Progressive aortic root and pulmonary artery aneurysms in a neonate with Loeys-Dietz Syndrome type 1B

Yukako Muramatsu, Tomoki Kosho, Miyuki Magota, Taro Yokotsuka, Masatoki Ito, Ayako Yasuda, Osamu Kito, Chizuko Suzuki, Yoshie Nagata, Satoru Kawai, Masanobu Ikoma, Tameo Hatano, Masato Nakayama, Rie Kawamura, Keiko Wakui, Hiroko Morisaki, Takayuki Morisaki, Yoshimitsu Fukushima

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Abstract

Loeys-Dietz Syndrome (LDS) is an autosomal dominant aortic aneurysm syndrome with multisystem involvement, caused by heterozygous mutations of transforming growth factor b receptor type 1 (TGFBR1) or type 2 (TGFBR2) genes. We report on a neonate with the disorder caused by a known TGFBR2 mutation, who developed neonatal-onset progressive dilation of the aortic valve and aneurysms of the aortic root and main pulmonary artery (PA) associated with a large left-to-right shunt via a ventricular septal defect (VSD) and an atrial septal defect (ASD). He also had skeletal features (flexion contractures of the fingers, talipes equinovarus, a cleft palate, and joint laxity), mild facial dysmorphisms, and developmental delay. The dilation and aneurysms progressed after PA banding at age 12 days; and the patient received an intracardiac repair of the defects and PA plasty at age 42 days, followed by no further progression of the dilation and the aneurysms. Neonates with generalized hypotonia, a cleft palate, inguinal herniae, musculoskeletal features such as camptodactyly and talipes equinovarus, and a cardiac murmur should be suspected to have LDS, and extensive cardiovascular evaluation and testing of TGFBR1 and TGFBR2 are recommended. LDS patients with cardiac defects that lead to a large left-to-right shunt and congestive heart failure such as VSD should be considered for intracardiac repair even in early infancy.

Original languageEnglish
Pages (from-to)417-421
Number of pages5
JournalAmerican Journal of Medical Genetics, Part A
Volume152
Issue number2
DOIs
Publication statusPublished - 01-02-2010

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All Science Journal Classification (ASJC) codes

  • Genetics
  • Genetics(clinical)

Cite this

Muramatsu, Y., Kosho, T., Magota, M., Yokotsuka, T., Ito, M., Yasuda, A., Kito, O., Suzuki, C., Nagata, Y., Kawai, S., Ikoma, M., Hatano, T., Nakayama, M., Kawamura, R., Wakui, K., Morisaki, H., Morisaki, T., & Fukushima, Y. (2010). Progressive aortic root and pulmonary artery aneurysms in a neonate with Loeys-Dietz Syndrome type 1B. American Journal of Medical Genetics, Part A, 152(2), 417-421. https://doi.org/10.1002/ajmg.a.33263