ABSTRACT
Los defectos del tubo neural constituyen las malformaciones congénitas más frecuentes en muchos países. Dentro de los defectos del tubo neural, se encuentra la espina bífida, la cual constituye un defecto que afecta la piel, los tejidos blandos y arcos vertebrales subyacentes, con exposición del canal; lo cual resulta de un fallo del cierre del extremo caudal del tubo neural. Existe la llamada espina bífida abierta, dentro de las que se encuentran el mielomeningocele y el meningocele (85 por ciento del total de las espinas bífidas). El objetivo del trabajo es resaltar la importancia del diagnóstico precoz de malformaciones congénitas y/o defectos estructurales del feto, por ultrasonografía, en la atención primaria de salud. Se presentan las imágenes ecográficas de un caso de afectación fetal por espina bífida abierta a las 22 semanas, sin otros hallazgos ultrasonográficos. Previo asesoramiento genético, la pareja decidió la terminación del embarazo. El caso fue confirmado por anatomía patológica como un feto con espina bífida abierta con mielomeningocele en la región lumbar(AU)
Neural tube defects are very frequent in many countries. The term spina bifida is still commonly used as a synonym for spinal dysraphism, although it properly refers to defective fusion of posterior spinal bony elements. Both myelomeningoceles and myeloceles originate from defective closure of the primary neural tube, which are present in most spina bifida cases (85 percent. The objective of this article is to emphasize the importance of early diagnosis of congenital malformations by ultrasonography in primary health care. We present a case of prenatal ultrasonographic diagnosis of open spina bifida at 22 weeks of gestation, with no other ultrasonographic findings. Prior genetic counseling, the couple decided the termination of pregnancy. The case was confirmed by pathology as an open spina bifida with lumbar myelomeningocele(AU)
Subject(s)
Humans , Female , Pregnancy , Adult , Spinal Dysraphism/complications , Pregnancy Complications , Spinal Dysraphism/genetics , Abortion, Induced/methodsABSTRACT
Background: Mandatory fortification with folic acid (FA) was implemented in Chile in 2000. Thereafter, the rate of spina bifida decreased by 52 to 55%. Genetic abnormalities in folate metabolism may be involved in the etiology of spina bifida. Aim: To evaluate the association between myelomeningocele (MM) and c.A1298C and c.C677T polymorphisms within the coding gene for 5,10-methylenetetrahydrofolate reductase (MTHFR) in the Chilean population. Material and Methods: These polymorphisms were genotyped in 105 patients showing isolated MM, born after the onset of FA fortification, and in their parents. The transmission disequilibrium test (TDT) was performed to evaluate alterations in the transmission of both alleles and haplotypes MTHFR polymorphism. We also evaluated the presence of parent-origin-effect (POE) of alleles using the Clayton’s extension of the TDT. Results: TDT analysis showed no significant distortions in the transmission of alleles or haplotypes. Moreover, although the POE showed increased risk for maternally derived allele, this risk was not statistically significant. Conclusions: The studied variants in the MTHFR gene (c.C677T and c.A1298C) do not constitute risk factors for MM in this sample of Chilean patients and their parents.
Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Meningomyelocele/genetics , /genetics , Polymorphism, Genetic/genetics , Spinal Dysraphism/genetics , Chile , Gene Frequency , Genotype , Haplotypes , Meningomyelocele/enzymology , Risk Factors , Spinal Dysraphism/enzymologyABSTRACT
Neural tube defects (NTDs) are a group of congenital anomalies that affect the central nervious system. Spina Bifida (SB) is the most frecuent NTD in live births andi t is usually associated to disease, disability; and mortality. NTDs are considered as a multifactorial disease. Women who use folic acid periconceptionally are at a 50-70% reduced risk for NTD-affected pregnancies. More than 80 candidates genes to SB are been studied, someones related to folic acid metabolic pathway. MTHFR gene is the gene more studied in NTDs. Its allele 677T is asóciate to higher risk to NTD. It is important to study polymorphisms in MTHFR gene in Chile because Chilean population has dfferent ethnic origen from others previous studied populations.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Spinal Dysraphism/embryology , Spinal Dysraphism/genetics , Chile , Congenital Abnormalities , Neural Tube Defects/embryology , Neural Tube Defects/geneticsABSTRACT
Background: Several population studies have shown that patients with neural tube defects (NTD), have a higher frequency of a genetic mutation related with thermolability of the enzyme 5,10-metylentetrahydrofolate reductase (MTHFR). There are regional and ethnic variations in the genotypic or allelic frequency of this mutation and its possible relationship with NTD and others congenital anomalies. Aim: To estimate the frequency of the C677T polymorphism of MTHFR in control women and mothers of spina bifida cases. Patients and Methods: We analyzed 58 blood samples from mothers who had a child diagnosed with spina bifida. A group of 184 healthy mothers matched by age and with no NTD offspring served as controls. We determined the C677T polymorphism on the MTHFR gene by means of PCR and the analysis of the digestion pattern of HinfI restriction enzyme. Results: The genotypic frequencies showed concordance with Hardy-Weinberg equilibrium, in controls (p=0.35), and in mothers of the cases (p=0.95). The odds ratio to the TT genotype compared with the CC genotype (reference category) was estimated as 1.54 (IC 95%: 0,66-3,61), while the odds ratio for the TC genotype compared with CC genotype was 1.06 (IC 95%: 0,48-2,33). Conclusion: No differences in the C677T polymorphism of the MTHFR were observed between mothers who had a child diagnosed with spina bifida and control mothers (Rev Méd Chile 2003; 131: 1399-404).
Subject(s)
Humans , Female , Child , Adolescent , Adult , Middle Aged , Methylenetetrahydrofolate Dehydrogenase (NAD+)/genetics , Polymorphism, Genetic , Spinal Dysraphism/genetics , Alleles , Case-Control Studies , Chile , Genotype , Methylenetetrahydrofolate Dehydrogenase (NAD+)/blood , Mothers , Mutation , Spinal Dysraphism/bloodABSTRACT
Um caso raro de meningite recorrente devido a meningocele sacral anterior e agenesia das vértebras sacras é descrito. Herança autossômica dominante para malformaçao medular caudal é demonstrada e, possíveis fatores ambientais (ligados ao cromo), sao discutidos.