Multidisciplinary follow-up in a patient with Morgagni hernia leads to diagnosis of Marfan syndrome.


Journal

Italian journal of pediatrics
ISSN: 1824-7288
Titre abrégé: Ital J Pediatr
Pays: England
ID NLM: 101510759

Informations de publication

Date de publication:
07 May 2024
Historique:
received: 05 12 2022
accepted: 05 04 2024
medline: 8 5 2024
pubmed: 8 5 2024
entrez: 7 5 2024
Statut: epublish

Résumé

congenital diaphragmatic hernia (CDH) is a birth defect occurring in isolated or syndromic (chromosomal or monogenic) conditions. The diaphragmatic defect can be the most common one: left-sided posterolateral, named Bochdalek hernia; or it can be an anterior-retrosternal defect, named Morgagni hernia. Marfan syndrome (MFS) is a rare autosomal dominant inherited condition that affects connective tissue, caused by mutations in fibrillin-1 gene on chromosome 15. To date various types of diaphragmatic defects (about 30 types) have been reported in association with MFS, but they are heterogeneous, including CDH and paraesophageal hernia. We describe the case of a child incidentally diagnosed with Morgagni hernia through a chest X-ray performed due to recurrent respiratory tract infections. Since the diagnosis of CDH, the patient underwent a clinical multidisciplinary follow-up leading to the diagnosis of MFS in accordance with revised Ghent Criteria: the child had typical clinical features and a novel heterozygous de novo single-base deletion in exon 26 of the FBN1 gene, identified by Whole-Exome Sequencing. MFS diagnosis permitted to look for cardiovascular complications and treat them, though asymptomatic, in order to prevent major cardiovascular life-threatening events. Our case shows the importance of a long-term and multidisciplinary follow-up in all children with diagnosis of CDH.

Sections du résumé

BACKGROUND BACKGROUND
congenital diaphragmatic hernia (CDH) is a birth defect occurring in isolated or syndromic (chromosomal or monogenic) conditions. The diaphragmatic defect can be the most common one: left-sided posterolateral, named Bochdalek hernia; or it can be an anterior-retrosternal defect, named Morgagni hernia. Marfan syndrome (MFS) is a rare autosomal dominant inherited condition that affects connective tissue, caused by mutations in fibrillin-1 gene on chromosome 15. To date various types of diaphragmatic defects (about 30 types) have been reported in association with MFS, but they are heterogeneous, including CDH and paraesophageal hernia.
CASE PRESENTATION METHODS
We describe the case of a child incidentally diagnosed with Morgagni hernia through a chest X-ray performed due to recurrent respiratory tract infections. Since the diagnosis of CDH, the patient underwent a clinical multidisciplinary follow-up leading to the diagnosis of MFS in accordance with revised Ghent Criteria: the child had typical clinical features and a novel heterozygous de novo single-base deletion in exon 26 of the FBN1 gene, identified by Whole-Exome Sequencing. MFS diagnosis permitted to look for cardiovascular complications and treat them, though asymptomatic, in order to prevent major cardiovascular life-threatening events.
CONCLUSION CONCLUSIONS
Our case shows the importance of a long-term and multidisciplinary follow-up in all children with diagnosis of CDH.

Identifiants

pubmed: 38715046
doi: 10.1186/s13052-024-01643-8
pii: 10.1186/s13052-024-01643-8
doi:

Substances chimiques

Fibrillin-1 0
FBN1 protein, human 0
Adipokines 0

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

94

Informations de copyright

© 2024. The Author(s).

Références

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Auteurs

Ester Capecchi (E)

Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 28, 20122, Milan, Italy.

Roberta Villa (R)

Medical Genetic Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Alessandro Pini (A)

Cardiovascular Genetic Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.

Maria Iascone (M)

Laboratory of Medical Genetics, ASST Papa Giovanni XXIII, Bergamo, Italy.

Laura Messina (L)

Pediatric Physical Medicine & Rehabilitation Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Paola Francesca Ajmone (PF)

Child and Adolescent Neuropsychiatric Service (UONPIA), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Fabio Mosca (F)

Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 28, 20122, Milan, Italy.
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.

Silvana Gangi (S)

Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 28, 20122, Milan, Italy. silvana.gangi@policlinico.mi.it.

Maria Francesca Bedeschi (MF)

Medical Genetic Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

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