Publications by authors named "Viola Alesi"

High-grade glioma with pleomorphic and pseudopapillary features (HPAP) is a recently identified methylation cluster comprised of relatively circumscribed gliomas enriched for variants in TP53, RB1, NF1, NF2, BRAF and with a more favorable clinical outcome than IDH-wildtype glioblastoma. Here, we present two cases occurring in young adults, one of which occurred in the background of NF2-related schwannomatosis. Both cases demonstrated characteristic histologic features including ependymoma-like areas (Case #1) and an astroblastoma-like phenotype (Case #2), as well as archetypal pseudopapillary structures and pleomorphic tumor cells.

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CDKL5 deficiency disorder (CDD) is an X-linked dominant epileptic encephalopathy, characterized by early-onset and drug-resistant seizures, psychomotor delay, and slight facial features. Genomic variants inactivating or impairing its protein product kinase activity have been reported, making next-generation sequencing (NGS) and chromosomal microarray analysis (CMA) the standard diagnostic tests. We report a suspicious case of CDD in a female child who tested negative upon NGS and CMA and harbored an X chromosome de novo pericentric inversion.

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Article Synopsis
  • Sotos syndrome is a genetic condition marked by traits like overgrowth, advanced bone age, and learning difficulties, mainly caused by genetic mutations in a gene on chromosome 5q35.
  • The study examined 45 patients with Sotos syndrome and found that about 60% had heart defects, with the most common issues being septal defects and other vascular anomalies.
  • The prevalence of heart defects in these patients was higher than previously reported in literature, highlighting the need for thorough heart evaluations in individuals with Sotos syndrome.
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Interstitial deletions involving 6q chromosomal region are rare. Less than 30 patients have been described to date, and fewer have been characterized by high-resolution techniques, such as chromosomal microarray. Deletions involving 6q21q22.

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Introduction: X-linked gene has recently been pointed as one of the most interesting candidates for involvement in neurodevelopmental disorders (NDs), such as intellectual disability (ID) and autism spectrum disorder (ASD). encodes the patched domain-containing protein 1 (), which is mainly expressed in the developing brain and adult brain tissues. To date, major studies have focused on the biological function of the gene, while the mechanisms underlying neuronal alterations and the cognitive-behavioral phenotype associated with mutations still remain unclear.

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  • PATZ1-rearranged CNS tumors may or may not be a distinct tumor type, as researchers investigated a pediatric series of 7 cases using various advanced analysis techniques to understand their characteristics.* -
  • MRI results showed these tumors mainly occur in the occipital lobe and have two major types: one resembling glial cells (NET) and another showing spindle cell features (SM), both identified via histologic analysis.* -
  • Although both groups share molecular similarities, gene expression analysis revealed they form two distinct subgroups, with those in the SM group showing important genes related to tumor progression; most patients are disease-free following treatment.*
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  • - Neurofibromatosis type 1 (NF1) is an inherited genetic disorder that can be challenging to diagnose due to gene inactivation and limitations in existing genetic testing methods, which may miss certain mutations.
  • - The study focuses on a specific familial NF1 case caused by a LINE-1 element insertion in a gene, leading to skipped gene segments, highlighting the complexity of such mutations.
  • - By using advanced techniques like Optical Genome Mapping and whole-genome sequencing (WGS), the researchers successfully identified the mutation and its impact, underscoring the need for specialized methods in cases that remain undiagnosed.
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As a relevant element of novelty, the fifth CNS WHO Classification highlights the distinctive pathobiology underlying gliomas arising primarily in children by recognizing for the first time the families of paediatric-type diffuse gliomas, both high-grade and low-grade. This review will focus on the family of paediatric-type diffuse high-grade gliomas, which includes four tumour types: 1) Diffuse midline glioma H3 K27-altered; 2) Diffuse hemispheric glioma H3 G34-mutant; 3) Diffuse paediatric-type high-grade glioma H3-wildtype and IDH-wildtype; and 4) Infant-type hemispheric glioma. The essential and desirable diagnostic criteria as well as the entities entering in the differential will be discussed for each tumour type.

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Complex genomic rearrangements (CGRs) are structural variants arising from two or more chromosomal breaks, which are challenging to characterize by conventional or molecular cytogenetic analysis (karyotype and FISH). The integrated approach of standard and genomic techniques, including optical genome mapping (OGM) and genome sequencing, is crucial for disclosing and characterizing cryptic chromosomal rearrangements at high resolutions. We report on a patient with a complex developmental and epileptic encephalopathy in which karyotype analysis showed a de novo balanced translocation involving the long arms of chromosomes 2 and 18.

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Silver-Russell syndrome is an imprinting disorder characterised by pre- and post-natal growth retardation and several heterogeneous molecular defects affecting different human genomic loci. In the majority of cases, the molecular defect is the loss of methylation (LOM) of the differentially methylated region (DMR, also known as IC1) at the telomeric domain of the 11p15.5 imprinted genes cluster, which causes the altered expression of the growth controlling genes, and .

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Filamin C is a protein specifically expressed in myocytes and cardiomyocytes and is involved in several biological functions, including sarcomere contractile activity, signaling, cellular adhesion, and repair. variants are associated with different disorders ranging from striated muscle (myofibrillar distal or proximal) myopathy to cardiomyopathies (CMPs) (restrictive, hypertrophic, and dilated), or both. The outcome depends on functional consequences of the detected variants, which result either in haploinsufficiency or in an aberrant protein, the latter affecting sarcomere structure leading to protein aggregates.

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Neurofibromatosis type 1 (NF1), an autosomal dominant disorder characterized by skin pigmentary lesions and multiple cutaneous neurofibromas, is caused by neurofibromin 1 (NF1) loss of function variants. Currently, a molecular diagnosis is frequently established using a multistep protocol based on cDNA and gDNA sequence analysis and/or Multiplex Ligation-dependent Probe Amplification (MLPA) assay on genomic DNA, providing an overall detection rate of about 95-97%. The small proportion of clinically diagnosed patients, which at present do not obtain a molecular confirmation likely are mosaic, as their pathogenic variant may remain undetected due to low sensitivity of low coverage NGS approaches, or they may carry a type of pathogenic variant refractory to currently used technologies.

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Biallelic variants of the gene encoding for the zinc-finger protein 142 (ZNF142) have recently been associated with intellectual disability (ID), speech impairment, seizures, and movement disorders in nine individuals from five families. In this study, we obtained phenotype and genotype information of 26 further individuals from 16 families. Among the 27 different ZNF142 variants identified in the total of 35 individuals only four were missense.

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Astroblastomas are neuroepithelial tumours defined by the presence of MN1 rearrangement and are typically located in the cerebral hemispheres. Rare cases of astroblastoma-like tumours carrying an EWSR1-BEND2 fusion have been recently described in the brain stem and spinal cord. We report a paediatric case of neuroepithelial astroblastoma-like tumour occurring in the spine and carrying a novel MAMLD1-BEND2 fusion.

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Only a few patients with deletions or duplications at Xp11.4, bridging USP9X, DDX3X, and CASK genes, have been described so far. Here, we report on a female harboring a de novo Xp11.

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Recessive hereditary methemoglobinemia (RHM) due to NADH-cytochrome b5 reductase deficiency is a rare disease caused by pathogenic variants in . Unlike type I, in RHM type II (RHM2), the enzymatic defect affects erythrocytes and all body tissues, thus resulting in cyanosis and neurological impairment. Although the first description of RHM2 dates back to the mid-1950s, detailed clinical and neuroimaging information are available for only a few patients.

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Congenital heart defects (CHDs) are known to occur in 9%-25% of patients with KBG syndrome. In this study we analyzed the prevalence and anatomic types of CHDs in 46 personal patients with KBG syndrome, carrying pathogenetic variants in ANKRD11 or 16q24.3 deletion, and reviewed CHDs in patients with molecular diagnosis of KBG syndrome from the literature.

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Deletions involving the distal portion of the short arm of chromosome 8(8p23.1) show a high phenotypic variability. Congenital heart diseases (CHD) are often described.

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Background: Monosomy 1p36 syndrome is now considered the most common terminal deletion syndrome, with an estimated incidence of 1 in 5000. Cardiac involvement is well described in the literature mainly in terms of congenital heart defects (CHDs) and cardiomyopathies (CMPs). Few data in the literature describe the potential progressive nature of aortic dilatation (root and ascending aorta) in 1p36 deletion syndrome.

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Article Synopsis
  • Human coenzyme Q4 (COQ4) is crucial for producing coenzyme Q, and mutations in COQ4 lead to childhood neurodegeneration, prompting a study of its clinical spectrum and cellular effects.
  • The analysis included 44 patients from 36 families, revealing 23 genetic variants, three distinct disease patterns, and their correlation with clinical symptoms and brain imaging.
  • Findings indicated that COQ4 mutations result in low COQ4 protein and cellular coenzyme Q levels, suggesting a need for new treatment options since standard CoQ supplements didn’t yield sufficient improvement.
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Bi-allelic inactivation of XPD protein, a nucleotide excision repair (NER) signaling pathway component encoded by ERCC2 gene, has been associated with several defective DNA repair phenotypes, including xeroderma pigmentosum, photosensitive trichothiodystrophy, and cerebro-oculo-facio-skeletal syndrome. We report a pediatric patient harboring two compound heterozygous variants in ERCC2 gene, c.361-1G>A and c.

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Article Synopsis
  • Distal Arthrogryposis type 5D (DA5D) is a genetic condition marked by joint contractures, short stature, and various physical traits, inherited in an autosomal recessive pattern linked to mutations in the ECEL1 gene.
  • Researchers reported two Sardinian patients with a new homozygous variant in ECEL1 that may disrupt mRNA splicing, potentially leading to the condition.
  • This study adds to the understanding of DA5D by documenting this rare variant and reviewing known mutations in the ECEL1 gene, enhancing the database of genetic causes.
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