Document Detail


Genetic syndrome suspicion: examples of clinical approach in the neonatal unit.
MedLine Citation:
PMID:  21089741     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Overgrowth syndromes: the practical clinical approach. Excessive growth can be present in a variety of medical conditions as result of abnormal fetal metabolism (i.e., maternal gestational diabetes) or of an overgrowth syndrome. Within this latter group of diseases, a LGA newborn requires a complex differential diagnosis encompassing several syndromes, such as Beckwith-Wiedemman, Sotos, Weaver, Simpson-Golabi-Behmel, Perlman, and Bannayan-Riley-Ruvalcaba. Partial or global overgrowth, other dysmorphisms, abdominal organs anomalies, as well as benign and malignant tumors are the common issues to examine for the diagnosis and the monitoring of all these disorders. The molecular bases of these conditions, even if partially known so far, can help in explaining the clinical features and prognosis. The diagnostic course, the genetic investigations and the follow-up of a LGA patient will be presented during the seminar. A wide clinical spectrum from esophageal atresia to VACTERL association. Oesophageal atresia (OA) occurs approximately in 1 in 3000 live births. It can be clinically divided into isolated and syndromic, when associated with other features. The aetiology is largely unknown and is likely to be multifactorial, however, various clues have been uncovered in animal experiments particularly defects in the expression of the gene Sonic hedgehog (Shh). The vast majority of cases are sporadic and the recurrence risk for siblings is 1%. Survival is directly related to birth weight and to the presence of a major cardiac defect. The VACTERL association refers to anomalies of the bony spinal column (V), atresias in the gastrointestinal tract (A), congenital heart lesions (C), tracheoesophageal defects (TE), renal and distal urinary tract anomalies (R) and limb lesions (L). The overall phenotype of a series of newborn patients we observed may vary widely, reflecting the aetiologic heterogeneity of this group of conditions. Therefore, possible additional defects must be accurately investigated in all newborns with OA.
Authors:
M Giuffrè; L De Sanctis
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Minerva pediatrica     Volume:  62     ISSN:  0026-4946     ISO Abbreviation:  Minerva Pediatr.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-11-22     Completed Date:  2010-12-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400740     Medline TA:  Minerva Pediatr     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  199-201     Citation Subset:  IM    
Affiliation:
UO di Neonatologia e Terapia Intensiva Neonatale, Dipartimento Materno Infantile, Università degli Studi di Palermo.
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Multiple / diagnosis,  genetics
Anal Canal / abnormalities
Birth Weight
Congenital Abnormalities / diagnosis,  genetics
Early Diagnosis*
Esophageal Atresia / diagnosis,  epidemiology,  genetics
Esophagus / abnormalities
Fetal Macrosomia / diagnosis,  etiology
Genetic Diseases, Inborn / diagnosis*
Genetic Testing*
Heart Defects, Congenital / diagnosis,  epidemiology,  genetics
Hedgehog Proteins / deficiency,  genetics
Humans
Infant, Newborn
Intensive Care Units, Neonatal*
Kidney / abnormalities
Limb Deformities, Congenital / diagnosis,  epidemiology,  genetics
Neonatology / methods*
Patient Care Team
Spine / abnormalities
Syndrome
Trachea / abnormalities
Chemical
Reg. No./Substance:
0/Hedgehog Proteins; 0/SHH protein, human

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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