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1.
Epilepsia ; 2024 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-38953796

RESUMEN

OBJECTIVE: DYNC1H1 variants are involved on a disease spectrum from neuromuscular disorders to neurodevelopmental disorders. DYNC1H1-related epilepsy has been reported in small cohorts. We dissect the electroclinical features of 34 patients harboring de novo DYNC1H1 pathogenic variants, identify subphenotypes on the DYNC1H1-related epilepsy spectrum, and compare the genotype-phenotype correlations observed in our cohort with the literature. METHODS: Patients harboring de novo DYNC1H1 pathogenic variants were recruited through international collaborations. Clinical data were retrospectively collected. Latent class analysis was performed to identify subphenotypes. Multivariable binary logistic regression analysis was applied to investigate the association with DYNC1H1 protein domains. RESULTS: DYNC1H1-related epilepsy presented with infantile epileptic spasms syndrome (IESS) in 17 subjects (50%), and in 25% of these individuals the epileptic phenotype evolved into Lennox-Gastaut syndrome (LGS). In 12 patients (35%), focal onset epilepsy was defined. In two patients, the epileptic phenotype consisted of generalized myoclonic epilepsy, with a progressive phenotype in one individual harboring a frameshift variant. In approximately 60% of our cohort, seizures were drug-resistant. Malformations of cortical development were noticed in 79% of our patients, mostly on the lissencephaly-pachygyria spectrum, particularly with posterior predominance in a half of them. Midline and infratentorial abnormalities were additionally reported in 45% and 27% of subjects. We have identified three main classes of subphenotypes on the DYNC1H1-related epilepsy spectrum. SIGNIFICANCE: We propose a classification in which pathogenic de novo DYNC1H1 variants feature drug-resistant IESS in half of cases with potential evolution to LGS (Class 1), developmental and epileptic encephalopathy other than IESS and LGS (Class 2), or less severe focal or genetic generalized epilepsy including a progressive phenotype (Class 3). We observed an association between stalk domain variants and Class 1 phenotypes. The variants p.Arg309His and p.Arg1962His were common and associated with Class 1 subphenotype in our cohort. These findings may aid genetic counseling of patients with DYNC1H1-related epilepsy.

2.
Clin Genet ; 2024 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-38837402

RESUMEN

Microcephalic osteodysplastic primordial dwarfism type I (MOPDI) is a very rare and severe autosomal recessive disorder characterized by marked intrauterine growth retardation, skeletal dysplasia, microcephaly and brain malformations. MOPDI is caused by biallelic mutations in RNU4ATAC, a non-coding gene involved in U12-type splicing of 1% of the introns in the genome, which are recognized by their specific splicing consensus sequences. Here, we describe a unique observation of immunodeficiency in twin sisters with mild MOPDI, who harbor a novel n.108_126del mutation, encompassing part of the U4atac snRNA 3' stem-loop and Sm protein binding site, and the previously reported n.111G>A mutation. Interestingly, both twin sisters show mild B-cell anomalies, including low naive B-cell counts and increased memory B-cell and plasmablasts counts, suggesting partial and transitory blockage of B-cell maturation and/or excessive activation of naive B-cells. Hence, the localization of a mutation in stem II of U4atac snRNA, as observed in another RNU4ATAC-opathy with immunodeficiency, that is, Roifman syndrome (RFMN), is not required for the occurrence of an immune deficiency. Finally, we emphasize the importance of considering immunodeficiency in MOPDI management to reduce the risk of serious infectious episodes.

3.
Fetal Diagn Ther ; 2024 Jun 24.
Artículo en Inglés | MEDLINE | ID: mdl-38934150

RESUMEN

INTRODUCTION: Congenital microgastria (CM) is a rare condition due to early interruption of stomach development between the 4th and 8th week of gestation, leading to a small midline tubular stomach. Prenatal diagnosis of CM is a challenge with important implications. This study explores the value of biochemical amniotic fluid (AF) analysis and fetal magnetic resonance imaging (MRI) for the prenatal diagnosis of CM in case of non visible stomach on fetal ultrasound. CASE PRESENTATION: Four cases of CM were retrospectively investigated in terms of fetal ultrasound, MRI findings and biochemical AF analyses. The patients were referred to the Prenatal Diagnosis Unit of the Hôpital Femme Mère Enfant (Lyon, France) at a mean age of 21 weeks of gestation for absent or small fetal stomach on ultrasound with a suspected diagnosis of esophageal atresia. Ultrasound examination confirmed that the stomach was absent in two of the four fetuses and small in the other two. This feature was associated with a congenital heart defect in two cases and a terminal transverse limb defect in one case. Standard genetic workup (CGH array) results were normal. Biochemical AF analysis, including the esophageal atresia (EA) index were not suggestive of EA. Fetal MRI showed a small midline tubular stomach, associated with a dilated esophagus, highly suggestive of CM. CONCLUSION: If the fetal stomach is absent on ultrasound, CM should be considered if the AF volume is normal, especially during the third trimester, and if the EA index is not suggestive of gastrointestinal obstruction. In these cases, the diagnosis can be confirmed by fetal MRI, through observation of a small midline tubular stomach associated with a dilated esophagus.

4.
Childs Nerv Syst ; 2024 May 18.
Artículo en Inglés | MEDLINE | ID: mdl-38761265

RESUMEN

INTRODUCTION: Disturbances in plasma sodium levels are a major complication following recent resections of craniopharyngiomas in children. They must be properly managed to avoid neurological sequelae. We aimed to describe the variations and characteristics of postoperative natremia in children who had undergone a first craniopharyngioma resection with a particular focus on the frequency of triphasic syndrome in these patients. METHODS: Paediatric patients with craniopharyngiomas who underwent a first surgical resection in the neurosurgery department of the Hôpital Femme Mère Enfant (Lyon, France) between January 2010 and September 2021 were included in the present study and the medical records were analysed retrospectively. RESULTS: A total of 26 patients were included. Of these, 17 (65.4%) had a postoperative course characterised by the occurrence of both initial diabetes insipidus (DI) and hyponatremia a few days later. Eight patients (30.8%) presented then with isolated and persistent DI. Patients with the triphasic syndrome had a significantly higher grade of Puget classification on MRI (1 and 2), compared to the other patients. CONCLUSION: Dysnatremia is common after craniopharyngioma resections in children. This immediate postoperative complication is particularly difficult to manage and requires rapid diagnosis and prompt initiation of medical treatment to minimize fluctuations in sodium levels and avoid neurological sequelae.

5.
J Vasc Interv Radiol ; 35(1): 127-136.e1, 2024 01.
Artículo en Inglés | MEDLINE | ID: mdl-37704038

RESUMEN

PURPOSE: To retrospectively evaluate sclerotherapy using consecutive polidocanol and bleomycin foam (CPBF) for large untreated venous malformations (VMs) and/or those resistant to prior treatment. MATERIALS AND METHODS: This retrospective study included all patients treated with CPBF for untreated VMs larger than 10 mL and/or refractory to treatment between May 2016 and October 2019. Baseline and follow-up VM volumes were measured on fat-suppressed T2-weighted magnetic resonance (MR) imaging. Outcome was evaluated on postprocedural MR imaging volumetry and by a retrospective survey assessing clinical response and adverse events. Imaging response was considered good for volume reduction from 50% to 70% and excellent for volume reduction ≥70%. Symptoms and quality-of-life (QoL) scores were compared before and after CPBF sclerotherapy. RESULTS: Forty-five patients (mean age, 16 years; range, 1-63 years; 25 males) with 57 VMs were analyzed and treated by 80 sclerotherapy. Sixty percent (27 of 45) of patients had undergone prior treatment for VM. Median VM volume was 36.7 mL (interquartile range, 84 mL) on pretherapy MR imaging. Good and excellent results after the last sclerotherapy were achieved in 36% (16 of 45) and 29% (13 of 45) of patients, respectively, corresponding to a decrease of >50% in 60% (34 of 57) of VMs. QoL score increased by at least 3 points, regardless of initial symptoms. Most patients did not desire additional sclerotherapy owing to near complete symptomatic relief, even for patients who did not achieve a good response. Swelling, pain, and motor impairment scores significantly improved after CPBF. Adverse events included fever (44%, 15 of 34) and nausea/vomiting (29%, 10 of 34). CONCLUSIONS: CPBF sclerotherapy represents an effective therapy for large and/or refractory VMs with minimal adverse events.


Asunto(s)
Escleroterapia , Malformaciones Vasculares , Masculino , Humanos , Adolescente , Escleroterapia/efectos adversos , Escleroterapia/métodos , Polidocanol , Estudios Retrospectivos , Soluciones Esclerosantes , Bleomicina/efectos adversos , Calidad de Vida , Venas/anomalías , Imagen por Resonancia Magnética , Malformaciones Vasculares/diagnóstico por imagen , Malformaciones Vasculares/terapia , Resultado del Tratamiento
6.
Eur J Med Genet ; 67: 104893, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38070825

RESUMEN

Developmental and epileptic encephalopathies (DEEs) refer to a group of severe epileptic syndromes characterized by seizures as well as a developmental delay which can be a consequence of the underlying etiology and/or the epileptic encephalopathy. The genes responsible for DEEs are numerous and their number is increasing since the availability of Next-Generation Sequencing. Pathogenic variants in GRM7, encoding the metabotropic glutamate receptor 7, were recently shown as a cause of a severe DEE with autosomal recessive inheritance. To date, only ten patients have been reported in the literature, generally with severe phenotypes including early-onset epilepsy, microcephaly, brain anomalies, and spasticity. We report here 5 patients from 3 independent families with biallelic variants in the GRM7 gene. We review the literature and provide further elements for the understanding of the genotype-phenotype correlation of this rare syndrome.


Asunto(s)
Encefalopatías , Epilepsia , Trastornos del Neurodesarrollo , Receptores de Glutamato Metabotrópico , Humanos , Epilepsia/genética , Encefalopatías/genética , Convulsiones , Trastornos del Neurodesarrollo/genética , Fenotipo
7.
Eur J Obstet Gynecol Reprod Biol ; 291: 261-263, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37925339

RESUMEN

BACKGROUND: Prenatal diagnosis of craniosynostosis remains rare and challenging, easier in syndromes with craniosynostosis due to the association with other sonographic anomalies. Crouzon syndrome is the most frequent syndrome with craniosynostosis but is difficult to detect antenatally because of mild skull deformation without specific associated anomaly during gestation. CASE: This report presents the case of a fetus with Crouzon syndrome related to the variant c.1646A>C in exon 14 of the FGFR2 gene and presenting with apparently isolated scaphocephaly on fetal US. CONCLUSION: This observation supports the interest of systematic prenatal panel genes testing when facing an apparently isolated craniosynostosis diagnosed on fetal imaging, even if non-syndromic craniosynostosis are much more frequent in such situation. TEACHING POINTS: Syndromic craniosynostosis can appear as apparently isolated form on fetal imaging. Systematic prenatal panel genes testing can be contributive even when facing an apparently isolated craniosynostosis on fetal imaging.


Asunto(s)
Disostosis Craneofacial , Craneosinostosis , Embarazo , Femenino , Humanos , Craneosinostosis/diagnóstico por imagen , Craneosinostosis/genética , Disostosis Craneofacial/genética , Diagnóstico Prenatal , Cabeza , Síndrome
9.
Fetal Diagn Ther ; 50(3): 143-157, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36693325

RESUMEN

INTRODUCTION: Our objective was to evaluate the outcome of fetuses with first- and second-trimester fetal cytomegalovirus infection (CMVi) according to prenatal imaging patterns, especially fetuses presenting with mild imaging features (MF), being currently of uncertain prognosis. MATERIAL AND METHODS: In a retrospective study of 415 suspected CMVi cases, 59 cases were confirmed. Among prenatal imaging features, microcephaly, cortical disorder, and cerebellar hypoplasia as well as severe IUGR and fetal hydrops were considered as severe imaging features (SF). Other imaging features were considered as MF. Postnatal outcome was classified as "normal outcome," "mild sequelae" characterized mainly by sensorineural disorder (SND) and "severe sequelae" characterized by cognitive impairment. RESULTS: Only first-trimester (T1) and second-trimester (T2) CMVi cases were included in our study (n = 49) since all third-trimester cases (n = 10) had normal imaging and outcome. Sixteen fetuses had normal prenatal imaging and normal outcome, except one showing SND. Abnormal ultrasound findings were present in 33 fetuses, including SF noted in 16 fetuses, related exclusively to first-trimester CMVi. Termination of pregnancy was performed in 18 cases. Twelve first-trimester infected fetuses presented SF, whereas 6 fetuses (T1: n = 5, T2: n = 1) presented isolated MF. Four fetal deaths were encountered. Live-born babies with abnormal imaging included 10 fetuses with MF and one with SF. Among the 10 live babies with isolated MF, SND was encountered in 5 cases, whereas 5 children demonstrated normal outcome. Overall, 50% of our babies showing MF suffered from SND. No case of cognitive disorders was reported in babies showing only MF. CONCLUSION: SF were encountered only in first-trimester CMVi and should be distinguished from MF. Among our 10 live babies with prenatal MF following first- or second-trimester infection, 50% showed SND, whereas none presented severe sequelae. In 16 fetuses displaying normal fetal imaging, SND was encountered in one first-trimester case (6%).


Asunto(s)
Infecciones por Citomegalovirus , Enfermedades Fetales , Complicaciones Infecciosas del Embarazo , Embarazo , Lactante , Femenino , Niño , Humanos , Estudios Retrospectivos , Ultrasonografía Prenatal/métodos , Infecciones por Citomegalovirus/diagnóstico por imagen , Infecciones por Citomegalovirus/congénito , Diagnóstico Prenatal/métodos , Complicaciones Infecciosas del Embarazo/diagnóstico por imagen , Enfermedades Fetales/diagnóstico por imagen
10.
Pediatr Radiol ; 53(4): 695-705, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36329164

RESUMEN

The incidence of urolithiasis in children has increased over the two last decades. Urolithiasis formation results from urine oversaturation following insufficient water intake, urinary obstruction (notably in cases of congenital uropathies), excess production of an insoluble compound, or imbalance between crystallization promoters and inhibitors. Whereas most urolithiases in adults occur secondary to environmental factors, in children, secondary causes are far more frequent, and 15% are related to genetic causes, most often monogenic. This is especially true in recurrent forms, with early and rapid progression and bilateral stones, and in cases of familial history or consanguinity. Because of differing clinical management, one should rule out cystinuria, primary hyperoxaluria and renal tubular acidosis, among other causes of urolithiasis. As such, a complete biochemical evaluation must be performed in all cases of pediatric urolithiasis, even in cases of an underlying uropathy. Ultrasound examination is the first-line modality for imaging pediatric urolithiasis, allowing both diagnosis (urolithiasis and its complications) and follow-up. US examination should also explore clues to an underlying cause of urolithiasis. This review is focused on the role of imaging in the management and etiological assessment of pediatric urolithiasis. Radiologists play an important role in pediatric urolithiasis, facilitating diagnosis, follow-up and surgical management. A trio of clinicians (pediatric nephrologist, pediatric surgeon, pediatric radiologist) is thus necessary in the care of these pediatric patients.


Asunto(s)
Cistinuria , Urolitiasis , Adulto , Niño , Humanos , Urolitiasis/diagnóstico por imagen , Urolitiasis/complicaciones , Urolitiasis/epidemiología , Cistinuria/complicaciones , Factores de Riesgo , Pediatras , Radiólogos
11.
Virchows Arch ; 481(4): 665-669, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35527322

RESUMEN

Ewing sarcoma (ES) is a highly malignant round cell sarcoma, characterized by gene fusion involving FET (FUS, EWSR1, TAF15) and ETS family genes, respectively. The involvement of the EWSR1 gene has been reported in approximately 90% of cases of ES, with the EWSR1::FLI1 fusion being the most frequent. We report the case of a newborn with a localized soft tissue paravertebral neoplasm diagnosed prenatally. Histopathology and immunophenotype were consistent with a CD99 + , NKX2.2 + undifferentiated round cell sarcoma (URSC); whole-exome RNA-sequencing demonstrated an undescribed in-frame TAF15::ETV4 fusion transcript, while consensus clustering analysis showed high transcriptomic proximity to the ES group. Given clinical context, high tumor chemosensitivity to ES conventional drugs, morphological characteristics, nature of the fusion partners involved, and high transcriptomic proximity to bona fide ESs, this case may represent a new genetic variant of ES.


Asunto(s)
Sarcoma de Ewing , Sarcoma , Neoplasias de los Tejidos Blandos , Factores Asociados con la Proteína de Unión a TATA , Fusión Génica , Humanos , Recién Nacido , Proteínas de Fusión Oncogénica/genética , Proteínas Proto-Oncogénicas c-ets/genética , ARN , Proteína EWS de Unión a ARN/genética , Sarcoma/genética , Sarcoma de Ewing/diagnóstico , Sarcoma de Ewing/genética , Sarcoma de Ewing/patología , Neoplasias de los Tejidos Blandos/patología , Factores Asociados con la Proteína de Unión a TATA/genética , Translocación Genética
12.
Childs Nerv Syst ; 38(6): 1137-1145, 2022 06.
Artículo en Inglés | MEDLINE | ID: mdl-35505148

RESUMEN

PURPOSE: To characterize natural history and early changes of craniovertebral junction stenosis in achondroplasia correlating with clinical and radiological outcome. METHODS: Retrospective measures on craniovertebral junction were performed blindly, on sagittal T2-weighted images, in 21 patients with achondroplasia referred from 2008 to 2020. Clinical and polysomnography data were retrospectively collected. Each patient was paired for age and gender with four controls. Wilcoxon means comparison or Student's t-tests were applied. RESULTS: Twenty-one patients (11 females, from 0.1 to 39 years of age) were analyzed and paired with 84 controls. A craniovertebral junction stenosis was found in 11/21 patients (52.4%), all before the age of 2 years. Despite a significant reduction of the foramen magnum diameter (mean ± SD: patients 13.6 ± 6.2 mm, controls 28.5 ± 4.7 mm, p < .001), craniovertebral junction stenosis resulted from the narrowing of C2 dens-opisthion antero-posterior diameter (8.7 ± 3.9 mm vs 24.6 ± 5.1 mm, p < .001). Other significant changes were opisthion anterior placement (-0.4 ± 2.8 mm vs 9.4 ± 2.3 mm, p < .001), posterior tilt of C2 (46.2 ± 13.7° vs 31.6 ± 7.9°, p < .001) and of C1 (15.1 ± 4.3° vs 11.9 ± 5.0°, p = 0.01), and dens thickening (9.4 ± 2.2 mm vs 8.5 ± 2.1 mm, p = 0.03), allowing to define three distinguishable early craniovertebral junction patterns in achondroplasia. All children with C2-opisthion antero-posterior diameter of more than 6 mm had a better clinical and radiological outcome. CONCLUSION: Craniovertebral junction in achondroplasia results from narrowing between C2 dens and opisthion related to anterior placement of opisthion, thickening of C2 dens, and posterior tilt of C1-C2. A threshold of 6 mm for dens-opisthion sagittal diameter seems to correlate with clinical and radiological outcome.


Asunto(s)
Acondroplasia , Acondroplasia/complicaciones , Acondroplasia/diagnóstico por imagen , Vértebras Cervicales , Niño , Preescolar , Constricción Patológica , Femenino , Foramen Magno/diagnóstico por imagen , Humanos , Radiografía , Estudios Retrospectivos
13.
Brain Dev ; 44(8): 567-570, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35623960

RESUMEN

INTRODUCTION: Pathogenic variants in ATP1A3 cause various phenotypes of neurological disorders, including alternating hemiplegia of childhood 2, CAPOS syndrome (cerebellar ataxia, areflexia, pes cavus, optic atrophy, and sensorineural hearing loss) and rapid-onset dystonia-parkinsonism (RDP). Early developmental and epileptic encephalopathy has also been reported. Polymicrogyria has recently been added to the phenotypic spectrum of ATP1A3-related disorders. CASE REPORT: We report here a male patient with early developmental delay who at 12 months presented dystonia of the right arm which evolved into hemidystonia at the age of 2. A cerebral MRI showed bilateral perisylvian polymicrogyria with intact basal ganglia. Whole-exome and whole-genome sequencing analyses identified a de novo new ATP1A3 missense variant (p.Arg914Lys) predicted pathogenic. Hemidystonia was thought not to be due to polymicrogyria, but rather a consequence of this variant. CONCLUSION: This case expands the phenotypic spectrum of ATP1A3-related disorders with a new variant associated with hemidystonia and polymicrogyria and thereby, suggests a clinical continuum between the different phenotypes of this condition.


Asunto(s)
Distonía , Trastornos Distónicos , Polimicrogiria , Trastornos Distónicos/genética , Humanos , Masculino , Mutación/genética , Fenotipo , Polimicrogiria/diagnóstico por imagen , Polimicrogiria/genética , ATPasa Intercambiadora de Sodio-Potasio/genética
15.
Prenat Diagn ; 42(4): 484-494, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-34984691

RESUMEN

OBJECTIVES: To characterize a suggestive prenatal imaging pattern of Aicardi syndrome using ultrasound and MR imaging. METHODS: Based on a retrospective international series of Aicardi syndrome cases from tertiary centers encountered over a 20-year period (2000-2020), we investigated the frequencies of the imaging features in order to characterize an imaging pattern highly suggestive of the diagnosis. RESULTS: Among 20 cases included, arachnoid cysts associated with a distortion of the interhemispheric fissure were constantly encountered associated with complete or partial agenesis of the corpus callosum (19/20, 95%). This triad in the presence of other CNS disorganization, such as polymicrogyria (16/17, 94%), heterotopias (15/17, 88%), ventriculomegaly (14/20, 70%), cerebral asymmetry [14/20, 70%]) and less frequently extra-CNS anomaly (ocular anomalies [7/11, 64%], costal/vertebral segmentation defect [4/20, 20%]) represent a highly suggestive pattern of Aicardi syndrome in a female patient. CONCLUSION: Despite absence of genetic test to confirm prenatal diagnosis of AS, this combination of CNS and extra-CNS fetal findings allows delineation of a characteristic imaging pattern of AS, especially when facing dysgenesis of the corpus callosum.


Asunto(s)
Síndrome de Aicardi , Malformaciones del Sistema Nervioso , Agenesia del Cuerpo Calloso/diagnóstico por imagen , Síndrome de Aicardi/diagnóstico por imagen , Cuerpo Calloso/diagnóstico por imagen , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Malformaciones del Sistema Nervioso/diagnóstico por imagen , Embarazo , Diagnóstico Prenatal/métodos , Estudios Retrospectivos , Ultrasonografía Prenatal/métodos
16.
Front Pediatr ; 9: 764040, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34820344

RESUMEN

Introduction: The use of teriparatide has been reported in children with hypoparathyroidism as an investigational physiologic replacement therapy. Methods: We aimed to retrospectively report our pediatric experience of bi-daily sub-cutaneous teriparatide. Results are presented as median (25th-75th quartile). As part of the routine follow-up of these patients with hypoparathyroidism, total calcium at H0 (i.e., just before injection) and H4 (i.e., 4 h after teriparatide injection) and other biomarker parameters were regularly assessed. Results: At a median age of 10.7 (8.1-12.6) years, an estimated glomerular filtration rate (eGFR) of 110 (95-118) mL/min/1.73 m2, calcium levels of 1.87 (1.81-1.96) mmol/L and an age-standardized phosphate of 3.8 (2.5-4.9) SDS, teriparatide therapy was introduced in 10 patients at the dose of 1.1 (0.7-1.5) µg/kg/day (20 µg twice daily), with further adjustment depending on calcium levels. Six patients already displayed nephrocalcinosis. Severe side effects were reported in one child: two episodes of symptomatic hypocalcemia and one of iatrogenic hypercalcemia; one teenager displayed dysgueusia. Calcium levels at H0 did not significantly increase whilst calcium at H4 and phosphate levels significantly increased and decreased, respectively. After 12 months, eGFR, calcium and age-standardized phosphate levels were 108 (90-122) mL/min/1.73 m2, 2.36 (2.23-2.48) mmol/L, 0.5 (-0.1 to 1.5), and 68 (63-74) nmol/L, respectively, with a significant decrease in phosphate levels (p = 0.01). Urinary calcium and calcium/creatinine ratio remained stable; no nephrolithiasis was observed but two moderate nephrocalcinosis appeared. Conclusion: Intermittent teriparatide therapy significantly improves calcium and phosphate control, without increasing calciuria. It appears to be safe and well-tolerated in children.

17.
Eur J Med Genet ; 64(11): 104320, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34438093

RESUMEN

De novo heterozygous missense mutations in TRPM3 have been shown to cause developmental and epileptic encephalopathies (DEE). It is a very rare condition, as only 9 patients have been described to date. We report here a novel patient carrying the recurrent p.Val837Met variant and presenting new clinical features, such as trigonocephaly, expanding the phenotypical spectrum of the disease.


Asunto(s)
Mutación Missense , Fenotipo , Espasmos Infantiles/genética , Canales Catiónicos TRPM/genética , Preescolar , Humanos , Masculino , Espasmos Infantiles/diagnóstico por imagen , Espasmos Infantiles/patología
18.
Fetal Diagn Ther ; 48(3): 217-226, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33684914

RESUMEN

OBJECTIVES: Our goal was to provide a better understanding of isolated short corpus callosum (SCC) regarding prenatal diagnosis and postnatal outcome. METHODS: We retrospectively reviewed prenatal and postnatal imaging, clinical, and biological data from 42 cases with isolated SCC. RESULTS: Prenatal imaging showed SCC in all cases (n = 42). SCC was limited to rostrum and/or genu and/or splenium in 21 cases, involved body in 16 cases, and was more extensive in 5 cases. Indirect imaging features included typical buffalo horn ventricles (n = 14), septal dysmorphism (n = 14), parallel lateral ventricles (n = 12), and ventriculomegaly (n = 4), as well as atypical features in 5 cases. SCC was associated with interhemispheric cysts and pericallosal lipomas in 3 and 6 cases, respectively. Aneuploidy was found in 2 cases. Normal psychomotor development, mild developmental disorders, and global developmental delay were found in 70, 15, and 15% of our cases, respectively. CONCLUSIONS: SCC should be investigated to look for pericallosal lipoma and typical versus atypical indirect features of corpus callosum agenesis (CCA). Prenatal counselling should be guided by imaging as well as clinical and genetic context. Outcome of patients with SCC was similar to the one presenting with complete CCA.


Asunto(s)
Cuerpo Calloso , Ultrasonografía Prenatal , Agenesia del Cuerpo Calloso/diagnóstico por imagen , Cuerpo Calloso/diagnóstico por imagen , Femenino , Humanos , Imagen por Resonancia Magnética , Embarazo , Estudios Retrospectivos
19.
Pediatr Infect Dis J ; 40(5): 411-417, 2021 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33538543

RESUMEN

BACKGROUND: Due to the low resolution of historical imaging technologies, descriptions of Septic Arthritis of Facet Joint (SAFJ) in children are scarce, though severe cases are known. We first aimed to estimate the incidence rate of SAFJ in children; we further aimed to specify SAFJ clinical, imaging and laboratory findings, and identify avenues for appropriate management. METHODS: A 10-year consecutive SAFJ case series using our imaging center database combined with a 50-year systematic review of literature cases. RESULTS: The mean ± SD incidence of pediatric SAFJ was 0.23 ± 0.4/100,000 children-years. The key symptoms were potty refusal (in toddlers) or painful sitting (78%) and lateralized signs (paravertebral tenderness and/or swelling, 88%). SAFJ diagnosis and extension were obtained using magnetic resonance imaging (MRI) (94%), and found an epidural extension in 8/16 cases. The mean duration of antibiotic treatment was 5.1 weeks. The compliance with guidelines was 79% for empiric and 62% for targeted antibiotic therapies. CONCLUSIONS: SAFJ incidence in children is much greater than expected from the literature. Half of cases were complicated by an epidural infection. Simple clinical symptoms detected as early as the bedside allow a strong suspicion of SAFJ, justifying the use of a first-line MRI to confirm the diagnosis and precisely describe the extension. Focusing on simple clinical signs is key to justify the transfer of a child or the shortening of the delay to obtain an MRI. However, as MRI availability increases in most Western countries, and the capacity for diagnosis increases, the awareness of SAFJ must be spread to avoid missed cases.


Asunto(s)
Artritis Infecciosa/diagnóstico por imagen , Artritis Infecciosa/diagnóstico , Artritis Infecciosa/epidemiología , Articulación Cigapofisaria , Adolescente , Antibacterianos/uso terapéutico , Artritis Infecciosa/terapia , Niño , Preescolar , Bases de Datos Factuales , Femenino , Francia/epidemiología , Humanos , Incidencia , Lactante , Imagen por Resonancia Magnética , Masculino , Evaluación de Síntomas
20.
Med Sci (Paris) ; 36(10): 866-871, 2020 Oct.
Artículo en Francés | MEDLINE | ID: mdl-33026328

RESUMEN

Pathogenic variants of the gene NDE1 (Nuclear Distribution Element 1) in humans lead to microlissencephaly which associates a reduced head circumference and a simplified gyration. Microlissencephaly is the most severe deficit of neurogenesis described to date but its precise physiopathological mechanism is not yet well known. The NDE1 gene encodes a phosphoprotein that is essential to neurogenesis and that is expressed in various cell compartments of neuroblasts. More than 60 interaction partners with NDE1 have been reported, notably various proteins involved in formation of the mitotic spindle, in ciliation, in genome protection of dividing neuroblasts or even in apoptosis (like LIS1, dynein or cohesin), which are all avenues that we explore in this review.


TITLE: Variations pathogènes de NDE1 et microlissencéphalie - De la pathologie au développement cérébral normal. ABSTRACT: Les variants pathogènes du gène NDE1 sont responsables de microlissencéphalies chez l'homme et constituent le déficit de la neurogenèse le plus sévère décrit à ce jour. Le gène NDE1 code une phosphoprotéine essentielle à la neurogenèse, qui est exprimée dans différents compartiments cellulaires des neuroblastes. Le mécanisme physiopathologique précis de la microlissencéphalie n'est pas encore complètement élucidé. Plus de 60 partenaires d'interaction protéique avec NDE1 ont été rapportés, notamment des protéines impliquées dans la formation du fuseau mitotique, la ciliation, la protection du génome des neuroblastes en division ou encore l'apoptose (la LIS1, la dynéine, la cohésine) et constituent autant de pistes explorées dans cette revue.


Asunto(s)
Encéfalo/embriología , Microcefalia/genética , Proteínas Asociadas a Microtúbulos/genética , Neurogénesis/genética , Encéfalo/crecimiento & desarrollo , Humanos , Microcefalia/patología , Mitosis/genética , Células-Madre Neurales/fisiología
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