Hameed Marya, Qureshi Muhammad Fazal Hussain
Department of Radiology, National Institute of Child Health, Karachi, Pakistan; Assistant Professor, Department of Radiology, Jinnah Sindh Medical University, Karachi, Pakistan.
Department of Radiology, National Institute of Child Health, Karachi, Pakistan.
Pediatr Neurol. 2024 Aug;157:114-117. doi: 10.1016/j.pediatrneurol.2024.05.021. Epub 2024 Jun 3.
Caudal regression syndrome (CRS), also known as caudal agenesis, results from abnormal development of the caudal aspect of the spinal cord and vertebral column due to an earlier abnormality of gastrulation.
This report showcases a unique scenario where three siblings, devoid of any prior family history or identifiable risk factors, exhibit symptoms of CRS and receive care at a government-run tertiary facility dedicated to children's health. In establishing a concrete diagnosis, we relied on skeletal surveys, comprehensive symptom evaluation, and medical history assessment. Additionally, we recommended further investigation through magnetic resonance imaging and genetic testing to attain a more in-depth understanding and confirmation of the condition. Unfortunately, the financial constraints faced by the parents led to the unfeasibility of pursuing these advanced diagnostic options. Given the rarity of this syndrome and the limited existing literature, our report is a significant contribution. It marks the first comprehensive exploration of CRS from the genetic and familial predisposition perspective, shedding new light on this rare condition.
This case series pioneers our understanding of the familial and genetic connections between CRS and sacral agenesis. Strikingly, each subsequent generation has experienced more severe manifestations earlier, furnishing compelling evidence that underpins the genetic predisposition to CRS.
尾椎退化综合征(CRS),也称为尾椎发育不全,是由于原肠胚形成早期异常导致脊髓和脊柱尾部发育异常所致。
本报告展示了一个独特的案例,三个兄弟姐妹没有任何家族病史或可识别的风险因素,却出现了CRS症状,并在一家政府运营的儿童健康三级医疗机构接受治疗。在进行明确诊断时,我们依靠骨骼检查、全面的症状评估和病史评估。此外,我们建议通过磁共振成像和基因检测进行进一步调查,以更深入地了解和确认病情。不幸的是,父母面临的经济限制导致无法采用这些先进的诊断方法。鉴于这种综合征的罕见性和现有文献的有限性,我们的报告具有重要意义。它标志着首次从遗传和家族易感性角度对CRS进行全面探索,为这种罕见疾病带来了新的认识。
本病例系列开创了我们对CRS与骶骨发育不全之间家族和遗传联系的理解。引人注目的是,每一代后续患者都更早出现了更严重的症状,提供了有力证据支持CRS的遗传易感性。