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Soliman SE, Halliday W, Shaikh F, Chan H, Hèon E, Gallie BL. White orbital mass after enucleation for retinoblastoma: The power of illusion. Ophthalmic Genet 2017; 38:584-586. [PMID: 28306364 DOI: 10.1080/13816810.2017.1300923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sameh E Soliman
- a Department of Ophthalmology and Vision Sciences , The Hospital for Sick Children, University of Toronto , Toronto , Ontario , Canada.,b Department of Ophthalmology, Faculty of Medicine , University of Alexandria , Alexandria , Egypt
| | - William Halliday
- c Department of Pathology , The Hospital for Sick Children, University of Toronto , Toronto , Ontario , Canada
| | - Furqan Shaikh
- d Department of Hematology and Oncology , The Hospital for Sick Children, University of Toronto , Toronto , Ontario , Canada
| | - Helen Chan
- d Department of Hematology and Oncology , The Hospital for Sick Children, University of Toronto , Toronto , Ontario , Canada
| | - Elise Hèon
- a Department of Ophthalmology and Vision Sciences , The Hospital for Sick Children, University of Toronto , Toronto , Ontario , Canada.,e Department of Ophthalmology and Vision Sciences , University of Toronto , Toronto , Ontario , Canada
| | - Brenda L Gallie
- a Department of Ophthalmology and Vision Sciences , The Hospital for Sick Children, University of Toronto , Toronto , Ontario , Canada.,e Department of Ophthalmology and Vision Sciences , University of Toronto , Toronto , Ontario , Canada.,f Departments of Medical Biophysics and Molecular Genetics , University of Toronto , Toronto , Ontario , Canada
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2
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Bamaga AK, Riazi S, Amburgey K, Ong S, Halliday W, Diamandis P, Guerguerian AM, Dowling JJ, Yoon G. Neuromuscular conditions associated with malignant hyperthermia in paediatric patients: A 25-year retrospective study. Neuromuscul Disord 2016; 26:201-6. [PMID: 26951757 DOI: 10.1016/j.nmd.2016.02.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 09/18/2015] [Revised: 02/05/2016] [Accepted: 02/15/2016] [Indexed: 01/08/2023]
Abstract
Malignant Hyperthermia (MH) is a rare pharmacogenetic syndrome that can be fatal and the risk of MH in non RYR1-related disorders is unknown. We conducted a retrospective study to determine the prevalence of neuromuscular disorders among patients with MH at our centre. Patients who were admitted to the Hospital for Sick Children during the study period of January 1, 1990 to April 1, 2015 with a CK level > 8000 IU/L, or who received dantrolene, or who had a clinical diagnosis of MH were included. Medical records of 166 patients who met the inclusion criteria were reviewed and 13 patients were identified with MH-like reactions. Nine patients were classified as having true MH after review of the anaesthesia record and genetic testing results were available for 7 patients, 5 of whom had mutations in RYR1. Of the four patients who had severe reactions to anaesthesia but did not meet the criteria for true MH, two had Duchenne muscular dystrophy (DMD). In this retrospective study over 25 years, RYR1 mutations were the most common cause of MH in our cohort, and of these, one third had an underlying neuromuscular diagnosis. Genetic testing of RYR1 is indicated for all patients with MH, and anaesthetic precautions should be considered for any child with symptoms of neuromuscular disease.
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Affiliation(s)
- Ahmed K Bamaga
- Division of Neurology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Sheila Riazi
- Malignant Hyperthermia Investigation Unit, Toronto General Hospital, Toronto, Ontario, Canada
| | - Kimberly Amburgey
- Division of Neurology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Shaun Ong
- Division of Neurology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - William Halliday
- Division of Pathology, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Phedias Diamandis
- Division of Pathology, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Anne-Marie Guerguerian
- Departments of Critical Care Medicine and Paediatrics, Neuroscience and Mental Health Program, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - James J Dowling
- Division of Neurology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Grace Yoon
- Division of Neurology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Division of Clinical and Metabolic Genetics, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
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3
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Liba Z, Muthaffar O, Tang J, Minassian B, Halliday W, Branson H, Ann Yeh E. Rasmussen encephalitis: Response to early immunotherapy in a case of immune-mediated encephalitis. Neurol Neuroimmunol Neuroinflamm 2015; 2:e69. [PMID: 25738166 PMCID: PMC4335812 DOI: 10.1212/nxi.0000000000000069] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 01/07/2015] [Indexed: 11/15/2022]
Affiliation(s)
- Zuzana Liba
- Department of Pediatric Neurology (Z.L.), 2nd Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czech Republic; Division of Neurology (O.M., B.M., E.A.Y.), Division of Pathology (W.H.), and Division of Neuroradiology (H.B.), Hospital for Sick Children, Toronto, Ontario, Canada; and Department of Pediatrics (O.M., B.M., E.A.Y.), Department of Internal Medicine (J.T.), Department of Laboratory Medicine & Pathobiology (W.H.), and Department of Medical Imaging (H.B.), University of Toronto, Ontario, Canada
| | - Osama Muthaffar
- Department of Pediatric Neurology (Z.L.), 2nd Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czech Republic; Division of Neurology (O.M., B.M., E.A.Y.), Division of Pathology (W.H.), and Division of Neuroradiology (H.B.), Hospital for Sick Children, Toronto, Ontario, Canada; and Department of Pediatrics (O.M., B.M., E.A.Y.), Department of Internal Medicine (J.T.), Department of Laboratory Medicine & Pathobiology (W.H.), and Department of Medical Imaging (H.B.), University of Toronto, Ontario, Canada
| | - Joyce Tang
- Department of Pediatric Neurology (Z.L.), 2nd Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czech Republic; Division of Neurology (O.M., B.M., E.A.Y.), Division of Pathology (W.H.), and Division of Neuroradiology (H.B.), Hospital for Sick Children, Toronto, Ontario, Canada; and Department of Pediatrics (O.M., B.M., E.A.Y.), Department of Internal Medicine (J.T.), Department of Laboratory Medicine & Pathobiology (W.H.), and Department of Medical Imaging (H.B.), University of Toronto, Ontario, Canada
| | - Berge Minassian
- Department of Pediatric Neurology (Z.L.), 2nd Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czech Republic; Division of Neurology (O.M., B.M., E.A.Y.), Division of Pathology (W.H.), and Division of Neuroradiology (H.B.), Hospital for Sick Children, Toronto, Ontario, Canada; and Department of Pediatrics (O.M., B.M., E.A.Y.), Department of Internal Medicine (J.T.), Department of Laboratory Medicine & Pathobiology (W.H.), and Department of Medical Imaging (H.B.), University of Toronto, Ontario, Canada
| | - William Halliday
- Department of Pediatric Neurology (Z.L.), 2nd Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czech Republic; Division of Neurology (O.M., B.M., E.A.Y.), Division of Pathology (W.H.), and Division of Neuroradiology (H.B.), Hospital for Sick Children, Toronto, Ontario, Canada; and Department of Pediatrics (O.M., B.M., E.A.Y.), Department of Internal Medicine (J.T.), Department of Laboratory Medicine & Pathobiology (W.H.), and Department of Medical Imaging (H.B.), University of Toronto, Ontario, Canada
| | - Helen Branson
- Department of Pediatric Neurology (Z.L.), 2nd Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czech Republic; Division of Neurology (O.M., B.M., E.A.Y.), Division of Pathology (W.H.), and Division of Neuroradiology (H.B.), Hospital for Sick Children, Toronto, Ontario, Canada; and Department of Pediatrics (O.M., B.M., E.A.Y.), Department of Internal Medicine (J.T.), Department of Laboratory Medicine & Pathobiology (W.H.), and Department of Medical Imaging (H.B.), University of Toronto, Ontario, Canada
| | - E Ann Yeh
- Department of Pediatric Neurology (Z.L.), 2nd Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czech Republic; Division of Neurology (O.M., B.M., E.A.Y.), Division of Pathology (W.H.), and Division of Neuroradiology (H.B.), Hospital for Sick Children, Toronto, Ontario, Canada; and Department of Pediatrics (O.M., B.M., E.A.Y.), Department of Internal Medicine (J.T.), Department of Laboratory Medicine & Pathobiology (W.H.), and Department of Medical Imaging (H.B.), University of Toronto, Ontario, Canada
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Abstract
ABSTRACT:Background:Hyaline body myopathy (HBM) is a rare chronic nonprogressive congenital myopathy, with variable patterns of inheritance.Methods:We describe a patient with congenital HBM with progression of weakness and increasing muscle pain in adulthood. Three muscle biopsies, done at various times in her life, are reported.Results:Symptoms started during childhood; however, as an adult, following a period of stability with no progression of the disease, the patient became symptomatic with worsening proximal limb weakness, severe aching pain and hypertrophy of calves. Moderate elevations of serum creatine kinase and myopathic features were noted on electrophysiologic testing. Muscle pathology showed significant fatty infiltration of skeletal muscle and increased number of fibers with internal nuclei. Histology demonstrated the presence of subsarcolemmal, well-delineated hyaline areas, which on histochemical studies was shown to be limited to type1 fibers. The hyaline bodies were dark with pH 4.2 ATPase and with immunohistochemical studies reacted only with myosin heavy chain slow. Electron microscopy showed the hyaline bodies to be composed of nonmembrane bound, fairly even sized granular material, which merged with the adjacent myofibrils. Earlier muscle biopsies, done during childhood, also revealed presence of similar subsarcolemmal hyaline deposits.Conclusion:There appears to be a pattern of presentation with adulthood progression in HBM, which has not been described before. Further case studies are required to understand the clinical progression in HBM.
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Affiliation(s)
- Mubeen F Rafay
- Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
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5
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Chrestian N, Dowling J, Amburgey K, Moraes T, Cohn R, Hawkins C, Halliday W, McAdam L, Biggar D, Vajsar J. G.P.47. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.061] [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: 10/24/2022]
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Abstract
Septo-optic dysplasia (SOD) is a rare entity in which a variable spectrum of brain abnormalities, classically involving midline structures septum pellucidum (SP) and/or corpus callosum (CC) are associated with optic nerve hypoplasia (ONH) and hypothalamic-pituitary dysfunction. Sudden unexpected death (SUD) in the setting of SOD is recognized but there is a paucity of postmortem studies of this patient population. A retrospective clinicopathological analysis of seven autopsy cases of pediatric patients (ages: ten weeks to 17 years) with SOD was performed. Six patients were found vital signs absent at home. The seventh child was admitted to the hospital in shock, and died after being maintained on life support for 16 days. At autopsy, in all cases there were central nervous system (CNS) abnormalities and stigmata of panhypopituitarism (PHP), confirming the underlying diagnosis of SOD. Infectious or other acute pathological processes to account for sudden death were not identified. Forensic pathologists need to be aware of SOD because it predisposes to SUD and an appreciation of the underlying neuroendocrine complexities of the disorder is required for proper death certification.
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Affiliation(s)
- Maria P. Bonasoni
- Pathologist at the Perinatal-Pediatric Autopsy Service, Arcispedale Santa Maria Nuova/IRCCS, Reggio Emilia, Italy
| | - Jeanette Reyes
- The Hospital for Sick Children - Department of Paediatric Laboratory Medicine, Toronto, ON
| | - Susan Cromwell
- The Hospital for Sick Children - Department of Paediatric Laboratory Medicine, Toronto, ON
| | - William Halliday
- The Hospital for Sick Children - Department of Paediatric Laboratory Medicine, Toronto, ON
| | - Glenn P. Taylor
- The Hospital for Sick Children - Department of Paediatric Laboratory Medicine, Toronto, ON
| | - David A. Chiasson
- The Hospital for Sick Children - Department of Paediatric Laboratory Medicine, Toronto, ON
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7
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Spence T, Sin-Chan P, Picard D, Barszczyk M, Hoss K, Lu M, Kim SK, Ra YS, Nakamura H, Fangusaro J, Hwang E, Kiehna E, Toledano H, Wang Y, Shi Q, Johnston D, Michaud J, La Spina M, Buccoliero AM, Adamek D, Camelo-Piragua S, Peter Collins V, Jones C, Kabbara N, Jurdi N, Varlet P, Perry A, Scharnhorst D, Fan X, Muraszko KM, Eberhart CG, Ng HK, Gururangan S, Van Meter T, Remke M, Lafay-Cousin L, Chan JA, Sirachainan N, Pomeroy SL, Clifford SC, Gajjar A, Shago M, Halliday W, Taylor MD, Grundy R, Lau CC, Phillips J, Bouffet E, Dirks PB, Hawkins CE, Huang A. CNS-PNETs with C19MC amplification and/or LIN28 expression comprise a distinct histogenetic diagnostic and therapeutic entity. Acta Neuropathol 2014; 128:291-303. [PMID: 24839957 PMCID: PMC4159569 DOI: 10.1007/s00401-014-1291-1] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 05/01/2014] [Accepted: 05/02/2014] [Indexed: 10/26/2022]
Abstract
Amplification of the C19MC oncogenic miRNA cluster and high LIN28 expression has been linked to a distinctly aggressive group of cerebral CNS-PNETs (group 1 CNS-PNETs) arising in young children. In this study, we sought to evaluate the diagnostic specificity of C19MC and LIN28, and the clinical and biological spectra of C19MC amplified and/or LIN28+ CNS-PNETs. We interrogated 450 pediatric brain tumors using FISH and IHC analyses and demonstrate that C19MC alteration is restricted to a sub-group of CNS-PNETs with high LIN28 expression; however, LIN28 immunopositivity was not exclusive to CNS-PNETs but was also detected in a proportion of other malignant pediatric brain tumors including rhabdoid brain tumors and malignant gliomas. C19MC amplified/LIN28+ group 1 CNS-PNETs arose predominantly in children <4 years old; a majority arose in the cerebrum but 24 % (13/54) of tumors had extra-cerebral origins. Notably, group 1 CNS-PNETs encompassed several histologic classes including embryonal tumor with abundant neuropil and true rosettes (ETANTR), medulloepithelioma, ependymoblastoma and CNS-PNETs with variable differentiation. Strikingly, gene expression and methylation profiling analyses revealed a common molecular signature enriched for primitive neural features, high LIN28/LIN28B and DNMT3B expression for all group 1 CNS-PNETs regardless of location or tumor histology. Our collective findings suggest that current known histologic categories of CNS-PNETs which include ETANTRs, medulloepitheliomas, ependymoblastomas in various CNS locations, comprise a common molecular and diagnostic entity and identify inhibitors of the LIN28/let7/PI3K/mTOR axis and DNMT3B as promising therapeutics for this distinct histogenetic entity.
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Affiliation(s)
- Tara Spence
- Division of Hematology-Oncology, Department of Pediatrics, The Hospital for Sick Children, Arthur and Sonia Labatt Brain Tumor Research Centre, Peter Gilgan CRL,686 Bay Street, 17th Floor, 179712, Toronto, ON M5G0A4 Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - Patrick Sin-Chan
- Division of Hematology-Oncology, Department of Pediatrics, The Hospital for Sick Children, Arthur and Sonia Labatt Brain Tumor Research Centre, Peter Gilgan CRL,686 Bay Street, 17th Floor, 179712, Toronto, ON M5G0A4 Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - Daniel Picard
- Division of Hematology-Oncology, Department of Pediatrics, The Hospital for Sick Children, Arthur and Sonia Labatt Brain Tumor Research Centre, Peter Gilgan CRL,686 Bay Street, 17th Floor, 179712, Toronto, ON M5G0A4 Canada
| | - Mark Barszczyk
- Department of Pathology, The Hospital for Sick Children, Toronto, ON Canada
| | - Katharina Hoss
- Division of Hematology-Oncology, Department of Pediatrics, The Hospital for Sick Children, Arthur and Sonia Labatt Brain Tumor Research Centre, Peter Gilgan CRL,686 Bay Street, 17th Floor, 179712, Toronto, ON M5G0A4 Canada
| | - Mei Lu
- Division of Hematology-Oncology, Department of Pediatrics, The Hospital for Sick Children, Arthur and Sonia Labatt Brain Tumor Research Centre, Peter Gilgan CRL,686 Bay Street, 17th Floor, 179712, Toronto, ON M5G0A4 Canada
| | - Seung-Ki Kim
- Department of Neurosurgery, Seoul National University Children’s Hospital, Seoul, South Korea
| | - Young-Shin Ra
- Department of Neurosurgery, Asan Medical Center, Seoul, South Korea
| | - Hideo Nakamura
- Department of Neurosurgery, Kumamoto University, Kumamoto, Japan
| | - Jason Fangusaro
- Division of Pediatric Hematology/Oncology and Stem Cell Transplantation, Children’s Memorial Hospital, Chicago, IL USA
| | - Eugene Hwang
- Center for Cancer and Blood Disorders, Children’s National Medical Center, Washington, DC USA
| | - Erin Kiehna
- Department of Neurosurgery, Children’s Hospital of Los Angeles, Los Angeles, CA USA
| | - Helen Toledano
- Oncology Department, Schneider Hospital, Petach Tikva, Israel
| | - Yin Wang
- Department of Neuropathology Huashan Hospital, Fudan University, Shanghai, China
| | - Qing Shi
- Department of Pathology, Shanghai Children’s Hospital Affiliated Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Donna Johnston
- Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, ON Canada
| | - Jean Michaud
- Department of Pathology and Laboratory Medicine, Children’s Hospital of Eastern Ontario, Ottawa, ON Canada
| | - Milena La Spina
- Paediatric Haematology and Oncology Division, University of Catania, Sicily, Italy
| | | | - Dariusz Adamek
- Department of Pathomorphology, Jagiellonian University Medical College, Krakow, Poland
| | | | | | - Chris Jones
- Department of Paediatric Molecular Pathology, Institute of Cancer Research, Sutton, UK
| | - Nabil Kabbara
- Division of Pediatric Hematology Oncology, Rafic Hariri University Hospital, Beirut, Lebanon
| | - Nawaf Jurdi
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Pascale Varlet
- Medical and Department of Neuropathology, Sainte-Anne Hospital, University Paris V Descartes, Paris, France
| | - Arie Perry
- Department of Pathology and Laboratory Medicine, University of California, San Francisco, CA USA
| | - David Scharnhorst
- Department of Pathology, Children’s Hospital Central California, Madera, CA USA
| | - Xing Fan
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI USA
| | - Karin M. Muraszko
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI USA
| | - Charles G. Eberhart
- Division of Pathology, John Hopkins University School of Medicine, Baltimore, MD USA
| | - Ho-Keung Ng
- Department of Anatomical and Cellular Physiology, Chinese University of Hong Kong, Hong Kong, China
| | | | - Timothy Van Meter
- Department of Pediatrics, Virginia Commonwealth University, Richmond, VA USA
| | - Marc Remke
- Division of Neurosurgery, Arthur and Sonia Labatt Brain Tumor Research Centre, The Hospital for Sick Children, Toronto, ON Canada
| | - Lucie Lafay-Cousin
- Department of Pediatric Oncology, Alberta Children’s Hospital, Calgary, AB Canada
| | - Jennifer A. Chan
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB Canada
| | - Nongnuch Sirachainan
- Departments of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand
| | - Scott L. Pomeroy
- Department of Neurology, Children’s Hospital Boston, Boston, MA USA
| | - Steven C. Clifford
- Northern Institute for Cancer Research, Newcastle University, Newcastle Upon Tyne, UK
| | - Amar Gajjar
- Neuro-oncology Division, St Jude Children’s Research Hospital, Memphis, TN USA
| | - Mary Shago
- Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON Canada
| | - William Halliday
- Department of Pathology, The Hospital for Sick Children, Toronto, ON Canada
| | - Michael D. Taylor
- Division of Neurosurgery, Arthur and Sonia Labatt Brain Tumor Research Centre, The Hospital for Sick Children, Toronto, ON Canada
| | - Richard Grundy
- Children’s Brain Tumor Research Centre, Queen’s Medical Centre University of Nottingham, Nottingham, UK
| | - Ching C. Lau
- Texas Children’s Cancer Center, Baylor College of Medicine, Houston, TX USA
| | - Joanna Phillips
- Department of Pathology and Laboratory Medicine, University of California, San Francisco, CA USA
| | - Eric Bouffet
- Division of Hematology-Oncology, Department of Pediatrics, The Hospital for Sick Children, Arthur and Sonia Labatt Brain Tumor Research Centre, Peter Gilgan CRL,686 Bay Street, 17th Floor, 179712, Toronto, ON M5G0A4 Canada
| | - Peter B. Dirks
- Division of Neurosurgery, Arthur and Sonia Labatt Brain Tumor Research Centre, The Hospital for Sick Children, Toronto, ON Canada
| | - Cynthia E. Hawkins
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
- Department of Pathology, The Hospital for Sick Children, Toronto, ON Canada
| | - Annie Huang
- Division of Hematology-Oncology, Department of Pediatrics, The Hospital for Sick Children, Arthur and Sonia Labatt Brain Tumor Research Centre, Peter Gilgan CRL,686 Bay Street, 17th Floor, 179712, Toronto, ON M5G0A4 Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
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Yousef YA, Halliday W, Chan HS, Héon E, Gallie BL, Dimaras H. No ocular motility complications after subtenon topotecan with fibrin sealant for retinoblastoma. Canadian Journal of Ophthalmology 2013; 48:524-8. [DOI: 10.1016/j.jcjo.2013.05.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 05/21/2013] [Accepted: 05/30/2013] [Indexed: 11/25/2022]
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Lines MA, Hewson S, Halliday W, Sabatini PJB, Stockley T, Dipchand AI, Bowdin S, Siriwardena K. Danon Disease Due to a Novel LAMP2 Microduplication. JIMD Rep 2013; 14:11-6. [PMID: 24222494 DOI: 10.1007/8904_2013_277] [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] [Received: 09/14/2013] [Revised: 10/10/2013] [Accepted: 10/15/2013] [Indexed: 04/28/2023] Open
Abstract
Danon disease is a rare X-linked disorder comprising hypertrophic cardiomyopathy, skeletal myopathy, intellectual disability, and retinopathy; mutations of the lysosome-associated membrane protein gene LAMP2 are responsible. Most affected persons exhibit "private" point mutations; small locus rearrangements have recently been reported in four cases. Here, we describe the clinical, pathologic, and molecular features of a male proband and his affected mother with Danon disease and a small LAMP2 microduplication. The proband presented at age 12 years with exercise intolerance, hypertrophic cardiomyopathy, and increased creatine kinase. Endomyocardial biopsy findings were nonspecific, showing myocyte hypertrophy and reactive mitochondrial changes. Quadriceps muscle biopsy demonstrated the characteristic autophagic vacuoles with sarcolemma-like features. LAMP2 tissue immunostaining was absent; however, LAMP2 sequencing was normal. Deletion/duplication testing by multiplex ligation-dependent probe amplification (MLPA) assay revealed a 1.5kb microduplication containing LAMP2 exons 4 and 5. RT-PCR studies were consistent with the inclusion of these two duplicated exons in the final spliced transcript, resulting in a frameshift. The proband's mother, who had died following cardiac transplantation due to suspected myocarditis at age 35, was reviewed and was shown to be affected upon immunostaining of banked myocardial tissue. This case constitutes the second report of a pathogenic microduplication in Danon disease, and illustrates a number of potential diagnostic pitfalls. Firstly, given the imperfect sensitivity of LAMP2 sequencing, tissue immunostaining and/or MLPA should be considered as a diagnostic adjunct in the workup for this disorder. Secondly, the pathological findings in myocardium may be falsely indicative of relatively common conditions such as myocarditis.
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Affiliation(s)
- Matthew A Lines
- Division of Metabolics and Newborn Screening, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
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10
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Antony R, Zagardo M, Gujrati M, Lin J, Antony R, Al-Rahawan M, Zagardo M, Gujrati M, Lin J, Broniscer A, Bhardwaj R, Hampton C, Ozols V, Chakravadhanula M, Bouffet E, Hawkins C, Scheinemann K, Zelcer S, Johnston D, Lafay-Cousin L, Larouche V, Jabado N, Carret AS, Hukin J, Eisenstat D, Pond G, Poskitt K, Wilson B, Bartels U, Tabori U, Dhall G, Haley K, Finlay J, Rushing T, Sposto R, Seeger R, Garvin J, Rupani K, Stark E, Anderson R, Feldstein N, Grill J, Hargrave D, Massimino M, Jaspan T, Varlet P, Jones C, Morgan P, Le Deley MC, Azizi A, Canete A, Bouffet E, Saran F, Bachir J, Bubuteishvili-Pacaud L, Rousseau R, Vassal G, Gupta S, Robinson N, Dhir N, Wong K, Zhou S, Finlay J, Dhall G, Kumabe T, Kawaguchi T, Saito R, Kanamori M, Yamashita Y, Sonoda Y, Tominaga T, Miyagawa T, Nwachukwu C, Youland R, Laack N, Filipek I, Drogosiewicz M, Polnik MP, Swieszkowska E, Dembowska-Baginska B, Jurkiewicz E, Perek D, Perek D, Dembowska-Baginska B, Drogosiewicz M, Polnik MP, Grajkowska W, Roszkowski M, Sobol G, Musiol K, Wachowiak J, Kazmierczak B, Pogorzelski JP, Mlynarski W, Szewczyk BZ, Wysocki M, Niedzielska E, Kowalczyk J, Slusarz HW, Balwierz W, Czepko EZ, Szolkiewicz A, Perek D, Perek-Polnik M, Dembowska-Baginska B, Drogosiewicz M, Grajkowska W, Lastowska M, Chojnacka M, Filipek I, Tarasinska M, Roszkowski M, Perreault S, Chao K, Ramaswamy V, Shih D, Remke M, Luu B, Schubert S, Fisher P, Partap S, Vogel H, Taylor M, Goumnerova L, Cho YJ, Robison N, Dhall G, Brown R, Cloughesy T, Davidson TB, Krieger M, Berger M, Wong K, Perry A, Gilles F, Finlay JL, Robison N, Dhir N, Khemani J, Wong K, Gupta S, Britt B, Grimm J, Finlay J, Dhall G, Ruge MI, Blau T, Hafkemeyer V, Hamisch C, Klinger K, Simon T, Sadighi Z, Ellezam B, Guindani M, Ater J, Shimizu Y, Arai H, Miyajima M, Shimoji K, Kondo A, Shinohara E, Perkins S, DeWees T, Slavc I, Chocholous M, Leiss U, Haberler C, Peyrl A, Azizi AA, Dieckmann K, Woehrer A, Dorfer C, Czech T, Spence T, Picard D, Barszczyk M, Kim SK, Ra YS, Fangusaro J, Toledano H, Nakamura H, Lafay-Cousin L, Fan X, Muraszko KM, Ng HK, Bouffet E, Halliday W, Shago M, Hawkins CE, Huang A, Suzuki M, Kondo A, Miyajima M, Arai H, van Zanten SV, Jansen M, van Vuurden D, Hulleman E, Idema S, Noske D, Wolf N, Hendrikse H, Vandertop P, Kaspers GJ, Muller K, Schlamann A, Warmuth-Metz M, Pietsch T, Pietschmann S, Kortmann RD, Kramm CM, von Bueren AO, Walston S, Williams T, Hamstra D, Oh K, Pelloski C, Zhukova N, Pole J, Mistry M, Fried I, Bartels U, Huang A, Lapperiere N, Dirks P, Scheinemann K, An J, Alon N, Nathan P, Greenberg M, Bouffet E, Malkin D, Hawkins C, Tabori U. PEDIATRICS CLINICAL RESEARCH. Neuro Oncol 2013; 15:iii165-iii172. [PMCID: PMC3823900 DOI: 10.1093/neuonc/not185] [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: 09/01/2023] Open
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11
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Kirwan C, Ngan BY, Halliday W, Alexander S, Ali A. Primary conjunctival anaplastic large cell lymphoma in a child. J AAPOS 2013; 17:437-9. [PMID: 23896363 DOI: 10.1016/j.jaapos.2013.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 12/06/2012] [Revised: 04/04/2013] [Accepted: 04/07/2013] [Indexed: 11/30/2022]
Abstract
Conjunctival tumors in children are uncommon and behave differently from those in adults. The vast majority of tumors are benign. Of the malignant lesions in this age group, lymphoma and melanoma are most commonly reported. Most lymphoid tumors in children represent lymphoid hyperplasia, not lymphoma. Clinical differentiation of these two entities is not possible and biopsy is required to establish the diagnosis. We present an unusual case of primary anaplastic large cell lymphoma of the conjunctiva in a young boy.
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Affiliation(s)
- Caitriona Kirwan
- Department of Ophthalmology and Vision Science, The Hospital for Sick Children, Toronto, Ontario, Canada.
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12
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Abla O, Halliday W, Laughlin S, Weitzman S. Central nervous system juvenile xanthogranuloma after langerhans cell histiocytosis. Pediatr Blood Cancer 2013; 60:342-3. [PMID: 23109301 DOI: 10.1002/pbc.24379] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 09/27/2012] [Indexed: 11/07/2022]
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13
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Buysse K, Riemersma M, Powell G, van Reeuwijk J, Chitayat D, Roscioli T, Kamsteeg EJ, van den Elzen C, van Beusekom E, Blaser S, Babul-Hirji R, Halliday W, Wright GJ, Stemple DL, Lin YY, Lefeber DJ, van Bokhoven H. Missense mutations in β-1,3-N-acetylglucosaminyltransferase 1 (B3GNT1) cause Walker-Warburg syndrome. Hum Mol Genet 2013; 22:1746-54. [PMID: 23359570 PMCID: PMC3613162 DOI: 10.1093/hmg/ddt021] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Several known or putative glycosyltransferases are required for the synthesis of laminin-binding glycans on alpha-dystroglycan (αDG), including POMT1, POMT2, POMGnT1, LARGE, Fukutin, FKRP, ISPD and GTDC2. Mutations in these glycosyltransferase genes result in defective αDG glycosylation and reduced ligand binding by αDG causing a clinically heterogeneous group of congenital muscular dystrophies, commonly referred to as dystroglycanopathies. The most severe clinical form, Walker–Warburg syndrome (WWS), is characterized by congenital muscular dystrophy and severe neurological and ophthalmological defects. Here, we report two homozygous missense mutations in the β-1,3-N-acetylglucosaminyltransferase 1 (B3GNT1) gene in a family affected with WWS. Functional studies confirmed the pathogenicity of the mutations. First, expression of wild-type but not mutant B3GNT1 in human prostate cancer (PC3) cells led to increased levels of αDG glycosylation. Second, morpholino knockdown of the zebrafish b3gnt1 orthologue caused characteristic muscular defects and reduced αDG glycosylation. These functional studies identify an important role of B3GNT1 in the synthesis of the uncharacterized laminin-binding glycan of αDG and implicate B3GNT1 as a novel causative gene for WWS.
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Affiliation(s)
- Karen Buysse
- Department of Human Genetics 855, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
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14
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Dimaras H, Parulekar MV, Kwok G, Simpson ER, Ali A, Halliday W, Shago M, Harbour JW, Héon E, Gallie BL, Chan HSL. Molecular testing prognostic of low risk in epithelioid uveal melanoma in a child. Br J Ophthalmol 2013; 97:323-6. [PMID: 23292925 DOI: 10.1136/bjophthalmol-2012-302561] [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: 01/06/2023]
Abstract
AIMS To characterise a histologically unusual paediatric uveal melanoma by gene expression and karyotypic profiling and assess prognosis. METHODS The tumour was studied by histopathology, karyotype analysis, single nucleotide polymorphism and gene expression profile analysis for correlation with clinical outcome. RESULTS The tumour had predominantly epithelioid histology. Karyotype analysis showed none of the poor prognosis features normally associated with uveal melanoma. single nucleotide polymorphism analysis revealed no imbalance at chromosome 3. Gene expression profiling indicated low risk disease. CONCLUSIONS We report a child remaining relapse-free 6 years after diagnosis of a very rare uveal melanoma, with poor prognosis epithelioid histology, but gene expression profiling that accurately predicted low risk disease.
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Affiliation(s)
- Helen Dimaras
- Division of Hematology/ Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
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15
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Balogun JA, Halliday W, Bouffet E, Kulkarni AV. Spinal clear cell meningioma in a 3-year-old: a case report. Pediatr Neurosurg 2013; 49:311-5. [PMID: 25377168 DOI: 10.1159/000366452] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [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: 06/15/2014] [Accepted: 07/29/2014] [Indexed: 11/19/2022]
Abstract
Clear cell meningioma (CCM) is an aggressive meningioma variant with a tendency to early recurrence posing a challenge to its treatment. Although spinal meningiomas are uncommon in children, this rare entity has been described as the most common variant of spinal meningiomas in the pediatric age group. We present the case of a 3-year-old with a confirmed lumbar spine CCM and discuss the problems encountered in the management of this disease.
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Affiliation(s)
- James A Balogun
- Division of Neurosurgery, The Hospital for Sick Children, Toronto, Ont., Canada
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16
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Yousef YA, Shroff M, Halliday W, Gallie BL, Héon E. Detection of optic nerve disease in retinoblastoma by use of spectral domain optical coherence tomography. J AAPOS 2012; 16:481-3. [PMID: 23084390 DOI: 10.1016/j.jaapos.2012.05.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [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: 03/29/2012] [Revised: 05/24/2012] [Accepted: 05/28/2012] [Indexed: 11/29/2022]
Abstract
We present the case of a child affected with retinoblastoma and evolving optic nerve pathology detected by spectral domain optical coherence tomography (SD-OCT) before magnetic resonance imaging. At 6 months of age, the patient was diagnosed with bilateral retinoblastoma, which was managed with systemic chemotherapy and focal therapy. Six months after the third and final cycle of systemic chemotherapy, the right optic disk clinically appeared progressively edematous, raising concerns of tumor infiltration of the optic nerve head. Images obtained via magnetic resonance imaging could not confirm the presence of a tumor at the optic nerve head, whereas findings on SD-OCT were suggestive of optic nerve head disease. Histopathologic findings after enucleation revealed viable tumor over the optic nerve head, supporting the OCT findings.
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Affiliation(s)
- Yacoub A Yousef
- Department of Ophthalmology and Visual Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
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17
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Abstract
A 9-year-old boy with known Duchenne type muscular dystrophy (DMD) presented with signs of increased intracranial pressure. Radiological investigations revealed a lesion in the midline of the posterior fossa. Subtotal resection was performed. Pathology findings were consistent with the diagnosis of anaplastic medulloblastoma. The postoperative lumbar CSF was positive for malignant cells. Postoperatively, the patient showed severe neurological deterioration and lost his capacity to walk. He was treated with craniospinal radiation followed by nonintensive chemotherapy. At 30 months postsurgery, he was still in complete remission but had not recovered his walking ability. This is the second report of a malignant brain tumor in a boy with DMD. The possible link between the 2 conditions is discussed, as are ethical considerations regarding the management of medulloblastoma in children with DMD.
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Affiliation(s)
- Machiel van den Akker
- Division of Haematology/Oncology, Hospital for Sick Children, University of Toronto, Ontario, Canada.
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18
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Epelman M, Daneman A, Halliday W, Whyte H, Blaser SI. Abnormal corpus callosum in neonates after hypoxic-ischemic injury. Pediatr Radiol 2012; 42:321-30. [PMID: 21935701 DOI: 10.1007/s00247-011-2238-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [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: 05/19/2011] [Revised: 07/30/2011] [Accepted: 08/05/2011] [Indexed: 11/25/2022]
Abstract
BACKGROUND Literature regarding callosal injury after hypoxic-ischemic injury (HII) is scant. OBJECTIVE To present the MRI and US findings of callosal injury after HII. MATERIALS AND METHODS MRI and US studies of 76 neonates were evaluated for HII and 53 were considered positive. RESULTS Of the 53 neonates with HII, 40 demonstrated restricted diffusion on DWI; of these, 30 revealed callosal involvement. Nine of the 13 neonates with normal DWI, whose routine MRI images were compatible with HII, were imaged after 1 week of age. Five out of ten neonates imaged during the 1st week of life who did not show callosal restriction on DWI had predominantly basal ganglia injury. Callosal US images were regarded as abnormal in 16 out of the 53 neonates with HII, 15 of which revealed concomitant restricted diffusion on DWI. CONCLUSION Callosal injuries are common after HII. DWI is effective in confirming these injuries and easily demonstrates injury if performed prior to 1 week of age. The restricted diffusion demonstrated after this time could be attributed to continued injury. US is not a sensitive modality for callosal injury detection; however, abnormally increased callosal echogenicity might be a specific marker of injury in this setting.
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Affiliation(s)
- Monica Epelman
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada.
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19
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Soh SY, Dimaras H, Gupta A, Rushlow D, Swallow C, Crump M, Halliday W, Doyle JJ, Babyn P, Héon E, Gallie BL, Chan HSL. Adult ovarian retinoblastoma genomic profile distinct from prior childhood eye tumor. ACTA ACUST UNITED AC 2011; 129:1101-4. [PMID: 21825202 DOI: 10.1001/archophthalmol.2011.220] [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: 11/14/2022]
Affiliation(s)
- Shui Yen Soh
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
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20
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Skidmore DL, Chitayat D, Morgan T, Hinek A, Fischer B, Dimopoulou A, Somers G, Halliday W, Blaser S, Diambomba Y, Lemire EG, Kornak U, Robertson SP. Further expansion of the phenotypic spectrum associated with mutations in ALDH18A1, encoding Δ1-pyrroline-5-carboxylate synthase (P5CS). Am J Med Genet A 2011; 155A:1848-56. [DOI: 10.1002/ajmg.a.34057] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2011] [Accepted: 03/25/2011] [Indexed: 11/11/2022]
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21
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Hutchinson C, Elbers J, Halliday W, Branson H, Laughlin S, Armstrong D, Hawkins C, Westmacott R, Benseler SM. Treatment of small vessel primary CNS vasculitis in children: an open-label cohort study. Lancet Neurol 2010; 9:1078-84. [PMID: 20889380 DOI: 10.1016/s1474-4422(10)70243-x] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Clare Hutchinson
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, ON, Canada
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22
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Elbers J, Halliday W, Hawkins C, Hutchinson C, Benseler SM. Brain biopsy in children with primary small-vessel central nervous system vasculitis. Ann Neurol 2010; 68:602-10. [DOI: 10.1002/ana.22075] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Dimaras H, Rushlow D, Halliday W, Doyle JJ, Babyn P, Abella EM, Williams J, Héon E, Gallie BL, Chan HSL. Using RB1 mutations to assess minimal residual disease in metastatic retinoblastoma. Transl Res 2010; 156:91-7. [PMID: 20627193 DOI: 10.1016/j.trsl.2010.05.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [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: 01/14/2010] [Revised: 04/22/2010] [Accepted: 05/25/2010] [Indexed: 11/30/2022]
Abstract
To assess complete remission before subjecting nongermline metastatic retinoblastoma patients to an autologous peripheral stem cell transplant, we tested for patient-specific retinoblastoma tumor suppressor gene (RB1) mutant alleles in cerebrospinal fluid (CSF) and bone marrow. In 1 child with CSF and 1 with bone marrow metastases, allele-specific polymerase chain reaction (AS-PCR) detected the biallelic RB1 mutations specific to their tumors. The tumor of Child A was homozygous for R251X, and in Child B, it was homozygous for R358X. In Child A, the R251X mutation was detected in mutant controls diluted to 1:12,800 but not in CSF samples, corroborating clinical remission after chemotherapy. In Child B's bone marrow, AS-PCR for R358X was strongly positive at the detection of relapse, and subsequent bone marrow samples corroborated clinical remission after chemotherapy. No mutant tumor RB1 alleles were detected in their harvested peripheral blood stem cells. Both children were deemed suitable candidates for supralethal-dosage consolidation chemotherapy followed by autologous peripheral stem cell rescue of the bone marrow aimed at curing their metastatic retinoblastoma. When Child A recurred, the mutant tumor RB1 allele was detected 3.5 months before conventional pathology detected retinoblastoma tumor cells in the CSF. Assaying tumor-specific RB1 mutations complements cytological and immunohistochemical assessment of retinoblastoma involvement of CSF and bone marrow. Tumor cells can be detected in numbers lower than possible by conventional methods. An early diagnosis of relapse may allow an early institution of new therapy. A prospective international multicenter trial of the rare patients with metastatic retinoblastoma would assess the role of molecular monitoring in surveillance for minimal residual disease and recurrence.
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Affiliation(s)
- Helen Dimaras
- Divisions of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario, Canada
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Lafay-Cousin L, Mabbott DJ, Halliday W, Taylor MD, Tabori U, Kamaly-Asl ID, Kulkarni AV, Bartels U, Greenberg M, Bouffet E. Use of ifosfamide, carboplatin, and etoposide chemotherapy in choroid plexus carcinoma. J Neurosurg Pediatr 2010; 5:615-21. [PMID: 20515336 DOI: 10.3171/2010.3.peds09354] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Choroid plexus carcinomas (CPCs) are rare pediatric tumors with a generally poor prognosis. Although the role of surgery is well recognized, the role of adjuvant chemotherapy and radiation therapy remains unclear. In this paper, the authors' goal was to assess the role of second-look surgery and neoadjuvant ifosfamide, carboplatin, etoposide (ICE) chemotherapy in the management of CPC and to study neurocognitive outcome. METHODS The authors performed an institutional retrospective review of patients in whom CPC was diagnosed between 1985 and 2006 at the Hospital for Sick Children in Toronto. Fourteen patients (7 boys and 7 girls) were included. The median age at diagnosis was 18.6 months (range 1.1-65.3 months). Four patients had evidence of metastatic disease at diagnosis. Two of the 14 patients underwent gross-total resection during initial surgery; 12 of the patients received neoadjuvant chemotherapy, 10 of whom underwent second surgery. In total, of 12 patients who received chemotherapy with a curative intent, 11 underwent a greater than 95% resection. Neoadjuvant ICE chemotherapy was given prior to second surgery (median 4 cycles, range 2-5 cycles) and was continued after second resection for a median total of 7 cycles (range 4-16 cycles). RESULTS No tumor progression was observed during chemotherapy prior to second surgery. Five patients subsequently experienced tumor progression/relapse. At a median follow-up of 6.9 years (range 1.9-18.5 years), 8 patients are alive. None of the survivors received radiation therapy. However, 6 of 8 display significant neurocognitive and/or sensorial deficit. CONCLUSIONS In this experience, second surgery following neoadjuvant ICE chemotherapy led to a high rate of complete or near-complete resection. Chemotherapy appears to facilitate second-look surgery, in particular through a reduction of intraoperative blood loss. Despite radiation avoidance, the majority of survivors experienced significant neurocognitive impairment.
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Affiliation(s)
- Lucie Lafay-Cousin
- Department of Pediatric Oncology and Bone Marrow Transplantation, Alberta Children's Hospital, Calgary, Alberta, Canada.
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25
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Quercia N, Somers GR, Halliday W, Kantor PF, Banwell B, Yoon G. Friedreich ataxia presenting as sudden cardiac death in childhood: clinical, genetic and pathological correlation, with implications for genetic testing and counselling. Neuromuscul Disord 2010; 20:340-2. [PMID: 20338762 DOI: 10.1016/j.nmd.2010.02.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Revised: 01/22/2010] [Accepted: 02/23/2010] [Indexed: 11/28/2022]
Abstract
Friedreich ataxia (FRDA) is the most common cause of childhood onset ataxia. We report on a 4 year old boy who suffered sudden cardiac death and was found to have a dilated cardiomyopathy with left ventricular hypertrophy on post-mortem studies. Molecular genetic testing subsequently confirmed the diagnosis of Friedreich ataxia. To our knowledge, this is the first report of Friedreich ataxia presenting as sudden cardiac death in early childhood.
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Affiliation(s)
- Nada Quercia
- Division of Clinical and Metabolic Genetics, Hospital for Sick Children, University of Toronto, Toronto, Canada
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26
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D'Silva CN, Yoshimoto M, Natalino R, Soares F, Antoneli C, Ribeiro K, Halliday W, Gallie BL, Squire JA. Abstract 4361: Retinoblastoma (RB) genomic progression analysis using Tissue Microarrays (TMA) comprising 121 RB patient tumors. Cancer Res 2010. [DOI: 10.1158/1538-7445.am10-4361] [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: 11/16/2022]
Abstract
Abstract
Retinoblastoma is the second most common childhood intraocular malignancy and development of the tumor is initiated by bi-allelic loss of the RB1 gene. Bi-allelic RB1 loss may not always directly lead to malignant retinoblastoma, rather other genetic changes are likely involved. Subsequent mutational events, specifically gain and loss of chromosomal regions harboring key oncogenes and tumor suppressor genes, appear to underlie the progression of precursor lesions such as retinoma to retinoblastoma. Research thus far has implicated several cytogenetic aberrations in this sequence of molecular events, the two most recurrent and notable being the augmented copy number status of KIF14 and MDM4 on 1q and of DEK and E2F3 on 6p. A small subset of retinoblastoma also exhibits high-level amplification of the MYCN gene on chromosome 2p. KIF14, MDM4, DEK, E2F3 and MYCN have been widely characterized as oncogenes in a variety of cancers. The functional roles of the proteins encoded by these genes would also confer tumor cells manifesting these genomic changes with a selective survival and proliferative advantage. Our project is testing the hypothesis that 1q and 6p gain and 2p amplification - defined by extra copies of KIF14 and MDM4, DEK and E2F3 and MYCN respectively - are associated with clinical parameters of progression. The study comprises formalin-fixed paraffin-embedded fluorescence in situ hybridization (FFPE-FISH) analysis of pre-constructed tissue microarrays comprising 121 patient tumours, in order to determine the genomic copy number status of the five aforementioned genes. Results show 1q gain (3-10 copies) in 102/121 (84%), 6p gain in 115/121 (95%), MYCN gain in 14/121 (12%) and MYCN amplification (>10 copies) in 16/121 (14%) patient tumors. Assessment of potential correlations between the copy number status of these genes and clinical variables of disease progression include patient age, pathology at the time of diagnosis, optic nerve invasion, choroid involvement, laterality of the disease, number of tumor foci present at the time of diagnosis and histopathological parameters. To our knowledge, there has been no recent study associating genomic change of these five genes with clinical parameters of progression in a sample size of statistical significance. The large cohort and consequent statistical power of our results will facilitate a better understanding of the biological role of these genes in the progression from retinoma to retinoblastoma.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4361.
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Affiliation(s)
| | | | | | | | | | | | - William Halliday
- 3Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Brenda L. Gallie
- 4Division of Applied Molecular Oncology, Ontario Cancer Institute, Toronto, Ontario, Canada
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27
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King JAJ, Auguste KI, Halliday W, Drake JM, Kulkarni AV. Ventriculocystostomy and endoscopic third ventriculostomy/shunt placement in the management of hydrocephalus secondary to giant retrocerebellar cysts in infancy. J Neurosurg Pediatr 2010; 5:403-7. [PMID: 20367348 DOI: 10.3171/2009.10.peds09208] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [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: 11/06/2022]
Abstract
Hydrocephalus secondary to giant retrocerebellar cysts in infancy is a challenging condition and many treatment options exist. The authors report on 3 consecutive cases involving infants under the age of 6 months treated successfully with ventriculocystostomy in combination with direct hydrocephalus treatment (endoscopic third ventriculostomy or shunt placement). They describe the operative procedure, the surgical morbidity, and outcome in each case and review the literature regarding surgical approaches to this condition.
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Affiliation(s)
- James A J King
- Department of Neurosurgery, The Royal Melbourne Hospital, Melbourne, Australia
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Dimaras H, Héon E, Budning A, Doyle JJ, Halliday W, Gallie BL, Chan HSL. Retinoblastoma CSF metastasis cured by multimodality chemotherapy without radiation. Ophthalmic Genet 2010; 30:121-6. [PMID: 19941416 DOI: 10.1080/13816810902988780] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Cerebrospinal fluid (CSF) metastasis is the most difficult type of retinoblastoma metastasis to cure, even with bone marrow transplant. Most metastatic retinoblastoma cells express P-glycoprotein causing multidrug resistance (MDR). P-glycoprotein-rich blood vessels form blood-brain and blood-eye barriers, inhibit drug entry into central nervous system (CNS) and eyes. High-dose craniospinal radiation is too morbid for treatment of young children. To cure CSF metastasis without radiation, we designed an intensive multimodality chemotherapy regimen. METHOD After left eye enucleation, a 4-month-old boy with bilateral International Intraocular Retinoblastoma Classification Group E eyes and CSF metastasis was treated with 7-cycle high-dose carboplatin and etoposide, standard-dose vincristine, and high-dose/short-infusion cyclosporine to inhibit P-glycoprotein. Intraventricular drugs, non-substrate of P-glycoprotein (cytarabine), or less susceptible to MDR (topotecan), contributed to treatment of the metastasis. On achieving complete response, he was consolidated with supralethal-dosage carboplatin, etoposide, and cyclophosphamide, and his bone marrow rescued with autologous cord blood stem cells. RESULTS Following 1-cycle systemic chemotherapy and 2-dose intraventricular chemotherapy, the CSF metastasis cleared. The right eye tumor regressed completely. The patient remains in remission 8.3 years after diagnosis and 7.8 years post-transplant. CONCLUSION Intensive multimodality chemotherapy can cure CSF metastasis in retinoblastoma without incurring extreme morbidity from craniospinal radiation.
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Affiliation(s)
- Helen Dimaras
- Division of Hematology/Oncology, The Hospital for Sick Children, and The University of Toronto, Toronto, Ontario, Canada
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Cameron JM, Levandovskiy V, MacKay N, Utgikar R, Ackerley C, Chiasson D, Halliday W, Raiman J, Robinson BH. Identification of a novel mutation in GYS1 (muscle-specific glycogen synthase) resulting in sudden cardiac death, that is diagnosable from skin fibroblasts. Mol Genet Metab 2009; 98:378-82. [PMID: 19699667 DOI: 10.1016/j.ymgme.2009.07.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2009] [Revised: 07/21/2009] [Accepted: 07/22/2009] [Indexed: 11/17/2022]
Abstract
We report here the identification of a patient with muscle-specific glycogen synthase deficiency. The 8-year-old patient showed no prior signs of distress before collapsing during a bout of exercise, resulting in death. Initial post-mortem analysis of tissues suggested death was due to metabolic complications of mitochondrial myopathy, but upon further examination it was found that the anomalies were indicative of mitochondrial proliferation and oxidative compensation. A homozygous two base pair deletion was identified in exon 2 of GYS1, and the parents and sibling were confirmed as heterozygous carriers of the deletion. This case highlights the importance of differentiating between mitochondrial compensatory phenomena and true mitochondrial disease, and suggests that GYS1 deficiency could be a common cause of sudden cardiac death in children. Children with abnormal cardiac responses to increased workloads as well as those with defined myocardial disease should therefore be tested for GYS1 deficiency.
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Affiliation(s)
- Jessie M Cameron
- Genetics and Genome Biology, The Research Institute, The Hospital for Sick Children, Toronto, Canada
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Galicia E, Imai K, Mohamed IS, Go C, Fujimoto A, Ochi A, Sakuta R, Halliday W, Rutka JT, Chuang SH, Snead OC, Otsubo H. Changing ictal-onset EEG patterns in children with cortical dysplasia. Brain Dev 2009; 31:569-76. [PMID: 18834684 DOI: 10.1016/j.braindev.2008.08.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [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: 05/12/2008] [Revised: 08/13/2008] [Accepted: 08/20/2008] [Indexed: 10/21/2022]
Abstract
PURPOSE Cortical dysplasia (CD) is intrinsically epileptogenic. We hypothesize that CDs clinically emerging in the early developing brain tend to extend into multifocal or larger epileptic networks to pronounce intractability in contrast to CDs which clinically emerge at a later age. METHODS We evaluated the spatial and temporal profiles of ictal-onset EEG patterns in children with histopathologically confirmed CD. We designated Group A as children with changing ictal-onset EEG patterns over time, and Group B without change. We compared seizure profiles, consecutive scalp video-EEGs (VEEGs), MRI, MEG, and surgical outcomes. RESULTS We found 14 children consisting of 10 Group A patients (7 girls) and 4 Group B patients (all boys). Eight (80%) Group A patients had their seizure onset <5 years while all Group B patients had seizure onset >or=5 years (p<.05). Changes of ictal onset EEG pattern in Group A consisted of bilateral (4 patients), extending (2); extending and bilateral (2); and generalized (2). We saw MRI lesions (6) and single clustered MEG spike sources (MEGSSs) in (5). Six patients underwent surgery before 15 years of age, and 4 of them attained seizure freedom. All 4 Group B patients had MRI lesions and single clustered MEGSSs. Three patients underwent surgery after 15 years of age. All 4 patients attained seizure freedom. CONCLUSION Ictal-onset EEG patterns change over time in children with early seizure onset and intractable epilepsy caused by CD. Younger epileptic children with CD more frequently have multifocal epileptogenic foci or larger epileptogenic foci. Early resection of CD, guided by MRI, MEG, and intracranial video EEG, resulted in seizure freedom despite changes in ictal-onset EEG patterns.
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Affiliation(s)
- Elaine Galicia
- Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
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Abstract
The authors report on a child with known neurofibromatosis Type 1 who developed high-grade diffuse leptomeningeal gliomatosis, without a known primary glioma. To the authors' knowledge, this is the first report of the coexistence of these conditions in a child.
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Affiliation(s)
- James A J King
- Department of Neurosurgery, Royal Melbourne Hospital, Parkville, Victoria, Australia.
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Dai S, Dimaras H, Héon E, Budning A, Doyle J, Halliday W, Drake J, Gallie BL, Chan HSL. Trilateral retinoblastoma with pituitary-hypothalamic dysfunction. Ophthalmic Genet 2008; 29:120-5. [PMID: 18766991 DOI: 10.1080/13816810802043678] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Trilateral retinoblastoma is characterized by retinal tumors in one or both eyes, as well as tumors of the pineal gland or parasellar region of the brain. Here we describe a 4-month-old girl, presenting with pituitary dysfunction, hypothalamic overgrowth syndrome and central blindness, in addition to suprasellar and bilateral retinal tumors. Biopsy of the suprasellar tumor confirmed the diagnosis of trilateral retinoblastoma. After biopsy, cerebrospinal fluid (CSF) metastasis was discovered. Overgrowth persisted, but blindness and pituitary dysfunction resolved when the suprasellar tumor and CSF metastasis responded to cyclosporine-modulated systemic chemotherapy with intraventricular chemotherapy, consolidated with marrow-ablative chemotherapy and stem cell rescue of the bone marrow. Twenty months after diagnosis and 12 months after transplant, an unusual pattern of tumor recurrence was observed along the catheter of the Ommaya reservoir used for delivering intraventricular chemotherapy, which was also at the site of the previous suprasellar needle biopsy. Salvage therapy consisted of resection, stereotactic radiation, and further systemic and intraventricular chemotherapy. At 25 months after diagnosis, the patient was developing well and seeing better. However, she died 32 months after diagnosis despite the salvage therapy. This case highlights the possibility of tumor dissemination after needle biopsy of a suprasellar tumor. Biopsy may be avoided if a characteristic clinicoradiological picture of trilateral retinoblastoma is recognized. We recommend that if a pineal or suprasellar tumor is observed in a child, the eyes should be examined for retinoblastoma, thereby avoiding biopsies of the intracranial tumor, which may track difficult-to-treat tumor cells through the brain, and disseminate tumor cells into the CSF.
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Affiliation(s)
- Shuan Dai
- Department of Ophthalmology/Visual Science, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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McAuliffe F, Chitayat D, Halliday W, Keating S, Shah V, Fink M, Nevo O, Ryan G, Shannon P, Blaser S. Rhombencephalosynapsis: prenatal imaging and autopsy findings. Ultrasound Obstet Gynecol 2008; 31:542-548. [PMID: 18409180 DOI: 10.1002/uog.5318] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVES Rhombencephalosynapsis is a rare, but increasingly recognized, brain malformation characterized by congenital fusion of the cerebellar hemispheres and absence of the vermis. Rhombencephalosynapsis is associated with significant developmental delay, seizures and involuntary head movements. We report four cases, with correlation of prenatal and postnatal imaging and autopsy findings. METHODS Over a 2-year period, four cases of rhombencephalosynapsis were diagnosed in the perinatal period, three in one center and one in another center. The clinical cases were reviewed, and correlation was made between the prenatal and postnatal imaging and autopsy findings where available. RESULTS All cases presented initially with ventriculomegaly on prenatal ultrasound examination. Subsequent magnetic resonance imaging (MRI) established the diagnosis in two cases and postnatal MRI established the diagnosis in a further two cases. Autopsy was available and confirmed the diagnosis in two cases. In one case the pregnancy was terminated, two infants died in the neonatal period and one died in infancy. CONCLUSIONS The cases in this perinatal series of rhombencephalosynapsis showed a very poor prognosis. The presence of ventriculomegaly on prenatal ultrasound imaging should alert the physician to consider rhombencephalosynapsis in the differential diagnosis. MRI appears to be the imaging modality of choice in establishing the diagnosis.
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Affiliation(s)
- F McAuliffe
- University College Dublin School of Medicine and Medical Science, Obstetrics and Gynaecology, National Maternity Hospital, Dublin, Ireland.
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Abstract
CASE REPORT We report a case of congenital tubular aggregate myopathy associated with retinal degeneration. COMMENTS Bilateral, asymmetric retinal degeneration developed in a 37-year-old woman with a history of congenital tubular aggregate myopathy. The major pathological feature was the presence of tubular aggregates, believed to arise from the sarcoplasmic reticulum, which are present in skeletal muscles only. The abnormal functioning of the smooth muscles of the pupillary dilator, together with retinal degeneration in our patient, suggests that tubular aggregates may represent a more generalized disequilibrium of intracellular calcium homeostasis that may not be confined to skeletal muscles.
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Affiliation(s)
- Manoj V Parulekar
- Department of Ophthalmology & Vision Sciences, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
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Dimaras H, Khetan V, Halliday W, Orlic M, Prigoda NL, Piovesan B, Marrano P, Corson TW, Eagle RC, Squire JA, Gallie BL. Loss of RB1 induces non-proliferative retinoma: increasing genomic instability correlates with progression to retinoblastoma. Hum Mol Genet 2008; 17:1363-72. [PMID: 18211953 DOI: 10.1093/hmg/ddn024] [Citation(s) in RCA: 210] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Retinoblastoma clinical observations revealed the role of tumor suppressor genes in human cancer, Knudson's 'two-hit' model of cancer induction. We now demonstrate that loss of both RB1 tumor suppressor gene alleles initiates quiescent RB1(-/-) retinomas with low level genomic instability and high expression of the senescence-associated proteins p16(INK4a) and p130. Although retinomas can remain unchanged throughout life, highly proliferative, clonal and aneuploid retinoblastomas commonly emerge, exhibiting altered gene copy number and expression of oncogenes (MYCN, E2F3, DEK, KIF14 and MDM4) and tumor suppressor genes (CDH11, p75(NTR)) and reduced expression of p16(INK4a) and p130. We suggest that RB1 inactivation in developing retina induces genomic instability, but senescence can block transformation at the stage of retinoma. However, stable retinoma is rarely clinically observed because progressive genomic instability commonly leads to highly proliferative retinoblastoma.
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Affiliation(s)
- Helen Dimaras
- Department of Molecular and Medical Genetics, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, ON, Canada
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Abstract
Fetal magnetic resonance provides a new tool in the imaging of the posterior fossa and is proving useful in cases that are difficult to assess sonographically by allowing further assessment of the fourth ventricle, cisterna magna, and vermian growth and development. We describe various criteria with which to evaluate vermian growth, including vermian biometry and the relationship between the superior and inferior lobes. We demonstrate 2 markers of normal vermian development: the primary fissure and fastigial point. We illustrate the tegmento-vermian angle, "closure" of the fourth ventricle, and communication of the fourth ventricle with the basal cisterns during development and in several disorders. We correlate those features with the expected embryological course of development and illustrate identification of these features and associated abnormalities of the posterior fossa, brain stem, and central nervous system in mid-trimester scans of fetuses with abnormal development. Correlation with contemporaneous ultrasound examinations is demonstrated.
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Affiliation(s)
- Ashley J Robinson
- Department of Radiology, Children's Hospital of British Columbia, Vancouver V6H 3V4, Canada.
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van Marle G, Antony J, Ostermann H, Dunham C, Hunt T, Halliday W, Maingat F, Urbanowski MD, Hobman T, Peeling J, Power C. West Nile virus-induced neuroinflammation: glial infection and capsid protein-mediated neurovirulence. J Virol 2007; 81:10933-49. [PMID: 17670819 PMCID: PMC2045515 DOI: 10.1128/jvi.02422-06] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.1] [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: 01/14/2023] Open
Abstract
West Nile virus (WNV) infection causes neurological disease at all levels of the neural axis, accompanied by neuroinflammation and neuronal loss, although the underlying mechanisms remain uncertain. Given the substantial activation of neuroinflammatory pathways observed in WNV infection, we hypothesized that WNV-mediated neuroinflammation and cell death occurred through WNV infection of both glia and neurons, which was driven in part by WNV capsid protein expression. Analysis of autopsied neural tissues from humans with WNV encephalomyelitis (WNVE) revealed WNV infection of both neurons and glia. Upregulation of proinflammatory genes, CXCL10, interleukin-1beta, and indolamine-2',3'-deoxygenase with concurrent suppression of the protective astrocyte-specific endoplasmic reticulum stress sensor gene, OASIS (for old astrocyte specifically induced substance), was evident in WNVE patients compared to non-WNVE controls. These findings were supported by increased ex vivo expression of these proinflammatory genes in glia infected by WNV-NY99. WNV infection caused endoplasmic reticulum stress gene induction and apoptosis in neurons but did not affect glial viability. WNV-infected astrocytic cells secreted cytotoxic factors, which caused neuronal apoptosis. The expression of the WNV-NY99 capsid protein in neurons and glia by a Sindbis virus-derived vector (SINrep5-WNVc) caused neuronal death and the release of neurotoxic factors by infected astrocytes, coupled with proinflammatory gene induction and suppression of OASIS. Striatal implantation of SINrep5-WNV(C) induced neuroinflammation in rats, together with the induction of CXCL10 and diminished OASIS expression, compared to controls. Moreover, magnetic resonance neuroimaging showed edema and tissue injury in the vicinity of the SINrep5-WNVc implantation site compared to controls, which was complemented by neurobehavioral abnormalities in the SINrep5-WNVc-implanted animals. These studies underscore the important interactions between the WNV capsid protein and neuroinflammation in the pathogenesis of WNV-induced neurological disorders.
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Affiliation(s)
- Guido van Marle
- Departments of Microbiology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
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Briggs T, Abdel-Salam G, Balicki M, Baxter P, Bertini E, Bishop N, Browne B, Chitayat D, Chong W, Eid M, Halliday W, Hughes I, Klusmann-Koy A, Kurian M, Nischal K, Rice G, Stephenson J, Surtees R, Talbot J, Tehrani N, Tolmie J, Toomes C, van der Knaap M, Crow Y. Cerebroretinal microangiopathy with calcifications and cysts (CRMCC). Am J Med Genet A 2007; 146A:182-90. [DOI: 10.1002/ajmg.a.32080] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Comati A, Beck H, Halliday W, Snipes GJ, Plate KH, Acker T. Upregulation of Hypoxia-Inducible Factor (HIF)-1α and HIF-2α in Leptomeningeal Vascular Malformations of Sturge-Weber Syndrome. J Neuropathol Exp Neurol 2007; 66:86-97. [PMID: 17204940 DOI: 10.1097/nen.0b013e31802d9011] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [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: 11/26/2022] Open
Abstract
Cutaneous and leptomeningeal vascular malformations are hallmarks of the Sturge-Weber Syndrome (SWS), resulting in chronic ischemic tissue damage. The mechanisms underlying the pathobiology of these progressive lesions are unknown. Aberrant expression of angiogenic factors has been implicated in the genesis and maintenance of vascular malformations. To assess the role of angiogenesis in SWS vascular lesions we determined the expression of key angiogenic factors by immunohistochemistry and in situ hybridization in 8 SWS patients (age: 8 months to 18 years). We observed increased expression of vascular endothelial growth factor (VEGF), its cognate receptors VEGFR-1, VEGFR-2, and neuropilin (NP)-1 as well as Tie2 in leptomeningeal SWS blood vessels. Intriguingly, these factors are known to be transcriptionally induced by hypoxia-inducible factor (HIF). The HIF system has emerged as the key regulatory system of responses to hypoxia. Immunohistochemical analysis demonstrated markedly elevated nuclear HIF-1alpha and HIF-2alpha protein levels in SWS vessels. Concomitantly, SWS vessels revealed signs of enhanced endothelial cell (EC) turnover as evidenced by increased EC proliferation and apoptosis. Thus, in terms of angiogenesis, vascular malformations in SWS are not static lesions but constitute dynamic structures. Our observation of a dysregulated HIF-alpha expression in SWS vessels are in agreement with recent findings that EC-specific HIF activation provides a setting which supports and sustains angiogenesis and could be of potential use for developing therapeutic strategies to treat these currently incurable lesions.
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Milic A, Blaser S, Robinson A, Viero S, Halliday W, Winsor E, Toi A, Thomas M, Chitayat D. Prenatal detection of microtia by MRI in a fetus with trisomy 22. Pediatr Radiol 2006; 36:706-10. [PMID: 16770674 DOI: 10.1007/s00247-006-0155-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2006] [Accepted: 02/22/2006] [Indexed: 10/24/2022]
Abstract
Trisomy 22 is a rare chromosomal abnormality infrequently detected prenatally. External ear abnormalities, in particular microtia, are often associated with trisomy 22, but prenatal detection of microtia has not been reported in association with trisomy 22. We report a fetus with trisomy 22, with fetal MRI findings of microtia, craniofacial dysmorphism, and polygyria. Fetal MRI is a useful tool for auricular assessment and might have utility in the prenatal detection of chromosomal abnormalities, especially among fetuses with structural anomalies.
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Affiliation(s)
- Andrea Milic
- Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Toronto, Canada
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Abstract
Orbital teratomas are rare embryonic tumors composed of a wide diversity of tissues derived from the three germinal layers. The presenting features include, a healthy newborn with extreme unilateral proptosis; marked stretching of the eyelids over a tense, fluctuating mass, with elongation of the palpebral fissure; enlargement of the bony orbit (two to three times normal size) with subsequent nasal and malar deformities; and transillumination of all or part of the orbital mass. Commonly the eye is normally developed but often vision is not preserved either due to exposure or secondary optic atrophy. The objective in the management of orbital teratoma is to save the eye to encourage orbitofacial development, maintain cosmesis and retain some vision. We report a case of massive congenital orbital teratoma successfully removed by an eyelid-sparing exenteration technique.
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Affiliation(s)
- Lawrence Gnanaraj
- Department of Ophthalmology, The Hospital for Sick Children, University of Toronto, Canada
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Gupta V, Keller A, Halliday W, Sanche S, Hassegawa W, Messner H, Kiss T, Lipton J. Cavernous sinus thrombosis presenting with diplopia in an allogeneic bone marrow transplant recipient. Am J Hematol 2004; 77:77-81. [PMID: 15307111 DOI: 10.1002/ajh.20145] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Although neurological complications are common in patients undergoing allogeneic bone marrow transplant (alloBMT), cavernous sinus thrombosis (CST) has rarely been described. An allograft recipient is described who presented with diplopia and developed CST in the early post-transplant period likely caused by a filamentous fungus. Clinical course and serial radiological studies of this patient are described and correlated with autopsy findings.
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Affiliation(s)
- Vikas Gupta
- Department of Medical Oncology and Hematology, Princess Margaret Hospital/University Health Network, Toronto, Ontario, Canada.
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Burton JM, Kern RZ, Halliday W, Mikulis D, Brunton J, Fearon M, Pepperell C, Jaigobin C. Neurological manifestations of West Nile virus infection. Can J Neurol Sci 2004; 31:185-93. [PMID: 15198442 DOI: 10.1017/s0317167100053828] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.5] [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: 11/06/2022]
Abstract
BACKGROUND Over the past four years, West Nile virus (WNV) has become a significant health issue in North America. In 2002, WNV infection made its first appearance in the human population in Canada. METHODS Patients who presented to the University Health Network and Mount Sinai Hospital in Toronto with neurological disease attributed to WNV infection were identified and followed by the neurology service. Clinical features and results of laboratory, electrodiagnostic, radiological and pathological studies are presented. RESULTS In August and September 2002, 26 patients were admitted with WNV infection; 14 presented with neurological illness. Encephalitis was the most common presentation (11 patients). Eleven patients developed neuromuscular disease; two at presentation and nine after encephalitis. While the majority had a motor process that localized to the anterior horn cell and/or motor neuron, two patients had evidence of a demyelinating neuropathy and one a sensorimotor axonal neuropathy. Less common manifestations included rhombencephalitis, ataxia, myelopathy and parkinsonism. Death occurred in four patients; two > 75 years of age, and two who were immunocompromised. CONCLUSIONS The most common neurological manifestation of WNV infection was encephalitis with subsequent neuromuscular involvement. The diversity of clinical and pathological findings, however, suggests widespread involvement of the central and peripheral nervous system. A poorer prognosis for neurological recovery and overall survival was seen in older and immunocompromised patients.
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Affiliation(s)
- Jodie M Burton
- University Health Network, University of Toronto Department of Medicine, Division of Neurology, Toronto, Ontario, Canada
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Affiliation(s)
- Dipanka Sarma
- Division of Neuroradiology, Fell 3-210, Toronto Western Hospital, University Health Network, University of Toronto, 399 Bathurst Street, Toronto M5T 2S8, Ontario, Canada
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Abstract
In recent decades the organic solvent toluene (methylbenzene) has emerged as one of the best-studied neurotoxins. Long-term and intense exposure to toluene vapors in humans who abuse spray paint and related substances has led to the recognition that toluene has a severe impact on central nervous system myelin. Chronic toluene abuse produces a devastating neurological disorder, of which dementia is the most disabling component. The clinical syndrome, toluene leukoencephalopathy, can be detected by a combination of characteristic symptoms and signs, detailed neurobehavioral evaluation, and brain magnetic resonance imaging. In this paper, we consider the impact of toluene abuse on our society, describe the specific neurobehavioral deficits in toluene leukoencephalopathy, review the spectrum of neuroimaging findings in patients with this disorder, summarize the teratogenic effects of toluene in both humans and animal models, and offer possible explanations for the range of neuropathological damage seen in brains of individuals who chronically abuse toluene.
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Affiliation(s)
- Christopher M Filley
- Department of Neurology, University of Colorado School of Medicine, Denver, Colorado 80262, USA
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Richter EO, Hoque T, Halliday W, Lozano AM, Saint-Cyr JA. Determining the position and size of the subthalamic nucleus based on magnetic resonance imaging results in patients with advanced Parkinson disease. J Neurosurg 2004; 100:541-6. [PMID: 15035292 DOI: 10.3171/jns.2004.100.3.0541] [Citation(s) in RCA: 135] [Impact Index Per Article: 6.8] [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: 11/06/2022]
Abstract
Object. The subthalamic nucleus (STN) is a target in surgery for Parkinson disease, but its location according to brain atlases compared with its position on an individual patient's magnetic resonance (MR) images is incompletely understood. In this study both the size and location of the STN based on MR images were compared with those on the Talairach and Tournoux, and Schaltenbrand and Wahren atlases.
Methods. The position of the STN relative to the midcommissural point was evaluated on 18 T2-weighted MR images (2-mm slices). Of 35 evaluable STNs, the most anterior, posterior, medial, and lateral borders were determined from axial images, dorsal and ventral borders from coronal images. These methods were validated using histological measurements in one case in which a postmortem examination was performed.
The mean length of the anterior commissure—posterior commissure was 25.8 mm. Subthalamic nucleus borders derived from MR imaging were highly variable: anterior, 4.1 to −3.7 mm relative to the midcommissural point; posterior, 4.2 to 10 mm behind the midcommissural point; medial, 7.9 to 12.1 mm from the midline; lateral, 12.3 to 15.4 mm from the midline; dorsal, 0.2 to 4.2 mm below the intercommissural plane; and ventral, 5.7 to 9.9 mm below the intercommissural plane.
The position of the anterior border on MR images was more posterior, and the medial border more lateral, than its position in the brain atlases. The STN was smaller on MR images compared with its size in atlases in the anteroposterior (mean 5.9 mm), mediolateral (3.7 mm), and dorsoventral (5 mm) dimensions.
Conclusions. The size and position of the STN are highly variable, appearing to be smaller and situated more posterior and lateral on MR images than in atlases. Care must be taken in relying on coordinates relative to the commissures for targeting of the STN.
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Affiliation(s)
- Erich O Richter
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
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Affiliation(s)
- Julio C Furlan
- Department of Surgery, Division of Neurosurgery, University of Toronto, Canada
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Kleiner-Fisman G, Rogaeva E, Halliday W, Houle S, Kawarai T, Sato C, Medeiros H, St George-Hyslop PH, Lang AE. Benign hereditary chorea: clinical, genetic, and pathological findings. Ann Neurol 2003; 54:244-7. [PMID: 12891678 DOI: 10.1002/ana.10637] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [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: 11/06/2022]
Abstract
Benign hereditary chorea is an autosomal dominant disorder presenting with childhood-onset chorea, no dementia, and little or no progression. We present a family with typical clinical features of benign hereditary chorea. Pathological investigation of the brain of an affected family member who died of an unrelated condition showed no significant gross or histological abnormalities. Genetic evaluation showed a novel single nucleotide substitution of intron 2 of the TITF-1 gene (also referred to as TTF, NKX2.1, and T/ebp) on chromosome 14 which is predicted to have drastic consequences on the maturation processes of TITF-1.
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Pepperell C, Rau N, Krajden S, Kern R, Humar A, Mederski B, Simor A, Low DE, McGeer A, Mazzulli T, Burton J, Jaigobin C, Fearon M, Artsob H, Drebot MA, Halliday W, Brunton J. West Nile virus infection in 2002: morbidity and mortality among patients admitted to hospital in southcentral Ontario. CMAJ 2003; 168:1399-405. [PMID: 12771068 PMCID: PMC155955] [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: 03/02/2023] Open
Abstract
BACKGROUND In August and September 2002 an outbreak of West Nile virus (WNV) infection occurred in southern Ontario. We encountered a number of seriously ill patients at our hospitals. In this article we document the clinical characteristics of these cases. METHODS We conducted a retrospective chart review of patients who came to the attention of infectious disease or neurology consultants or the microbiology laboratories at 7 hospitals in the municipalities of Toronto, Peel and Halton, Ont. Patients were included if they had been admitted to hospital or stayed overnight in the emergency department, had serological evidence of WNV infection and had clinical evidence of WNV fever, aseptic meningitis, encephalomyelitis or motor neuronopathy. RESULTS In all, 64 patients met the inclusion criteria; 57 had encephalitis or neuromuscular weakness or both, 5 had aseptic meningitis, and 2 had WNV fever. The mean age was 61 years (range 26-87). The patients were predominantly active, middle-aged or elderly people living independently in the community. Seven patients were immunocompromised A febrile prodromal illness preceded the neurological symptoms in almost all cases. The most common neurological abnormality was decreased level of consciousness; this frequently evolved to severe lower motor neuron neuromuscular weakness. Ataxia and swallowing disorders were frequent and important problems. Sixteen patients (25%) required intubation and mechanical ventilation because of a decreased level of consciousness, inability to clear secretions or respiratory muscle weakness; 9 others had disabling muscle weakness of one or more limbs. Ten patients died. The study patients were in hospital a total of 1856 patient-days, including 532 patient-days in an intensive care unit. Only 28% (13/47) of the patients who survived encephalitis or neuromuscular weakness, or both, were discharged home without additional support. Slow turnaround time for serological test results resulted in delayed diagnosis. INTERPRETATION The 2002 WNV infection outbreak in Ontario caused serious morbidity and mortality in the subset of patients who had encephalitis or neuromuscular weakness severe enough to require hospital admission.
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Affiliation(s)
- Caitlin Pepperell
- Divisions of Infectious Diseases, University of Toronto, Toronto, Ont., Canada
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