Silva Alessandra Pawelec da, Rosa Rafael Fabiano Machado, Trevisan Patrícia, Dorneles Juliana Cavalheiro, Mesquita Camila Saporiti, Mattos Vinicius Freitas de, Paskulin Giorgio Adriano, Zen Paulo Ricardo Gazzola
Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
Sao Paulo Med J. 2015 May-Jun;133(3):191-8. doi: 10.1590/1516-3180.2013.7762204. Epub 2014 Oct 17.
Oculo-auriculo-vertebral spectrum (OAVS) is considered to be a defect of embryogenesis involving structures originating from the first branchial arches. Our objective was to describe the clinical and cytogenetic findings from a sample of patients with the phenotype of OAVS.
Cross-sectional study in a referral hospital in southern Brazil.
The sample consisted of 23 patients who presented clinical findings in at least two of these four areas: orocraniofacial, ocular, auricular and vertebral. The patients underwent a clinical protocol and cytogenetic evaluation through high-resolution karyotyping, fluorescence in situ hybridization for 5p and 22q11 microdeletions and investigation of chromosomal instability for Fanconi anemia.
Cytogenetic abnormalities were observed in three cases (13%) and consisted of: 47,XX,+mar; mos 47,XX,+mar/46,XX; and 46,XX,t(6;10)(q13; q24). We observed cases of OAVS with histories of gestational exposition to fluoxetine, retinoic acid and crack. One of our patients was a discordant monozygotic twin who had shown asymmetrical growth restriction during pregnancy. Our patients with OAVS were characterized by a broad clinical spectrum and some presented atypical findings such as lower-limb reduction defect and a tumor in the right arm, suggestive of hemangioma/lymphangioma.
We found a wide range of clinical characteristics among the patients with OAVS. Different chromosomal abnormalities and gestational expositions were also observed. Thus, our findings highlight the heterogeneity of the etiology of OAVS and the importance of these factors in the clinical and cytogenetic evaluation of these patients.
眼-耳-脊椎综合征(OAVS)被认为是一种涉及起源于第一鳃弓结构的胚胎发育缺陷。我们的目的是描述具有OAVS表型的患者样本的临床和细胞遗传学发现。
在巴西南部一家转诊医院进行的横断面研究。
样本包括23例患者,他们在以下四个区域中的至少两个区域出现临床症状:口颅面、眼部、耳部和脊椎。患者接受了临床方案和细胞遗传学评估,包括高分辨率核型分析、针对5p和22q11微缺失的荧光原位杂交以及范可尼贫血的染色体不稳定性检测。
在3例(13%)患者中观察到细胞遗传学异常,包括:47,XX,+mar;mos 47,XX,+mar/46,XX;以及46,XX,t(6;10)(q13;q24)。我们观察到有OAVS病例,其孕期有接触氟西汀、视黄酸和强效纯可卡因的病史。我们的一名患者是异卵单合子双胞胎,在孕期表现出不对称生长受限。我们的OAVS患者具有广泛的临床谱,一些患者呈现非典型表现,如下肢发育不全和右臂肿瘤,提示为血管瘤/淋巴管瘤。
我们在OAVS患者中发现了广泛的临床特征。还观察到不同的染色体异常和孕期接触情况。因此,我们的发现突出了OAVS病因的异质性以及这些因素在这些患者临床和细胞遗传学评估中的重要性。