PEUTZ-JEGHERS SYNDROME IN RESOURCE-LIMITED SCENARIO

ABSTRACT BACKGROUND: Peutz-Jeghers Syndrome (PJS) is a rare, autosomal dominant disease, caused by deletions in the chromosome 19p33.3/ gene LKB1/STK11. These mutations inactivate a serine/threonine kinase and predispose to carcinogenesis. In PJS, tumors of the gastrointestinal, testicles, pulmonary, breast, pancreas, uterus and ovaries can be found. OBJECTIVE: To evaluate demographics, clinical presentation and complication/outcomes of pediatric patients presenting with Peutz-Jeghers syndrome (PJS), as well as to present and discuss management in the context of limited resources. METHODS: We conducted a retrospective chart review of a cohort of six patients, who were diagnosed and/or followed at the Clinics Hospital, University of Campinas - Sao Paulo/Brazil, between 2000 and 2018. Data analyzed included gender, age of presentation, age of diagnosis, family history, PJS complications. RESULTS: Median age of diagnosis of 6.7 years, with a mean time of follow-up of 8.1 years. Mucocutaneous pigmentation was universally present. Half of the patients had a known family history at the time of diagnosis. On follow up, intestinal intussusception was documented in four out of six patients, in most (three), in different locations and in multiple occasions. The active investigation of siblings and parents of the index case led to the diagnosis of three first-degree relatives in the present case series. CONCLUSION: In this first pediatric PJS Brazilian case series, we report a wide spectrum of PJS manifestations and complications. In a resource limited scenario, despite limitations for the surveillance of complications, the relative frequency of complications was not higher than historically reported.

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Main Authors: SANDY,Natascha Silva, LOMAZI,Elizete Aparecida, SERVIDONI,Maria de Fátima, BELLOMO-BRANDÃO,Maria Angela
Format: Digital revista
Language:English
Published: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. 2020
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032020000300227
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spelling oai:scielo:S0004-280320200003002272020-11-09PEUTZ-JEGHERS SYNDROME IN RESOURCE-LIMITED SCENARIOSANDY,Natascha SilvaLOMAZI,Elizete AparecidaSERVIDONI,Maria de FátimaBELLOMO-BRANDÃO,Maria Angela Peutz-Jeghers syndrome Intussusception Demographic data Child ABSTRACT BACKGROUND: Peutz-Jeghers Syndrome (PJS) is a rare, autosomal dominant disease, caused by deletions in the chromosome 19p33.3/ gene LKB1/STK11. These mutations inactivate a serine/threonine kinase and predispose to carcinogenesis. In PJS, tumors of the gastrointestinal, testicles, pulmonary, breast, pancreas, uterus and ovaries can be found. OBJECTIVE: To evaluate demographics, clinical presentation and complication/outcomes of pediatric patients presenting with Peutz-Jeghers syndrome (PJS), as well as to present and discuss management in the context of limited resources. METHODS: We conducted a retrospective chart review of a cohort of six patients, who were diagnosed and/or followed at the Clinics Hospital, University of Campinas - Sao Paulo/Brazil, between 2000 and 2018. Data analyzed included gender, age of presentation, age of diagnosis, family history, PJS complications. RESULTS: Median age of diagnosis of 6.7 years, with a mean time of follow-up of 8.1 years. Mucocutaneous pigmentation was universally present. Half of the patients had a known family history at the time of diagnosis. On follow up, intestinal intussusception was documented in four out of six patients, in most (three), in different locations and in multiple occasions. The active investigation of siblings and parents of the index case led to the diagnosis of three first-degree relatives in the present case series. CONCLUSION: In this first pediatric PJS Brazilian case series, we report a wide spectrum of PJS manifestations and complications. In a resource limited scenario, despite limitations for the surveillance of complications, the relative frequency of complications was not higher than historically reported.info:eu-repo/semantics/openAccessInstituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. Arquivos de Gastroenterologia v.57 n.3 20202020-09-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032020000300227en10.1590/s0004-2803.202000000-44
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author SANDY,Natascha Silva
LOMAZI,Elizete Aparecida
SERVIDONI,Maria de Fátima
BELLOMO-BRANDÃO,Maria Angela
spellingShingle SANDY,Natascha Silva
LOMAZI,Elizete Aparecida
SERVIDONI,Maria de Fátima
BELLOMO-BRANDÃO,Maria Angela
PEUTZ-JEGHERS SYNDROME IN RESOURCE-LIMITED SCENARIO
author_facet SANDY,Natascha Silva
LOMAZI,Elizete Aparecida
SERVIDONI,Maria de Fátima
BELLOMO-BRANDÃO,Maria Angela
author_sort SANDY,Natascha Silva
title PEUTZ-JEGHERS SYNDROME IN RESOURCE-LIMITED SCENARIO
title_short PEUTZ-JEGHERS SYNDROME IN RESOURCE-LIMITED SCENARIO
title_full PEUTZ-JEGHERS SYNDROME IN RESOURCE-LIMITED SCENARIO
title_fullStr PEUTZ-JEGHERS SYNDROME IN RESOURCE-LIMITED SCENARIO
title_full_unstemmed PEUTZ-JEGHERS SYNDROME IN RESOURCE-LIMITED SCENARIO
title_sort peutz-jeghers syndrome in resource-limited scenario
description ABSTRACT BACKGROUND: Peutz-Jeghers Syndrome (PJS) is a rare, autosomal dominant disease, caused by deletions in the chromosome 19p33.3/ gene LKB1/STK11. These mutations inactivate a serine/threonine kinase and predispose to carcinogenesis. In PJS, tumors of the gastrointestinal, testicles, pulmonary, breast, pancreas, uterus and ovaries can be found. OBJECTIVE: To evaluate demographics, clinical presentation and complication/outcomes of pediatric patients presenting with Peutz-Jeghers syndrome (PJS), as well as to present and discuss management in the context of limited resources. METHODS: We conducted a retrospective chart review of a cohort of six patients, who were diagnosed and/or followed at the Clinics Hospital, University of Campinas - Sao Paulo/Brazil, between 2000 and 2018. Data analyzed included gender, age of presentation, age of diagnosis, family history, PJS complications. RESULTS: Median age of diagnosis of 6.7 years, with a mean time of follow-up of 8.1 years. Mucocutaneous pigmentation was universally present. Half of the patients had a known family history at the time of diagnosis. On follow up, intestinal intussusception was documented in four out of six patients, in most (three), in different locations and in multiple occasions. The active investigation of siblings and parents of the index case led to the diagnosis of three first-degree relatives in the present case series. CONCLUSION: In this first pediatric PJS Brazilian case series, we report a wide spectrum of PJS manifestations and complications. In a resource limited scenario, despite limitations for the surveillance of complications, the relative frequency of complications was not higher than historically reported.
publisher Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE.
publishDate 2020
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032020000300227
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