Notable contribution of large CFTR gene rearrangements to the diagnosis of cystic fibrosis in fetuses with bowel anomalies

Eur J Hum Genet. 2010 Oct;18(10):1166-9. doi: 10.1038/ejhg.2010.80. Epub 2010 May 26.

Abstract

Grade III fetal bowel hyperechogenicity and/or loop dilatation observed at the second trimester of pregnancy can be due to several disease conditions, including cystic fibrosis (CF). Screening for frequent CF mutations is performed as a first step and, in certain situations, such as when a frequent CF mutation is found in the fetus, the increased risk of CF justifies an in-depth study of the second allele. To determine the contribution of large CFTR gene rearrangements in such cases, detected using a semiquantitative fluorescent multiplex PCR (QFM-PCR) assay, we collated data on 669 referrals related to suspicion of CF in fetuses from 1998 to 2009. Deletions were found in 5/70 cases in which QFM-PCR was applied, dele19, dele22_23, dele2_6b, dele14b_15 and dele6a_6b, of which the last three remain undescribed. In 3/5 cases, hyperechogenicity was associated with dilatation and/or gallbladder anomalies. Of the total cases of CF recognized in the subgroup of first-hand referrals, deletions represent 16.7% of CF alleles. Our study thus strengthens the need to consider large CFTR gene rearrangements in the diagnosis strategy of fetal bowel anomalies, in particular in the presence of multiple anomalies.

MeSH terms

  • Abnormalities, Multiple / embryology
  • Abnormalities, Multiple / genetics
  • Chromosome Aberrations
  • Cystic Fibrosis / diagnosis*
  • Cystic Fibrosis / embryology
  • Cystic Fibrosis / genetics*
  • Cystic Fibrosis Transmembrane Conductance Regulator / genetics*
  • DNA Mutational Analysis
  • Echogenic Bowel / genetics*
  • Female
  • Fetal Diseases / diagnosis
  • Fetal Diseases / genetics
  • Gallbladder / abnormalities
  • Gene Rearrangement*
  • Genetic Testing*
  • Humans
  • Infant, Newborn
  • Intestines / embryology
  • Point Mutation
  • Polymerase Chain Reaction
  • Pregnancy
  • Pregnancy Trimester, Second
  • Prenatal Diagnosis*
  • Sequence Deletion

Substances

  • CFTR protein, human
  • Cystic Fibrosis Transmembrane Conductance Regulator