Prenatal features of Costello syndrome: Ultrasonographic findings and atrial tachycardia

Angela E. Lin, Barbara O'Brien, Laurie A. Demmer, Kristina K. Almeda, Cynthia Blanco, Patrick F. Glasow, Charles I. Berul, Robert Hamilton, A. Micheil Innes, Julie L. Lauzon, Katia Sol-Church, Karen W. Gripp

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Objective: Delineate prenatal features of Costello syndrome (caused by HRAS mutations), which consists of mental retardation, facial, cardiovascular, skin, and musculoskeletal anomalies, and tumor predisposition. Methods: Literature and new cases classified as Group I (pre-HRAS), Group II (HRAS confirmed), and Group III (HRAS confirmed in natural history study, plus three contributed cases). Results: Polyhydramnios occurred in most (mean 79%) pregnancies of cases in Groups I (98), II (107), and III (17); advanced paternal age and prematurity were noted in approximately half. Less frequent were nuchal thickening, ascites, shortened long bones, abnormal hand posture, ventriculomegaly, macrosomia, and macrocephaly. Fetal arrhythmia occurred in nine cases (six supraventricular or unspecified tachycardia, one unspecified arrhythmia, and two premature atrial contractions, PACs); excluding three new cases and two with PACs, the estimated prenatal frequency is 4/222 (2%). Conclusion: Costello syndrome can be suspected prenatally when polyhydramnios is accompanied by nuchal thickening, hydrops, shortened long bones, abnormal hand posture, ventriculomegaly, large size, and macrocephaly, and especially fetal atrial tachycardia. Consideration should be given for timely prenatal diagnostic studies for confirmative HRAS gene mutations and for maternal treatment of serious fetal arrhythmia.

Original languageEnglish (US)
Pages (from-to)682-690
Number of pages9
JournalPrenatal Diagnosis
Volume29
Issue number7
DOIs
StatePublished - Jul 2009

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Costello Syndrome
Tachycardia
Megalencephaly
Hand Bones
Polyhydramnios
Cardiac Arrhythmias
Posture
Paternal Age
Atrial Premature Complexes
Mutation
Natural History
Ascites
Intellectual Disability
Edema
Mothers
Pregnancy
Skin
Genes
Neoplasms

Keywords

  • Chaotic atrial rhythm
  • Chaotic atrial tachycardia
  • Costello syndrome
  • Fetal arrhythmia
  • HRAS gene
  • Polyhydramnios
  • Prenatal ultrasound
  • Supraventricular tachycardia

ASJC Scopus subject areas

  • Genetics(clinical)
  • Obstetrics and Gynecology

Cite this

Lin, A. E., O'Brien, B., Demmer, L. A., Almeda, K. K., Blanco, C., Glasow, P. F., ... Gripp, K. W. (2009). Prenatal features of Costello syndrome: Ultrasonographic findings and atrial tachycardia. Prenatal Diagnosis, 29(7), 682-690. https://doi.org/10.1002/pd.2276

Prenatal features of Costello syndrome : Ultrasonographic findings and atrial tachycardia. / Lin, Angela E.; O'Brien, Barbara; Demmer, Laurie A.; Almeda, Kristina K.; Blanco, Cynthia; Glasow, Patrick F.; Berul, Charles I.; Hamilton, Robert; Innes, A. Micheil; Lauzon, Julie L.; Sol-Church, Katia; Gripp, Karen W.

In: Prenatal Diagnosis, Vol. 29, No. 7, 07.2009, p. 682-690.

Research output: Contribution to journalArticle

Lin, AE, O'Brien, B, Demmer, LA, Almeda, KK, Blanco, C, Glasow, PF, Berul, CI, Hamilton, R, Innes, AM, Lauzon, JL, Sol-Church, K & Gripp, KW 2009, 'Prenatal features of Costello syndrome: Ultrasonographic findings and atrial tachycardia', Prenatal Diagnosis, vol. 29, no. 7, pp. 682-690. https://doi.org/10.1002/pd.2276
Lin, Angela E. ; O'Brien, Barbara ; Demmer, Laurie A. ; Almeda, Kristina K. ; Blanco, Cynthia ; Glasow, Patrick F. ; Berul, Charles I. ; Hamilton, Robert ; Innes, A. Micheil ; Lauzon, Julie L. ; Sol-Church, Katia ; Gripp, Karen W. / Prenatal features of Costello syndrome : Ultrasonographic findings and atrial tachycardia. In: Prenatal Diagnosis. 2009 ; Vol. 29, No. 7. pp. 682-690.
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abstract = "Objective: Delineate prenatal features of Costello syndrome (caused by HRAS mutations), which consists of mental retardation, facial, cardiovascular, skin, and musculoskeletal anomalies, and tumor predisposition. Methods: Literature and new cases classified as Group I (pre-HRAS), Group II (HRAS confirmed), and Group III (HRAS confirmed in natural history study, plus three contributed cases). Results: Polyhydramnios occurred in most (mean 79{\%}) pregnancies of cases in Groups I (98), II (107), and III (17); advanced paternal age and prematurity were noted in approximately half. Less frequent were nuchal thickening, ascites, shortened long bones, abnormal hand posture, ventriculomegaly, macrosomia, and macrocephaly. Fetal arrhythmia occurred in nine cases (six supraventricular or unspecified tachycardia, one unspecified arrhythmia, and two premature atrial contractions, PACs); excluding three new cases and two with PACs, the estimated prenatal frequency is 4/222 (2{\%}). Conclusion: Costello syndrome can be suspected prenatally when polyhydramnios is accompanied by nuchal thickening, hydrops, shortened long bones, abnormal hand posture, ventriculomegaly, large size, and macrocephaly, and especially fetal atrial tachycardia. Consideration should be given for timely prenatal diagnostic studies for confirmative HRAS gene mutations and for maternal treatment of serious fetal arrhythmia.",
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AU - Blanco, Cynthia

AU - Glasow, Patrick F.

AU - Berul, Charles I.

AU - Hamilton, Robert

AU - Innes, A. Micheil

AU - Lauzon, Julie L.

AU - Sol-Church, Katia

AU - Gripp, Karen W.

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N2 - Objective: Delineate prenatal features of Costello syndrome (caused by HRAS mutations), which consists of mental retardation, facial, cardiovascular, skin, and musculoskeletal anomalies, and tumor predisposition. Methods: Literature and new cases classified as Group I (pre-HRAS), Group II (HRAS confirmed), and Group III (HRAS confirmed in natural history study, plus three contributed cases). Results: Polyhydramnios occurred in most (mean 79%) pregnancies of cases in Groups I (98), II (107), and III (17); advanced paternal age and prematurity were noted in approximately half. Less frequent were nuchal thickening, ascites, shortened long bones, abnormal hand posture, ventriculomegaly, macrosomia, and macrocephaly. Fetal arrhythmia occurred in nine cases (six supraventricular or unspecified tachycardia, one unspecified arrhythmia, and two premature atrial contractions, PACs); excluding three new cases and two with PACs, the estimated prenatal frequency is 4/222 (2%). Conclusion: Costello syndrome can be suspected prenatally when polyhydramnios is accompanied by nuchal thickening, hydrops, shortened long bones, abnormal hand posture, ventriculomegaly, large size, and macrocephaly, and especially fetal atrial tachycardia. Consideration should be given for timely prenatal diagnostic studies for confirmative HRAS gene mutations and for maternal treatment of serious fetal arrhythmia.

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