Lahmar-Boufaroua Ahlem, Yacoubi Mohamed Tahar, Belaid Leila, Delezoide Anne Lize
Department of Pathology, Farhat Hached Hospital, Sousse, Tunisia.
Fetal Diagn Ther. 2009;25(2):216-9. doi: 10.1159/000214860. Epub 2009 Apr 29.
Several different types of lethal short-limbed skeletal dysplasia with platyspondylia have been recognized with a different mode of inheritance. Schneckenbecken dysplasia, a very rare lethal osteochondrodysplasia, is included in these entities, with an autosomal recessive mode of inheritance. We describe 4 new Tunisian cases with clinical, radiographic and histopathological features. The fetuses were of consanguineous parents. Prenatal diagnostics of short limbs were carried out on ultrasounds at 20, 22, 23 and 28 weeks of gestation. The radiographic findings were typical, showing especially the small ilia with medial snail-like projection. The chondro-osseous histology of the 4 cases was compatible with the diagnostics demonstrating cartilage anomalies characterized by hypercellularity, hypervascularisation and chondrocytes with central large round nucleus. Schneckenbecken dysplasia should be considered when the phenotype of dwarfism and snail feature of iliac bone associated with histological finding are presented. Frozen fetal samples should be taken in order to look for candidate genes.
几种不同类型的伴有椎体扁平的致死性短肢骨骼发育不良已被确认,且具有不同的遗传模式。蜗牛骨盆发育不良是一种非常罕见的致死性骨软骨发育不良,属于这些病症之一,呈常染色体隐性遗传模式。我们描述了4例具有临床、影像学和组织病理学特征的突尼斯新病例。这些胎儿的父母为近亲。在妊娠20、22、23和28周时通过超声进行了短肢的产前诊断。影像学表现典型,尤其显示出小髂骨伴有内侧蜗牛样突出。这4例病例的软骨骨组织学与诊断结果相符,显示出软骨异常,其特征为细胞增多、血管增生以及具有中央大圆形细胞核的软骨细胞。当出现侏儒症表型以及髂骨的蜗牛样特征并伴有组织学发现时,应考虑蜗牛骨盆发育不良。应采集冷冻胎儿样本以寻找候选基因。