Wiedemann-Beckwith syndrome: clinical, cytogenetical and radiological observations in 39 new cases.

Thirty-nine patients (82% under 1 year of age) with Wiedemann-Beckwith syndrome (WBS) were prospectively studied. To evaluate the somatometric data the normal range was set out at mean +/- 2 SD. The relevant physical findings were a characteristic face, non increased mean height and weight, normal head circumference, defective abdominal wall, a predominance of the upper segment, and tibial bowing. Mental retardation was documented in 5 cases but in only 1 it was related to hypoglycemia. The 32 cases karyotyped were normal. Since neonatal hypoglycemia is frequent (34.3% in our series) and potentially deleterious for the CNS we propose to monitor the glycemia every 6 h during the first 3 days in WBS newborns in order to correct glycemia below of 2.6 mmol/l (46.8 mg/dl) according to recent studies. The comparison with previous large series enabled us to precise the frequency, onset and evolution of the main stigmata.

[Rheumatic features of Grave's disease in children]. / Aspectos reumáticos de la enfermedad de Graves en niños.

We report three cases from girls with Graves disease who developed serious rheumatic manifestations. One patient had systemic lupus erythematosus with articular, renal, neurological and cardiac afectation with fatal outcome. Other patient presented clinical features of scleroderma with skin thickness, myopathy, arthritis, Raynaud's phenomenon and findings of pulmonary fibrosis. A lupus-like syndrome associated to methimazole therapy (polyarthritis, rash and hemolytic anemia) with positive Cel-LE preparations but negative antinuclear-antibodies was observed in a third patient. A careful history and the recognition of these manifestations will help in the identification of these syndromes.

Severe Silver-Russell syndrome and translocation (17;20) (q25;q13)

An 8-year-8-month-old girl with Silver-Russell syndrome (SRS) and a paternally inherited balanced t(17;20)(q25;q13) is described. This observation suggests that an SRS gene(s) maps on chromosome 17 or 20 and that the patient phenotype resulted from either unmasking of heterozygosity or genomic imprinting via paternal disomy.

The Wiedemann-Beckwith syndrome in four sibs including one with associated congenital hypothyroidism.

Two boys and two girls from a sibship of six, affected with the Wiedemann-Beckwith syndrome (WBS), are reported. One of the patients also had congenital hypothyroidism, an association hitherto undescribed and possibly fortuitous. Neither stigmata of WBS in other family members nor parental consanguinity were found, indicating a possible autosomal dominant inheritance comprising either a delayed mutation of an unstable premutated gene or non-penetrance.

Peutz-Jeghers syndrome with feminizing sertoli cell tumor.

A case involving a 6-year-old boy with Peutz-Jeghers syndrome and an unilateral feminizing Sertoli cell tumor is described. Endocrinologic studies revealed consistently high plasma and urine levels of estrogens and normal levels of testosterone and dihydrotestosterone. The increased levels of estrogens did not show changes that could be correlated with exogenous gonadotropin administration, thus indicating an autonomous nature. The histopathologic studies of nontumorous testicular tissue revealed changes in the seminiferous tubules which suggested that estrogens, directly or indirectly, may have had both stimulating and atrophying effects. It is concluded that gonadal tumors are in additional manifestation of the Peutz-Jeghers syndrome gene in both male and female patients.

Tetrasomy 9p: clinical aspects and enzymatic gene dosage expression.

A girl aged 13 years and 9 months with a phenotypic appearance of 9p trisomy was studied. Chromosome analysis of peripheral blood lymphocytes revealed a 9p tetrasomy [47,XX,+i(9p)] with no evidence of mosaicism. Biochemical studies corroborate the gene dosage effect for galactose-1-phosphate uridyltransferase. The roentgenological findings were quite similar to those of the 9p trisomy except for hypoplastic and angulated ribs, and malformed vertebral bodies, which are probably exclusive of the tetrasomic state.

Enanismo Mulibrey en un nino mexicano / Mulibrey nanisn in a Mexican child

Se estudio a un nino de cuatro anos de edad cuyas manifestaciones fenotipicas permitieron llegar al diagnostico de enanismo Mulibrey. Los padres del paciente no eran consaguineos, no tenian ascendencia europea, ni antecedentes de familiares similarmente afectados. La presente observacion concuerda con la herencia autosomica recesiva postulada para esta entidad, corrobora la amplia distribucion geografica de la misma y sugiere que la mutacion tiene un origen multiple