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Spectrum of congenital anomalies among VACTERL cases: a EUROCAT population-based study.
- Source :
-
Pediatric research [Pediatr Res] 2020 Feb; Vol. 87 (3), pp. 541-549. Date of Electronic Publication: 2019 Sep 09. - Publication Year :
- 2020
-
Abstract
- Background: The VACTERL (Vertebral anomalies, Anal atresia, Cardiac malformations, Tracheo-Esophageal fistula, Renal anomalies, Limb abnormalities) association is the non-random occurrence of at least three of these congenital anomalies: vertebral, anal, cardiac, tracheo-esophageal, renal, and limb anomalies. Diagnosing VACTERL patients is difficult, as many disorders have multiple features in common with VACTERL. The aims of this study were to clearly outline component features, describe the phenotypic spectrum among the largest group of VACTERL patients thus far reported, and to identify phenotypically similar subtypes.<br />Methods: A case-only study was performed assessing data on 501 cases recorded with VACTERL in the JRC-EUROCAT (Joint Research Centre-European Surveillance of Congenital Anomalies) central database (birth years: 1980-2015). We differentiated between major and minor VACTERL features and anomalies outside the VACTERL spectrum to create a clear definition of VACTERL.<br />Results: In total, 397 cases (79%) fulfilled our VACTERL diagnostic criteria. The most commonly observed major VACTERL features were anorectal malformations and esophageal atresia/tracheo-esophageal fistula (both occurring in 62% of VACTERL cases), followed by cardiac (57%), renal (51%), vertebral (33%), and limb anomalies (25%), in every possible combination. Three VACTERL subtypes were defined: STRICT-VACTERL, VACTERL-LIKE, and VACTERL-PLUS, based on severity and presence of additional congenital anomalies.<br />Conclusion: The clearly defined VACTERL component features and the VACTERL subtypes introduced will improve both clinical practice and etiologic research.
- Subjects :
- Consensus
Databases, Factual
Europe epidemiology
Genetic Predisposition to Disease
Heart Defects, Congenital classification
Heart Defects, Congenital epidemiology
Heart Defects, Congenital genetics
Humans
International Classification of Diseases
Limb Deformities, Congenital classification
Limb Deformities, Congenital epidemiology
Limb Deformities, Congenital genetics
Phenotype
Predictive Value of Tests
Prevalence
Terminology as Topic
Anal Canal abnormalities
Esophagus abnormalities
Heart Defects, Congenital diagnosis
Kidney abnormalities
Limb Deformities, Congenital diagnosis
Spine abnormalities
Trachea abnormalities
Subjects
Details
- Language :
- English
- ISSN :
- 1530-0447
- Volume :
- 87
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Pediatric research
- Publication Type :
- Academic Journal
- Accession number :
- 31499513
- Full Text :
- https://doi.org/10.1038/s41390-019-0561-y