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胎儿纤毛病:回顾性观察性单中心研究。

Fetal ciliopathies: a retrospective observational single-center study.

机构信息

Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.

Department of Neonatology and Pediatric Intensive Care, University Hospital Bonn, Bonn, Germany.

出版信息

Arch Gynecol Obstet. 2022 Jul;306(1):71-83. doi: 10.1007/s00404-021-06265-7. Epub 2021 Oct 1.

Abstract

PURPOSE

Report on the diagnosis of prenatally suspected multisystem ciliopathies in a single center between 2002 and 2020.

METHODS

Retrospective observational single-center study including pregnancies with prenatal ultrasound features of multisystem ciliopathies, such as hyperechogenic kidneys together with polydactyly and/or other skeletal and extraskeletal findings. Cases were compared according to their prenatal findings and outcomes.

RESULTS

36 cases of multisystem ciliopathies were diagnosed. Meckel-Gruber syndrome (MKS) was the most common ciliopathy (n = 19/36, 52.8%), followed by disorders that belong to the group of short-rib thoracic dysplasia (SRTD, n = 10/36, 27.8%) McKusick-Kaufmann syndrome (MKKS, n = 4/36, 11.1%), Bardet-Biedl syndrome (BBS, n = 2/36, 5.5%) and Joubert syndrome (n = 1/36, 2.8%). All cases showed abnormalities of the kidneys, most often hyperechogenic parenchyma (n = 26/36, 72.2%), cystic dysplasia (n = 24/36, 66.7%), and/or bilateral kidney enlargement (n = 22/36, 61.1%). Oligohydramnios was mainly present in fetuses with MKS. Polydactyly (n = 18/36), abnormalities of the CNS (n = 25/36), and heart defects (n = 10/36) were associated in 50%, 69.4%, and 27.8%, respectively.

CONCLUSION

Prenatal detection of renal abnormalities associated with skeletal or brain abnormalities should raise the suspicion for multisystem ciliopathies. Prenatal ultrasound can help to differentiate between different diseases and pave the way for subsequent targeted genetic testing.

摘要

目的

报告 2002 年至 2020 年间在单一中心对产前疑似多系统纤毛病进行的诊断。

方法

回顾性观察性单中心研究,纳入具有多系统纤毛病产前超声特征的妊娠,如肾脏回声增强伴多指(趾)畸形和/或其他骨骼和骨骼外表现。根据产前发现和结局对病例进行比较。

结果

诊断出 36 例多系统纤毛病。麦-格综合征(MKS)是最常见的纤毛病(n=19/36,52.8%),其次是属于短肋胸发育不良(SRTD)组的疾病(n=10/36,27.8%)、麦克库斯克-考夫曼综合征(MKKS,n=4/36,11.1%)、Bardet-Biedl 综合征(BBS,n=2/36,5.5%)和 Joubert 综合征(n=1/36,2.8%)。所有病例均有肾脏异常,最常见的是肾脏实质回声增强(n=26/36,72.2%)、囊性发育不良(n=24/36,66.7%)和/或双侧肾脏增大(n=22/36,61.1%)。MKS 胎儿主要存在羊水过少。多指(趾)畸形(n=18/36)、中枢神经系统异常(n=25/36)和心脏缺陷(n=10/36)的发生率分别为 50%、69.4%和 27.8%。

结论

产前发现肾脏异常伴骨骼或中枢神经系统异常应怀疑多系统纤毛病。产前超声有助于区分不同疾病,并为随后的靶向基因检测铺平道路。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9dc3/9300526/3c083a0e7a4a/404_2021_6265_Fig1_HTML.jpg

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