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Syndromic (phenotypic) diarrhoea of infancy/tricho-hepato-enteric syndrome
  1. Alexandre Fabre1,2,
  2. Anne Breton3,
  3. Marie-Edith Coste1,
  4. Virginie Colomb4,
  5. Beatrice Dubern5,
  6. Alain Lachaux6,
  7. Julie Lemale5,
  8. Julien Mancini7,8,
  9. Evelyne Marinier9,
  10. Christine Martinez-Vinson9,
  11. Noel Peretti6,
  12. Ariane Perry9,
  13. Bertrand Roquelaure1,
  14. Aude Venaille5,
  15. Jacques Sarles1,
  16. Olivier Goulet4,
  17. Catherine Badens2,10
  1. 1Service de Pédiatrie Multidisciplinaire, Hôpital d'enfants de la Timone, Marseille, France
  2. 2Faculté de Médecine, Inserm UMRS 910, Aix-Marseille Université, Marseille, France
  3. 3Service d'Hépato-gastroentérologie et Nutrition Pédiatrique, Hôpital d'enfant de Toulouse, Toulouse, France
  4. 4Service de Gastro-entérologie, Centre de référence pour les pathologies intestinales rares, Hôpital Necker-Enfants Malades, Paris, France
  5. 5Gastroentérologie et Nutrition, Pédiatrique, Hôpital Armand Trousseau, Paris, France
  6. 6Unité Fonctionnelle de Nutrition, Hôpital Femme Mère Enfant de Lyon, Bron, France
  7. 7Aix-Marseille Univ, UMR 912 (SESSTIM), Marseille, France
  8. 8APHM, UF Biostatistiques, Marseille, France
  9. 9Service de Gastroentérologie, Centre de référence pour les pathologies intestinales rares, Hôpital Robert Debré, Paris, France
  10. 10Laboratoire de Génétique Moléculaire, Hôpital d'enfants de la Timone, Marseille, France
  1. Correspondence to Dr Alexandre Fabre, Service de pédiatrie multidisciplinaire, Hopital d'enfant de la Timone, 264 rue Saint Pierre, Marseille 13005, France; a.fabre13{at}yahoo.fr

Abstract

Objectives Syndromic diarrhoea/tricho-hepato-enteric syndrome (SD/THE) is a rare congenital syndrome. The main features are intractable diarrhoea of infancy, hair abnormalities, facial dysmorphism, intrauterine growth restriction and immune system abnormalities. It has been linked to abnormalities in two components of the putative human ski complex: SKIV2L and TTC37. The long-term outcome of this syndrome is still unknown. We aim to describe the long-term outcome, in the French cohort of patients born since 1992.

Design Review of the clinical and biological features of the 15 patients with SD/THE, followed in France and born between 1992 and 2010.

Results All patients presented typical SD/THE syndrome features, of intractable diarrhoea in infancy requiring parenteral nutrition, a facial dysmorphism with hair abnormalities, and immunological disorders. Half of them also had liver and skin abnormalities. Five children died, among which 3 died due to infections. Probabilities of survival according to the Kaplan-Meier method were 93.3%, 86.7%, 74.3 and 61.9%, respectively at 1 year, 5 years, 10 years and 15 years of age. 3/15 were weaned from parenteral nutrition (PN) with likelihood of weaning being 10% at 5 years and 40% at 10 years. At birth 80% were small for gestational age and the short stature persisted in 60%. Haemophagocytic syndrome was noted in 60% and mild mental retardation was present in 60%.

Conclusions SD/THE is a rare disease with high morbidity and mortality. Management should be focused on nutrition and immunological defects.

  • Genetics
  • Gastroenterology
  • Growth

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