1
|
Mehawej C, Chouery E, Al Hage Chehade G, Bejaoui Y, Mahfoud D, Gerges M, Delague V, El Hajj N, Megarbane A. Report on a Case with Moreno-Nishimura-Schmidt Overgrowth Syndrome: A Clinically Delineated Disease Yet of an Unknown Origin! Mol Syndromol 2023; 14:219-224. [PMID: 37323196 PMCID: PMC10267562 DOI: 10.1159/000527215] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 09/23/2022] [Indexed: 12/03/2023] Open
Abstract
Introduction Overgrowth syndromes are a heterogeneous group of genetic disorders characterized by excessive growth, often accompanied by additional clinical features, such as facial dysmorphism, hormonal imbalances, cognitive impairment, and increased risk for neoplasia. Moreno-Nishimura-Schmidt (M-N-S) overgrowth syndrome is a very rare overgrowth syndrome characterized by severe pre- and postnatal overgrowth, dysmorphic facial features, kyphoscoliosis, large hands and feet, inguinal hernia, and distinctive skeletal features. The clinical and radiological features of the disorder have been well delineated, yet its molecular pathogenesis remains unclear. Case Presentation We report on a Lebanese boy with M-N-S syndrome, whose clinical manifestations were compared with those of previously reported 5 affected individuals. Whole-exome sequencing combined with comparative genome hybridization analysis failed to delineate the molecular basis of the phenotype. However, epigenetic studies revealed a different methylation status of several CpG sites between him and healthy controls, with methyltransferase activity showing the most significant enrichment. Conclusion An additional case of M-N-S syndrome recapitulated the clinical and radiological manifestations described in the previous reports. The data in the epigenetic studies implicated that abnormal methylations might play an essential role in development of the disease phenotype. However, additional studies in a clinically homogeneous cohort of patients are crucial to confirm this hypothesis.
Collapse
Affiliation(s)
- Cybel Mehawej
- Department of Human Genetics, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Eliane Chouery
- Department of Human Genetics, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Ghada Al Hage Chehade
- Pediatric Endocrinology and Diabetology, Pediatrics Department, Hammoud Hospital University Medical Center, Saida, Lebanon
- Pediatric Endocrinology and Diabetology, Pediatric Division, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Yosra Bejaoui
- College of Health and Life Sciences, Qatar Foundation, Education City, Hamad Bin Khalifa University, Doha, Qatar
| | - Daniel Mahfoud
- Department of Radiology, Gilbert and Rose-Marie Ghagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Maya Gerges
- Genetic Laboratory, American University of Science and Technology, Beirut, Lebanon
| | - Valérie Delague
- Inserm, MMG, U 1251, Institut Marseille Maladies Rares (MarMaRa), Aix Marseille University, Marseille, France
| | - Nady El Hajj
- College of Health and Life Sciences, Qatar Foundation, Education City, Hamad Bin Khalifa University, Doha, Qatar
| | - Andre Megarbane
- Department of Human Genetics, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- Institut Jérôme Lejeune, Paris, France
| |
Collapse
|
2
|
Balestrini S, Guerrini R, Sisodiya SM. Rare and Complex Epilepsies from Childhood to Adulthood: Requirements for Separate Management or Scope for a Lifespan Holistic Approach? Curr Neurol Neurosci Rep 2021; 21:65. [PMID: 34817708 PMCID: PMC8613076 DOI: 10.1007/s11910-021-01154-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE In this descriptive review, we describe current models of transition in rare and complex epilepsy syndromes and propose alternative approaches for more holistic management based on disease biology. RECENT FINDINGS Previously published guidance and recommendations on transition strategies in individuals with epilepsy have not been systematically and uniformly applied. There is significant heterogeneity in models of transition/transfer of care across countries and even within the same country. We provide examples of the most severe epilepsy and related syndromes and emphasise the limited data on their outcome in adulthood. Rare and complex epilepsy syndromes have unique presentations and require high levels of expertise and multidisciplinary approach. Lifespan clinics, with no transition, but instead continuity of care from childhood to adulthood with highly specialised input from healthcare providers, may represent an alternative effective approach. Effectiveness should be measured by evaluation of quality of life for both patients and their families/caregivers.
Collapse
Affiliation(s)
- Simona Balestrini
- Department of Clinical and Experimental Epilepsy, University College of London (UCL) Queen Square Institute of Neurology, London WC1N 3BG and Chalfont Centre for Epilepsy, London, Bucks, UK.
- Neuroscience Department, Meyer Children's Hospital, European Reference Network ERN EpiCARE, 50139, Florence, Italy.
| | - Renzo Guerrini
- Neuroscience Department, Meyer Children's Hospital, European Reference Network ERN EpiCARE, 50139, Florence, Italy
| | - Sanjay M Sisodiya
- Department of Clinical and Experimental Epilepsy, University College of London (UCL) Queen Square Institute of Neurology, London WC1N 3BG and Chalfont Centre for Epilepsy, London, Bucks, UK
| |
Collapse
|