Panadizo herpetico en un neonato / Herpetic infection of the fingers in a newborn

La infección por el virus del herpes simple neonatal es una enfermedad potencialmente muy grave. Ocurre, en la mayoría de los casos, en el canal del parto, a partir de lesiones activas o de secreciones genitales infectadas. Presentamos un caso infrecuente de adquisición después del Parto, a partir de una localización orolabial materna, con aparición de lesiones limitadas a los dedos de la mano en un lactante de 22 días. El tratamiento correcto y precoz permitió la desaparición total de las lesiones cutáneas y la ausencia de complicaciones asociadas. (AU)

[Achondrogenesis type II-hypochondrogenesis: radiological features.Case report]. / Acondrogénesis tipo II-hipocondrogénesis. Aspectos radiológicos.

We present a case of lethal dysplasia in the neonatal period. The abnormality was suspected after ultrasonography of a pregnant woman presenting weak fetal movements revealed shortening of the extremities, voluminous cranium and polyhydramnios. Clinical and radiological findings showed platyspondylic dwarfism with short extremities, narrow thorax and hydropic appearance. The infant died on the third day of life from progressive respiratory distress. In the absence of histological, chondro-osseus and molecular studies, detailed clinical and radiological studies, as well as the lethal evolution during the neonatal period, guided the diagnosis of hypochondrogenesis. This entity, together with achondrogenesis II (and other dysplasias), forms part of the same spectrum of collagen type II abnormalities produced by a defect in the gene (COL2A1) that codifies collagen II, located in chromosome 12 I(12q13.1-13.2). When a heterozygote is produced, transmission is dominant autosomal. The phenotype shows wide variation and severity depends on the mechanism and location of the mutation. The definitive diagnosis is given by cytomolecular studies, while individualization of the different entities is based on histological data from the cartilage; clinical findings and skeletal radiology serve as a guide.

Acondrogénesis tipo II-hipocondrogénesis. Aspectos radiológicos / Achondrogenesis tupe II-Hypochondrogenesis: radiological features

Se presenta un caso de displasia fatal en el período neonatal, que se sospechó tras realizar una ecografía a una embarazada que presentaba movimientos fetales débiles, observándose un acortamiento de las extremidades, cráneo voluminoso y polihidramnios. Los hallazgos clínicos y radiológicos pusieron de manifiesto enanismo platispondílico de extremidades cortas, tórax estrecho y aspecto hidrópico, falleciendo a los 3 días de vida por distrés respiratorio progresivo. En ausencia de los estudios histológicos condroóseo y molecular, el análisis minucioso de la clínica y, sobre todo, de los signos radiológicos, así como por la evolución letal en el período neonatal, permitieron orientar el diagnóstico hacia hipocondrogénesis. Esta entidad, junto con la acondrogénesis II (y otras displasias), forman parte de un mismo espectro de las colagenopatías tipo II que son consecuencia de un defecto genético del gen (COL2A1) que codifica el colágeno II, localizado en el cromosoma 12 (12q13.1-13.2) y que, al producirse el estado heterozigoto, demuestra una transmisión autosómica dominante. Existe una amplia variabilidad fenotípica cuya gravedad depende del mecanismo de la mutación y de su localización. El diagnóstico definitivo se apoya en los estudios citomoleculares, mientras la individualización de las distintas entidades se basa en los datos proporcionados por la histología del cartílago; la sintomatología y la radiología esquelética son orientativas (AU)

[Fraser syndrome: frequency in our environment and clinical-epidemiological aspects of a consecutive series of cases]. / Síndrome de Fraser: frecuencia en nuestro medio y aspectos clínico-epidemiológicos de una serie consecutiva de casos.

OBJECTIVE: Four major characteristics (cryptophthalmos, syndactyly, genital anomalies and affected siblings) and eight minor characteristics (alterations of the nose, ears, larynx, oral clefts, umbilical hernia, renal agenesis, skeletal anomalies and mental retardation) have been defined for the diagnosis of Fraser syndrome. The generally accepted criterion for the diagnosis is at least the presence of 2 major and one minor characteristic, or one major and four minor characteristics. The etiology of the syndrome is autosomal recessive and siblings are frequently affected. PATIENTS AND METHODS: We show the characteristics of the 7 cases of Fraser syndrome identified in the consecutive series of 1,405,374 liveborn infants and 9,042 stillborn children surveyed by the Spanish Collaborative Study of Congenital Malformations (ECEMC) between April 1976 and March 1997. RESULTS AND CONCLUSIONS: The minimal estimated frequency of Fraser syndrome is 0.43 per 100,000 liveborn infants and 11.06 per 100,000 stillbirths. As has been shown in other case studies, we have observed a wide clinical expression of this syndrome. At present it is possible to prenatally detect some of the characteristics of Fraser syndrome through ultrasound examination of eyes, digits and kidneys. Four out of the 7 cases we present here were gypsies and the frequency of the syndrome among liveborn gypsy infants is 129.3 times higher than among the non-gypsy population. Therefore, given that the frequency of the gene is higher in the gypsy population than in other ethic groups, it is recommended that a special search among gypsies for the identification of this and other autosomal recessive syndromes be performed.

[Anophthalmia/micro-ophthalmia in syndromes: epidemiology study of newborns in Spain]. / Anoftalmía/microftalmía en síndromes: estudio epidemiológico en recién nacidos en España.

OBJECTIVE: The objective of this study was to perform an epidemiological analysis of the frequency of anophthalmia/microphthalmia (A/M) in syndromes identified in newborn infants in Spain. PATIENTS AND METHODS: Data of the Spanish Collaborative Study of Congenital Malformations during the period of 1976-1994, corresponding to more than 1,200,000 births, was analyzed. Among these, 86 newborn infants with A/M presented some of the recognized syndromes. RESULTS: There is a wide etiological heterogeneity among the syndromes with this ocular defect, with chromosomal syndromes being the most frequent (67.9% of total syndromes with A/M), followed by monogenic syndromes (19.1%), environmental (9.5%) and those of unknown etiology (3.6%). CONCLUSIONS: Some guidelines when a baby is born with A/M are derived from this study. First, given the tendency of the defect to present together with other anomalies, it is advisable to perform a detailed study to rule out or to confirm the existence of other defects. Adequate samples should be taken (even in stillborn infants) for cytogenetic study. Examine carefully the prenatal history, looking for chronic diseases, infectious processes or exposure to teratogens. Depending on the baby's survival, follow-up of the psychomotor development should be made. All of these aspects are always important in malformed babies, but especially in infants with A/M given the tendency of the defect to present in syndromes as the etiologic diagnosis determines the counselling regarding the risk of recurrence, detection of carriers in some cases and possible prenatal diagnosis.

[Syndromes with neural tube defects: epidemiologic analysis in Spain]. / Síndromes con defectos del tubo neural: análisis epidemiológico en España.

OBJECTIVE: We present, from an epidemiological perspective, the analysis of syndromes which present neural tube defects (NTD). Although there are many epidemiological studies on NTD all over the world, most of them are on isolated NTD; that is, when the infant only has NTD as the only anomaly. PATIENTS AND METHODS: The methodology is based on the review of hospital records of infants with congenital anomalies. This permitted the analysis of the prevalence. RESULTS: The results show that the frequency of syndromes with NTD is 27.5 time higher among stillborn infants than among liveborn infants. Nevertheless, there are not many syndromes in which the NTD are present more or less frequently. In fact, only 1.93% of the total cases with syndromes presented NTD, with the majority (43.4%) with genetic etiology. We also analyze the specific types of syndromes with NTD.