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来自巴西的13三体综合征(帕陶氏综合征)患者样本的临床特征与预后

Clinical features and prognosis of a sample of patients with trisomy 13 (Patau syndrome) from Brazil.

作者信息

Petry Patrícia, Polli Janaina B, Mattos Vinícius F, Rosa Rosana C M, Zen Paulo R G, Graziadio Carla, Paskulin Giorgio A, Rosa Rafael F M

机构信息

Pediatrics Service, Hospital Materno Infantil Presidente Vargas (HMIPV), and Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre, Rio Grande do Sul, Brazil.

出版信息

Am J Med Genet A. 2013 Jun;161A(6):1278-83. doi: 10.1002/ajmg.a.35863. Epub 2013 Apr 23.

Abstract

Trisomy 13 or Patau syndrome (PS) is a chromosomal disorder characterized by a well known presentation of multiple congenital anomalies. Our objective was to determine the clinical features and prognosis observed in a sample of patients with PS. The series was composed of patients with diagnosis of PS consecutively evaluated by a Clinical Genetics Service from a reference hospital of southern Brazil, in the period between 1975 and 2012. Statistical analysis was performed using PEPI program (version 4.0), with two-tailed Fisher's exact test for comparison of frequencies (P<0.05). The sample consisted of 30 patients, 60% male, median age at first evaluation of 9 days. Full trisomy of chromosome 13 was the main cytogenetic alteration (73%). The major clinical findings included: cryptorchidism (78%), abnormal auricles (77%), congenital heart defects (76%), polydactyly (63%), microphthalmia (60%) and micrognathia (50%). Four patients (13%) simultaneously had micro/anophthalmia, oral clefts and polydactyly. Some findings were only observed in our sample and included, among others, preauricular tags (10%), duplication of the hallux (3%) and spots following the lines of Blaschko (3%). Mosaicism (20% of cases) had a statistically significant association only with absence of cryptorchidism. The median of survival was 26 days. Patients with and without mosaicism had similar median of survival. Our findings, in agreement with the literature, show that the anomalies in patients with PS can be quite variable, sometimes even atypical. There is no pathognomonic finding, which may make the early identification of these patients challenging.

摘要

13三体综合征或帕陶综合征(PS)是一种染色体疾病,其特征是存在多种先天性异常的典型表现。我们的目的是确定PS患者样本中观察到的临床特征和预后。该系列研究由1975年至2012年期间在巴西南部一家参考医院的临床遗传学服务部门连续评估的PS诊断患者组成。使用PEPI程序(4.0版)进行统计分析,采用双侧Fisher精确检验比较频率(P<0.05)。样本包括30名患者,60%为男性,首次评估时的中位年龄为9天。13号染色体完全三体是主要的细胞遗传学改变(73%)。主要临床发现包括:隐睾(78%)、耳廓异常(77%)、先天性心脏缺陷(76%)、多指(63%)、小眼症(60%)和小颌畸形(50%)。4名患者(13%)同时患有小眼/无眼症、腭裂和多指。一些发现仅在我们的样本中观察到,包括耳前赘生物(10%)、拇趾重复(3%)和Blaschko线处的斑点(3%)。嵌合体(20%的病例)仅与无隐睾有统计学上的显著关联。中位生存期为26天。有嵌合体和无嵌合体的患者中位生存期相似。我们的研究结果与文献一致,表明PS患者的异常情况可能差异很大,有时甚至是非典型的。没有特征性表现,这可能使这些患者的早期识别具有挑战性。

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