Research: Retrospective evaluation of clinical and molecular data of 148 cases of esophageal atresia

Am J Med Genet A

. 2022 Oct 21.

 doi: 10.1002/ajmg.a.62989. Online ahead of print.

Retrospective evaluation of clinical and molecular data of 148 cases of esophageal atresia

Emmanuelle Ranza 1 2 3Morgane Le Gouez 4Anne Guimier 1 5Naziha Khen Dunlop 6Sylvie Beaudoin 6Valérie Malan 1Caroline Michot 1Geneviève Baujat 1Marlène Rio 1Valérie Cormier-Daire 1 5Véronique Abadie 4Sabine Sarnacki 6Christophe Delacourt 7Stanislas Lyonnet 1 5Tania Attié-Bitach 1 5Véronique Pingault 1 5Véronique Rousseau 6Jeanne Amiel 1 5

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Developmental abnormalities provide a unique opportunity to seek for the molecular mechanisms underlying human organogenesis. Esophageal development remains incompletely understood and elucidating causes for esophageal atresia (EA) in humans would contribute to achieve a better comprehension. Prenatal detection, syndromic classification, molecular diagnosis, and prognostic factors in EA are challenging. Some syndromes have been described to frequently include EA, such as CHARGE, EFTUD2-mandibulofacial dysostosis, Feingold syndrome, trisomy 18, and Fanconi anemia. However, no molecular diagnosis is made in most cases, including frequent associations, such as Vertebral-Anal-Cardiac-Tracheo-Esophageal-Renal-Limb defects (VACTERL). This study evaluates the clinical and genetic test results of 139 neonates and 9 fetuses followed-up at the Necker-Enfants Malades Hospital over a 10-years period. Overall, 52 cases were isolated EA (35%), and 96 were associated with other anomalies (65%). The latter group is divided into three subgroups: EA with a known genomic cause (9/148, 6%); EA with Vertebral-Anal-Cardiac-Tracheo-Esophageal-Renal-Limb defects (VACTERL) or VACTERL/Oculo-Auriculo-Vertebral Dysplasia (VACTERL/OAV) (22/148, 14%); EA with associated malformations including congenital heart defects, duodenal atresia, and diaphragmatic hernia without known associations or syndromes yet described (65/148, 44%). Altogether, the molecular diagnostic rate remains very low and may underlie frequent non-Mendelian genetic models.

Keywords: VACTERL; associated anomalies; esophageal atresia; genetics of esophageal atresia.

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