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17q12 缺失综合征的产前诊断:从胎儿肾回声增强到自闭症高风险

Prenatal diagnosis of 17q12 deletion syndrome: from fetal hyperechogenic kidneys to high risk for autism.

作者信息

Gilboa Yinon, Perlman Sharon, Pode-Shakked Naomi, Pode-Shakked Ben, Shrim Alon, Azaria-Lahav Einat, Dekel Benjamin, Yonath Hagith, Berkenstadt Michal, Achiron Reuven

机构信息

Prenatal Diagnostic Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel HaShomer, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Pediatric Stem Cell Research Institute, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel HaShomer, Israel.

出版信息

Prenat Diagn. 2016 Nov;36(11):1027-1032. doi: 10.1002/pd.4926. Epub 2016 Oct 25.

DOI:10.1002/pd.4926
PMID:27634641
Abstract

OBJECTIVE

The linkage between 17q12 microdeletions, renal anomalies, and higher risk for neurodevelopmental disorders is well described in the literature. The current study presents prenatal diagnosis of normal-sized fetal hyperechogenic kidneys leading to the diagnosis of 17q12 deletion syndrome and autism spectrum disorder.

METHODS

Over a period of 9 years in a single referral center, seven fetuses were diagnosed with hyperechogenic renal parenchyma and were followed up prospectively. Amniocentesis for molecular diagnosis was performed in all cases, and subsequently, five fetuses were found to harbor a 17q12 deletion by chromosomal microarray analysis. Postnatal evaluation was carried out by a developmental neurologist.

RESULTS

Five of the seven fetuses had molecular diagnosis of 17q12 deletion. One patient elected termination of pregnancy. On long-term follow-up, all of the four children showed symptoms consistent with neurodevelopmental disorders. The two fetuses with no deletion have a normal follow-up with regression of the renal hyperechogenicity.

CONCLUSIONS

We report a strikingly high correlation between prenatal hyperechogenic kidneys, 17q12 microdeletion, and autism spectrum disorder with the advantage of optimal prenatal counseling as well as early diagnosis and intervention. © 2016 John Wiley & Sons, Ltd.

摘要

目的

17q12微缺失、肾脏异常与神经发育障碍高风险之间的联系在文献中已有充分描述。本研究介绍了对正常大小胎儿高回声肾脏进行产前诊断,进而诊断出17q12缺失综合征和自闭症谱系障碍的情况。

方法

在一家单一转诊中心的9年时间里,7例胎儿被诊断为肾实质高回声,并进行了前瞻性随访。所有病例均进行了羊水穿刺分子诊断,随后通过染色体微阵列分析发现5例胎儿存在17q12缺失。产后由发育神经科医生进行评估。

结果

7例胎儿中有5例经分子诊断为17q12缺失。1例患者选择终止妊娠。长期随访显示,4名儿童均表现出与神经发育障碍一致的症状。另外2例未发生缺失的胎儿随访正常,肾脏高回声消失。

结论

我们报告了产前高回声肾脏、17q12微缺失与自闭症谱系障碍之间存在显著的高度相关性,具有优化产前咨询以及早期诊断和干预的优势。© 2016 John Wiley & Sons, Ltd.

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