Recurrence risks for neural tube defects in siblings of patients with lipomyelomeningocele.

Abstract

PURPOSE:

Neural tube defects (NTDs) are a group of widely varying congenital malformations resulting from incomplete or improper fusion of the neural tube during embryonic development. NTDs are traditionally classified by the presence or absence of a layer of skin covering the spinal defect. Although a genetic component has been well established in the etiology of open NTDs, studies examining the genetics of closed NTDs such as lipomyelomeningocele are rare. We and others have previously observed families in which multiple members were affected with a broad spectrum of NTDs, suggesting the possibility of a common genetic etiology.

METHODS:

We calculated the sibling recurrence risk in 52 pedigrees in which the proband was diagnosed with lipomyelomeningocele (LMM), defining recurrence broadly to include both closed and open neural tube defects.

RESULTS:

Although no recurrences of LMM were observed among younger siblings, one younger sibling had myelomeningocele, yielding an estimate of recurrence risk of 0.04 (95% CI 0.01-0.20). When all siblings of the proband were included, two additional affected siblings were identified, one with anencephaly and another with fatty filum, yielding an estimate of recurrence risk of 0.043 (95% CI 0.01-0.12).

CONCLUSIONS:

Although the sample size is small, these data are not inconsistent with recurrence risks for myelomeningocele, ranging from 2% to 5% in siblings. These data suggest the underlying genetic basis for closed defects may be the same or closely related to that for myelomeningocele in some families, although a larger sample will be necessary before these data are appropriate for use in a clinical setting. Further characterizations, including whether risk for recurrence of NTDs or LMM in families in which the proband is affected with LMM are altered by folate supplementation, may shed light on the underlying genetics.

• Authors: Courtney Drake Sebold, Elizabeth C Melvin, Debbie Siegel, Lorraine Mehltretter, David S Enterline, Jeffrey S Nye, John Kessler, Alexander Bassuk, Marcy C Speer, Timothy M George, NTD Collaborative Group
• Journal: Genetics in medicine : official journal of the American College of Medical Genetics (Genet Med) Vol. 7 Issue 1 Pg. 64-7 (Jan 2005) ISSN: 1098-3600 [Print] United States
• PMID: 15654231 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, P.H.S.)

Topics

• Case-Control Studies
• Female
• Genetic Predisposition to Disease (genetics)
• Genetic Testing
• Humans
• Male
• Meningomyelocele (genetics)
• Neural Tube Defects (genetics)
• Pedigree
• Risk Factors
• Siblings