0000000000899169
AUTHOR
Ettore Piro
Prematurity and twinning
Aim of the study: Newborns from multiple pregnancies are increasing in number and demonstrate a higher perinatal morbidity and mortality compared to singletons. Prematurity is the main reason for most neonatal diseases in twins, but other variables may play a role and their prenatal evaluation may improve the overall outcome. Main findings: Prematurity is six times more frequent in twins and therefore birth weight is significantly lower compared to singletons. Thus, twins are more exposed to prematurity related diseases (respiratory, cardiovas- cular, infectious, etc.) and to long-term complications (especially neurological disabilities). Results: It is very difficult to estimate the increa…
High Resolution CT Angiography in Detection of an Aneurysm of the Vein of Galen as a Source of Intracranial Haemorrhage in a Newborn.
Cerebral haemorrhage is a rare condition in infants and carries a known poor prognosis. Common causes of spontaneous haemorrhage include various vascular venous lesions due to incomplete hydrovenous maturation, among them Galen vein aneurysm may be a very rare cause of cerebral haemorrhage. This report emphasizes the role of multidector CT with high resolution CT angiography in a newborn with cerebral hemorrhage caused by Galen vein aneurysm rupture. MDCT with high resolution CT angiography helps to differentiate the cause of haemorrhage, and to address the appropriate treatment.
UP DATE IN NEUROLOGIA NEONATALE LA DIAGNOSTICA
Congenital pelvic skeletal anomalies: Clinical and radiographic evaluation of newborns with gastrointestinal malformation
Abstract Background Congenital pelvic skeletal anomalies (CPSA) may appear as isolated defects or in association with other anomalies like congenital malformations of the digestive system (CMDS). Minor CPSA in non-syndromic patients are often overlooked. We aimed to assess the frequency of CPSA in newborns with CMDS to review the diagnostic approaches. Study design A retrospective review of medical records of 201 newborns who underwent X-rays for different neonatal indications was conducted. In 122 patients CMDS were diagnosed and classified according to the ICD-10 classification; 79 non-CMDS patients acted as controls. Pelvic skeletal segments were examined by X-rays. Results Patients with…
Dysmorphic face, precociously senile appearance, microcephaly, growth retardation and neuropsychomotor delay
Cockayne's syndrome is a rare recessive autosomal disorder. Its frequency at birth is very low. In the classical form (type 1) the clinical appearance becomes evident by the second year of life. Itis characterized by severe growth delay, microcephaly, progressive loss of adipose tissue, senile appearance, dysmorphic facial features, ocular anomalies (retinal pigmentary degeneration, nistagmus, cataract, optic atrophy).
Neonatal ten-year retrospective study on neural tube defects in a second level University Hospital
Abstract Background Aim of this retrospective study was to describe clinical characteristics, diagnostic work-up, management and follow-up of newborns with neural tube defects (NTDs), admitted to the Mother and Child Department of the University Hospital of Palermo, in a ten years period. Methods The medical records of 7 newborns (5 males and 2 females) admitted, over a 10-year period from January 2010 to March 2020, to our Department on the first day of life were reviewed. Analyzed data were related to familiar and/or maternal risk factors (consanguinity, maternal preexisting and/or gestational diseases, exposure to teratogen/infectious agents, lack of preconception folic acid supplement),…
From Neonatal Intensive Care to Neurocritical Care: Is It Still a Mirage? The Sicilian Multicenter Project
Background. Neonatal brain injury (NBI) can lead to a significant neurological disability or even death. After decades of intense efforts to improve neonatal intensive care and survival of critically ill newborns, the focus today is an improved long-term neurological outcome through brain-focused care. The goal of neuroprotection in the neonatal intensive care unit (NICU) is the prevention of new or worsening NBI in premature and term newborns. As a result, the neonatal neurocritical care unit (NNCU) has been emerging as a model of care to decrease NBI and improve the long-term neurodevelopment in critically ill neonates. Purpose. Neurocritical care (NCC) Sicilian project includes three aca…
Parenting Stress Profile and Children Behaviour in Patients with Congenital Hypothyroidism
Background: Hypothyroidism has been associated with cognitive and motor impairments, the degree to which mild hypothyroidism, or subclinical hypothyroidism impacts mood and cognitive functions and whether these symptoms respond to treatment, remains controversial. Furthermore, hypothyroidism is associated with an increased susceptibility to depression and reductions in health-related quality of life. Objective and hypotheses: Recent longitudinal studies stressed that the follow-up of children with treated congenital hypothyroidism (CHT) should not be limited to the cognitive domain. This study attempted to evaluate the emotional–behavioural profiles in children with CHT and the parenting st…
ONLINE MENDELIAN INHERITANCE IN MAN (OMIM)
A refugee newborn with heart failure and initial hydrops: Diagnostic clues of spectral Doppler examinations
A newnborn admitted to NICU showed a severe clinical profile
Additional file 1 of Novel LRPPRC compound heterozygous mutation in a child with early-onset Leigh syndrome French-Canadian type: case report of an Italian patient
Additional file 1.
L’epilessia in età evolutiva : i farmaci d’elezione
EDEME GENERALIZZATO, IPOTONIA E IPERECCITABILITA' ALLA NASCITA IN NEONATO A TERMINE CON GALATTOSIALIDOSI:APPROCCIO CLINICO E DIAGNOSTICO
New insights in pediatrics in 2021: choices in allergy and immunology, critical care, endocrinology, gastroenterology, genetics, haematology, infectious diseases, neonatology, neurology, nutrition, palliative care, respiratory tract illnesses and telemedicine
AbstractIn this review, we report the developments across pediatric subspecialties that have been published in the Italian Journal of Pediatrics in 2021. We highlight advances in allergy and immunology, critical care, endocrinology, gastroenterology, genetics, hematology, infectious diseases, neonatology, neurology, nutrition, palliative care, respiratory tract illnesses and telemedicine.
Screening ecografico cerebrale nel neonato sano:descrizione di 3 casi di cisti aracnoidea
A premature infant with Costello syndrome due to a rare G13C HRAS mutation.
Costello syndrome is caused by mutations in the HRAS proto-oncogene whose clinical features in the first year of life include fetal and neonatal macrosomia with subsequent growth impairment due to severe feeding difficulties. We report on a premature male with Costello syndrome due to a rare G13C HRAS mutation and describe his clinical features and evolution during the first year of life. The diagnosis of Costello syndrome may be difficult at birth, especially in very preterm infants in whom feeding difficulties, reduced subcutaneous adipose tissue and failure to thrive are also part of their typical presentation.
Disabilità Intellettiva, riarrangiamenti genomici, ittioli
Ittiosi, disabilità intellettiva, riarrangiamenti genomici
Indagine Clinico Epidemiologica su 132 Nati da Gravidanze Multiple
AbstractL'epidemiologia delle gravidanze multiple si è notevolemente modificata nel corso degli ultimi due decenni in virtù del perfezionamento e della diffusione delle tecniche di riproduzione assistita. L'utilizzazione di induttori farmacologici della ovulazione (specie le gonadotropine ed il citrato di clomifene) e l'impianto in utero di più embrioni fecondati in vitro, sono fattori che maggiormente hanno contribuito a fare impennare verso l'alto il numero di nati da gravidanze plurigemine. L'incidenza di parti trigemini, ad esempio, considerata gli inizi degli anni '70 di circa 1:10,000 parti, oggi si è elevata sino ad 1:3,500 circa.Presentiamo i dati relativi a 132 soggetti nati da gra…
Neonatal presentation of Prader Willi sindrome. Personal records.
Epilessia in età evolutiva:i farmaci d'elezione
Autosomal recessive polycystic kidney disease: case report of a newborn with rare PKHD1 mutation, rapid renal enlargement and early fatal outcome
Abstract Introduction Autosomal recessive polycystic kidney disease (ARPKD; MIM#263200) is one of the most frequent pediatric renal cystic diseases, with an incidence of 1:20,000. It is caused by mutations of the PKHD1 gene, on chromosome 6p12. The clinical spectrum is highly variable, ranging from late-onset milder forms to severe perinatal manifestations. The management of newborns with severe pulmonary insufficiency is challenging, and causes of early death are sepsis or respiratory failure. In cases of massive renal enlargement, early bilateral nephrectomy and peritoneal dialysis may reduce infant mortality. However, there is no conclusive data on the role of surgery, and decision-makin…
A Case of Cardiomyopathy Due to Premature Ductus Arteriosus Closure: The Flip Side of Paracetamol.
Paracetamol (acetaminophen or N-acetyl-p-aminophenol) is considered a safe analgesic and antipyretic nonsteroidal antiinflammatory drug commonly used during pediatric ages and during pregnancy. We report on a term neonate with closed ductus arteriosus, severe cardiomyopathy, right ventricular dysfunction, and functional stenosis of pulmonary arteries at birth after maternal self-medication with paracetamol and consumption of polyphenol-rich foods in late pregnancy. This drug, especially when associated with other vasoconstrictors (such as polyphenols), interferes with prostaglandin metabolism, which seriously accentuates the intrauterine ductus arteriosus constriction and leads to pharmacol…
Oxidative stress in preterm infants: Overview of current evidence and future prospects
Preterm birth (PTB), defined as parturition prior to 37 weeks of gestation, is the leading cause of morbidity and mortality in the neonatal population. The incidence and severity of complications of prematurity increase with decreasing gestational age and birthweight. The aim of this review study is to select the most current evidence on the role of oxidative stress in the onset of preterm complication prevention strategies and treatment options with pre-clinical and clinical trials. We also provide a literature review of primary and secondary studies on the role of oxidative stress in preterm infants and its eventual treatment in prematurity diseases. We conducted a systematic literature s…
Aspetti neuroevolutivi
I disturbi del linguaggio.
Gemellarità e prematurità
Predictive Factors of Abdominal Compartment Syndrome in Neonatal Age
In the pediatric population, abdominal compartment syndrome (ACS) is a known complication of abdominal wall defect repair. However, there are only few reports on ACS in newborns and only a proposal of critical intra-abdominal pressure value (IAP) in term newborns, absent in preterm newborns. Although the prevalent clinical sign is tense abdominal distension, it may be difficult to distinguish ACS from pathologies that will not require decompression. The purpose of this study was to identify predictors for ACS and therefore morbidity or mortality indicators. We reviewed newborns presenting with tense abdominal distension and end organ failure. Anamnestic, clinical, laboratory, and instrument…
Case Report: Unusual Clinical Presentation of a Rare Cardiac Inflammatory Myofibroblastic Tumor in Children: The Differential Diagnosis With Pediatric Emergencies
Introduction: There are still no guidelines about pediatric cardiac cancers. The purpose of this work is to provide new scientific data facilitating the differential diagnosis of a rare cardiac tumor with an unusual presentation, such as the cardiac inflammatory myofibroblastic tumor (IMT).Case Presentation: A 3-year-old male child presented with several symptoms including unconsciousness, vomiting, and drowsiness. A clinical and neurological examination revealed a unilateral (right) motor delay and positive unilateral Babinski sign. Electrocardiogram (ECG) was normal.Diagnostic Assessment: The total body computed tomography (CT) scans showed hypodensity in the left temporal–parietal lobe, …
Intrauterine growth restriction and congenital malformations: a retrospective epidemiological study
Background: Intrauterine growth restriction (IUGR) and small for gestational age (SGA) birth have been considered possible indicators of the presence of malformations. The aim of this study is to evaluate such relationships in a population of newborns, along with other epidemiological and auxological parameters, in particular the ponderal index (PI). Methods: We analyzed the birth data of 1093 infants, classified according to weight for gestational age as SGA, appropriate for gestational age (AGA) or large for gestational age (LGA). The prevalence of malformations was analyzed in relation to weight percentile at birth and SGA birth, maternal smoking, pregnancy diseases and PI. Results: Our …
Esophageal atresia and Beckwith–Wiedemann syndrome in one of the naturally conceived discordant newborn twins: first report
Key Clinical Message Recent studies report a high incidence of monozygotic twinning in Beckwith–Wiedemann syndrome. A phenotypical discordance in monozygotic twins is rare. Twinning and Beckwith–Wiedemann syndrome show higher incidence in children born after assisted reproductive techniques. We report on the first observation of esophageal atresia and Beckwith–Wiedemann syndrome in one of the naturally conceived discordant monozygotic twins.
Artrogriposi multipla congenita da lesione del II motoneurone, descrizione di un caso e considerazioni clinico-diagnostiche.
Kabuki make-up (Niikawa-Kuroki) syndrome: Clinical and radiological observations in two sicilian children
The Authors describe two patients aged 5 and 8, a female and a male, affected by a condition of polymalformations known as Kabuki make-up or Niikawa-Kuroki syndrome, having a neonatal incidence of 1:32,000 in Japan. There are two hypothesis about the apparent rarity of the syndrome in the rest of the world, including the Asian Continent: the first is that it exists, but is infrequently recognized outside Japan and the second is that it is really more frequent in those parts of the world, where ethnic exchanges are uncommon, as it happens in Japan.
Potenziali evocati visivi, contributo nella gestione della idrocefalia postemorragica. Descrizione di un caso.
IVH, PEV
Neonato con spettro facio-auricolo-vertebrale a piena espressività clinica e grave compromissione funzionale.
SINDROME DI PALLISTER KILLIAN. DESCRIZIONE DI UN CASO E CORRELAZIONE CLINICO GENETICA
SINDROME DI PALLISTER KILLIAN
2q13 microdeletion syndrome: Report on a newborn with additional features expanding the phenotype
In this paper we describe an additional newborn patient with craniofacial dysmorphisms, congenital heart disease, hypotonia and a 2q13 deletion of 1.7 Mb, whose clinical and genomic findings are consistent with the diagnosis of 2q13 microdeletion syndrome.
WIDENING THE SCOPE OF NEXT GENERATION SEQUENCING APPLICATIONS IN PEDIATRIC MEDICAL GENETICS
Advances in DNA sequencing technologies through Next Generation Sequencing (NGS) approaches have enabled genome-wide discovery of chromosomal copy-number variants and single-nucleotide changes. NGS technologies are rapidly expanding our ability to identify and better define disease-causing mutations and genotype-phenotype correlation. Pediatric patients may particularly benefit from the introduction of these new technologies. Pediatricians must keep up with all these new skills, both in their residency programs as well as in their continuing medical education programs.
Intestinal malrotation in a female newborn affected by Osteopathia Striata with Cranial Sclerosis due to a de novo heterozygous nonsense mutation of the AMER1 gene
Abstract Background Osteopathia Striata with Cranial Sclerosis (OS-CS), also known as Horan-Beighton Syndrome, is a rare genetic disease; about 90 cases have been reported to date. It is associated with mutations (heterozygous for female subjects and hemizygous for males) of the AMER1 gene, located at Xq11.2, and shows an X-linked pattern of transmission. Typical clinical manifestations include macrocephaly, characteristic facial features (frontal bossing, epicanthal folds, hypertelorism, depressed nasal bridge, orofacial cleft, prominent jaw), hearing loss and developmental delay. Males usually present a more severe phenotype than females and rarely survive. Diagnostic suspicion is based o…
Congenital syphilis in a preterm newborn with gastrointestinal disorders and postnatal growth restriction.
Abstract Background Congenital syphilis (CS) depends on the placental transmission of Treponema pallidum (TP) spirochetes from an infected mother to fetus during pregnancy. It shows a wide clinical variability with cutaneous and visceral manifestations, including stillbirths, neonatal death, and asymptomatic cases. Preterm infants with CS may have more severe features of disease than the term ones, due to the combined pathogenic effect of both CS and prematurity. Case presentation We report on a female preterm (32+6 weeks of gestation) newborn showing most of the typical CS manifestations, in addition to gastrointestinal disorders including feeding difficulties, colon stenosis and malabsorp…
SINDROME DA ASTINENZA NEONATALE
IL NEONATO VARIAMENTE GROSSO
Etiological heterogeneity and clinical variability in newborns with esophageal atresia
Abstract Background The aim of this study was to define different characteristics of infants with esophageal atresia and correlations with neonatal level of care, morbidity and mortality occurring during hospital stay. Methods Charts of all newborns with esophageal atresia (EA) admitted to our University NICU between January 2003 and November 2016 were reviewed and subdivided in four groups related to different clinical presentations; EA as an isolated form (A), with a concomitant single malformation (B), as VACTERL association (C), and in the context of a syndrome or an entity of multiple congenital anomalies (D). Results We recruited 67 infants with EA (with or without tracheoesophageal f…
I gemelli: eterogeneità clinica e approccio multidisciplinare [Twins: Clinical heterogeneity and multidisciplinary approach]
The incidence of multiple pregnancy has increased during the last 15 years, particularly in relation to the advances in assisted reproductive technologies. Twins are conceived in about 1 in 80 pregnancies. Multiple gestations are high risk pregnancies, which may be complicated by pre-eclampsia, anemia, postpartum hemorrhage, pre-maturity, intrauterine growth restriction (IUGR), small for gestational age (SGA) newborn, neonatal morbidity and high perinatal, neonatal and infant mortality. Main complication is the twin-to-twin transfusion syndrome (TTTS) in monochorionic twin gestations; it is associated to high perinatal mortality and increased neurological, cardiovascular and renal dysfuncti…
A novel mutation in KCNQ3-related benign familial neonatal epilepsy: electroclinical features and neurodevelopmental outcome.
Benign familial neonatal epilepsy (BFNE) is caused, in about 5% of families, by mutations in the KCNQ3 gene encoding voltage-gated potassium channel subunits. Usually, newborns with BFNE show a normal neurological outcome, but recently, refractory seizures and/or developmental disability have been reported suggesting phenotype variability associated with KCNQ3-related BFNE. Here, we describe a proband from a BFNE family carrying a novel variant in the KCNQ3 gene. Regarding the paucity of data in the literature, we describe the presented case with a view to further establishing: (1) a genotype/phenotype correlation in order to define a BFNE phenotype associated with favourable outcome; (2) a…
New application of heart rate variability in newborns at developmental risk
Interstitial deletions of chromosome 1p: novel 1p31.3p22.2 microdeletion in a newborn with craniosynostosis, coloboma and cleft palate, and review of the genomic and phenotypic profiles
Abstract Background Rearrangements of unstable DNA sequences may alter the structural integrity or the copy number of dose-sensitive genes, resulting in copy number variations. They may lead more frequently to deletions, in addition to duplications and/or inversions, which are the underlying pathogenic mechanism of a group of conditions known as genomic disorders (or also contiguous gene syndromes). Interstitial deletions of the short arm of chromosome 1 are rare, and only about 30 patients have been reported. Their clinical features are variable, in respect of the extent of the deleted region. They include global developmental delay, central nervous system (CNS) malformations, craniosynost…
Sindrome di Pfeiffer:identificazione di una nuova mutazione nel gene FGFR2
Migraine in Children Under 7 Years of Age: a Review
Purpose of review: Despite the accumulation of a significant amount of data on pediatric headache, few studies have been conducted on its occurrence in children under 7 years of age. Within primary headaches in this age, migraine especially, turns out to be a disorder affecting up to 4% of the general population. An underestimate of its true prevalence can be due to lack of specific diagnostic markers, the frequent difficulty of describing pain in childhood, and the necessity of reliable parents’ reports. Thus, migraine in children under 7 years of age represents an important challenge for clinicians. The objective of this manuscript is to provide a comprehensive review of epidemiologic, cl…
New insights on partial trisomy 3q syndrome: de novo 3q27.1-q29 duplication in a newborn with pre and postnatal overgrowth and assisted reproductive conception
Abstract Background Duplications of the long arm of chromosome 3 are rare, and associated to a well-defined contiguous gene syndrome known as partial trisomy 3q syndrome. It has been first described in 1966 by Falek et al., and since then around 100 patients have been reported. Clinical manifestations include characteristic facial dysmorphic features, microcephaly, hirsutism, congenital heart disease, genitourinary anomalies, hand and feet abnormalities, growth disturbances and intellectual disability. Most of cases are due to unbalanced translocations, inherited from a parent carrying a balanced aberration (reciprocal translocation or inversion), and rarely the genomic anomaly arises de no…
Recognizable neonatal clinical features of aplasia cutis congenita
Abstract Background Aplasia cutis congenita (ACC), classified in nine groups, is likely to be underreported, since milder isolated lesions in wellbeing newborns could often be undetected, and solitary lesions in the context of polymalformative syndromes could not always be reported. Regardless of form and cause, therapeutic options have in common the aim to restore the deficient mechanical and immunological cutaneous protection and to limit the risk of fluid leakage or rupture of the exposed organs. We aimed to review our institutional prevalence, comorbidities, treatment and outcome of newborns with ACC. Methods We conducted a retrospective study including all newborns affected by ACC and …
LARGE FOR GESTATIONAL AGE, MACROSOMIA, OVERGROWTH: AN UPDATE ON DEFINITIONS AND DETERMINANTS
Human growth and development, starting from conception, are characterized by a progressive increase in body and organ dimensions, as well as specific functional maturity, under the influence of genetic as well as environmental and epigenetic determinants. Beyond a possible normal familial trait, increased fetal growth resulting in a large for gestational age newborn, isolated macrosomia or that associated with congenital malformation, can be attributable to both maternal metabolic and genetic pathology. Overgrowth syndromes are a heterogeneous group of diseases characterized by excessive tissue development often concomitant to neurodevelopmental involvement. Recently, an increased risk of f…
Il neonato ipossico
Rare chromosomal abnormalities: a mosaic of four cellular lines with two rings involving the chromosomes X and 21. First report in a male newborn patient
Congenital hypopituitarism and multiple midline defects in a newborn with non-familial Cat Eye syndrome
Abstract Background Cat eye syndrome (CES) is a rare chromosomal disease, with estimated incidence of about 1 in 100,000 live newborns. The classic triad of iris coloboma, anorectal malformations, and auricular abnormalities is present in 40% of patients, and other congenital defects may also be observed. The typical associated cytogenetic anomaly relies on an extra chromosome, derived from an inverted duplication of short arm and proximal long arm of chromosome 22, resulting in partial trisomy or tetrasomy of such regions (inv dup 22pter-22q11.2). Case presentation We report on a full-term newborn, referred to us soon after birth. Physical examination showed facial dysmorphisms, including …
Sorveglianza dello sviluppo in soggetti con anomalie del setto pellucido. descrizione di un caso con agenzia isolata.
malformazioni cerebrali, anomalie setto pellucido
Unusual paroxysmal autonomic manifestations in a 22 month old girl
10qter deletion: A new case
Vertebrate telomeres consist of tandem repeats of the TTAGGG sequence that cap the ends of chromosomes, protecting them from degradation and fusion. Extensive evidence has shown that telomere shortening and erosion lead lo chromo¬some end-to-end fusions and genomic instability, causing mental retardation and/or malformation syndromes. So far, over 19,000 patients with mental retardation have been tested and reported of whom -2.5% appeared to have a subtelomeric rearrange¬ment [Ravnan et al., 2006; Ballif et al., 2007; Ledbetter and Martin, 2007]. Since the identification of sub¬microscopic subtelomeric rearrangements as a major cause of mental retardation [Flint et al., 1995], testing for s…
Clinical and genetic approach in the characterization of newborns with anorectal malformation
Objective: This study aimed to investigate clinical, surgical, and genetic data of neonates with anorectal malformation (ARM). Study design: A retrospective observational study was conducted on neonates with ARM as an isolated type (group 1), with ≤2 (group 2), and with ≥3 associated malformations (group 3), born between 2009 and 2020. Distribution of ARM, associated abnormalities and genetic testing were analyzed, and risk factors for adverse outcomes were identified. Results: The 45 ARM cases (36% females) were divided as follows: 13 neonates belonging to group 1 (29%), 8 to group 2 (18%), and 24 to group 3 (53%). Cases were equally distributed over 11 years. Krickenbeck anatomy was: with…
Displasia setto-ottica,; descrizione di un caso ad esordio precoce.
FOLLOW-UP 2003-2008 DEI NATI VERY LOW BIRTH WEIGHT: ESITI NEUROLOGICI
PESCHIAMO NELLA RETE: ORPHANET
NF1 microdeletion syndrome: case report of two new patients
Abstract Background 17q11.2 microdeletions, which include the neurofibromatosis type 1 (NF1) gene region, are responsible for the NF1 microdeletion syndrome, observed in 4.2% of all NF1 patients. Large deletions of the NF1 gene and its flanking regions are associated with a more severe NF1 phenotype than the NF1 general population. Case presentation We hereby describe the clinical and molecular features of two girls (aged 2 and 4 years, respectively), with non-mosaic atypical deletions. Patient 1 showed fifteen café-au-lait spots and axillary freckling, as well as a Lisch nodule in the left eye, strabismus, high-arched palate, malocclusion, severe kyphoscoliosis, bilateral calcaneovalgus fo…
Displasia setto-ottica: descrizione di un caso con progressivo deterioramento dei PEV
Characterization of a complex rearrangement involving chromosomes 1, 4 and 8 by fish and array-CGH
Complex chromosomal rearrangements (CCRs) are structural aberrations involving more than two chromosomes with at least three breakpoints. CCRs can be divided into familial and de novo. Balanced CCR are extremely rare in humans and are at high risk of producing unbalanced gametes. Individuals with balanced CCR are usually phenotipically normal but report fertility problems, recurrent miscarriages or congenital anomalies in newborn offsprings as consequence of either meiotic failure or imbalanced chromosomes segregation.We describe the case of an unbalanced CCR involving chromosomes 1, 4 and 8 found in a girl with developmental delay, hexadactilia and microcephaly. The rearrangement, apparent…
Six patients with Pro250Arg mutation in FGFR3 in a family with coronal craniosynostosis: Intrafamilial variability and clinical management
Clinical and molecular characterization of 112 single-center patients with Neurofibromatosis type 1.
Abstract Background The aim of this retrospective study was to define clinical and molecular characteristics of a large sample of neurofibromatosis type 1 (NF1) patients, as well as to evaluate mutational spectrum and genotype-phenotype correlation. NF1 is a relatively common neurogenetic disorder (1:2500–1:3000 individuals). It is caused by mutations of the NF1 gene on chromosome 17ql1.2, with autosomal dominant pattern of inheritance and wide phenotypical variability. Café-au-lait spots (CALs), cutaneous and/or subcutaneous neurofibromas (CNFs/SCNFs), skinfold freckling, skeletal abnormalities, Lisch nodules of the iris and increased risk of learning and intellectual disabilities, as well…
Le problematiche IUGR nei gemelli
Intrauterin Growth Retardation is more common among twins than singleton. The reduction of intrauterine enviroment and level of transplacental diffusion of nutrients are main responsible factors. Moreover, anastomosis of vessels between the arterial and venous systems of twins may induce a different irroration and a discordance of growth. Levels of discordane greater than 25% between twin may be associated with a twin¬twin transfusion syndrome, in which the donor is pale and ischemic and the recipient shows hemodynamic troubles within the spectrum of a hyperviscosity syn¬drome. These twins show an additional risk of morta¬lity and morbidity with respect to singleton and con¬cordant twins. T…
IX SINDROME DI RETT DA AMPIA DELEZIONE DEL GENE MeCP2.
Grave ipotonia neonatale con artrogriposi: descrizione di un caso clinico e problematiche diagnostiche
KANGAROO MOTHER CARE UNA GUIDA PRATICA
Epilessia temporale e manifestazioni parossistiche neurovegetative in età prescolare: descrizione di un caso clinico emblematico
Perlman syndrome: Clinical report and nine-year follow-up
We present the clinical and follow-up data of a female infant with Perlman syndrome from birth to the age of 9 years. Main features of Perlman syndrome include polyhydramnios, fetal overgrowth, neonatal macrosomia, macrocephaly, dysmorphic facial features, visceromegaly, nephroblastomatosis, and a predisposition for Wilm's tumor. In our patient, the nephromegaly with nephroblastomatosis was not present at birth or during the neonatal period; it became evident in the first months of postnatal life. A Wilm's tumor was diagnosed when she was about 1 year old. Long term follow-up documents the natural history of Perlman syndrome and allows us to establish the long-term prognosis of the affected…
Mild twin–twin transfusion syndrome: Clinical report.
Marker cromosomico soprannumerario: iso 18p
Sindrome di Rett da ampia delezione del gene MeCP2
Riarrangiamento cromosomico subtelomerico Del 10Q25: descrizione di un caso con elevata espressività clinica.
PEV da flash a luce bianca,gialla,rossa, blu e verde in neonati a termine e pretermine. Utilità per un migliore studio della maturazione cerebrale
Rara aneuploidia cromosomica, trisomia parziale 14 (q24.3_ter) de novo
Growth charts of Down syndrome in Sicily: evaluation of 382 children 0-14 years of age.
We present the results of a study performed on a Sicilian population of children with Down syndrome (DS) 0–14 years of age, observed between 1977 and 1988. Data from the present report concern 382 subjects with nonmosaic 21 trisomy, including 239 males (62.6%) and 143 females (37.4%). We excluded all DS children observed in the same period with associated pathology (congenital heart defects, gastrointestinal malformations, malabsorption, hypothyroidism, and thalassemia). Overall, 1,464 measurements were performed of length or height, weight, and head circumference. Means and standard deviation (SD) were calculated for all of these parameters. Our data confirm a trend toward a progressive im…
Sindrome di Down da duplicazione della regione critica 21q22.2-q22.3
Autostima,sensation seeking e impulsività nell'uso problematico delle nuove tecnologie in adolescenza
Spontaneous Resorption of an Occipital Meningocele: Computed Tomography and Magnetic Resonance Imaging Evaluation
Cranial meningocele is a very rare variant of encephalocele. Meningocele can be associated with other disorders and may cause complications. Therapy is usually based on surgical treatment. To our knowledge, we describe the first case of spontaneous resorption of an occipital meningocele in a full-term newborn boy. A full-term newborn was noted to have a large non-skin covered, semitransparent cystic lump in the occipital bone. He underwent computed tomography and a diagnosis of meningocele was proposed. After a few hours, the cystic lump spontaneously readsorbed. After 1 week the patient underwent magnetic resonance. Histology confirmed the diagnosis.
Potenziali Evocati Visivi precoci in tre soggetti con sindrome di Apert
Diagnosi precoce di disabilità intellettiva sindromica
delezione 17p11.2, Sindrome di Smith-Magenis, anomalie congenite multiple
Intrauterine growth pattern and birthweight discordance in twin pregnancies: a retrospective study
Background: Twins, compared to singletons, have an increased risk of perinatal mortality and morbidity, due mainly to a higher prevalence of preterm birth and low birthweight. Intrauterine growth restriction (IUGR) is also common and can affect one or both fetuses. In some cases, however, one twin is much smaller than the other (growth discordance). Usually, high birthweight discordance is associated with increased perinatal morbidity. The aim of this study is to describe the epidemiological features of a population of twins at birth, with particular reference to the interpretation and clinical effects of birthweight discordance. Methods: We evaluated retrospectively the clinical features o…
MOESM1 of NF1 microdeletion syndrome: case report of two new patients
Additional file 1. Timelines of the clinical cases.
Sindrome di Pfeiffer: identificazione di una nuova mutazione nel gene FGFR2.
Infarto cerebrale in nato a termine:esiti a 12 mesi
Sindrome da duplicazione 1q21: variabile penetranza ed espressività clinica intrafamiliare di un riarrangimento genomico di circa 6 Mb non precedentemente descritto
Sindrome da duplicazione 1q21, riarrangimento genomico
The Bayley II test for assessing newborns at risk. Study based on samples of premature children without brain disorders and not premature children with brain damage:posssible correlations with the ADHD syndrome
IRSUTISMO SEVERO IN SINDROME DI KABUKI: DESCRIZIONE DI UN CASO
Diabete insipido centrale da idrocefalo congenito in un neonato di genitori immigrati
Congenital hepatic mesenchymal hamartoma associated with mesenchymal stem villous hyperplasia of the placenta: case report.
A newborn with an unusual association of hepatic mesenchymal hamartoma and mesenchymal stem villous hyperplasia of the placenta is presented. At birth, the large hepatic mass caused severe respiratory distress necessitating early surgical intervention. This report on the association of hepatic mesenchymal hamartoma and mesenchymal stem villous hyperplasia of the placenta strongly suggests a common pathogenetic origin of the 2 lesions.
Clinical cardiac assessment in newborns with prenatally diagnosed intrathoracic masses
Abstract Background Congenital space-occupying thoracic malformations and diaphragmatic hernia have in common pulmonary hypoplasia. Our study aims to assess cardiac involvement during post-natal adaptation. Methods A retrospective study was carried out on newborns with prenatally diagnosed intrathoracic mass. Gathering for respiratory distress syndrome (RDS), 35 neonates were compared for clinical course, cardiovascular enzymes, ECG, and ultrasound. Results The analysis revealed a high left heart defect rate in patients with severe RDS, without being influenced by the laterality. Ultrasound or laboratory assessment did not detect altered cardiac dimension or cardiomyopathy. Solely ECG signs…
Gestione pre eperinatale della malformazione adenoido-cistica polmonare congenita
Methemoglobinemia Associated with Late-Onset Neonatal Sepsis: A Single-Center Experience
Objective Methemoglobinemia (MetHb) is a rare congenital or acquired cause of infantile cyanosis. We examined the role of MetHb in a neonatal intensive care unit (NICU). Study Design A retrospective observational study was conducted reviewing blood gas analyses of hospitalized newborns over a 2-year period. MetHb-positive patients (MetHb >1.8%) were matched with a control group for gestational age, weight, disease, and illness severity at admission. Maternal, neonatal, clinical, and laboratory parameters were collected and analyzed in both groups. Results MetHb incidence was 6%. The mean MetHb in the case group was 7.2%, and the first positive samples were observed at a mean of 22 days …
Management of multiple pregnancy with an affected twin
Newborns from multiple pregnancies demonstrate a higher perinatal morbidity and mortality compared to singletons. Prematurity is more frequent in twins and therefore birth weight is significantly lower compared to singletons [1]. Thus, twins are more exposed to prema- turity related diseases (respiratory, cardiovascular, infec- tious, etc.) and to long-term complications [2]. It is very difficult to estimate the increased risk of neonatal mor- bidity related to twinning independently to the increased risk of prematurity. Prematurity is the main reason for most neonatal diseases in twins, but other variables may play a role. Fetal growth restriction [3] and congenital malformationsare major …
SINDROME DA MICRODELEZIONE 17q21.31: DESCRIZIONE DI UN CASO CON ELEVATA ESPRESSIVITA' CLINICA
La sr da microdelezione 17q21.31(prevalenza 1:16.000)è un disordine genomico di recente identificazione.I segni clinici comprendono: ritardo mentale e di sviluppo, ipotonia, dismorfismi faciali, voce nasale, dita affusolate, cardiopatia, anomalie cerebrali, convulsioni, anomalie renali ed urogenitali, iperlassità articolare, ipoacusia trasmissiva, anomalie dentarie, deformità del piede e della colonna, strabismo e ipermetropia.La diagnosi è confermata dal riscontro,all’analisi molecolare,della delezione della regione critica, che si estende per 424 kb in 17q21.31 ed include almeno sei geni, tra cui MAPT, altamente espresso nell’encefalo e coinvolto in numerose patologie neurodegenerative. D…
Sindrome del 13q intervento comportamentale e relazionale
Distal Arthrogryposis type 5 in an Italian family due to an autosomal dominant gain-of-function mutation of the PIEZO2 gene
Abstract Background Arthrogryposis multiplex congenita (AMC) is a group of clinically and etiologically heterogeneous conditions, characterized by prenatal onset contractures affecting two or more joints. Its incidence is about 1 in 3000 live births. AMC may be distinguished into amyoplasia, distal and syndromic arthrogryposis. Distal arthrogryposis (DA) predominantly affects hands and feet. It is currently divided into more than ten subtypes (DA1, DA2A/B, DA3–10), based on clinical manifestations, gene mutations and inheritance pattern. Among them, only a few patients with DA5 have been reported. It is associated to a gain-of-function pathogenic variant of the PIEZO2 gene, encoding for an …
Oloprosencefalia semilobare: aspetti elettroencefalografici
oloprosoencefalia,
POTENZIALI EVOCATI VISIVI (PEV) IN NEONATI DA GRAVIDANZA PLURIMA: RELAZIONE CON LA DISCORDANZA IN PESO (AGA VS SGA)
Premessa: I PEV consentono di valutare nel neonato lo sviluppo delle vie ottiche e del SNC. Un ritardo della maturazione morfologica del tracciato, una marcata riduzione di ampiezza, o un significativo aumento di latenza delle principali componenti è frequente in neonati con encefalopatia ipossico ischemica od emorragica, o affetti da patologia cerebrale sia congenita che secondaria a grave compromissione sistemica. Nelle gravidanze plurime è frequente il rilievo di una discordanza per il peso alla nascita (neonati AGA e SGA). Obiettivo: Valutare in un campione selezionato costituito da nati da gravidanza plurima, prevalentemente pretermine e con assenza di fattori di rischio perinatali per…
NEUROFIBROMATOSI TIPO 1 E TUMORI INFANTILI OSSERVAZIONI SU 9 CASI
La neurofibromatosi 1 in età evolutiva: contributo casistico e revisione clinica
Benign familial infantile epilepsy associated with KCNQ3 mutation: a rare occurrence or an underestimated event?
Abstract Benign familial infantile epilepsy (BFIE) is the most genetically heterogeneous phenotype among early-onset familial infantile epilepsies. It has an autosomal dominant inheritance pattern with incomplete penetrance. Although PRRT2 is the most mutated gene detected in families with BFIE, other mutations in KCNQ2, SCN2A, and GABRA6 genes have also been described. To date, KCNQ3 mutations have been detected in only four patients with BFIE. Here, we describe the clinical pattern and course of an additional individual with BFIE associated with a novel missense heterozygous KCNQ3 c.1850G>C variant inherited by his unaffected father. The incidence of KCNQ3 mutations among BFIE patients…
FOLLOW-UP DI SVILUPPO NEUROPSICOMOTORIO E CORRELAZIONI CON IL PONDERAL INDEX IN UN CAMPIONE DI NEONATI LATE PRETERM
late preterm, sviluppo neuropsicomotorio, ponderal index
Patologia cromosomica rara:47,XXX / 48 XXXX.
MACROCEPHALY FROM A NORMAL VARIANT TO A THREATENING CONDITION. A SINGLE CENTER RETROSPECTIVE STUDY ON 189 SUBJECTS
Introduction: Macrocephaly, defined as a head circumference more than two standard deviations from the normal distribution, is among the most frequently requested neuropediatric consultations. Materials: we conducted a retrospective study on 189 subjects with macrocephaly, from birth to 18 years old, enrolled from October 2001 to December 2019, for diagnostic definition and/or neurodevelopmental assessment. Brain sonography has been performed in all infants and CT or MR in selected patients. Results: macrocephaly was prevalent in males (62.4%), a head circumference >3SD (8.5%) has been associated with a neurodevelopmental impairment. A genetic and/or concomitant malformation were present…
INTELLECTUAL DISABILITY, EPILEPSY AND MILD DYSMORPHISMS DUE 22q11.2 DISTAL DUPLICATION: CLINICAL AND MOLECULAR CHARACTERIZATION OF A 0.5 Mb MINIMAL CRITICAL REGION
INTELLECTUAL DISABILITY, EPILEPSY, MILD DYSMORPHISMS, 22q11.2 DISTAL DUPLICATION
Interstitial deletion of chromosome 2p15-16.1: Report of two patients and critical review of current genotype–phenotype correlation
Abstract We report two individuals with developmental delay and dysmorphic features, in whom array-based comparative genomic hybridization (array CGH) led to the identification of a 2p15p16.1 de novo deletion. In the first patient (Patient 1) a familial deletion of 6q12, inherited from her father, was also detected. In the second patient (Patient 2) in addition to the 2p15p16.1 microdeletion a de novo deletion in Xq28 was detected. Both individuals shared dysmorphic features and developmental delay with the six reported patients with a 2p15p16.1 microdeletion described in medical literature. Conclusion: in the first patient a 642 kb 2p16.1 deletion (from 60.604 to 61.246 Mb), and a 930 kb 6…
Osservazioni cliniche su due coppie di gemelli monozigotici discordanti per la presenza di anencefalia
Congenital heart defects in newborns with apparently isolated single gastrointestinal malformation: A retrospective study.
Abstract Background Congenital gastrointestinal system malformations/abdominal wall defects (GISM) may appear as isolated defects (single or complex), or in association with multiple malformations. The high incidence of association of GISM and congenital heart defects (CHD) in patients with syndromes and malformative sequences is known, but less expected is the association of apparently isolated single GISM and CHD. The aim of this study was to investigate the frequency of CHD in newborns with isolated GISM, and the possibility to modify the diagnostic-therapeutic approach just before the onset of cardiac symptoms or complications. Methods Anamnestic, clinical, and imaging data of newborns …
DYKE DAVIDOFF MASSON SYNDROME:PROFILO DI SVILUPPO NEURO-COGNITIVO A 4 ANNI IN UN PAZIENTE CON DIAGNOSI IN EPOCA NEONATALE
ipoplasia emisferica, DDMS, dilatazione ventricolare
Infant developmental profile of Crisponi syndrome due to compound heterozygosity for CRLF1 deletion.
Crisponi syndrome/CISS1, is an autosomal recessive ciliary neurotrophic factor receptor (CNTFR)-related genodermatosis caused in 95% of cases by mutations in CRLF1 on chromosome 19p13. The CNTFR pathway is important for CNS development. Crisponi syndrome/ CISS1 can be suspected in the presence of the following clinical triad: camptodactyly with fisted hands, intermittent hyperthermia and muscular contractions with feeding difficulties.
Diagnosis and follow-up of complex congenital malformations/mental retardation (MRA/MR)
Complex congenital malformations, associated in 30% of cases with mental retardation, recognize different etiologies: environmental causes, mendelian disease, chromosomal abnormalities, imprinted anomalies. Frequently complex congenital disorders are rare diseases. Rare diseases are infrequent pathological conditions (prevalence in the general population of less than 1/2.000 live births1), and often poorly understood. Because of their rarity these morbid conditions often either go undiagnosed or are diagnosed late with a negative impact for both the affected person and the family. The birth prevalence is high (2-4% of all births). The diagnosis is essential to program complex and integrated…
Malformations of central nervous system: General issues
Malformations of the central nervous system (CNS) encompass a heterogeneous group of congenital anomalies that may be isolated or appear as part of a genetic syndrome. Advances in identifying the genetic etiology underlying many CNS malformation and syndromes have led to the current genetic-based classifications that allows us to better estimate prognosis and potential complications. Herein, we discuss the main genetic, clinical and radiological features and their implications for diagnostic testing and disease management
Germinal matrix hemorrhage-intraventricular hemorrhage: pathogenesis and outcomes
Germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) is one of the CNS injuries affecting preterm infants occurring in about 15%-20% of subjects weighing less than 1500 g. Currently, using ultrasonography, we recognize three grades of GMH-IVH. Grade I involving the subependymal parenchyma and/or extending in less than 10% of the ventricle, grade II with intraventricular bleeding not expanding in more than 50% of the ventricle, grade III characterized by consistent (> 50%)intraventricu- lar bleeding with ventricular dilatation. A concomitant intraparenchymal lesion (IPL), due to a venous infarction (ex grade IV), can be associated with any grade of IVH, worsening the prognosis. P…
Dilated azygos arch mimicking an aortic arch anomaly during thoracic surgery
Cardiovascular malformations are frequently associated in patients with esophageal atresia (EA). We observed azygos continuation mimicking an aortic arch anomaly in four newborns with type III EA. They presented concomitant rib anomalies indicating a common developmental defect. Foreknowledge is important for planning thoracotomy or interventional cardiac catheterization in this population.
Effetti a breve termine del Diabate Mellito Materno sulla maturazione ossea
Neonatal hyperinsulinemic hypoglycemia: case report of kabuki syndrome due to a novel KMT2D splicing-site mutation
Abstract Background Persistent neonatal hypoglycemia, owing to the possibility of severe neurodevelopmental consequences, is a leading cause of neonatal care admission. Hyperinsulinemic hypoglycemia is often resistant to dextrose infusion and needs rapid diagnosis and treatment. Several congenital conditions, from single gene defects to genetic syndromes should be considered in the diagnostic approach. Kabuki syndrome type 1 (MIM# 147920) and Kabuki syndrome type 2 (MIM# 300867), can be associated with neonatal hyperinsulinemic hypoglycemia. Patient presentation We report a female Italian (Sicilian) child, born preterm at 35 weeks gestation, with persistent hypoglycemia. Peculiar facial dys…
Arteria ombelicale unica (AOU): un marker di anomalie congenite
Growth patterns and associated risk factors of congenital malformations in twins.
AbstractBackgroundThe rate of twinning continues to increase due to the combined effect of a rise in parental age and increased use of assisted reproductive technology. The risk of congenital anomalies in twins is higher than in singletons, but it is less well reported in relation to growth patterns. We focused to the auxological outcome of twin pregnancies when one or both of twins are affected by one or more malformations.MethodsWe conducted a retrospective observational study reviewing the clinical charts of twins admitted in the period between January 2003 and December 2018 at the University Hospital of Palermo. The associations between malformations and anthropometric variables at birt…
IL NEONATO IPOTONICO: DIAGNOSTICA DI LABORATORIO
Diastematomelia:descrizione di un caso con quadro clinico peculiare
Transitional hemodynamics in infants of diabetic mothers by targeted neonatal echocardiography, electrocardiography and peripheral flow study
Objective: Metabolic alterations of intrauterine environment in diabetes mellitus (DM) lead to fetal cardiac dysfunctions that can persist after birth. The aim of the study was to assess the cardiovascular adaptation in infants born to diabetic mothers (IDM) with different degrees of glycometabolic control, in relation to revised guidelines for diagnosis of DM and quality improvements in neonatal care. Materials and methods: An observational case-control study was conducted on IDM with gestational, type 1 and type 2âDM. Relevant maternal and neonatal anamnestic, clinical and laboratory data were analyzed. Electrocardiographic and echocardiographic analyses, including structural and systo-…
Dyke-Davidoff-Masson syndrome: case report of fetal unilateral ventriculomegaly and hypoplastic left middle cerebral artery
Prenatal ultrasonographic detection of unilateral cerebral ventriculomegaly arises suspicion of pathological condition related to cerebrospinal fluid flow obstruction or cerebral parenchimal pathology. Dyke-Davidoff-Masson syndrome is a rare condition characterized by cerebral hemiatrophy, calvarial thickening, skull and facial asymmetry, contralateral hemiparesis, cognitive impairment and seizures. Congenital and acquired types are recognized and have been described, mainly in late childhood, adolescence and adult ages. We describe a female infant with prenatal diagnosis of unilateral left ventriculomegaly in which early brain MRI and contrast enhanced-MRI angiography, showed cerebral left…
Newborn screening of inherited metabolic disorders by tandem mass spectrometry: past, present and future
Inborn errors of metabolism are inherited biochemical disorders caused by lack of a functional enzyme, transmembrane transporter, or similar protein, which then results in blockage of the corresponding metabolic pathway. Taken individually, inborn errors of metabolism are rare. However, as a group these diseases are relatively frequent and they may account for most of neonatal mortality and need of health resources. The detection of genetic metabolic disorders should occur in a pre-symptomatic phase. Recently, the introduction of the tandem mass spectrometric methods for metabolite analysis has changed our ability to detect intermediates of metabolism in smaller samples and provides the mea…
Follow-Up to Ensure Continuity of Care and Support Preventive Care
Over the last decades, the prevalence of chronic health conditions and disabilities among children rose steadily, thanks to medical advances in both treating the primary condition and managing its complications. The improved long-term survival rates led to persistently high rates of pediatric chronic health conditions, which are often burdened with limitation in daily activity and dependence on medication, special diets, medical technology, assistive devices, and specialized staff. Therefore, children with complex chronic conditions are a frail population who generally need healthcare services beyond what is usual for healthy children. Indeed, their health issues often require specialized a…
Sindrome di Smith Magenis da delezione 17 q 11.2: descrizione di un caso ad elevata espressività clinica
FETAL GROWTH RESTRICTION: A GROWTH PATTERN WITH FETAL, NEONATAL AND LONG-TERM CONSEQUENCES
Fetal growth restriction (FGR) or intrauterine growth restriction (IUGR) are the terms used for a fetus which has not attained its full growth potential for gestational age. FGR is a multifactorial syndrome responsible for increased fetal and neonatal morbidity and mortality as well as long term adverse outcomes involving auxological, metabolic, organic and functional domains. Clinicians distinguish early and late onset FGR, in relation to specific fetal anthropometric parameters related to the possible primary etiology and to different patterns of placental and maternal cardiovascular pathologies. Delivery of an early onset FGR or growth impaired newborn with congenital pathology should be…
Encefalopatia neonatale e disfunzione multiorgano, considerazioni eziologiche e correlati clinici. Valutazione di una casistica
encefalopatia neonatale, disfunzione multiorgano
SINDROME DI APERT, SVILUPPO NEUROPSICOMOTORIO E FUNZIONE VISIVA: FATTORI DI RISCHIO PROGNOSTICO IN TRE PAZIENTI
Premessa: La sindrome di Apert, è causata da mutazione (Pro253Arg e Ser253Trp) a livello dell’esone 8 del gene FGFR2 (10q26). Tra i fattori di rischio in termini di prognosi evolutiva si annoverano il tipo di mutazione (1), la presenza di anomalie dello sviluppo cerebrale, la prematurità, la sofferenza cerebrale perinatale, lo stato di ossigenazione, la strategia e i tempi di intervento neurochirurgico e correttivo. Obiettivi: Valutare in soggetti con S. di Apert la correlazione tra fattori di rischio e lo sviluppo neuropsicomotorio e neurosensoriale visivo. Metodologia:Tre soggetti con diversa combinazione dei fattori di rischio, sono stati valutati con potenziali evocati visivi da flash (…
DIABETE INSIPIDO E PANIPOPITUITARISMO IN IDROCEFALO CONGENITO: DESCRIZIONE DI UN CASO
Paternal uniparental disomy chromosome 14-like syndrome due a maternal de novo 160 kb deletion at the 14q32.2 region not encompassing the IG- and the MEG3-DMRs: Patient report and genotype-phenotype correlation.
The human chromosome 14q32 carries a cluster of imprinted genes which include the paternally expressed genes (PEGs) DLK1 and RTL1, as well as the maternally expressed genes (MEGs) MEG3, RTL1as, and MEG8. PEGs and MEGs expression at the 14q32.2-imprinted region are regulated by two differentially methylated regions (DMRs): the IG-DMR and the MEG3-DMR, which are respectively methylated on the paternal and unmethylated on the maternal chromosome 14 in most cells. Genetic and epigenetic abnormalities affecting these imprinted gene clusters result in two different phenotypes currently known as maternal upd(14) syndrome and paternal upd(14) syndrome. However, only few patients carrying a maternal…
Microvillous Inclusion Disease in a newborn with positive family history of intractable diarrhoea
Congenital diaphragmatic hernia and esophageal atresia: The importance of respiratory follow-up in congenital thoracic malformations
Esophageal atresia, congenital diaphragmatic hernia, pulmonary function test, respiratory morbidity, Long-term follow-up
Sindrome di Aicardi: correlati elettroclinici e follow-up in un caso con associate multiple anomalie cerebrali.
Additional file 1 of Autosomal recessive polycystic kidney disease: case report of a newborn with rare PKHD1 mutation, rapid renal enlargement and early fatal outcome
Additional file 1.
LO SCREENING DI SVILUPPO
Un ritardo globale dello sviluppo si manifesta nel 1-3% dei bambini ed una disabilità dello sviluppo è presente nel 5-10% dei bambini (Shevell et al., 2003), di questi si stima che solo il 50% sia corretta¬mente identificato entro i 5 anni e la American Academy of Pediatrics sottolinea la necessità di una identificazione precoce (entro i due anni) (AAP Committee on children with disabilities, 2001) La valutazione dello sviluppo rientra tra i compiti assistenziali del pediatra e lo strumento ottimale per una corretta valutazione di svilup¬po è un test di screening validato per la popolazione in esame. Un valido test di screening deve essere dotato di una elevata sensibilità (capacità di iden…
Novel missense mutation of the TP63 gene in a newborn with Hay-Wells/Ankyloblepharon-Ectodermal defects-Cleft lip/palate (AEC) syndrome: clinical report and follow-up.
Abstract Introduction Ankyloblepharon-ectodermal defects-cleft lip/palate (AEC) syndrome, also known as Hay-Wells syndrome, is a rare genetic syndrome with ectodermal dysplasia. About 100 patients have been reported to date. It is associated to a heterozygous mutation of the tumor protein p63 (TP63) gene, located on chromosome 3q28. Typical clinical manifestations include: filiform ankyloblepharon adnatum (congenital adherence of the eyelids), ectodermal abnormalities (sparse and frizzy hair, skin defects, nail alterations, dental changes and hypohidrosis), and cleft lip/palate. Diagnostic suspicion is based on clinical signs and confirmed by genetic testing. Patient’s presentation We hereb…
Type and counter-type from specific chromosomal regions
Several studies have shown the importance of segmental deletions/duplications in the field of chromosome pathologies. Non allelic homologous recombination, NAHR, between chromosomes or sister chromatids, mediated by segmental duplications, is the foundation of frequent mechanisms for structural chromosome mutations such as micro-deletions, micro-duplications, translocations, inversions, and marker chromosomes. We analyzed three distinct genomic regions (22q11.2, 17p11.2, 16p11.2) and we discussed how the same chromosome region can be affected by deletion or by reciprocal duplication, respectively responsible for a syndrome or for a reciprocal counter-syndrome, with different phenotypic mani…
Hypertrophic pyloric stenosis masked by kidney failure in a male infant with a contiguous gene deletion syndrome at Xp22.31 involving the steroid sulfatase gene: case report
Abstract Background Contiguous gene deletion syndrome at Xp22.3 resulting in nullisomy in males or Turner syndrome patients typically encompasses the steroid sulfatase gene (STS) and contiguously located other genes expanding the phenotype. In large deletions, that encompass also the Kallmann syndrome 1 gene (KAL1), occasionally infantile hypertrophic pyloric stenosis (IHPS) and congenital anomalies of the kidney and urinary tract (CAKUT) have been reported. Patient presentation We report on a male newborn with family history in maternal uncle of renal abnormalities and short stature still without ichthyosiform dermatosis. The baby presented CAKUT with kidney failure and progressive vomitin…
Total colonic aganglionosis and cleft palate in a newborn with Janus-cysteine 618 mutation of RET proto-oncogene: a case report.
Abstract Background Hirschsprung disease, the most important congenital colonic dysmotility in children results from neural crest migration, differentiation, proliferation, or apoptosis defects where the rearranged during transfection (RET)-Protooncogene pathway has a central role. Although palatal and retinal anomalies in the context of chromosomopathies and some mono−/oligogenic syndromes are reported associated with Hirschsprung disease the role of inactivating RET mutations in these cases is not clarified. Case presentation We report on a dysmorphic newborn with cleft palate and palatal synechia, who showed intestinal obstruction after 24 h of life. Transient ileostomy and surgical biop…
Disturbo di regolazione in un campione a rischio: risultati di una intervista di screening ai genitori.
An acute headache due a nodulary swell- ing of the skull
Novel de novo missense mutation in the interferon regulatory factor 6 gene in an Italian infant with IRF6-related disorder
Abstract Background Congenital maxillomandibular syngnathia is a rare craniofacial anomaly leading to difficulties in feeding, breathing and ability to thrive. The fusion may consist of soft tissue union (synechiae) to hard tissue union. Isolated cases of maxillomandibular fusion are extremely rare, it is most often syndromic in etiology. Case presentation Clinical management of a female newborn with oromaxillofacial abnormities (synechiae, cleft palate, craniofacial dysmorphisms, dental anomaly) and extraoral malformations (skinfold overlying the nails of both halluces, syndactyly, abnormal external genitalia) is presented. The associated malformations addressed to molecular genetic invest…
LONG GAP ESOPHAGEAL ATRESIA AND ASSOCIATED ANOMALIES ATRESIA ESOFAGEA “LONG GAP” ED ANOMALIE ASSOCIATE
Patients with long gap esophageal atresia are often managed with gastrostomy and tube drainage of the proximal pouch, despite the high risk of aspiration and nosocomial infections. Long gap esophageal atresia has been reported in the presence of congenital anomalies, most often within the spectrum of the VACTERL association. We report on three preterm newborns in whom the association of long gap esophageal atresia, prematurity and congenital anomalies led to a significant reduction of the patients' life span, amplifying many clinical problems. Patients with long gap esophageal atresia are often managed with gastrostomy and tube drainage of the proximal pouch, despite the high risk of aspira…
Cardio-facio-cutaneous syndrome and gastrointestinal defects: report on a newborn with 19p13.3 deletion including the MAP 2 K2 gene
Abstract Background Cardio-facio-cutaneous syndrome (CFCS) belongs to RASopathies, a group of conditions caused by mutations in genes encoding proteins of the rat sarcoma/mitogen-activated protein kinase (RAS/MAPK) pathway. It is a rare syndrome, with about 300 patients reported. Main clinical manifestations include facial dysmorphisms, growth failure, heart defects, developmental delay, and ectodermal abnormalities. Mutations (mainly missense) of four genes (BRAF, MAP 2 K1, MAP 2 K2, and KRAS) have been associated to CFCS. However, whole gene deletions/duplications and chromosomal microdeletions have been also reported. Specifically, 19p13.3 deletion including MAP 2 K2 gene are responsible…
The social role of pediatrics in the past and present times.
AbstractPediatrics and society are closely related. This link is as old as the history of Pediatrics, and dates to the second half of the eighteenth century. The vocation of the first European pediatric schools, indeed, was clinical and scientific, as well as social. The founding fathers of Pediatrics were scientists of great talent, and many of them benefactors and philanthropists. They spent their lives assisting the suffering childhood, and became promoters and organizers of social securities for the poorest and most vulnerable categories. The attention to the problems of abandonment was closely linked to study, prevention, and treatment of pathologies (especially infectious, deficiency …
Delayed neonatal visual evoked potentials are associated to asymmetric growth pattern in twins
Abstract Objectives To study the association between intrauterine growth and visual pathways maturation by neonatal visual evoked potentials (VEPs) in twins, in view of a possible prognostic role. Methods Seventy-four twin neonates from 37 pregnancies were selected based on gestational age of more than 30 weeks and uneventful perinatal clinical course. Flash VEPs were recorded at the same postmenstrual age in each twin pair. The association between P2 latency and anthropometric variables at birth was analyzed by comparison within each twin pair and regarding each variable as ordered difference between the two twins. Results Analysis of differences within each twin pair highlighted that inte…
UNA NUOVA MUTAZIONE DEL GENE CREBBP IN UN BAMBINO CON SINDROME DI RUBINSTEIN TAYBI
Novel LRPPRC compound heterozygous mutation in a child with early-onset Leigh syndrome French-Canadian type: Case report of an Italian patient
Abstract Background Mitochondrial diseases, also known as oxidative phosphorylation (OXPHOS) disorders, with a prevalence rate of 1:5000, are the most frequent inherited metabolic diseases. Leigh Syndrome French Canadian type (LSFC), is caused by mutations in the nuclear gene (2p16) leucine-rich pentatricopeptide repeat-containing (LRPPRC). It is an autosomal recessive neurogenetic OXPHOS disorder, phenotypically distinct from other types of Leigh syndrome, with a carrier frequency up to 1:23 and an incidence of 1:2063 in the Saguenay-Lac-St Jean region of Quebec. Recently, LSFC has also been reported outside the French-Canadian population. Patient presentation We report a male Italian (Sic…
The world of twins: an update
In last years, owing to the widespread availability of assisted-reproduction technology, multiple pregnancy rates in Western countries have increased. In twin pregnancies, an increased rate of gestational complications, intrauterine growth restriction (IUGR), preterm birth and severe perinatal conditions is present. These complications are more frequent in monozygotic twins compared to dizygotic twins as well as an increased relative risk of chromosomal abnormalities and congenital malformation. Monochorionic twins are at higher risk for complications, since they share a common placenta where an imbalance in unidirectional arteriovenous anastomoses can lead to twin#x2013;twin transfusion sy…
Sciwora con mioclono spinale.Descrizione di un caso in età adolescenziale
Macrocefalia: analisi dei fattori predittivi di compromissione dello sviluppo neuropsicomotorio in un campione selezionato di 22 casi.
Developments in pediatrics in 2020: choices in allergy, autoinflammatory disorders, critical care, endocrinology, genetics, infectious diseases, microbiota, neonatology, neurology, nutrition, ortopedics, respiratory tract illnesses and rheumatology
AbstractIn this article, we describe the advances in the field of pediatrics that have been published in the Italian Journal of Pediatrics in 2020. We report progresses in understanding allergy, autoinflammatory disorders, critical care, endocrinology, genetics, infectious diseases, microbiota, neonatology, neurology, nutrition, orthopedics, respiratory tract illnesses, rheumatology in childhood.
Cutis verticis gyrata and Noonan syndrome: report of two cases with pathogenetic variant in SOS1 gene
Abstract Background Noonan and Noonan-like syndromes are multisystem genetic disorders, mainly with autosomal dominant trasmission, caused by mutations in several genes. Missense pathogenetic variants of SOS1 gene are the second most common cause of Noonan syndrome (NS) and account approximately for 13% to 17% of cases. Subjects carrying a pathogenetic variant in SOS1 gene tend to exhibit a distinctive phenotype that is characterized by ectodermal abnormalities. Cutis verticis gyrata (CVG) is a rare disease, congenital or acquired, characterized by the redundancy of skin on scalp, forming thick skin folds and grooves of similar aspect to cerebral cortex gyri. Several references in the liter…