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Acta Veterinaria Scandinavica Sep 2015Diagnosing the cause of bovine congenital malformations (BCMs) is challenging for bovine veterinary practitioners and laboratory diagnosticians as many known as well as... (Review)
Review
Diagnosing the cause of bovine congenital malformations (BCMs) is challenging for bovine veterinary practitioners and laboratory diagnosticians as many known as well as a large number of not-yet reported syndromes exist. Foetal infection with certain viruses, including bovine virus diarrhea virus (BVDV), Schmallenberg virus (SBV), blue tongue virus (BTV), Akabane virus (AKAV), or Aino virus (AV), is associated with a range of congenital malformations. It is tempting for veterinary practitioners to diagnose such infections based only on the morphology of the defective offspring. However, diagnosing a virus as a cause of BCMs usually requires laboratory examination and even in such cases, interpretation of findings may be challenging due to lack of experience regarding genetic defects causing similar lesions, even in cases where virus or congenital antibodies are present. Intrauterine infection of the foetus during the susceptible periods of development, i.e. around gestation days 60-180, by BVDV, SBV, BTV, AKAV and AV may cause malformations in the central nervous system, especially in the brain. Brain lesions typically consist of hydranencephaly, porencephaly, hydrocephalus and cerebellar hypoplasia, which in case of SBV, AKAV and AV infections may be associated by malformation of the axial and appendicular skeleton, e.g. arthrogryposis multiplex congenita. Doming of the calvarium is present in some, but not all, cases. None of these lesions are pathognomonic so diagnosing a viral cause based on gross lesions is uncertain. Several genetic defects share morphology with virus induced congenital malformations, so expert advice should be sought when BCMs are encountered.
Topics: Animals; Cattle; Cattle Diseases
PubMed: 26399846
DOI: 10.1186/s13028-015-0145-8 -
Journal of the Neurological Sciences May 2015Mutations in COL4A1, encoding one of the six collagen type IV proteins, cover a wide spectrum of autosomal dominant overlapping phenotypes including porencephaly,...
Mutations in COL4A1, encoding one of the six collagen type IV proteins, cover a wide spectrum of autosomal dominant overlapping phenotypes including porencephaly, small-vessel disease and hemorrhagic stroke, leukoencephalopathy, hereditary angiopathy with nephropathy, aneurysms and muscle cramp (HANAC) syndrome, and Walker-Warburg syndrome. Over 50 mutations are known, mainly being missense changes. Intra- and inter-familial variability has been reported. We studied two Italian families in which the proband had a clinical diagnosis of COL4A1-related disorder. We found two novel mutations (c.1249G>C; p.Gly417Arg and c.2662G>C; p.Gly888Arg). Both involved highly conserved amino acids and were predicted as being deleterious by bioinformatics tools. The c.1249G>C (p.Gly417Arg) segregated in four subjects with variable neurological phenotypes, namely leukoencephalopathy with muscle symptoms, brain small-vessel disease, and mild infantile encephalopathy. A fourth case was a carrier of the mutation without any neurological symptoms and an MRI with a specific white matter anomaly. The c.2662G>C (p.Gly888Arg) mutation was de novo in the proband. After a temporary motor impairment at age 14, the subject complained of mild imbalance at age 30, during the third trimester of her twin pregnancy, when an anomaly of the left brain hemisphere was documented in one fetus. Both her male dizygotic twins presented a severe motor delay, early convulsions, and leukoencephalopathy, and were carriers of the mutation. In summary, we confirm that high intra-familial variability of COL4A1 mutations with very mild phenotypes, the apparent incomplete penetrance, and de novo changes may become a "dilemma" for clinicians and genetic counselors.
Topics: Adolescent; Adult; Brain; Collagen Type IV; Family; Female; Humans; Italy; Leukoencephalopathies; Magnetic Resonance Imaging; Male; Motor Disorders; Mutation, Missense; Pedigree; Porencephaly; Pregnancy; Retinal Artery; Retinal Hemorrhage; Spasms, Infantile
PubMed: 25873210
DOI: 10.1016/j.jns.2015.03.042 -
The Journal of Veterinary Medical... Jul 2015Porencephaly is the congenital cerebral defect and a rare malformation and described few MRI reports in veterinary medicine. MRI features of porencephaly are recognized...
Porencephaly is the congenital cerebral defect and a rare malformation and described few MRI reports in veterinary medicine. MRI features of porencephaly are recognized the coexistence with the unilateral/bilateral hippocampal atrophy, caused by the seizure symptoms in human medicine. We studied 2 dogs and 1 cat with congenital porencephaly to characterize the clinical signs and MRI, and to discuss the associated MRI with hippocampal atrophy. The main clinical sign was the seizure symptoms, and all had hippocampal atrophy at the lesion side or the larger defect side. There is association between hippocampal atrophy or the cyst volume and the severe of clinical signs, and it is suggested that porencephaly coexists with hippocampal atrophy as well as humans in this study.
Topics: Animals; Atrophy; Cat Diseases; Cats; Dog Diseases; Dogs; Female; Hippocampus; Magnetic Resonance Imaging; Male; Porencephaly
PubMed: 25786357
DOI: 10.1292/jvms.14-0359 -
Circulation May 2015Collagen type IV alpha1 (COL4A1) and alpha2 (COL4A2) form heterotrimers critical for vascular basement membrane stability and function. Patients with COL4A1 or COL4A2...
BACKGROUND
Collagen type IV alpha1 (COL4A1) and alpha2 (COL4A2) form heterotrimers critical for vascular basement membrane stability and function. Patients with COL4A1 or COL4A2 mutations suffer from diverse cerebrovascular diseases, including cerebral microbleeds, porencephaly, and fatal intracerebral hemorrhage (ICH). However, the pathogenic mechanisms remain unknown, and there is a lack of effective treatment.
METHODS AND RESULTS
Using Col4a1 and Col4a2 mutant mouse models, we investigated the genetic complexity and cellular mechanisms underlying the disease. We found that Col4a1 mutations cause abnormal vascular development, which triggers small-vessel disease, recurrent hemorrhagic strokes, and age-related macroangiopathy. We showed that allelic heterogeneity, genetic context, and environmental factors such as intense exercise or anticoagulant medication modulated disease severity and contributed to phenotypic heterogeneity. We found that intracellular accumulation of mutant collagen in vascular endothelial cells and pericytes was a key triggering factor of ICH. Finally, we showed that treatment of mutant mice with a US Food and Drug Administration-approved chemical chaperone resulted in a decreased collagen intracellular accumulation and a significant reduction in ICH severity.
CONCLUSIONS
Our data are the first to show therapeutic prevention in vivo of ICH resulting from Col4a1 mutation and imply that a mechanism-based therapy promoting protein folding might also prevent ICH in patients with COL4A1 and COL4A2 mutations.
Topics: Animals; Blood Vessels; Blood-Brain Barrier; Brain; Cerebral Hemorrhage; Collagen; Collagen Type IV; Disease Models, Animal; Endothelial Cells; Female; Gene-Environment Interaction; Genetic Heterogeneity; Male; Mice; Mice, Inbred C57BL; Mice, Mutant Strains; Mutation; Neovascularization, Physiologic; Peptide Fragments; Pericytes; Phenotype; Physical Conditioning, Animal; Porencephaly; Retinal Vessels
PubMed: 25753534
DOI: 10.1161/CIRCULATIONAHA.114.013395 -
Genetics in Medicine : Official Journal... Nov 2015Two proα1(IV) chains, encoded by COL4A1, form trimers that contain, in addition, a proα2(IV) chain encoded by COL4A2 and are the major component of the basement... (Meta-Analysis)
Meta-Analysis Review
Two proα1(IV) chains, encoded by COL4A1, form trimers that contain, in addition, a proα2(IV) chain encoded by COL4A2 and are the major component of the basement membrane in many tissues. Since 2005, COL4A1 mutations have been known as an autosomal dominant cause of hereditary porencephaly. COL4A1 and COL4A2 mutations have been reported with a broader spectrum of cerebrovascular, renal, ophthalmological, cardiac, and muscular abnormalities, indicated as "COL4A1 mutation-related disorders." Genetic counseling is challenging because of broad phenotypic variation and reduced penetrance. At the Erasmus University Medical Center, diagnostic DNA analysis of both COL4A1 and COL4A2 in 183 index patients was performed between 2005 and 2013. In total, 21 COL4A1 and 3 COL4A2 mutations were identified, mostly in children with porencephaly or other patterns of parenchymal hemorrhage, with a high de novo mutation rate of 40% (10/24). The observations in 13 novel families harboring either COL4A1 or COL4A2 mutations prompted us to review the clinical spectrum. We observed recognizable phenotypic patterns and propose a screening protocol at diagnosis. Our data underscore the importance of COL4A1 and COL4A2 mutations in cerebrovascular disease, also in sporadic patients. Follow-up data on symptomatic and asymptomatic mutation carriers are needed for prognosis and appropriate surveillance.
Topics: Alleles; Anterior Eye Segment; Brain; Cerebral Hemorrhage; Cohort Studies; Collagen Type IV; Eye Abnormalities; Eye Diseases, Hereditary; Family; Gene Order; Genetic Association Studies; Genetic Loci; Genotype; Humans; Leukomalacia, Periventricular; Magnetic Resonance Imaging; Mutation; Pedigree; Phenotype; Porencephaly
PubMed: 25719457
DOI: 10.1038/gim.2014.210 -
BMJ Case Reports Feb 2015
Topics: Adult; Brain; Cysts; Female; Humans; Infant, Newborn; Intracranial Hemorrhages; Magnetic Resonance Imaging; Porencephaly; Pregnancy; Prenatal Diagnosis
PubMed: 25716048
DOI: 10.1136/bcr-2014-209130 -
Journal of Clinical and Diagnostic... Nov 2014A 2-day-old male child presented with history of enlarged head and seizures since birth, born by caesarean section. Head circumference was 56 cm (dilated) with widely...
A 2-day-old male child presented with history of enlarged head and seizures since birth, born by caesarean section. Head circumference was 56 cm (dilated) with widely open anterior and posterior fontanelle. Routine investigations were within normal limits. CT head revealed a large non-enhancing fluid attenuating cystic lesion in posterior parietal and occipital region with communicating to dilated bilateral lateral ventricles and subarachnoid space.
PubMed: 25584288
DOI: 10.7860/JCDR/2014/9981.5140 -
Magnetic Resonance in Medical Sciences... 2015Type IV collagen α1 (COL4A1) forms a sheet-like network beneath the endothelium and surrounding smooth muscle cells. Associations of mutations in COL4A1 with...
Type IV collagen α1 (COL4A1) forms a sheet-like network beneath the endothelium and surrounding smooth muscle cells. Associations of mutations in COL4A1 with porencephaly, schizencephaly, and intracranial hemorrhages are known. We report susceptibility-weighted imaging (SWI) findings showing hemorrhages in the peripheral portion of the region of schizencephaly, intraparenchymal hemorrhages, and tortuosity of the intracranial veins in a child with a COL4A1 mutation. SWI findings may be helpful for understanding the possible relationship between schizencephaly and COL4A1 mutations.
Topics: Brain; Collagen Type IV; Humans; Infant; Intracranial Hemorrhages; Magnetic Resonance Imaging; Male; Mutation; Schizencephaly
PubMed: 25500781
DOI: 10.2463/mrms.2014-0060 -
Diagnostic Pathology Nov 2014The present study describes the pathologic changes in the brain and the spinal cord of aborted, stillbirth and deformities of newborn lambs infected with viral agents.
BACKGROUND
The present study describes the pathologic changes in the brain and the spinal cord of aborted, stillbirth and deformities of newborn lambs infected with viral agents.
METHODS
From February 2012 to March 2013, a total of 650 aborted fetuses from 793 pregnant ewes were studied from 8 flocks at different areas in the Mazandaran province in the north of Iran. And randomly, systematic necropsy was performed to collect tissues, and all gross abnormalities were recorded at necropsy by the pathologist .Nevertheless, we conducted a limited number of necropsies for aborted fetuses.
RESULTS
In the most cases, arthrogryposis was the most common musculoskeletal defects and at necropsy, malformations of the brain included hydranencephaly, porencephaly, hydrocephalus and cerebellar hypoplasia, mainly in the brain stem and gray and white matter of the brain and cerebellum were observed. Histopathologic lesions included chronic multifocal lymphoplasmacytic encephalitis(nonsuppurative) with extensive perivascular cuffing in some cases, formation of glial nodules mainly in the mesencephalon, thalamus, hippocampus, pons and medulla oblongata in the brain of aborted fetuses, and neuronal degeneration, necrosis and central chromatolysis mainly in the cortex and subcortical of the brain and brain stem regions of them. Furthermore, microscopic lesions are mostly linked to a neurodegenerative and necrotic cell death process in the gray matter of ventral horn of the spinal cord. Briefly, histopathologic findings in the brain and spinal cord included hyperemia, hemorrhage, non-suppurative encephalitis, mononuclear perivascular cuffing, multifocal gliosis, cavitation, central chromatolysis, neuronal degeneration and necrosis, perineuronal and perivascular edema in the all regions of the brain and acute neuronal necrosis in the gray matter of ventral horn of the spinal cord were also seen.
CONCLUSION
Our study suggested that the sheep fetuses are fully susceptible to viral infections and may even develop neurolopathological lesions upon natural infection with mentioned pathogens .Therefore ,according to,specific lesions caused by viral infections, we believe that the histopathological pattern were detected in this study could be associated with either viral infection and or mainly by a Bunyavirus / or Flavivirus strains that extensively shares common lesions with Rift Valley fever ,Wesselsbron ,Cache valley virus / or and Akabaneviruses.
VIRTUAL SLIDES
The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_223.
Topics: Abortion, Veterinary; Animals; Animals, Newborn; Brain; Bunyaviridae Infections; Female; Flavivirus Infections; Microscopy; Neuropathology; Pregnancy; Pregnancy Complications, Infectious; Sheep; Sheep Diseases; Spinal Cord; Stillbirth
PubMed: 25425524
DOI: 10.1186/s13000-014-0223-7 -
Epilepsia Dec 2014Cortical resections in epilepsy surgery tend to be larger in children, compared to adults, partly due to underlying pathology. Some children show unilateral multifocal...
OBJECTIVE
Cortical resections in epilepsy surgery tend to be larger in children, compared to adults, partly due to underlying pathology. Some children show unilateral multifocal seizure onsets involving much of the hemisphere. If there were a significant hemiparesis present, hemispherectomy would be the procedure of choice. Otherwise, it is preferable to spare the primary sensorimotor cortex. We report the results of "subtotal" hemispherectomy in 23 children.
METHODS
All children (ages 1 year and 4 months to 14 years and 2 months) were operated on between 2001 and 2013 at Children's Hospital of Michigan (Detroit). Patients were evaluated with scalp video-electroencephalography (EEG), magnetic resonance imaging (MRI), (18) F-fluorodeoxyglucose-positron emission tomography (FDG-PET) scans, and neuropsychological assessments when applicable. Subsequently, each case was discussed in a multidisciplinary epilepsy surgery conference, and a consensus was reached pertaining to candidacy for surgery and optimum surgical approach. The actual extent of resection was based on the results from subdural electrocorticography (ECoG) monitoring. The surgical outcome is based on International League Against Epilepsy (ILAE) classification (class 1-6).
RESULTS
Among the 23 patients, 11 had epileptic spasms as their major seizure type; these were associated with focal seizures in 3 children. MRI showed focal abnormalities in 12 children. FDG-PET was abnormal in all but one subject. All except two children underwent chronic subdural ECoG. Multiple subpial transections were performed over the sensorimotor cortex in three subjects. On histopathology, various malformations were seen in 9 subjects; the remainder showed gliosis alone (n = 12), porencephaly (n = 1), and gliosis with microglial activation (n = 1). Follow-up ranged from 13 to 157 months (mean = 65 months). Outcomes consisted of class 1 (n = 17, 74%), class 2 (n = 2), class 3 (n = 1), class 4 (n = 1), and class 5 (n = 2).
SIGNIFICANCE
Extensive unilateral resections sparing only sensorimotor cortex can be performed with excellent results in seizure control. Even with the presence of widespread unilateral epileptogenicity or anatomic/functional imaging abnormalities, complete hemispherectomy can often be avoided, particularly when there is little hemiparesis.
Topics: Adolescent; Child; Child, Preschool; Electroencephalography; Epilepsies, Partial; Female; Fluorodeoxyglucose F18; Hemispherectomy; Humans; Infant; Longitudinal Studies; Magnetic Resonance Imaging; Male; Positron-Emission Tomography; Retrospective Studies; Treatment Outcome
PubMed: 25366422
DOI: 10.1111/epi.12845