Beckwith-wiedemann syndrome

Beckwith - Wiedemann 综合征
  • 文章类型: Journal Article
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  • 文章类型: Case Reports
    Beckwith-Wiedemann综合征(BWS)是一种影响胎儿生长的遗传性疾病,比如巨大儿,巨舌,半肥大,和腹壁缺陷。该病例报告了一名被诊断患有BWS的婴儿,出生时体重极低,为980克,与过度生长和巨大儿的典型表现相反。因此,BWS的诊断被推迟到患者达到八个月大,当BWS的其他临床特征时,比如半肥大,在后续访问中变得明显。虽然基因检测可以用来诊断这种情况,由患者的临床特征组成的临床评分系统就足够了,允许及时准确的诊断,这对于早期筛查和检测与此类综合征相关的胚胎性肿瘤具有重要意义。
    Beckwith-Wiedemann syndrome (BWS) is a genetic disorder that affects fetal growth in which those afflicted present with features pertaining to that, such as macrosomia, macroglossia, hemihypertrophy, and abdominal wall defects. This case reports the presentation of an infant diagnosed with BWS who was born with an extremely low birth weight of 980 grams, in contrast to the typical presentation of overgrowth and macrosomia. As a result, reaching a diagnosis of BWS was delayed until the patient reached eight months of age, when other clinical features of BWS, such as hemihypertrophy, became apparent on follow-up visits. Although genetic testing can be used to diagnose this condition, a clinical scoring system consisting of a patient\'s clinical features is sufficient, allowing for a timely and precise diagnosis, which is of great significance to allow for early screening and detection of the associated embryonal tumors with such a syndrome.
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  • 文章类型: Journal Article
    背景:长QT综合征(LQTS)和Beckwith-Wiedemann综合征(BWS)是起源不明的复杂疾病,强调需要对其机制进行深入的分子研究。这项研究的主要目的是确定LQTS和BWS之间的共享关键基因,揭示这些综合征潜在的共同分子途径。
    方法:LQTS和BWS数据集可从GEO数据库下载。鉴定了差异表达基因(DEGs)。加权基因共表达网络分析(WGCNA)用于检测重要模块和中心基因。进行基因富集分析。CIBERSORT用于免疫细胞浸润分析。使用STRING构建核心基因的预测性蛋白质相互作用(PPI)网络,使用TargetScan筛选调节中心基因的miRNA。
    结果:确定了与长QT综合征和Beckwith-Wiedemann综合征相关的500个DEG。GSEA分析揭示了T细胞受体信号通路的富集,MAPK信号,和心肌细胞中的肾上腺素能信号。免疫细胞浸润表明较高水平的记忆B细胞和幼稚CD4T细胞。四个核心基因(CD8A,ICOS,CTLA4,LCK)被识别,CD8A和ICOS在证候中低表达,在正常样本中高表达,提示潜在的反向调节作用。
    结论:长QT综合征和Beckwith-Wiedemann综合征中CD8A和ICOS的表达低,表明它们可能是这些综合征发病机制中的关键基因。LQTS和BWS之间共享关键基因的鉴定提供了对这些疾病的共同分子机制的见解。有可能促进有针对性的治疗策略的发展。
    BACKGROUND: Long QT Syndrome (LQTS) and Beckwith-Wiedemann Syndrome (BWS) are complex disorders with unclear origins, underscoring the need for in-depth molecular investigations into their mechanisms. The main aim of this study is to identify the shared key genes between LQTS and BWS, shedding light on potential common molecular pathways underlying these syndromes.
    METHODS: The LQTS and BWS datasets are available for download from the GEO database. Differential expression genes (DEGs) were identified. Weighted gene co-expression network analysis (WGCNA) was used to detect significant modules and central genes. Gene enrichment analysis was performed. CIBERSORT was used for immune cell infiltration analysis. The predictive protein interaction (PPI) network of core genes was constructed using STRING, and miRNAs regulating central genes were screened using TargetScan.
    RESULTS: Five hundred DEGs associated with Long QT Syndrome and Beckwith-Wiedemann Syndrome were identified. GSEA analysis revealed enrichment in pathways such as T cell receptor signaling, MAPK signaling, and adrenergic signaling in cardiac myocytes. Immune cell infiltration indicated higher levels of memory B cells and naive CD4 T cells. Four core genes (CD8A, ICOS, CTLA4, LCK) were identified, with CD8A and ICOS showing low expression in the syndromes and high expression in normal samples, suggesting potential inverse regulatory roles.
    CONCLUSIONS: The expression of CD8A and ICOS is low in long QT syndrome and Beckwith-Wiedemann syndrome, indicating their potential as key genes in the pathogenesis of these syndromes. The identification of shared key genes between LQTS and BWS provides insights into common molecular mechanisms underlying these disorders, potentially facilitating the development of targeted therapeutic strategies.
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  • 文章类型: Case Reports
    Beckwith-Wiedemann综合征(BWS)是一种罕见的基因组印记障碍,影响多个系统。主要特征可以表现为出生体重大,前腹壁缺损,巨舌,高胰岛素血症,器官肿大半肥大,和肾脏异常。特征相表现为面中部发育不全,轨道下折痕,面部单纯性痣,和前线性耳垂折痕/后螺旋耳窝,有肿瘤发展的倾向。该病例报告描述了一位33岁的G3P20母亲通过选择性剖宫产在妊娠38+5周时出生的沙特婴儿,有1型糖尿病和唐氏综合征家族史。产前超声显示前腹壁缺损。出生后,婴儿表现出巨大儿,巨舌,和脐膨出。基因检测证实了11p15.5中印记区域的父系二体。婴儿接受了成功的脐膨出修复,但经历了呼吸窘迫,在生命的第三天癫痫发作。插管,通风,并开始抗癫痫治疗。随后的调查显示右上叶塌陷,脑电图(EEG)上的新生儿癫痫发作,和磁共振成像(MRI)的薄call体。喂养困难导致两个月大的选择性部分舌片切除术。在她手术后两天住院期间,婴儿出现持续性低血糖,需要高葡萄糖输注率.广泛的内分泌评估显示高胰岛素和皮质醇水平。皮下给予奥曲肽反应最小。经过15天的葡萄糖逐渐减少,婴儿的血糖稳定,达到喂养目标。患者出院并接受随访预约。这个全面的案例强调了BWS婴儿严重复发性低血糖管理的复杂性。
    Beckwith-Wiedemann syndrome (BWS) is a rare genomic imprinting disorder that affects multiple systems. Major features can manifest as large birth weight, anterior abdominal wall defects, macroglossia, hyperinsulinism, organomegaly hemihypertrophy, and renal abnormalities. Characteristic facies manifested as midface hypoplasia, infraorbital creases, facial nevus simplex, and anterior linear ear lobe creases/posterior helical ear pits, with a predisposition to tumor development. This case report describes a Saudi infant born at 38+5 weeks gestation via elective cesarean section to a 33-year-old G3P2+0 mother, with a family history of type 1 diabetes and Down syndrome. Prenatal ultrasound revealed an anterior abdominal wall defect. Postnatally, the infant exhibited macrosomia, macroglossia, and omphalocele. Genetic testing confirmed paternal disomy of the imprinted region in 11p15.5. The infant underwent successful omphalocele repair but experienced respiratory distress, and seizures on the third day of life. Intubation, ventilation, and antiepileptic treatment were initiated. Subsequent investigations revealed right upper lobe collapse, neonatal seizures on electroencephalogram (EEG), and thin corpus callosum on magnetic resonance imaging (MRI). Feeding difficulties led to elective partial glossectomy at two months of age. During her hospital stay two days post surgery, the infant developed persistent hypoglycemia requiring high glucose infusion rates. Extensive endocrine evaluation revealed high insulin and cortisol levels. Subcutaneous octreotide was administered with minimal response. After 15 days of careful glucose tapering, the infant\'s blood glucose stabilized, reaching feeding targets. The patient was discharged with follow-up appointments. This comprehensive case highlights the complexity of managing severe relapsing hypoglycemia in an infant with BWS.
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  • 文章类型: Journal Article
    Beckwith-Wiedemann综合征(BWS)是一种以过度生长为特征的印记障碍,源于各种遗传和表观遗传变化。本研究探讨了IGF2上调在BWS中的作用,专注于胰岛素样生长因子途径,在这种综合症中鲜为人知。我们检查了IGF2R,IGF2的主要受体,WNT,和BWS患者来源的淋巴母细胞细胞系中的自噬/溶酶体途径,表现出不同的遗传和表观遗传缺陷。这些发现揭示了IGF2R蛋白的表达减少和错误定位,提示受体功能障碍。此外,我们的结果表明AKT/GSK-3/mTOR通路失调,以及自噬和WNT通路的失衡。总之,BWS细胞,无论遗传/表观遗传特征如何,其特征在于与自噬和溶酶体过程的扰动相关的IGF2R途径的改变。这些改变似乎是BWS分子发病机制的关键点,并可能导致BWS的特征性过度生长和癌症易感性。我们的研究还揭示了所有BWS细胞系中WNT途径的变化,与其在生长调节和癌症发展中的作用一致。
    Beckwith-Wiedemann Syndrome (BWS) is an imprinting disorder characterized by overgrowth, stemming from various genetic and epigenetic changes. This study delves into the role of IGF2 upregulation in BWS, focusing on insulin-like growth factor pathways, which are poorly known in this syndrome. We examined the IGF2R, the primary receptor of IGF2, WNT, and autophagy/lysosomal pathways in BWS patient-derived lymphoblastoid cell lines, showing different genetic and epigenetic defects. The findings reveal a decreased expression and mislocalization of IGF2R protein, suggesting receptor dysfunction. Additionally, our results point to a dysregulation in the AKT/GSK-3/mTOR pathway, along with imbalances in autophagy and the WNT pathway. In conclusion, BWS cells, regardless of the genetic/epigenetic profiles, are characterized by alteration of the IGF2R pathway that is associated with the perturbation of the autophagy and lysosome processes. These alterations seem to be a key point of the molecular pathogenesis of BWS and potentially contribute to BWS\'s characteristic overgrowth and cancer susceptibility. Our study also uncovers alterations in the WNT pathway across all BWS cell lines, consistent with its role in growth regulation and cancer development.
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  • 文章类型: Case Reports
    Beckwith-Wiedemann综合征(BWS)是一种过度生长障碍,表现为以分子异质性和表型变异性为特征的病因学基因组印记。先前尚未描述与局部发育异常软骨瘤病变和皮质神经元异位症的关联。
    一名33孕周的女性在出生时出现脐膨出和顽固性低血糖。胎盘显示胎盘间质发育不良。检测到IC1的高甲基化和IC2的低甲基化证实了Beckwith-Wiedemann综合征,最有可能是由于单亲偏见。其他发现包括右胫骨中段和右5-8发育异常软骨瘤病变,call体缺失和大量右侧皮质神经元异位症,右半肥大,多囊性肝间叶性错构瘤和肝婴儿血管瘤,Nisidioblosis和囊性胰腺病变。婴儿在生命的7周时死于多器官衰竭和anasarca。
    Beckwith-Wiedemann综合征异常可能包括多灶性发育性软骨瘤病变和脑神经元异位,横向化,和call体发育不全。
    UNASSIGNED: Beckwith-Wiedemann syndrome (BWS) is an overgrowth disorder that exhibits etiologic genomic imprinting characterized by molecular heterogeneity and phenotypic variability. Associations with localized developmental dysplastic chondromatous lesions and cortical neuronal heterotopias have not previously been described.
    UNASSIGNED: A 33-week gestational age female had an omphalocele and intractable hypoglycemia at birth. The placenta demonstrated placental mesenchymal dysplasia. Detection of hypermethylation of IC1 and hypomethylation of IC2 confirmed Beckwith-Wiedemann syndrome, most likely due to uniparental disomy. Additional findings included right mid-tibial and right 5-8th developmental dysplastic chondromatous lesions, absent corpus callosum and numerous right-sided cortical neuronal heterotopias, right hemihypertrophy, multiple cystic hepatic mesenchymal hamartomas and hepatic infantile hemangiomas, nisidioblastosis and cystic pancreatic lesions. The infant died with multi-organ failure and anasarca at 7 weeks of life.
    UNASSIGNED: Beckwith-Wiedemann syndrome anomalies may include multifocal developmental dysplastic chondromatous lesions and cerebral neuronal heterotopias, lateralized, and corpus callosum aplasia.
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  • 文章类型: Journal Article
    这项研究的目的是评估Beckwith-Wiedemann综合征(BWS)患者在手术减少巨舌后的术后病程和长期功能和美学结果,使用多个问卷。这项研究包括接受锁孔减少术治疗巨舌的BWS患者。记录每位患者的术后病程,并进行了多次问卷调查以评估美学问题,口腔机能不全或进食困难,睡眠呼吸紊乱的症状,和演讲。9例患者接受了十例复位舌肌成形术。手术时的平均年龄为22个月。每个病例的术后过程都很顺利,除了一个伤口裂开的病人.问卷显示舌头外观有显著改善,喂养,流口水,面部外观,和心理社会结果。手术后睡眠呼吸紊乱症状也显著减少。锁孔复位舌肌成形术是治疗BWS患者巨大舌肌的一种安全有效的方法,具有出色的功能和美学效果,并发症发生率低。
    The aim of this study was to evaluate the postoperative course and long-term functional and aesthetic outcomes in patients with Beckwith-Wiedemann syndrome (BWS) following surgical reduction of macroglossia, using multiple questionnaires. Patients with BWS who underwent keyhole reduction for macroglossia were included in this study. The postoperative course for each patient was recorded, and multiple questionnaires were administered to evaluate aesthetic concerns, oral incompetence or feeding difficulties, sleep-disordered breathing symptoms, and speech. Nine patients underwent ten reduction glossoplasty surgeries. The mean age at surgery was 22 months. The postoperative course for each case was uneventful, except for one patient who had wound dehiscence. The questionnaires revealed significant improvements in tongue appearance, feeding, drooling, facial appearance, and psychosocial outcomes. There was also a significant reduction in sleep-disordered breathing symptoms after surgery. Keyhole reduction glossoplasty is a safe and effective procedure for the treatment of macroglossia in BWS patients, with excellent functional and aesthetic outcomes and a low complication rate.
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  • 文章类型: Case Reports
    Beckwith-Wiedemann综合征(BWS)是一种常见的遗传性先天性疾病,其特征是躯体过度生长,其广泛的临床范围包括产前和产后巨大儿,巨舌,内脏肿大,新生儿低血糖的风险增加,和胚胎肿瘤的发展。BWS的发生是由于涉及生长调节基因的遗传/表观遗传变化,位于11p15区域,具有重要的基因型-表型相关性。先天性肾上腺增生(CAH)包括一系列常染色体隐性遗传疾病,由于缺乏涉及皮质醇分泌的一种酶而表现出多种临床表现。基于新生儿筛查的早期诊断可预防肾上腺危象和婴儿早期死亡。然而,高17-羟孕酮(17-OHP)水平可发生在新生儿或早产儿无CAH,在由于母亲或新生儿因素造成的压力的情况下。这里,我们报告了新生儿筛查期间21-羟化酶缺乏症假阳性诊断的新病例-两名女孩和一名男孩患有BWS。甲基化特异性多重连接依赖性探针扩增显示H19差异甲基化区域的甲基化增加。值得注意的是,所有三例都显示生化变化完全正常化,突出了这些模仿CAH经典形式的激素发现的短暂性。该报告揭示了新生儿筛查期间假阳性21-羟化酶缺乏症诊断的新原因:Beckwith-Wiedemann综合征。
    Beckwith-Wiedemann syndrome (BWS) is a common genetic congenital disease characterized by somatic overgrowth and its broad clinical spectrum includes pre- and post-natal macrosomia, macroglossia, visceromegaly, increased risk of neonatal hypoglycemia, and development of embryonic tumors. BWS occurs due to genetic/epigenetic changes involving growth-regulating genes, located on region 11p15, with an important genotype-phenotype correlation. Congenital adrenal hyperplasia (CAH) comprises a spectrum of autosomal recessive diseases presenting a variety of clinical manifestations due to a deficiency in one of the enzymes involved in cortisol secretion. Early diagnosis based on newborn screening prevents the adrenal crisis and early infant death. However, high 17-hydroxyprogesterone (17-OHP) levels can occur in newborns or premature infants without CAH, in situations of stress due to maternal or neonatal factors. Here, we report new cases of false-positive diagnosis of 21-hydroxylase deficiency during newborn screening - two girls and one boy with BWS. Methylation-specific multiplex ligation-dependent probe amplification revealed a gain of methylation in the H19 differentially methylated region. Notably, all three cases showed a complete normalization of biochemical changes, highlighting the transient nature of these hormonal findings that imitate the classical form of CAH. This report sheds light on a new cause of false-positive 21-hydroxylase deficiency diagnosis during newborn screening: Beckwith-Wiedemann syndrome.
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  • 文章类型: Case Reports
    大腿抬起手术通常在体重严重下降的患者中进行,尤其是那些接受减肥手术的人。然而,还有其他先天性畸形可能需要同样的治疗,比如BeckwithWideman综合征.
    Thigh lift surgery is generally performed in patients with severe weight loss outcomes, particularly those undergoing bariatric surgery. However, there are other congenital malformation conditions that may require the same treatment, such as Beckwith Wideman syndrome.
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  • 文章类型: Journal Article
    背景:DNA甲基化是人类中最稳定且特征最明确的表观遗传改变之一。因此,它已经在各种疾病背景下作为分子生物标志物发现了临床应用。用于甲基化相关病症的临床诊断的现有方法集中于使用标准化截止值在少量CpG位点中的异常检测,所述标准化截止值将健康与异常甲基化水平区分开。在这些方法中使用的标准化截止值不考虑已知在性别之间和随年龄而不同的甲基化模式。
    结果:在这里,我们对来自不同年龄和性别的健康对照以及Prader-Willi综合征(PWS)患者的血液样本的全基因组DNA甲基化进行了分析。Beckwith-Wiedemann综合征,脆性X综合征,Angelman综合征,和Silver-Russell综合征.我们提出了一个广义加性模型来对整个人类基因组中约700,000个CpG位点进行年龄和性别调整的离群值分析。利用每个站点的队列中的z分数,我们部署了基于集成的机器学习管道,并实现了0.96的组合预测精度(二项式95%置信区间0.868[公式:见文本]0.995)。
    结论:我们展示了一种基于大量健康个体队列的差异甲基化位点的年龄和性别调整异常检测方法。我们提出了一个定制的机器学习管道,利用这种离群值分析对样本进行分类,以确定潜在的甲基化相关的先天性疾病。当与机器学习方法一起用于对异常甲基化模式进行分类时,这些方法能够实现高准确性。
    BACKGROUND: DNA methylation is one of the most stable and well-characterized epigenetic alterations in humans. Accordingly, it has already found clinical utility as a molecular biomarker in a variety of disease contexts. Existing methods for clinical diagnosis of methylation-related disorders focus on outlier detection in a small number of CpG sites using standardized cutoffs which differentiate healthy from abnormal methylation levels. The standardized cutoff values used in these methods do not take into account methylation patterns which are known to differ between the sexes and with age.
    RESULTS: Here we profile genome-wide DNA methylation from blood samples drawn from within a cohort composed of healthy controls of different age and sex alongside patients with Prader-Willi syndrome (PWS), Beckwith-Wiedemann syndrome, Fragile-X syndrome, Angelman syndrome, and Silver-Russell syndrome. We propose a Generalized Additive Model to perform age and sex adjusted outlier analysis of around 700,000 CpG sites throughout the human genome. Utilizing z-scores among the cohort for each site, we deployed an ensemble based machine learning pipeline and achieved a combined prediction accuracy of 0.96 (Binomial 95% Confidence Interval 0.868[Formula: see text]0.995).
    CONCLUSIONS: We demonstrate a method for age and sex adjusted outlier detection of differentially methylated loci based on a large cohort of healthy individuals. We present a custom machine learning pipeline utilizing this outlier analysis to classify samples for potential methylation associated congenital disorders. These methods are able to achieve high accuracy when used with machine learning methods to classify abnormal methylation patterns.
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