Cierna Zuzana, Janega Pavol, Grochal Frantisek, Ferianec Vladimir, Braxatorisova Tatiana, Strieskova Lucia, Malova Jana, Jungova Petra, Szemes Tomas
1 Department of Pathology, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic.
2 Medirex group academy, n.o., Bratislava, Slovak Republic.
Pediatr Dev Pathol. 2017 Sep-Oct;20(5):449-454. doi: 10.1177/1093526616689184. Epub 2017 Feb 8.
Meckel-Gruber syndrome (MKS) is a rare lethal autosomal recessive disorder with typical anomalies including encephalocele, multicystic renal dysplasia, congenital liver fibrosis, and polydactyly. MKS is caused by mutations of genes localized on different chromosomes. Karyotypes of published Meckel-Gruber syndrome cases are without any aberrations. We present a male fetus with meningoencephalocele, multicystic renal dysplasia, congenital liver fibrosis, and other anomalies. Standard cytogenetic examination of cultured fetal skin and muscle fibroblasts showed mosaic trisomy 17. Homozygous deletion in CC2D2A gene was found by Sanger sequencing. This is to our knowledge the first case of genetically confirmed Meckel-Gruber syndrome with incidental cofinding of mosaic trisomy 17. Abnormal karyotype does not exclude diagnosis of MKS with risk of recurrence 25% in next pregnancy. In the case of anomalies typical for Meckel-Gruber syndrome, genetic analysis is indicated.
梅克尔-格鲁伯综合征(MKS)是一种罕见的致死性常染色体隐性疾病,典型异常包括脑膨出、多囊性肾发育不良、先天性肝纤维化和多指畸形。MKS由位于不同染色体上的基因突变引起。已发表的梅克尔-格鲁伯综合征病例的核型无任何畸变。我们报告一例男性胎儿,患有脑膜脑膨出、多囊性肾发育不良、先天性肝纤维化及其他异常。对培养的胎儿皮肤和肌肉成纤维细胞进行的标准细胞遗传学检查显示为17号染色体三体镶嵌。通过桑格测序发现CC2D2A基因存在纯合缺失。据我们所知,这是首例经基因确诊的梅克尔-格鲁伯综合征,同时意外发现17号染色体三体镶嵌。异常核型并不排除MKS的诊断,下一胎复发风险为25%。对于具有梅克尔-格鲁伯综合征典型异常的病例,建议进行基因分析。