"Serpentine-like syndrome"-A very rare multiple malformation syndrome characterised by brachioesophagus and vertebral anomalies.
"Serpentine-like syndrome" is a severe and rare association of multiple congenital malformations, characterised by brachioesophagus, secondary intrathoracic stomach, and vertebral anomalies. Other associated anomalies have been described, such as malposition and herniation of abdominal organs. We report the natural history of a baby girl born at 29 weeks of gestation with intra uterine growth restriction, short neck, large rachischisis from cervical to thoracic spine, a very short oesophagus, thoracic stomach associated with a midline diaphragmatic hernia, malrotated gut and median cleft lip. Most of these anomalies were detected antenatally. Molecular karyotype was normal. She died at age 12 days. To our knowledge, the present patient represents the 8th report of a case of "Serpentine-like syndrome". Brachioesophagus and congenital vertebral anomalies, in particular rachischisis, are the cardinal features of this condition. All reported cases have been sporadic and the cause is still unknown. We believe that the specificity of the presentation as well as the similarities between available descriptions of patients suggests a common, yet to identify, molecular cause, possibly involving a developmental "toolkit"/homeobox gene or related pathways.
Centre de Génétique Humaine, Cliniques Universitaires St. Luc, U.C.L., Brussels; Department of Clinical Genetics, Guy's Hospital, Great Maze Pond, London, SE1 9RT, UK. Electronic address: ana.beleza@gstt.nhs.uk.
Ana
A
Beleza-Meireles
Obstetrics Department, Cliniques Universitaires St.Luc, U.C.L. Brussels.
Patricia
P
Steenhaut
Neonatalogy Unit, Department of Paediatrics, Cliniques Universitaires St. Luc, U.C.L. Brussels.
Catheline
C
Hocq
Radiology Department, Cliniques Universitaires St. Luc, U.C.L. Brussels.
Philippe
P
Clapuyt
Obstetrics Department, Cliniques Universitaires St.Luc, U.C.L. Brussels.
Pierre
P
Bernard
Neonatalogy Unit, Department of Paediatrics, Cliniques Universitaires St. Luc, U.C.L. Brussels.
Christian
C
Debauche
Centre de Génétique Humaine, Cliniques Universitaires St. Luc, U.C.L., Brussels.
Yves
Y
Sznajer
D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology*; D000328:Adult; D003240:Connective Tissue Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology*; D004065:Digestive System Abnormalities / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000503:physiopathology; D065630:Hernias, Diaphragmatic, Congenital / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D007231:Infant, Newborn; D045822:Intestinal Volvulus / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013131:Spine / Q000000981:diagnostic imaging / Q000503:physiopathology