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与KAT6A变异相关的阿博莱达-塔姆综合征的产前诊断,表现为下腔静脉中断和胎儿生长受限。

Prenatal Diagnosis of Arboleda-Tham Syndrome Associated With KAT6A Variants Presented With Interrupted Inferior Vena Cava and Fetal Growth Restriction.

作者信息

Yu Qiu-Xia, Zhang Yong-Ling, Zhen Li, Li Dong-Zhi

机构信息

Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.

出版信息

Prenat Diagn. 2025 Jul;45(8):1078-1081. doi: 10.1002/pd.6845. Epub 2025 Jun 25.

DOI:10.1002/pd.6845
PMID:40563199
Abstract

Arboleda-Tham syndrome (ARTHS) is an autosomal dominant disorder characterized by core features of developmental delay and intellectual disability. While ARTHS has been documented in numerous postnatal patients, only a limited number of prenatal cases have been reported to date. We present three prenatal cases of KAT6A-related ARTHS. One case exhibited an interrupted inferior vena cava with azygos continuation to the superior vena cava at 24 weeks gestation. Two cases demonstrated retarded fetal growth during the third trimester. All three cases underwent invasive genetic investigations during pregnancy, and trio exome sequencing identified a de novo pathogenic variant in the KAT6A gene in the fetuses. The pregnancies were subsequently terminated. Our report contributes to the expansion of both the genotypic and phenotypic spectrum of ARTHS by detailing previously unreported prenatal clinical features and novel genetic variants. Furthermore, our study emphasizes that even nonspecific findings on prenatal ultrasound may warrant exome sequencing, as it provides significant benefits for families by facilitating timely diagnosis and enhancing clinical management.

摘要

阿博莱达 - 塔姆综合征(ARTHS)是一种常染色体显性疾病,其特征为发育迟缓与智力残疾的核心表现。虽然ARTHS在众多产后患者中已有记录,但迄今为止,仅报告了少数产前病例。我们呈现三例与KAT6A相关的ARTHS产前病例。一例在妊娠24周时表现为下腔静脉中断,奇静脉延续至上腔静脉。两例在孕晚期显示胎儿生长迟缓。所有三例在孕期均接受了侵入性基因检测,三联体全外显子测序在胎儿中鉴定出KAT6A基因的一个新发致病变异。随后终止了妊娠。我们的报告通过详细描述先前未报告的产前临床特征和新的基因变异,为ARTHS的基因型和表型谱的扩展做出了贡献。此外,我们的研究强调,即使产前超声检查结果不具特异性,也可能需要进行全外显子测序,因为它通过促进及时诊断和加强临床管理,为家庭带来显著益处。

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