A Case Report of Donnai-Barrow Syndrome
Autor: | Kristi Coe, Wanda T. Bradshaw, Melissa K Robinson |
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Rok vydání: | 2020 |
Předmět: |
Male
Pediatrics medicine.medical_specialty Renal Tubular Transport Inborn Errors Late preterm infant Hearing Loss Sensorineural Resuscitation medicine.medical_treatment Gene mutation 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Myopia Extracorporeal membrane oxygenation Humans Medicine 030212 general & internal medicine Hypertelorism Child Tetralogy of Fallot business.industry Infant Newborn Infant Congenital diaphragmatic hernia General Medicine Donnai–Barrow syndrome medicine.disease Proteinuria Pediatrics Perinatology and Child Health Agenesis of Corpus Callosum medicine.symptom Hernias Diaphragmatic Congenital business Infant Premature Neonatal resuscitation |
Zdroj: | Advances in Neonatal Care. 21:133-141 |
ISSN: | 1536-0903 |
DOI: | 10.1097/anc.0000000000000766 |
Popis: | Background A genetic disorder should be considered when an infant presents with multiple congenital anomalies. Because of the acute presentation of an infant with multiple life-threatening defects, a genetic diagnosis of a rare disorder took weeks to delineate. Clinical findings This case describes a late preterm infant who presented at birth with congenital diaphragmatic hernia, tetralogy of Fallot, cleft lip, low-set ears, and hypertelorism. Primary diagnosis Donnai-Barrow syndrome was the final diagnosis confirmed by a defect observed on the LRP2 (2q31.1) gene using sequence analysis. This is a rare disorder that presents with a variety of phenotypic features in infants. Interventions Initial neonatal resuscitation in the delivery room included intubation, positive pressure ventilation, and oxygen supplementation. Extracorporeal membrane oxygenation therapy was initiated from day of life 3 to 15. Initial surgery included correction of the congenital diaphragmatic hernia, and further surgical procedures included tracheostomy, gastrostomy tube, circumcision, ventricular septal defect repair, and cleft lip repair. Physical, occupational, and speech therapies were also initiated. Outcomes The infant was transported to a pediatric rehabilitation facility at 6 months of life for further management of his chronic lung disease requiring tracheostomy with ventilator dependence. Practice recommendations Early recognition and diagnosis of genetic syndromes can improve family education and guide treatment interventions. An underlying syndrome should be suspected when an infant presents with multiple congenital defects. Infants with Donnai-Barrow syndrome should have thorough cardiac, neurologic, ophthalmologic, audiologic, and renal examinations due to the gene mutation effects on those systems. |
Databáze: | OpenAIRE |
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