Publications by authors named "Constance Wells"

Article Synopsis
  • Prenatal exome sequencing (pES) is increasingly used to diagnose fetuses with structural defects, identifying additional conditions in about 30% who have normal chromosomal microarray analysis (CMA).
  • A study categorized prenatal phenotypes for fetuses with pathogenic variants, finding typical features in 67.9% of cases, while uncommon or unreported features complicated some interpretations.
  • Recommendations include standardizing prenatal feature descriptions, enhancing follow-up practices, and collecting larger datasets to improve pES analysis.
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Objective: To evaluate the postnatal outcome of children with antenatal colonic hyperechogenicity, currently considered as a sign of lysinuria-cystinuria, but which may also be a sign of other disorders with a more severe prognosis.

Method: We carried out a French multi-centric retrospective study via 15 Multidisciplinary Center for Prenatal Diagnosis from January 2011 to January 2021. We included pregnancies for which fetal colonic hyperechogenicity had been demonstrated.

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Article Synopsis
  • A pilot study in France used trio-ES on 150 fetuses with significant ultrasound anomalies, with a focus on influencing pregnancy management, and found a causal diagnosis in 34% of cases within about 28 days.
  • The study demonstrated a high diagnostic yield for trio-ES, comparable to postnatal diagnosis, indicating its potential for routine use in prenatal care when anomalies are detected.
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Corpus callosum defects are frequent congenital cerebral disorders caused by mutations in more than 300 genes. These include genes implicated in corpus callosum development or function, as well as genes essential for mitochondrial physiology. However, in utero corpus callosum anomalies rarely raise a suspicion of mitochondrial disease and are characterized by a very large clinical heterogeneity.

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Article Synopsis
  • Chromosomal microarray (CMA) is currently the preferred diagnostic tool for rare disorders, detecting copy number variations (CNVs) with a yield of 10%-20%, though whole exome sequencing (WES) and genome sequencing (WGS) are also available.
  • This study compares the effectiveness of CMA against GATK4 exome sequencing in identifying coding CNVs, utilizing a cohort of 615 individuals for validation and 2418 for a prospective analysis.
  • Results show that WES can improve diagnostic yield by a slight margin when used alongside SNV detection, suggesting it may be more beneficial to reevaluate CNVs before proceeding to WGS after inconclusive CMA or WES results.
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As part of the lacrimal apparatus, the lacrimal gland participates in the maintenance of a healthy eye surface by producing the aqueous part of the tear film. Alacrimia and hypolacrimia, which are relatively rare during childhood or young adulthood, have their origin in a number of mechanisms which include agenesia, aplasia, hypoplasia, or incorrect maturation of the gland. Moreover, impaired innervation of the gland and/or the cornea and alterations of protein secretion pathways can lead to a defective tear film.

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Article Synopsis
  • - This study focused on 15 infants under a year old in intensive care who were suspected to have genetic conditions and underwent rapid trio exome sequencing (rES) from April 2019 to April 2021.
  • - The key finding was that results from rES were available to parents within 16 days for 86% of the participants, and 40% received a confirmed diagnosis.
  • - The study highlights the potential of rES to enhance medical care for critically ill infants, despite some patients not receiving a diagnosis and a few passing away before results were available.
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Objectives: The antenatal phenotypic spectrum of Noonan Syndrome (NS) requires better characterization.

Methods: This multicenter retrospective observational included 16 fetuses with molecularly confirmed NS admitted for fetopathological examination between 2009 and 2016.

Results: Among 12 pathogenic variants (PV) in PTPN11 (80%), 5 (42%) fell between position c.

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Article Synopsis
  • - The study aimed to compare the effectiveness of remifentanil and sufentanil for performing feticide after 22 weeks of gestation in France, focusing on time to fetal asystole and other safety measures.
  • - A randomized trial included 66 women divided into two groups, with results showing no significant differences in time to fetal asystole or procedure success rates between the two drugs.
  • - Both remifentanil and sufentanil were safe, with no severe maternal side effects, and tissue examinations showed no significant differences in cellular modifications.
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  • The study aimed to identify the prenatal ultrasound characteristics of cleft palate without cleft lip by using 3D imaging techniques.
  • Conducted over seven years, the research involved analyzing fetal secondary palates through 2D and 3D ultrasound views and correlated the findings with postnatal examinations.
  • The results showed a high agreement between prenatal diagnoses and postnatal evaluations, successfully categorizing cleft palate types and establishing effective diagnostic methods for prenatal identification.
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  • * Researchers reported on 32 new individuals with confirmed KAT6B disorders, identified 24 new pathogenic variants, and suggested a classification for clinical subtypes based on phenotypic features.
  • * Key findings include increased prevalence of cerebral anomalies, optic nerve issues, and limb abnormalities, along with serious conditions like intestinal malrotation, underscoring the importance of thorough assessment in affected individuals.
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  • A patient with mild intellectual deficiency carries a de novo balanced translocation t(3;5), and detailed genetic testing showed no disruption of genes at the breakpoints.
  • The breakpoint on chromosome 5 was found 228-kb upstream of the MEF2C gene, which was overexpressed in the patient's cells during RNA studies.
  • This case is notable as the first documented instance of a balanced translocation that leads to MEF2C overexpression, resembling a functional duplication, paralleling existing cases of similar intellectual disabilities linked to microduplications of the same gene.
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Early infantile epileptic encephalopathy (EIEE) is a heterogeneous group of severe forms of age-related developmental and epileptic encephalopathies with onset during the first weeks or months of life. The interictal electroencephalogram (EEG) shows a "suppression burst" (SB) pattern. The prognosis is usually poor and most children die within the first two years or survive with very severe intellectual disabilities.

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Retinoblastoma (Rb) results from biallelic inactivation of the RB1 gene. Hereditary Rb patients i. e germline carriers of a RB1 mutation also have a risk of developing subsequent malignant neoplasms (SMN) such as osteosarcomas.

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Spondylocarpotarsal synostosis syndrome (SCTS) is characterized by intervertebral fusions and fusion of the carpal and tarsal bones. Biallelic mutations in FLNB cause this condition in some families, whereas monoallelic variants in MYH3, encoding embryonic heavy chain myosin 3, have been implicated in dominantly inherited forms of the disorder. Here, five individuals without FLNB mutations from three families were hypothesized to be affected by recessive SCTS on account of sibling recurrence of the phenotype.

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We report 15 individuals with de novo pathogenic variants in WDR26. Eleven of the individuals carry loss-of-function mutations, and four harbor missense substitutions. These 15 individuals comprise ten females and five males, and all have intellectual disability with delayed speech, a history of febrile and/or non-febrile seizures, and a wide-based, spastic, and/or stiff-legged gait.

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CHARGE syndrome (MIM#214800) (Coloboma, Heart defect, Atresia of choanae, Retarded growth and development, Genital hypoplasia, Ear abnormalities/deafness) is caused by heterozygous mutation of CHD7 transmitted in an autosomal dominant manner. In this report, we describe a patient with bilateral hearing impairment, unusually-shaped ears, no intellectual disability and a patent ductus arteriosus. Further investigation showed abnormal semicircular canals and the presence of olfactory bulbs.

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Article Synopsis
  • Molecular cytogenetics, particularly array-CGH, has allowed for the identification of new syndromes, such as the 8q24.3 microdeletion syndrome.
  • The syndrome is considered a contiguous gene syndrome, where the effects are linked to adjacent genes SCRIB and PUF60.
  • A case study of a fetus with this deletion revealed various physical abnormalities, and notably, it is the first instance where the SCRIB gene's expected effects were absent.
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