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Maternal urinary steroid profiles in prenatal diagnosis of Smith–Lemli–Opitz syndrome: first patient series comparing biochemical and molecular studies
Author(s) -
JezelaStanek A,
Małunowicz EM,
Ciara E,
Popowska E,
GorylukKozakiewicz B,
Spodar K,
Czerwiecka M,
Jezuita J,
Nowaczyk MJM,
KrajewskaWalasek M
Publication year - 2006
Publication title -
clinical genetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.543
H-Index - 102
eISSN - 1399-0004
pISSN - 0009-9163
DOI - 10.1111/j.1399-0004.2006.00551.x
Subject(s) - smith–lemli–opitz syndrome , amniotic fluid , prenatal diagnosis , chorionic villus sampling , endocrinology , urinary system , gestation , fetus , medicine , pregnancy , urine , sterol , biology , physiology , reductase , cholesterol , enzyme , 7 dehydrocholesterol reductase , genetics , biochemistry
Smith–Lemli–Opitz syndrome (SLOS) is an autosomal recessive disorder caused by reduced activity of 7‐dehydrocholesterol (7DHC) reductase, resulting in a decreased level of cholesterol and increased concentrations of 7DHC and 8DHC in body fluids and tissues. Ten pregnancies at 25% risk of SLOS underwent prenatal testing. Diagnostic studies included DHCR7 mutation analysis in chorionic villus samples, amniotic fluid sterol analysis and serial measurements of oestriol (E 3 ), pregnanetriol (PT), 7‐dehydropregnanetriol (7DHPT) and 8‐dehydroesteriol (8DHE 3 ) concentrations in maternal urine samples obtained between 9 and 20 weeks of gestation. All tests were diagnostic and revealed nine unaffected foetuses (two normal homozygotes and seven DHCR7 heterozygotes) and one affected foetus. In the affected pregnancy, 7DHC and 8DHC in amniotic fluid were 9.87 and 3.7 µg/ml, respectively [reference range (RR) 0.0026 ± 0.0015 µg/ml and not detectable, respectively] and maternal urinary steroid analyses showed increased ratios of 7DHPT/PT and 8DHE 3 /E 3 of 0.74 and 1.7, respectively (RR 0–0.0147 and 0–0.019). In the heterozygous foetuses, 7DHPT/PT and 8DHE 3 /E 3 ratios did not exceed those found in 48 normal controls. This is the first series of prenatal diagnostic testing for SLOS where non‐invasive biochemical testing was performed in tandem with invasive diagnostic testing. We conclude that steroid measurements in maternal urine are a reliable means of prenatal diagnosis for SLOS.