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长骨弯曲的骨骼发育异常:产前诊断的拟议流程图及病例展示

Skeletal dysplasia with bowing long bones: Proposed flowchart for prenatal diagnosis with case demonstration.

作者信息

Tonni Gabriele, Palmisano Marcella, Lituania Mario, Grisolia Gianpaolo, Baffico Ave Maria, Bonasoni Maria Paola, Pattacini Pierpaolo, De Felice Claudio, Araujo Júnior Edward

机构信息

Prenatal Diagnostic Unit, Department of Obstetrics and Gynecology, AUSL (Azienda Unità Sanitaria Locale) Reggio Emilia, Italy.

Prenatal Diagnostic Unit, Department of Obstetrics and Gynecology, AUSL (Azienda Unità Sanitaria Locale) Reggio Emilia, Italy.

出版信息

Taiwan J Obstet Gynecol. 2016 Dec;55(6):771-776. doi: 10.1016/j.tjog.2015.10.027.

Abstract

OBJECTIVE

Skeletal dysplasia with bowing long bones is a rare group of multiple characterized congenital anomalies.

MATERIALS AND METHODS

We introduce a simple, practical diagnostic flowchart that may be helpful in identifying the appropriate pathway of obstetrical management.

RESULTS

Herein, we describe four fetal cases of bent bony dysplasia that focus on ultrasound findings, phenotype, molecular tests, distinctive X-ray features, and chondral growth plate histology. The first case was a typical campomelic dysplasia resulting from a de novo mutation in the SOX9 gene. The second fetus was affected by osteogenesis imperfecta Type II carrying a mutation in the COLA1 gene. The third case was a rare presentation of campomelic dysplasia, Cumming type, in which SOX9 examination was normal. Subsequently, a femoral hypoplasia unusual facies syndrome is also discussed.

CONCLUSION

Targeted molecular tests and genetic counseling are required for supplementing ultrasound imaging in order to diagnose the correct skeletal disorders.

摘要

目的

伴有长骨弯曲的骨骼发育不良是一组罕见的具有多种特征的先天性异常。

材料与方法

我们介绍一种简单、实用的诊断流程图,这可能有助于确定适当的产科管理途径。

结果

在此,我们描述4例胎儿弯曲性骨发育不良病例,重点关注超声检查结果、表型、分子检测、独特的X线特征以及软骨生长板组织学。第一例是典型的弯肢侏儒症,由SOX9基因的新发突变引起。第二例胎儿患有II型成骨不全症,携带COL1A1基因的突变。第三例是弯肢侏儒症的罕见表现,即卡明型,其中SOX9检查正常。随后,还讨论了股骨发育不全-特殊面容综合征。

结论

为了诊断正确的骨骼疾病,需要进行靶向分子检测和遗传咨询以补充超声成像。

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