BACKGROUND Conjoined twins are a rare twin malformation commonly presenting as single amniotic sac twinning,with double amniotic sac twinning being extremely rare and poorly reported.Most conjoined twins are females.C...BACKGROUND Conjoined twins are a rare twin malformation commonly presenting as single amniotic sac twinning,with double amniotic sac twinning being extremely rare and poorly reported.Most conjoined twins are females.CASE SUMMARY A woman of childbearing age conceived naturally,and at 8 wk of gestation,transvaginal ultrasonography showed an embryo and cardiac tube pulsation in both amniotic sacs.On dynamic observation,the two embryos were connected in the lower abdomen,with restricted movement.A repeat transvaginal ultrasound at 11 wk showed that the intestinal tubes of both fetuses were connected in the lower abdomen.The pregnancy was terminated and labor was induced.CONCLUSION Transvaginal ultrasound may detect conjoined twin malformations in an early stage.Our case provides diagnostic insights for ultrasonographers and can help develop early therapeutic interventions.展开更多
BACKGROUND Familial cases of autosomal recessive spastic ataxia of charlevoix-saguenay have not been reported in the Arabian Peninsula,although the consanguineous marriage rate is very high.We report the first family ...BACKGROUND Familial cases of autosomal recessive spastic ataxia of charlevoix-saguenay have not been reported in the Arabian Peninsula,although the consanguineous marriage rate is very high.We report the first family from the Arabian Peninsula harboring a novel frameshift mutation in the SACS gene.CASE SUMMARY A 33-year-old man presented to our neurology clinic with balance problems and weakness of distal upper and lower limbs.He was previously clinically diagnosed with Friedreich's ataxia.However,the severity of polyneuropathy and the electrodiagnostic studies(EDX)findings are atypical features of Friedreich’s ataxia,and the deterioration was attributed to diabetic neuropathy.Close examination of other family members identified cerebellar ataxia,lower-limb pyramidal signs,peripheral neuropathy,and magnetic resonance imaging findings characterized by pontine linear hypointensities.Genetic testing for Friedreich’s ataxia did not yield a diagnosis.Whole exome sequencing identified a novel frameshift germline mutation in the SACS gene termed c.5824_5827delTACT using the transcript NM_014363.5,which is predicted to cause premature termination of the sacsin protein at amino acid position 1942(p.Tyr1942Metfs*9)and disrupts the sacsin SRR3 and domains downstream from it.The mutation segregated with the disease in the family.CONCLUSION Our data add to the spectrum of mutations in the SACS gene and argues for a need to implement suitably integrated clinical and diagnostic services,including next generation sequencing technology,to better classify ataxia in this area of the world.展开更多
文摘BACKGROUND Conjoined twins are a rare twin malformation commonly presenting as single amniotic sac twinning,with double amniotic sac twinning being extremely rare and poorly reported.Most conjoined twins are females.CASE SUMMARY A woman of childbearing age conceived naturally,and at 8 wk of gestation,transvaginal ultrasonography showed an embryo and cardiac tube pulsation in both amniotic sacs.On dynamic observation,the two embryos were connected in the lower abdomen,with restricted movement.A repeat transvaginal ultrasound at 11 wk showed that the intestinal tubes of both fetuses were connected in the lower abdomen.The pregnancy was terminated and labor was induced.CONCLUSION Transvaginal ultrasound may detect conjoined twin malformations in an early stage.Our case provides diagnostic insights for ultrasonographers and can help develop early therapeutic interventions.
文摘BACKGROUND Familial cases of autosomal recessive spastic ataxia of charlevoix-saguenay have not been reported in the Arabian Peninsula,although the consanguineous marriage rate is very high.We report the first family from the Arabian Peninsula harboring a novel frameshift mutation in the SACS gene.CASE SUMMARY A 33-year-old man presented to our neurology clinic with balance problems and weakness of distal upper and lower limbs.He was previously clinically diagnosed with Friedreich's ataxia.However,the severity of polyneuropathy and the electrodiagnostic studies(EDX)findings are atypical features of Friedreich’s ataxia,and the deterioration was attributed to diabetic neuropathy.Close examination of other family members identified cerebellar ataxia,lower-limb pyramidal signs,peripheral neuropathy,and magnetic resonance imaging findings characterized by pontine linear hypointensities.Genetic testing for Friedreich’s ataxia did not yield a diagnosis.Whole exome sequencing identified a novel frameshift germline mutation in the SACS gene termed c.5824_5827delTACT using the transcript NM_014363.5,which is predicted to cause premature termination of the sacsin protein at amino acid position 1942(p.Tyr1942Metfs*9)and disrupts the sacsin SRR3 and domains downstream from it.The mutation segregated with the disease in the family.CONCLUSION Our data add to the spectrum of mutations in the SACS gene and argues for a need to implement suitably integrated clinical and diagnostic services,including next generation sequencing technology,to better classify ataxia in this area of the world.
