Introduction
Embryology of midgut rotation: correlation of morphological change with molecular events
Overview of intestinal malrotation
Intestinal malrotation due to mutations in known genes
Intestinal malrotation due to mutations in the forkhead box transcription factor FOXF1
Reference (OMIM) | Gastro-intestinal | Pancreatic or hepato-biliary | Genito-urinary | Cardiovascular | Cranio-facial | Other | Consanguinity/sib recurrence | References |
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Syndromes of known genetic aetiology
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Alveolar capillary dysplasia due to mutations in FOXF1 at 16q24.1 (265380) | Malrotation, congenital short bowel, duodenal stenosis | Annular pancreas | Hydronephrosis, bicornuate uterus with cervical duplication | AVSD, partial APVD | Micrognathia, low-set ears | Alveolar capillary dysplasia, left pulmonary isomerism | Autosomal dominant inheritance | [9] |
Chronic idiopathic intestinal pseudo-obstruction due to mutations in FLNA at xq28 (300048) | Malrotation, intestinal pseudo-obstruction, pyloric stenosis | No | Hydronephrosis, undescended testes | Patent ductus arteriosus | No | Thrombo-cytopenia | X-linked recessive inheritance | [46] |
Due to abnormalities of L–R patterning
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CFC1 (605194) | Malrotation, right-sided stomach, | Extra-hepatic biliary atresia, central liver | Genito-urinary anomalies (unspecified) | DC, TGA, ASD, VSD, DORV, CAVC, total APVD, PDA, RAA, HAA, bilateral SVC, HLHS | Absent corpus callosum, myelocele | Asplenia, polysplenia, omphalocele | Autosomal dominant inheritance | [47] |
ZIC3 (300265) | Malrotation, TEF, DA, AA | Biliary atresia, abnormal liver lobation | Horseshoe kidney, double ureter, adrenal aplasia, ureteral stenosis | DC, TGA, ASD, VSD, DORV, TAPVD, HLHS, CAVC, bilateral SVC | Olfactory nerve aplasia, neural tube defect, cerebellar hypoplasia | Asplenia, polysplenia, sacral agenesis, situs inversus, omphalocele, radial dysplasia | X-linked recessive inheritance | |
NKX2.5 (600584) | Malrotation | No | No | ASD, VSD, TOF, PS, PA, atrial fibrillation, AV conduction abnormalities | No | Polysplenia, asplenia, | Autosomal dominant inheritance | [50] |
ACVR2B (602730) | Malrotation | Midline liver | No | DC, ASD, total APVR, bilateral SVC, VSD, CAVC, RAA, DORV, TGA, PS | No | Asplenia, polysplenia | Autosomal dominant inheritance | [51] |
LEFTY A (601877) | Malrotation, right-sided stomach | Midline liver | No | DC, HLHS, CAVC, aortic atresia, aortic coarctation | No | Left pulmonary isomerism, polysplenia | Autosomal dominant inheritance | [52] |
Non-syndromic malrotation
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Smith (193250) | Malrotation | No | No | No | No | No | Three affected generations | [11] |
Beaudoin (193250) | Malrotation | No | No | No | No | No | Three sibs, possibly mother | [12] |
Malrotation with multiple additional congenital malformations
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Martinez-Frias (601346) | Malrotation, EA, PA, DA, JA | Gall bladder agenesis, intra- and extra-hepatic biliary atresia, hypoplastic or annular pancreas | Hypospadias | Congenital heart defect | No | Neonatal diabetes mellitus | Consanguinity, sib recurrence | |
Multiple gastro-intestinal atresias (243150) | Malrotation, DA, JA, IA, CA, AA Intraluminal calcification | Cystic dilatation of bile duct and pancreatic duct | No | No | No | No | Consanguinity, sib recurrence | |
Congenital short bowel/malrotation (not listed) | Malrotation, congenital short bowel | No | No | No | No | No | Consanguinity, sib recurrence | [20] |
MMIH (249210) | Malrotation, microcolon, microileum, intestinal hypoperistalsis | No | Megacystis | No | No | Consanguinity, sib recurrence | [22] | |
Pumberger (606894) | Malrotation, duodeno-jejunal atresia; absence of dorsal mesentery and of superior mesenteric artery | No | No | No | No | No | Sib recurrence | [27] |
Stalker and Chitayat (193250) | Malrotation, JA | No | No | No | Frontal bossing, telecanthus, long palpebral fissures | No | Sib recurrence | [28] |
McPherson and Clemens (601165) | Malrotation | Focal endocrine hyperplasia | Nephromegaly | DORV, ASD, VSD, hypoplastic right ventricle | Bilateral cleft lip and palate, hypertelorism, flat face | Subependymal and cerebellar cortical glial heterotopia | Sib recurrence | [29] |
Kapur-Toriello (244300) | Malrotation, rectal stenosis, heterotopic gastric mucosa in Meckel diverticulum | No | No | Hypoplastic left heart, double outlet right ventricle | Cleft lip and palate, flat-tipped bulbous nose, long columella. Mental retardation. | Microphthalmia, coloboma | Sib recurrence | [32] |
Hardikar (612726) | Malrotation, intestinal septa | Obstructive hepatic cholestasis, cholangitis | Hydronephrosis, hydroureter, vaginal atresia, common urogenital sinus | Coarctation | Cleft lip and palate | Pigmentary retinopathy | Sib recurrence | [30] |
Serpentine fibula-polycystic kidney syndrome (600330) | Malrotation | No | Polycystic kidneys | ASD, PDA | High-arched eyebrows, hirsuit forehead, micrognathia | S-shaped fibula, ulna, radius, megalocornea, ptosis. | Sib recurrence | [31] |
Microgastria-Limb reduction defects (156810) | Malrotation, microgastria, EA, AA | Absent gall bladder, annular pancreas | Renal agenesis, cystic dysplasia, | ASD, VSD, truncus arteriosus | No | Arrhinencephaly polymicrogyria, hydrocephalus, terminal transverse limb defects | Multiple case reports | [33] |
Maegawa (not listed) | Malrotation, DA | Biliary atresia | No | No | Bilateral microtia, absent external auditory meati, Mondini dysplasia | Thyroid aplasia | Single case report | [34] |
Kumar (not listed) | Malrotation, duodenal stenosis | No | No | Tetralogy of Fallot | Lateral facial clefts, low-set malformed ears, cleft palate | No | Single case report | [35] |
Farag (243600) | Malrotation, apple peel jejunal atresia | No | No | No | No | Nil | Consanguinity, sib recurrence | [25] |
Stromme (243605) | Malrotation, apple peel jejunal atresia | No | No | No | No | Microcornea, sclerocornea, microphthalmia, microcephaly, hydrocephalus, neuronal migration defect | Sib recurrence | [24] |
Chromosomal
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Ring chromosome 4 (not listed) | Malrotation, DA | Gall bladder aplasia | Hypospadias | No | Cleft lip and palate, dysmorphic facial features | Mental retardation, growth retardation | Sporadic | |
13q (not listed) | Malrotation, DA, JA, IA, agenesis of colonic mesentery | Hypoplastic gallbladder | Undescended testes | Cardiomegaly | Dysmorphic facial features | Mental retardation, bilateral retinoblastoma, vertebral anomalies | Sporadic | [41] |
Duplication of long arm of chromosome 16 (not listed) | Malrotation, AA, short bowel | Gall bladder aplasia | Vesico-ureteric reflux, hydronephrosis, genital hypoplasia | ASD, patent ductus arteriosus, total anomalous pulmonary venous drainage | Cleft palate, dysmorphic facial features | Mental retardation, growth retardation | Sporadic |