J Pediatr Genet 2019; 08(02): 086-090
DOI: 10.1055/s-0038-1675338
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Early-Onset Marfan Syndrome: A Case Series

Mohanageetha Ardhanari
1   Division of Pediatric Cardiology, Department of Pediatrics, Jackson Memorial Hospital, University of Miami, Miller School of Medicine, Miami, Florida, United States
,
Deborah Barbouth
2   Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami, Miller School of Medicine, Miami, Florida, United States
,
Sethuraman Swaminathan
1   Division of Pediatric Cardiology, Department of Pediatrics, Jackson Memorial Hospital, University of Miami, Miller School of Medicine, Miami, Florida, United States
› Author Affiliations
Funding None.
Further Information

Publication History

08 August 2018

17 September 2018

Publication Date:
02 November 2018 (online)

Abstract

Mutations in fibrillin 1 cause Marfan syndrome (MFS), an autosomal dominant disorder of the connective tissue, with multisystem manifestations. In early-onset MFS, the physical characteristics are expressed much earlier than the classical MFS. Those affected by this form generally have their mutations restricted to the gene “hotspot” region of exons 24 to 32. Historically, affected individuals usually die within the first few years of life due to heart failure secondary to severe valvular insufficiency. We report three patients with early-onset MFS, whose clinical evolution has been remarkably positive, when compared with other reported cases in the literature.

Financial Disclosure

All the authors have no financial relationships relevant to this manuscript to disclose.


 
  • References

  • 1 Judge DP, Dietz HC. Marfan's syndrome. Lancet 2005; 366 (9501): 1965-1976
  • 2 Tiecke F, Katzke S, Booms P. , et al. Classic, atypically severe and neonatal Marfan syndrome: twelve mutations and genotype-phenotype correlations in FBN1 exons 24-40. Eur J Hum Genet 2001; 9 (01) 13-21
  • 3 Abdel-Massih T, Goldenberg A, Vouhé P. , et al. [Marfan syndrome in the newborn and infants less than 4 months: a series of 9 patients]. Arch Mal Coeur Vaiss 2002; 95 (05) 469-472
  • 4 Ghandi Y, Zanjani KS, Mazhari-Mousavi SE, Parvaneh N. Neonatal Marfan syndrome: report of two cases. Iran J Pediatr 2013; 23 (01) 113-117
  • 5 Amaral FT, Carvalho SR, Granzotti JA, Vieira LH, Pina Neto JM, Nunes MA. [Neonatal heart failure and Marfan syndrome]. Arq Bras Cardiol 1996; 67 (05) 355-357
  • 6 Ramaswamy P, Lytrivi ID, Nguyen K, Gelb BD. Neonatal Marfan syndrome: in utero presentation with aortic and pulmonary artery dilatation and successful repair of an acute flail mitral valve leaflet in infancy. Pediatr Cardiol 2006; 27 (06) 763-765
  • 7 Robinson PN, Godfrey M. The molecular genetics of Marfan syndrome and related microfibrillopathies. J Med Genet 2000; 37 (01) 9-25
  • 8 Brito-Filho SL, Oporto V, Campos O, Alvares AB, Carvalho AC. A case of neonatal Marfan syndrome with good late follow-up: is it possible to avoid an early unfavourable outcome?. Cardiol Young 2013; 23 (02) 301-303
  • 9 Stheneur C, Faivre L, Collod-Béroud G. , et al. Prognosis factors in probands with an FBN1 mutation diagnosed before the age of 1 year. Pediatr Res 2011; 69 (03) 265-270
  • 10 Amado M, Calado MA, Ferreira R, Lourenço T. Neonatal Marfan syndrome: a successful early multidisciplinary approach. BMJ Case Rep 2014; 2014: xx
  • 11 Loeys BL, Dietz HC, Braverman AC. , et al. The revised Ghent nosology for the Marfan syndrome. J Med Genet 2010; 47 (07) 476-485
  • 12 Deshpande PG, Dixit MP, Vaidya PG, Wagle SU, Irani S. Marfan's syndrome: a neonatal presentation (a case report). J Postgrad Med 1990; 36 (01) 41-43
  • 13 Sureka D, Stheneur C, Odent S, Arno G, Murphy D, Bernstein JA. A recurrent fibrillin-1 mutation in severe early onset Marfan syndrome. J Pediatr Genet 2014; 3 (03) 157-162
  • 14 Faivre L, Collod-Beroud G, Callewaert B. , et al. Clinical and mutation-type analysis from an international series of 198 probands with a pathogenic FBN1 exons 24-32 mutation. Eur J Hum Genet 2009; 17 (04) 491-501
  • 15 Loeys B, Nuytinck L, Delvaux I, De Bie S, De Paepe A. Genotype and phenotype analysis of 171 patients referred for molecular study of the fibrillin-1 gene FBN1 because of suspected Marfan syndrome. Arch Intern Med 2001; 161 (20) 2447-2454
  • 16 Roman MJ, Devereux RB, Kramer-Fox R, Spitzer MC. Comparison of cardiovascular and skeletal features of primary mitral valve prolapse and Marfan syndrome. Am J Cardiol 1989; 63 (05) 317-321
  • 17 Bresters D, Nikkels PG, Meijboom EJ, Hoorntje TM, Pals G, Beemer FA. Clinical, pathological and molecular genetic findings in a case of neonatal Marfan syndrome. Acta Paediatr 1999; 88 (01) 98-101
  • 18 Hennekam RC. Severe infantile Marfan syndrome versus neonatal Marfan syndrome. Am J Med Genet A 2005; 139 (01) 1
  • 19 Maeda J, Kosaki K, Shiono J, Kouno K, Aeba R, Yamagishi H. Variable severity of cardiovascular phenotypes in patients with an early-onset form of Marfan syndrome harboring FBN1 mutations in exons 24-32. Heart Vessels 2016; 31 (10) 1717-1723
  • 20 Strigl S, Quagebeur JM, Gersony WM. Quadrivalvar replacement in infantile Marfan syndrome. Pediatr Cardiol 2007; 28 (05) 403-405
  • 21 Krasemann T, Kotthoff S, Kehl HG. , et al. Cardiac transplantation in neonatal Marfan syndrome -- a life-saving approach. Thorac Cardiovasc Surg 2005; 53 (Suppl. 02) S146-S148
  • 22 Nishimura RA, Otto CM, Bonow RO. , et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Circulation 2017; 135 (25) e1159-e1195
  • 23 Dervanian P, Macé L, Folliguet TA. , et al. Surgical treatment of aortic root aneurysm related to Marfan syndrome in early childhood. Pediatr Cardiol 1998; 19 (04) 369-373
  • 24 Negrini S, Donzelli S, Aulisa AG. , et al. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord 2018; 13: 3
  • 25 Morse RP, Rockenmacher S, Pyeritz RE. , et al. Diagnosis and management of infantile Marfan syndrome. Pediatrics 1990; 86 (06) 888-895