We report a case of a newborn infant whose mother had systemic lupus erythematosus (SLE) diagnosed before pregnancy.The child had clinical manifestations of neonatal lupus as well as chondrodysplasia punctata and other findings that resemble the congenital anomalies associated with the use of oral anticoagulants, with no history of exposure. We speculate that the combined action of the different maternal autoantibodies may produce the whole spectrum of manifestations.
ResumenLa are: c umbilical urrca [AUU) es una malformocicn cenfinela que debe orien'ar a la busqueca mas exhaustive de mclfcrmaciones asociadas que pueden no ser siempre evidentes, ya sea que estas se presenten en forma de sindrones a bien co r un patron desconocido. Este estudio incluye a las casos registrac'os de AUU en la Lnidad de Neonatolog'c del Hbspiral Clinico de la IHvers'dad de Chi e desde enero de 1978 hasfa abril de 1998. Observamos, como se ha reportaco en la literature, que la AUU aislada o asociada a malformaciones menores t'ene buen pronostico, en contraoosicion a lo que ocurre cuando se acompana de unc o mas malfcrmaciones mayores. Se encontro a la AUU como pcrte de un sindrome en un 36,4% de los casos y se detectaron caisas crornosomicas en 10,9% de ellos. Es importante intentar realizcr un c'iagn6sl"co preciso, de manera de estimar el riesgo de recurrencia que puedan tener los pad'es en futures emba r azos.(Palabras clave: arteria umbilical unica.. rnal'ormaciones co^gen'tas.] Single umbilical artery and associated malformationsSingle umbi'ical artery |SUA) is a sentinel malforna ; ion wh'ch should guide lo the more exhaustive sea r ch of congenital associated anomalies which are not always evicent, w~ethe r as part of well-identified syndromes or as part of unrecognized malfo'mation patterns In 'his study., which includes the cases of SJA registered in the Neonatology Unit of the University of Chile Cirical Hospital, between January of 1978 and aprJ of 1998, we found that when SUA is accompanied with one or more major malformations there is a poor prognos's, confirming previous reports. We found SUA os part of a syndrome in 36,4% of the cases and a chromosomal abnormality in 10,9% of them. :( is important to intend to per f orm an accurate diagnosis, because of the impl'cct'ons for the parents in relation to recurrence risk in a "ext pregnancy.(Key words: single jnbil'cal arte'y, congenital malformations.;Austin-Ward E. y cols. Revlsta Chilena de PediatrfaSeptiembre-Octubre 1998
Marker chromosomes present a problem in genetic counseling because there are often no clear phenotype-karyotype correlations. We present the clinical findings in a patient who is mosaic for a supernumerary marker chromosome 20 determined by fluorescence in situ hybridization (FISH) and compare these findings to others reported in the literature.
ResumenLa hernia diafragmatica congenita |HDC] continue siendo me patologia que pone en peligro la vido a pesar de los adelantos en su manejo. Las malformaciones congenital asociadas resul'an ser uno de los factcres mas importantes que conlribuyen a elevar los tasas de rnortalidad en estos pacientes. zn este Iraoajo presentamos nues*ra exoeriencia con re'acicn a esta anomcl'a, :a cual forma parte del Esludio Colaborativo Latinoamericano de Malformaciones Congenitos (ECLAMC), en^ocado principalme^te en lo asociacion de la HDC con otras malformaciones congenitas, y revise mos los aspectos relacionaccs con el patron de herencia involjcrado e^ los casos famil'cres de HDC. En este estudio enconlramos que las malformac'ones mayo res, especi aim erne las cardiacas, y un bajo peso al nacer con'ieren un mal p'onostico a los recien nacacs con HDC. (Palabras clave: hernia diaframatica congen.ta, malformcciones concenitas,] Congenital diaphragmatic hernia and associated malformationsCongenital diapfragmatic hern a (CDH) continues to be a life-threatening condition despite the improvements in the management. Associated congenital malformations seem to be one of the mosl important fccto's that leads to en increase ; n mo'tality ra~es '.n these patents. We present "ere CLT experience with this cond't'on as part of the Latinoamerican Collaborative Study cf Congenial Malformations (ECLAAAC) focused on rhe CDH association with olher congenital malformations a^d c review of ?he issues related to the pattern of inheritance 'nvolved in t^e famiLcr cases of CDH. We found that ma or malfo.'mct'ons, specially cardiac and a low birth weight confer poor prognosis to the newborns with CDH.(Key words: congenital diaphragmatic hernia., major ma.formations.]La hernia diafragmatica congenita (HDC) consiste en un defecto anatomico que resulta en una ausencia completa o parcial del diafragma 1 , que permite una comunicaci6n entre las cavidades pleural y peritoneal facilitando el paso de contenido abdominal al torax. Esto resulta en una compresi6n de las estructuras tora"cicas, lo que lleva a un desarrollo pulmonar anormal y a un funcionamiento inadecuado del sistcma cardiopulmonar desde los primeros minutos de 1. Servicio de Genetica, Departamento de Medicina. Hospital Clmico de la Universidad de Chile.2. Unidad de Neonatologia, Hospital Clinico de la Universidad de Chile.vida extrauterina. El contenido abdominal puede herniarse a traves de dos tipos de defectos diafragmaticos, de distinto origen, los cuales pueden presentarse de manera individual (lo que se conoce como agenesia parcial del diafragma) o conjunta (agenesia diafragmatica bilateral o total). La hernia a trav6s del foramen de Bochdalek se refiere al defecto de la regi6n posterolateral izquierda del diafragma, y es causada por una falla en la formacidn o en la fusion de las membranas pleuroperitoneales 2 . La herniaci6n a traves del foramen de Morgagni se refiere al defecto en las regiones central y lateral derechas y es causada por una falla en el desanrollo del segmento retroester...
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