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母亲患 HELLP 综合征/子痫前期的新生儿中 Beckwith-Wiedemann 综合征:伴有胎儿生长受限和缺乏典型致病遗传变异的文献分析及病例报告。

Beckwith-Wiedemann Syndrome in Newborn of Mother with HELLP Syndrome/Preeclampsia: An Analysis of Literature and Case Report with Fetal Growth Restriction and Absence of Typical Pathogenic Genetic Variation.

机构信息

Chair and Department of Gynecology, Obstetrics and Gynecologic Oncology, Medical University of Silesia, 40-211 Katowice, Poland.

出版信息

Int J Mol Sci. 2023 Aug 29;24(17):13360. doi: 10.3390/ijms241713360.

Abstract

Beckwith-Wiedemann Syndrome (BWS) is an imprinting disorder, which manifests by overgrowth and predisposition to embryonal tumors. The evidence on the relationship between maternal complications such as HELLP (hemolysis, elevated liver enzymes, and low platelet count) and preeclampsia and the development of BWS in offspring is scarce. A comprehensive clinical evaluation, with genetic testing focused on screening for mutations in the CDKN1C gene, which is commonly associated with BWS, was conducted in a newborn diagnosed with BWS born to a mother with a history of preeclampsia and HELLP syndrome. The case study revealed typical clinical manifestations of BWS in the newborn, including hemihyperplasia, macroglossia, midfacial hypoplasia, omphalocele, and hypoglycemia. Surprisingly, the infant also exhibited fetal growth restriction, a finding less commonly observed in BWS cases. Genetic analysis, however, showed no mutations in the gene, which contrasts with the majority of BWS cases. This case report highlights the complex nature of BWS and its potential association with maternal complications such as preeclampsia and HELLP syndrome. The atypical presence of fetal growth restriction in the newborn and the absence of gene mutations have not been reported to date in BWS.

摘要

贝克威思-威德曼综合征(BWS)是一种印迹疾病,表现为过度生长和胚胎肿瘤易感性。关于母体并发症(如溶血性贫血、肝酶升高和血小板计数降低的 HELLP 综合征)和子痫前期与后代 BWS 发展之间的关系的证据很少。对一名患有子痫前期和 HELLP 综合征的母亲所生的诊断为 BWS 的新生儿进行了全面的临床评估,并进行了基因检测,重点筛查与 BWS 相关的 CDKN1C 基因突变。该病例研究揭示了新生儿 BWS 的典型临床表现,包括半身肥大、巨舌、中面部发育不全、脐膨出和低血糖。令人惊讶的是,婴儿还表现出胎儿生长受限,这在 BWS 病例中较少见。然而,基因分析显示 基因无突变,这与大多数 BWS 病例不同。本病例报告强调了 BWS 的复杂性及其与母体并发症(如子痫前期和 HELLP 综合征)的潜在关联。在新生儿中出现不典型的胎儿生长受限以及 基因无突变的情况尚未在 BWS 中报道。

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