RESUMO
La osteocondrodisplasia de tipo displasia campomélica es una alteración del desarrollo esquelético que se presenta de forma autosómica dominante. Se caracteriza por la angulación de las extremidades, junto con otras alteraciones, cardiopulmonares, orofaciales y neurológicas. Las mutaciones estudiadas presentes en el gen SOX9 son responsables de la mayoría de casos de estas alteraciones. Se presenta aquí un caso de displasia campomélica hijo de madre de 22 años con embarazo de 24 semanas.
Campomelic dysplasia (CD) is a type of osteochondrodysplasia or disorder of skeletal development with autosomal dominant inheritance. It is characterized by angulation of the limbs along with cardiopulmonary, orofacial and neurological alterations. Mutations involving the SOX9 gene are responsible for CD in most affected individuals. A case of CD is presented in a boy born at 24 weeks of gestational age to a 22-year-old mother.
Assuntos
Humanos , Feminino , Gravidez , Adulto Jovem , Anormalidades Congênitas , Displasia Campomélica , AutopsiaRESUMO
El síndrome FATCO, por las siglas en inglés de aplasia fibular (Fibular Aplasia), campomelia de tibia (Tibial Campomelia) y oligosindactilia (Oligosyndactyly), es un conjunto de malformaciones óseas, en las que la alteración se centra en los huesos de la pierna. Es una entidad rara y hay pocos casos descritos en la Literatura internacional, y, hasta ahora, no se ha descrito ningún caso en Colombia. Presentamos aquí el caso de un recién nacido de sexo masculino con signos clínicos de manera prenatal y posnatal consistentes con síndrome FATCO sin otras malformaciones asociadas. Exponemos también una breve discusión sobre las diferentes malformaciones óseas y otros casos de FATCO en el mundo.
The FATCO syndrome, (Fibular Aplasia, Tibial Campomelia and Oligosyndactyly) are bone malformations with main alteration in lower limbs. It is a rare entity and there are few cases reported in international literature, and so far there are not published cases in Colombia. Here we present a case of a male newborn with prenatal and postnatal signs consistent with FATCO syndrome without other organs malformations, and there is a brief discussion about this syndrome and other different malformations associated with it.
Assuntos
Humanos , Masculino , Recém-Nascido , Deformidades Congênitas do Pé/diagnóstico , Deformidades Congênitas da Mão/diagnóstico , Sindactilia/diagnóstico , Displasia Campomélica/diagnóstico , Tíbia/anormalidades , Dedos do Pé/anormalidades , Fíbula/anormalidades , Dedos/anormalidadesRESUMO
The FATCO syndrome, (Fibular Aplasia, Tibial Campomelia and Oligosyndactyly) are bone malformations with main alteration in lower limbs. It is a rare entity and there are few cases reported in international literature, and so far there are not published cases in Colombia. Here we present a case of a male newborn with prenatal and postnatal signs consistent with FATCO syndrome without other organs malformations, and there is a brief discussion about this syndrome and other different malformations associated with it.
El síndrome FATCO, por las siglas en inglés de aplasia fibular (Fibular Aplasia), campomelia de tibia (Tibial Campomelia) y oligosindactilia (Oligosyndactyly), es un conjunto de malformaciones óseas, en las que la alteración se centra en los huesos de la pierna. Es una entidad rara y hay pocos casos descritos en la Literatura internacional, y, hasta ahora, no se ha descrito ningún caso en Colombia. Presentamos aquí el caso de un recién nacido de sexo masculino con signos clínicos de manera prenatal y posnatal consistentes con síndrome FATCO sin otras malformaciones asociadas. Exponemos también una breve discusión sobre las diferentes malformaciones óseas y otros casos de FATCO en el mundo.
Assuntos
Displasia Campomélica/diagnóstico , Fíbula/anormalidades , Dedos/anormalidades , Deformidades Congênitas do Pé/diagnóstico , Deformidades Congênitas da Mão/diagnóstico , Sindactilia/diagnóstico , Tíbia/anormalidades , Dedos do Pé/anormalidades , Humanos , Recém-Nascido , MasculinoRESUMO
BACKGROUND: The association of balanced rearrangements with breakpoints near SOX9 [SRY (sex determining region Y)-box 9] with skeletal abnormalities has been ascribed to the presumptive altering of SOX9 expression by the direct disruption of regulatory elements, their separation from SOX9 or the effect of juxtaposed sequences. CASE PRESENTATION: We report on two sporadic apparently balanced translocations, t(7;17)(p13;q24) and t(17;20)(q24.3;q11.2), whose carriers have skeletal abnormalities that led to the diagnosis of acampomelic campomelic dysplasia (ACD; MIM 114290). No pathogenic chromosomal imbalances were detected by a-CGH. The chromosome 17 breakpoints were mapped, respectively, 917-855 kb and 601-585 kb upstream of the SOX9 gene. A distal cluster of balanced rearrangements breakpoints on chromosome 17 associated with SOX9-related skeletal disorders has been mapped to a segment 932-789 kb upstream of SOX9. In this cluster, the breakpoint of the herein described t(17;20) is the most telomeric to SOX9, thus allowing the redefining of the telomeric boundary of the distal breakpoint cluster region related to skeletal disorders to 601-585 kb upstream of SOX9. Although both patients have skeletal abnormalities, the t(7;17) carrier presents with relatively mild clinical features, whereas the t(17;20) was detected in a boy with severe broncheomalacia, depending on mechanical ventilation. Balanced and unbalanced rearrangements associated with disorders of sex determination led to the mapping of a regulatory region of SOX9 function on testicular differentiation to a 517-595 kb interval upstream of SOX9, in addition to TESCO (Testis-specific enhancer of SOX9 core). As the carrier of t(17;20) has an XY sex-chromosome constitution and normal male development for his age, the segment of chromosome 17 distal to the translocation breakpoint should contain the regulatory elements for normal testis development. CONCLUSIONS: These two novel translocations illustrate the clinical variability in carriers of balanced translocations with breakpoints near SOX9. The translocation t(17;20) breakpoint provides further evidence for an additional testis-specific SOX9 enhancer 517 to 595 kb upstream of the SOX9 gene.
Assuntos
Displasia Campomélica/genética , Cromossomos Humanos Par 17 , Cromossomos Humanos Par 20 , Cromossomos Humanos Par 7 , Fatores de Transcrição SOX9/genética , Translocação Genética , Criança , Pré-Escolar , Aberrações Cromossômicas , Feminino , Humanos , Hibridização in Situ Fluorescente , Masculino , Família Multigênica , Análise de Sequência com Séries de Oligonucleotídeos , Fenótipo , Análise de Sequência de DNA , Testículo/embriologiaRESUMO
La displasia campomélica es una osteocondrodisplasia poco frecuente, incluida dentro del grupo de las osteocondrodisplasias letales. Su origen genético son mutaciones en el gen SOX9 que se heredan de forma autosómica dominante. Se caracteriza clínicamente por la forma arqueada de las extremidades, malformaciones de la caja torácica, alteraciones cartilaginosas en el árbol traqueobronquial, alteraciones en la diferenciación genital y otras anomalías menores. Los pacientes con este diagnóstico no tienen un buen pronóstico, a pesar de instaurarse un manejo adecuado. Usualmente, la muerte se da en el período neonatal por insuficiencia respiratoria, debido a las malformaciones torácicas, aunque se describen casos con buen pronóstico. El diagnóstico temprano in utero, a través de la ecografía prenatal y la confirmación diagnóstica con radiografía convencional, son indispensables para un adecuado abordaje interdisciplinario del paciente. Se presenta el caso de un recién nacido masculino con displasia campomélica y su abordaje diagnóstico desde la radiología.
Campomelicdysplasia is a rare osteochondrodysplasia, which is included in the lethal osteochondrodysplasias group. Mutations in SOX9 gene are responsible for this disorder and its inheritance mechanism is autosomal dominant. Campomelicdysplasia is characterized by congenital bowing and angulations of long bones, tracheobronchial tree abnormalities, ambiguous genitalia, dislocated hips and other minor abnormalities. Prognosis is poor in spite of suitable management. Death is usually produced by respiratoryfailure due to thoracic malformations. The early in utero diagnosis through prenatal ultrasonography and its confirmation by conventional Xray are both essential for an interdisciplinary management. We present a case of a male newborn with campomelicdysplasia and its radiological diagnostic approach.