Prenatal diagnosis of Joubert syndrome: A case report and literature review

Medicine (Baltimore). 2017 Dec;96(51):e8626. doi: 10.1097/MD.0000000000008626.

Abstract

Introduction: Joubert syndrome (JS) is a rare autosomal recessive inherited disease belonging to ciliopathy with the causative mutation of genes. Except for X-linked inheritance, the high recurrence rate of a family is about 25%. After birth, it may cause a series of neurological symptoms, even with retina, kidney, liver, and other organ abnormalities, which is defined as Joubert syndrome and related disorders (JSRD). Molecular genetics research contributes to disease prediction and genetic counseling. Prenatal diagnosis is rare. Magnetic resonance imaging (MRI) is usually the first-choice diagnostic modality with typical brain images characterized by the molar tooth sign. We describe a case of JS prenatally and Dandy-Walker malformation for the differential diagnosis based on ultrasonograms. We also review the etiology, imaging features, clinical symptoms, and diagnosis of JSRD.

Case presentation: A 22-year-old woman was pregnant at 27 1/7 weeks' gestation with fetal cerebellar vermis hypoplasia. Fetal ultrasonography and MRI confirmed a diagnosis of JS at our center. The couple finally opted to terminate the fetus, which had a normal appearance and growth parameters. The couple also had an AHI1 gene mutation on chromosome 6.

Conclusions: Currently, a diagnosis of JS is commonly made after birth. Fewer cases of prenatal diagnosis by ultrasonography have been made, and they are more liable to be misdirected because of some nonspecial features that also manifest in Dandy-Walker malformation, cranio-cerebello-cardiac syndrome, and so on.

Publication types

  • Case Reports

MeSH terms

  • Abnormalities, Multiple / diagnosis*
  • Abnormalities, Multiple / diagnostic imaging
  • Adaptor Proteins, Signal Transducing / genetics*
  • Adaptor Proteins, Vesicular Transport
  • Cerebellum / abnormalities*
  • Cerebellum / diagnostic imaging
  • Dandy-Walker Syndrome / complications
  • Dandy-Walker Syndrome / diagnosis*
  • Dandy-Walker Syndrome / diagnostic imaging
  • Diagnosis, Differential
  • Eye Abnormalities / complications
  • Eye Abnormalities / diagnosis*
  • Eye Abnormalities / diagnostic imaging
  • Female
  • Genetic Counseling
  • Gestational Age
  • Humans
  • Kidney Diseases, Cystic / complications
  • Kidney Diseases, Cystic / diagnosis*
  • Kidney Diseases, Cystic / diagnostic imaging
  • Mutation
  • Pregnancy
  • Retina / abnormalities*
  • Retina / diagnostic imaging
  • Ultrasonography, Prenatal
  • Young Adult

Substances

  • AHI1 protein, human
  • Adaptor Proteins, Signal Transducing
  • Adaptor Proteins, Vesicular Transport

Supplementary concepts

  • Agenesis of Cerebellar Vermis