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Fetal Smith-Lemli-Opitz syndrome can be detected accurately and reliably by measuring amniotic fluid dehydrocholesterols.

Abstract
The Smith-Lemli-Opitz syndrome, characterized by limb, face and organ abnormalities, and mental retardation, is caused by an inherited block in the step of cholesterol biosynthesis in which the delta 7 double bond of 7-dehydrocholesterol is reduced. It is diagnosed by the presence of markedly elevated levels of 7-dehydrocholesterol and 8-dehydrocholesterol in plasma and tissue. We measured amniotic fluid sterols in 15 pregnancies in 13 women who had previously carried an affected fetus. Cholesterol, 7-dehydrocholesterol and 8-dehydrocholesterol concentrations averaged 18 +/- 3, 9.8 +/- 2.9 and 5.0 +/- 1.7 micrograms/ml, respectively, in seven pregnancies with an affected fetus or child. In contrast, these levels were 19 +/- 3, 0.05 +/- 0.01 and < 0.005 micrograms/ml, respectively, in eight increased-risk pregnancies with normal outcomes and 16 +/- 2, 0.07 +/- 0.01 and < 0.005 micrograms/ml in normal controls. 7-dehydrocholesterol concentrations, 2.2-26 and 0.05-0.10 micrograms/ml in pregnancies with an affected and unaffected fetus, respectively, did not overlap. Thus, abnormally elevated amniotic fluid dehydrocholesterol concentrations are an accurate predictor of fetal Smith-Lemli-Opitz syndrome. A false-positive or a false-negative result is highly unlikely.
AuthorsG S Tint, D Abuelo, M Till, M P Cordier, A K Batta, S Shefer, A Honda, M Honda, G Xu, M Irons, E R Elias, G Salen
JournalPrenatal diagnosis (Prenat Diagn) Vol. 18 Issue 7 Pg. 651-8 (Jul 1998) ISSN: 0197-3851 [Print] England
PMID9706645 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Cholestadienols
  • Dehydrocholesterols
  • cholesta-5,8-dien-3 beta-ol
  • Cholesterol
  • 7-dehydrocholesterol
Topics
  • Adult
  • Amniocentesis
  • Amniotic Fluid (chemistry)
  • Cholestadienols (analysis)
  • Cholesterol (analysis)
  • Dehydrocholesterols (analysis)
  • Female
  • Gas Chromatography-Mass Spectrometry
  • Gestational Age
  • Humans
  • Pregnancy
  • Pregnancy Outcome
  • Reference Values
  • Smith-Lemli-Opitz Syndrome (diagnosis)

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