Nonisolated diaphragmatic hernia in Simpson-Golabi-Behmel syndrome

Prenat Diagn. 2018 Jan;38(2):117-122. doi: 10.1002/pd.5198. Epub 2018 Jan 24.

Abstract

Objective: Congenital diaphragmatic hernia (CDH) is associated with Simpson-Golabi-Behmel syndrome (SGBS), but few cases diagnosed prenatally have been reported. The aim of this series is to highlight the association of nonisolated CDH with SGBS type I on prenatal ultrasound and emphasize the importance of genetic testing, fetal autopsy, and family history in confirming this diagnosis.

Method: Retrospective review of 3 cases of SGBS type I in a single tertiary care centre. Family history, fetal ultrasound, autopsy findings, and genetic testing for GPC3 was performed for each case.

Results: Fetal ultrasound findings in the second trimester were CDH, omphalocele, increased nuchal fold, renal anomaly, and cleft lip and palate. Fetal autopsy confirmed the prenatal ultrasound findings and also showed dysmorphic facial features and premalignant lesions on renal and gonadal histology. Microarray and DNA analysis of the GPC3 gene confirmed the diagnosis of SGBS type I in each case.

Conclusion: Nonisolated CDH in a male fetus suggests a diagnosis of SGBS type I. Fetal autopsy, pedigree analysis, and genetic testing for GPC3 are all essential to confirming the diagnosis. The histological findings of ovotestes and nephroblastomatosis indicate that cancer predisposition is established early in fetal life.

Publication types

  • Case Reports

MeSH terms

  • Abnormalities, Multiple / genetics
  • Arrhythmias, Cardiac / diagnostic imaging*
  • Arrhythmias, Cardiac / embryology
  • Arrhythmias, Cardiac / genetics
  • Female
  • Genetic Diseases, X-Linked / diagnostic imaging*
  • Genetic Diseases, X-Linked / embryology
  • Genetic Diseases, X-Linked / genetics
  • Gigantism / diagnostic imaging*
  • Gigantism / embryology
  • Gigantism / genetics
  • Glypicans / genetics*
  • Heart Defects, Congenital / diagnostic imaging*
  • Heart Defects, Congenital / embryology
  • Heart Defects, Congenital / genetics
  • Hernias, Diaphragmatic, Congenital / diagnostic imaging*
  • Hernias, Diaphragmatic, Congenital / embryology
  • Hernias, Diaphragmatic, Congenital / genetics
  • Humans
  • Intellectual Disability / diagnostic imaging*
  • Intellectual Disability / embryology
  • Intellectual Disability / genetics
  • Male
  • Pregnancy
  • Retrospective Studies
  • Ultrasonography, Prenatal*

Substances

  • GPC3 protein, human
  • Glypicans

Supplementary concepts

  • Simpson-Golabi-Behmel syndrome