate the fan flaps done during the past two years with regard to applicability, reliability, functional perspective and complications.Materials and Methods:All the fan flaps done were reviewed by inspecting case records and directly following up the patients (at periodic intervals). The indications, applicability to defect size, postoperative aesthetic and functional results and drawbacks were noted.Results: Eight fan flaps were done during this period. All were done for squamous cell carcinoma affecting lower lip. All the flaps survived. Two early cases of Gilles fan flap developed significant microstomia. Later flaps with neurovascular preservation maintained sensations with good commissural competence. Nakajima fan flaps gave good overall results.Conclusions: The fan flaps, especially the Nakajima modification with neurovascular preservation are safe and reliable flaps for lip reconstruction in terms of form and function.
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Affiliation(s)
| | | | - S. Jagadeesh
- Department of Plastic Surgery, Medical College, Calicut, India
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46
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47
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Sheeja R, Saramma V, Jagadeesh S. Fan flaps for Cheiloplasty (lower lip reconstruction): A two year experience. Indian J Plast Surg 2006. [DOI: 10.4103/0970-0358.29546] [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] [Indexed: 11/04/2022] Open
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48
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Mathew J, Varghese S, Jagadeesh S. Tumescent infiltration versus femoral nerve block for skin graft harvest-a prospective randomized study. Indian J Plast Surg 2005. [DOI: 10.1055/s-0039-1699116] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
ABSTRACTIn this prospective, randomized study, 60 patients requiring a single sheet of graft were randomized into 2 groups. Tumescent infiltration was used for anesthesia in one group and femoral nerve block in the other. The pain during administration of anesthesia, the time required for onset of action, the pain during graft harvest and the failure rates were recorded. Statistical comparison was done using Fischers Exact probability test for the failure rates and Mann Whitney- U test for the other parameters. The pain during administration was significantly higher for tumescent infiltration. The time for onset of action was significantly faster with femoral nerve block. The pain during harvest and the failure rates did not show any significant difference. We conclude that tumescent infiltration is more painful than femoral nerve block but equally effective as anesthesia with no difference in the failure and complication rates.
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Affiliation(s)
- J Mathew
- Medical College, Kozhikode, Kerala, India
| | - S Varghese
- Medical College, Kozhikode, Kerala, India
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49
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Mathew J, Varghese S, Jagadeesh S. Tumescent infiltration versus femoral nerve block for skin graft harvest-a prospective randomized study. Indian J Plast Surg 2005. [DOI: 10.4103/0970-0358.19777] [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] [Indexed: 11/04/2022] Open
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50
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Ma PC, Tretiakova MS, Jagadeeswaran R, Jagadeesh S, Nallasura V, Kindler HL, Lingen M, Vokes EE, Husain A, Salgia R. Role of c-MET in lung cancer, malignant mesothelioma, and head and neck cancer. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.9539] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- P. C. Ma
- University of Chicago, Chicago, IL
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