Multidisciplinary follow-up in a patient with Morgagni hernia leads to diagnosis of Marfan syndrome

• Published in: Italian journal of pediatrics 2024-05, Vol.50 (1), p.94-6, Article 94
• Main Authors: Capecchi, Ester, Villa, Roberta, Pini, Alessandro, Iascone, Maria, Messina, Laura, Ajmone, Paola Francesca, Mosca, Fabio, Gangi, Silvana, Bedeschi, Maria Francesca
• Format: Article
• Language: English
• Subjects: Adipokines; Age; Aortic dissection; Births; Case Report; Child; Children & youth; Chromosome 15; Congenital defects; Congenital diaphragmatic hernia; Connective tissues; Diagnosis; Diaphragm; Families & family life; FBN1 mutation; Fibrillin; Fibrillin-1 - genetics; Follow-Up Studies; Gene deletion; Hernia; Hernias; Hernias, Diaphragmatic, Congenital - complications; Humans; Marfan syndrome; Marfan Syndrome - complications; Marfan Syndrome - diagnosis; Marfan Syndrome - genetics; Mutation; Patients; Respiratory tract infection
• ISSN: 1824-7288; 1720-8424; 1824-7288
• DOI: 10.1186/s13052-024-01643-8

congenital diaphragmatic hernia (CDH) is a birth defect occurring in isolated or syndromic (chromosomal or monogenic) conditions. The diaphragmatic defect can be the most common one: left-sided posterolateral, named Bochdalek hernia; or it can be an anterior-retrosternal defect, named Morgagni hernia. Marfan syndrome (MFS) is a rare autosomal dominant inherited condition that affects connective tissue, caused by mutations in fibrillin-1 gene on chromosome 15. To date various types of diaphragmatic defects (about 30 types) have been reported in association with MFS, but they are heterogeneous, including CDH and paraesophageal hernia. We describe the case of a child incidentally diagnosed with Morgagni hernia through a chest X-ray performed due to recurrent respiratory tract infections. Since the diagnosis of CDH, the patient underwent a clinical multidisciplinary follow-up leading to the diagnosis of MFS in accordance with revised Ghent Criteria: the child had typical clinical features and a novel heterozygous de novo single-base deletion in exon 26 of the FBN1 gene, identified by Whole-Exome Sequencing. MFS diagnosis permitted to look for cardiovascular complications and treat them, though asymptomatic, in order to prevent major cardiovascular life-threatening events. Our case shows the importance of a long-term and multidisciplinary follow-up in all children with diagnosis of CDH.