title: Phenotype of five cases of prenatally diagnosed campomelic dysplasia harboring novel mutations of the SOX9 gene.
abstract: OBJECTIVE
  Campomelic dysplasia is a rare congenital skeletal disorder characterized by bowing of the long bones and a variety of other skeletal and extraskeletal defects, many of which can now be identified prenatally using advanced ultrasound equipment. The disorder is caused by mutations in SRY-box 9 (SOX9), a gene that is abundantly expressed in chondrocytes as well as in other tissues. However, the correlation between genotype and phenotype is still unclear. We report five cases of prenatally detected campomelic dysplasia in which the diagnosis was confirmed by molecular analysis.
  
  
  METHODS
  Ultrasound examinations were performed between 12 and 32 weeks. Standard fetal biometric measurements were obtained. Fetal sex was determined sonographically and confirmed by chromosomal analysis. Genomic DNA was obtained in four cases before termination of pregnancy from chorionic villi or amniocytes and in one case postnatally from peripheral blood.
  
  
  RESULTS
  Skeletal dysplasia, most often limb shortening and bowed femora, was observed in one case in the first trimester, in three cases in the second trimester and in one case, presenting late for antenatal care, in the third trimester. Four of the pregnancies were terminated and one was carried to term. Postmortem/postnatal physical and radiographic examinations confirmed the presence of anomalies characteristic of campomelic dysplasia. A de novo mutation in the SOX9 gene was detected in all four cases that underwent termination. The father of the proband in the case that went to term was a carrier of a somatic mosaic mutation without clinical or radiographic signs of campomelic dysplasia.
  
  
  CONCLUSIONS
  It is likely that the integrated expertise of ultrasonographers, obstetricians, pediatricians and clinical geneticists will markedly improve the likelihood of accurate prenatal clinical diagnoses of campomelic dysplasia. This will, in turn, encourage more specific molecular testing and facilitate comprehensive genetic counseling.
authors.affiliation: Fondazione IRCCS, Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, UOD Genetica Medica, Milano, Italy. barbara.gentilin@libero.it
authors.forename: B
authors.initials: B
authors.lastname: Gentilin
authors.forename: F
authors.initials: F
authors.lastname: Forzano
authors.forename: M F
authors.initials: MF
authors.lastname: Bedeschi
authors.forename: T
authors.initials: T
authors.lastname: Rizzuti
authors.forename: F
authors.initials: F
authors.lastname: Faravelli
authors.forename: C
authors.initials: C
authors.lastname: Izzi
authors.forename: M
authors.initials: M
authors.lastname: Lituania
authors.forename: C
authors.initials: C
authors.lastname: Rodriguez-Perez
authors.forename: M P
authors.initials: MP
authors.lastname: Bondioni
authors.forename: G
authors.initials: G
authors.lastname: Savoldi
authors.forename: E
authors.initials: E
authors.lastname: Grosso
authors.forename: G
authors.initials: G
authors.lastname: Botta
authors.forename: E
authors.initials: E
authors.lastname: Viora
authors.forename: A M
authors.initials: AM
authors.lastname: Baffico
authors.forename: F
authors.initials: F
authors.lastname: Lalatta
mesh_terms: D000028:Abortion, Induced; D000328:Adult; D055036:Campomelic Dysplasia / Q000000981:diagnostic imaging* / Q000196:embryology / Q000235:genetics*; D005260:Female; D005817:Genetic Counseling; D005838:Genotype; D005865:Gestational Age; D006801:Humans; D010641:Phenotype; D017354:Point Mutation / Q000235:genetics; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D055758:SOX9 Transcription Factor / Q000235:genetics*; D016216:Ultrasonography, Prenatal; D055815:Young Adult
chemical_list: D055758:SOX9 Transcription Factor; C527932:SOX9 protein, human