• 제목/요약/키워드: Hypotonia

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Myotonic dystrophy diagnosed during the perinatal period: A case series report

  • Shin, You Jung;Kim, Do Jin;Park, So Yeon;Chung, Jin Hoon;Lee, Yeon Kyung;Ryu, Hyun Mee
    • Journal of Genetic Medicine
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    • 제13권2호
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    • pp.105-110
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    • 2016
  • Congenital myotonic dystrophy (CMD) which is transmitted in an autosomal-dominant manner, can also be observed in newborns born to asymptomatic parents who have a myotonic dystrophy type 1 or premutation allele, especially from the mother. A mother with myotonic dystrophy could be subfertile and the pregnancy could be complicated with the risk of a preterm birth. Newborns with CMD may demonstrate symptoms such as hypotonia and poor motor activity, as well as respiratory and feeding difficulties. Additionally, CMD has a high mortality rate at birth. Detection of the signs and symptoms during pregnancy is helpful for a prenatal diagnosis of CMD in cases where the family history is not known.

Prader-Willi 증후군에서 방광요관 역류를 동반한 양측성 Hutch 게실 1례 (A Case of Prader-Willi Syndrome with Bilateral Butch Diverticula Associated with Vesicoureteral Reflux)

  • 한승정;이택;김원홍;홍영진;전용훈;이지은
    • Childhood Kidney Diseases
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    • 제9권1호
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    • pp.112-116
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    • 2005
  • 저자들은 PWS로 확진된 영아에서 양측성의 심한 Hutch 방광게실과 방광요관 역류가 동반됨을 처음으로 발견하였다. PWS의 근긴장도 저하와 Hutch 게실의 관련성을 생각할 수 있으며 향후 보다 많은 증례 연구를 통해 선천성 방광 게실과 관련한 증후군에 PWS를 포함시킬 것을 고려 해 야 하겠다.

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Beneficial Effects of Growth Hormone Treatment in Prader-Willi Syndrome

  • Kim, Jinsup;Yang, Aram;Cho, Sung Yoon;Jin, Dong-Kyu
    • Journal of mucopolysaccharidosis and rare diseases
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    • 제3권2호
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    • pp.41-43
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    • 2017
  • Prader-Willi syndrome (PWS) is a genetic disorder that is considered, especially on child, to cause poor feeding, hypotonia, failure to thrive, developmental delay and hypogonadism which is known to affect between 1 in 10,000 and 30,000 people. The children with PWS are viewed as affected by growth hormone (GH) insufficiency, although the exact mechanisms of GH deficiency are not fully understood. However, the benefits of GH treatment in children with PWS are well established. Myers, et al. (2006), Grugni, et al. (2016) indicated its positive effects on linear growth, body composition, motor function, respiratory function and psychomotor development. Despite of its effectiveness and advantages had been well known and proven in many other studies, there is only one recombinant GH product that is approved for PWS in Korea, $Genotropin^{(R)}$, till now. A phase III clinical study of GH treatment with $Eutropin^{TM}$, in 34 Korean PWS children is in progress, which is expected to have comparable effects and safety profile with the active control by assessing auxological changes such as height standard deviation score, body composition changes such as lean body mass and percent body fat, motor and cognitive development using Bayley scale, and safety profiles.

A Korean Case of Neonatal Nemaline Myopathy Carrying KLHL40 Mutations Diagnosed Using Next Generation Sequencing

  • Suh, Yoong-a;Sohn, Young Bae;Park, Moon Sung;Lee, Jang Hoon
    • Neonatal Medicine
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    • 제28권2호
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    • pp.89-93
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    • 2021
  • Nemaline myopathy is a genetically heterogeneous neuromuscular disorder and one of the most common congenital myopathies. The clinical manifestations usually vary depending on the age of onset. Neonatal nemaline myopathy has the worst prognosis, primarily due to respiratory failure. Several genes associated with nemaline myopathy have been identified, including NEB, ACTA1, TPM3, TPM2, TNNT1, CFL2, KBTBD13, KLHL40, KLHL41, LMOD3, and KBTBD13. Here, we report a neonatal Korean female patient with nemaline myopathy carrying compound heterozygous mutations in the gene KLHL40 as revealed using next generation sequencing (NGS). The patient presented with postnatal cyanosis, respiratory failure, dysphagia, and hypotonia just after birth. To identify the genetic cause underlying the neonatal myopathy, NGS-based gene panel sequencing was performed. Compound heterozygous pathogenic variants were detected in KLHL40: c.[1405G>T];[1582G>A] (p. [Gly469cys];[Glu528Lys]). NGS allows quick and accurate diagnosis at a lower cost compared to traditional serial single gene sequencing, which is greatly advantageous in genetically heterogeneous disorders such as myopathies. Rapid diagnosis will facilitate efficient and timely genetic counseling, prediction of disease prognosis, and establishment of treatments.

Growth Hormone Therapy in PWS with Mobile Application-Living with PWS

  • Im, Minji
    • Journal of mucopolysaccharidosis and rare diseases
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    • 제4권2호
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    • pp.42-44
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    • 2018
  • Prader-Willi syndrome (PWS) is a multisystemic complex disorder characterized by hyperphagia and impaired satiety which lead to severe and early obesity. In infancy, hypotonia and poor suck are main problems, and a child goes through Failure-to-thrive. During childhood, clinical manifestations change to food seeking as well as excessive weight gain, short stature, developmental delay, cognitive disability and behavioral problems. Also, growth hormone insufficiency is frequent. Most patients receive the recombinant growth hormone (rGH) therapy that provides improvement in growth, body composition, and physical attributes. The clinical care guideline for rGH therapy in PWS had been noticed in 2013. The rGH therapy helps in body fat, lean body mass, height SDS and head circumference. Also, the rGH therapy helps motor function, psychomotor development and cognition and behavioral issues.In Samsung medical center, there are clinical care guidelines for rGH therapy in PWS and an useful application for the patients. 'Living with PWS', the name of an moblie application for PWS patients, was introduced in the lecture. The application revised to version 2. It was made more convenient to users than in version 1. It helps caregivers to schedule the rGH therapy and to monitor height and weight.

튜불린 부호화 유전자인 TUBB3 돌연변이에서 나타난 복합 뇌피질 발달기형 (A Complex Cortical Malformation Caused by a Mutation in the Tubulin-Encoding TUBB3 Gene)

  • 이유현;박노혁
    • 대한영상의학회지
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    • 제81권5호
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    • pp.1246-1249
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    • 2020
  • 튜불린병증, 즉 튜불린 유전자의 변이는 복합 뇌피질 발달 기형의 원인으로 알려져 있다. 그중에서 TUBB3 유전자가 기형의 원인인 사례는 매우 드물어 이를 보고하고자 한다. 21개월 남아가 발달지연을 주소로 내원하였다. 환아는 혼자 걷지 못하였고 구사 가능한 단어가 5개 이내였다. 신체검사상 우측 내사시와 양하지 근력저하가 관찰되었다. 뇌 자기공명영상에서 뇌간의 이형성, 기저핵의 이형성 및 과형성 소견이 보였고 우측 시상의 크기가 좌측보다 작았으며 붕괴된 소뇌이랑의 소견이 보였다. DNA 염기서열 분석 결과 TUBB3 유전자의 과오돌연변이가 확인되었다.

Prader-Willi syndrome 환자의 치과 치료 : 증례보고 (DENTAL MANAGEMENT OF A PATIENT WITH PRADER-WILLI SYNDROME : A CASE REPORT)

  • 이명연;정연욱;김성오;최형준;손흥규;이효설
    • 대한장애인치과학회지
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    • 제10권1호
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    • pp.26-30
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    • 2014
  • 프라더 윌리 증후군과 원인을 알 수 없는 심낭 삼출을 앓고 있는 3세 남환이 치아우식을 주소로 내원하여 임상 구강 검사 결과 다발성 우식증과 구강 전반에 걸친 치아 마모증이 관찰되었다. 약 10개월간 보존적인 수복치료와 구강 위생관리를 시도하였으나, 치아 우식의 빠른 진행과 환아의 협조도 부족으로 전신마취 하 우식 치료를 시행하였다.

Identification of Potocki-Lupski syndrome in patients with developmental delay and growth failure

  • Jun, Sujin;Lee, Yena;Oh, Arum;Kim, Gu-Hwan;Seo, Eulju;Lee, Beom Hee;Choi, Jin-Ho;Yoo, Han-Wook
    • Journal of Genetic Medicine
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    • 제16권2호
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    • pp.49-54
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    • 2019
  • Purpose: Potocki-Lupski syndrome (PTLS), is a recently identified, rare genomic disorder. The patients are affected by infantile hypotonia, poor growth and developmental delay. Facial dysmorphism may not be obvious in some patients. PTLS is associated with microduplication at chromosome 17p11.2. In the current study, three Korean patients are reported with their clinical and genetic features. Materials and Methods: The clinical findings of each patient were reviewed. Karyotyping and multiplex ligation-dependent probe amplification (MLPA) analyses were done for genetic diagnoses. Results: All the patients did not have the characteristic dysmorphic features, such as broad forehead, triangular face, asymmetric smile and palpebral fissures. On the other hand, all three patients were affected by variable degree of developmental delay, poor oral intake, failure to thrive, and language development disorders. Chromosome 17p11.2 duplication was identified by conventional karyotyping analysis only in one patient, whereas the other confirmed by MLPA analyses. Conclusion: Delayed development was mostly commonly observed in our patients without distinct dysmorphic facial features. In this respect, genomic screening in patients with developmental delay would identify more cases with PTLS to understand their long-term clinical courses with the development of adequate psychological and rehabilitation education program.

Application of array comparative genomic hybridization in Korean children under 6 years old with global developmental delay

  • Lee, Kyung Yeon;Shin, Eunsim
    • Clinical and Experimental Pediatrics
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    • 제60권9호
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    • pp.282-289
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    • 2017
  • Purpose: Recent advancements in molecular techniques have greatly contributed to the discovery of genetic causes of unexplained developmental delay. Here, we describe the results of array comparative genomic hybridization (CGH) and the clinical features of 27 patients with global developmental delay. Methods: We included 27 children who fulfilled the following criteria: Korean children under 6 years with global developmental delay; children who had at least one or more physical or neurological problem other than global developmental delay; and patients in whom both array CGH and G-banded karyotyping tests were performed. Results: Fifteen male and 12 female patients with a mean age of $29.3{\pm}17.6months$ were included. The most common physical and neurological abnormalities were facial dysmorphism (n=16), epilepsy (n=7), and hypotonia (n=7). Pathogenic copy number variation results were observed in 4 patients (14.8%): 18.73 Mb dup(2)(p24.2p25.3) and 1.62 Mb del(20p13) (patient 1); 22.31 Mb dup(2) (p22.3p25.1) and 4.01 Mb dup(2)(p21p22.1) (patient 2); 12.08 Mb del(4)(q22.1q24) (patient 3); and 1.19 Mb del(1)(q21.1) (patient 4). One patient (3.7%) displayed a variant of uncertain significance. Four patients (14.8%) displayed discordance between G-banded karyotyping and array CGH results. Among patients with normal array CGH results, 4 (16%) revealed brain anomalies such as schizencephaly and hydranencephaly. One patient was diagnosed with Rett syndrome and one with $M{\ddot{o}}bius$ syndrome. Conclusion: As chromosomal microarray can elucidate the cause of previously unexplained developmental delay, it should be considered as a first-tier cytogenetic diagnostic test for children with unexplained developmental delay.

대장절제술 후 발생한 설사 환자에 대한 한의치료 증례보고 1례 (A Case Report of Korean Medicine Treatment of a Patient with Diarrhea after Hemicolectomy)

  • 김영지;송주연;문지성;민선우;김학겸;최동준
    • 대한한방내과학회지
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    • 제41권5호
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    • pp.926-932
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    • 2020
  • This report presents examples of the use of Korean medicine to treat diarrhea after colon hemicolectomy. The patient was a male in his 80s who had undergone hemicolectomy 3 years previously for colon cancer. He complained of diarrhea and fecal incontinence and had attempted suicide. He was admitted to the internal medicine ward through the emergency room. Treatment did not improve his diarrhea, even with the use of antidiarrheal drugs, so he was transferred to the Korean Medicine Hospital, where he received daily acupuncture and medicine treatment. After Korean medicine treatment, his symptoms improved rapidly and his fecal incontinence stopped after one week of hospitalization. Two weeks after hospitalization, his stool had improved to normal stool, his hypotonia had also improved, and he was discharged. This report shows that Korean medicine treatment can be effective in treating patients with diarrhea. In the future, related cases will need to be accumulated.