Pneumothorax from subpleural blebs-a new association of sotos syndrome?
We describe two unrelated patients with molecularly confirmed Sotos syndrome with multiple subpleural blebs and pneumothorax. We propose this as a new association. Patient 1 is a 3-year-old boy with a 1.9 Mb interstitial deletion of the long arm of chromosome 5, with breakpoints at q35.2 and q35.3, encompassing NSD1 and Patient 2 is a 9-year-old girl with a de novo truncating mutation within NSD1. Both patients presented with sudden onset dyspnea due to a unilateral pneumothorax: Patient 1 at the age of 18 months and Patient 2 at 9 years. In both, the pneumothorax recurred following removal of the chest drain and, on further investigations, multiple subpleural blebs were identified necessitating a pleurodesis and tissue resection. This is the first report of multiple subpleural blebs leading to pneumothorax in association with Sotos syndrome. Given the similar and unusual presentation in the two affected patients, we suggest that this may be a real association, albeit a rare one. While screening would not be advocated for such a rare association, we recommend that clinicians consider pneumothorax in patients with Sotos syndrome and sudden onset of dyspnea and are aware that it may be refractory to first line treatment.
Sheffield Clinical Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, Yorkshire, United Kingdom.
Meena
M
Balasubramanian
Emma
E
Shearing
Kath
K
Smith
R
R
Chavasse
R
R
Taylor
Katrina
K
Tatton-Brown
Robert
R
Primhak
Kelechi
K
Ugonna
Michael J
MJ
Parker
D001706:Biopsy; D002675:Child, Preschool; D002872:Chromosome Deletion; D002895:Chromosomes, Human, Pair 5; D055028:Comparative Genomic Hybridization; D019066:Facies; D005260:Female; D000076983:Histone Methyltransferases; D011495:Histone-Lysine N-Methyltransferase; D006801:Humans; D007223:Infant; D047908:Intracellular Signaling Peptides and Proteins / Q000235:genetics; D008297:Male; D009687:Nuclear Proteins / Q000235:genetics; D010641:Phenotype; D011030:Pneumothorax / Q000175:diagnosis / Q000473:pathology*; D058495:Sotos Syndrome / Q000175:diagnosis* / Q000235:genetics; D020708:Thoracoscopes; D014057:Tomography, X-Ray Computed
D047908:Intracellular Signaling Peptides and Proteins; D009687:Nuclear Proteins; D000076983:Histone Methyltransferases; D011495:Histone-Lysine N-Methyltransferase; C113272:NSD1 protein, human
5q35 microdeletion; Sotos Syndrome; aCGH; developmental delay; pneumothorax; subpleural blebs