A skeletal dysplasia leading to a perinatal death in 17th–19th century Lisbon, Portugal

IF 1.1 3区 历史学 Q2 ANTHROPOLOGY International Journal of Osteoarchaeology Pub Date : 2024-09-03 DOI:10.1002/oa.3338
Marina Lourenço, Eugénia Cunha, Carolina Meco, Francisco Curate
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Abstract

Congenital skeletal disorders are a heterogeneous group of anomalies that become evident during gestation. They are expressed in the shape and growth of the bones during development because of a defective genetic background. With the follow-up of pregnant women and the advances in prenatal ultrasonographic examination and molecular genetic tests, nowadays, congenital skeletal disorders are identified at an early gestational age. If they are considered lethal, the termination of pregnancy is advised. This work unveils an exceptional instance of a rare pathological condition identified in a perinate (birth ± 2 weeks) from the 17th to 19th centuries, recovered during an excavation at the cloister of the São Domingos Convent in Lisbon, Portugal. The skeleton presents with exuberant modifications that include, among others, severe shortening (micromelia) and bowing of the long bones of the upper and lower limbs. The main skeletal findings indicated a presumptive general diagnosis of skeletal dysplasia, while the differential diagnosis includes hypophosphatasia, campomelic dysplasia, achondrogenesis, thanatophoric dysplasia, and severe achondroplasia with developmental delay and acanthosis nigricans (SADDAN) as the most plausible causes for the observed skeletal changes. Even though an exact diagnosis is unattainable based only on the macroscopic analysis of the bones, the phenotypic features observed in this perinate are more consistent with thanatophoric dysplasia type 1.

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17-19 世纪葡萄牙里斯本导致围产期死亡的骨骼发育不良症
先天性骨骼疾病是一组在妊娠期就已显现的异常现象。由于遗传背景的缺陷,它们在发育过程中表现为骨骼的形状和生长。随着对孕妇的随访以及产前超声波检查和分子遗传学检测技术的进步,如今,先天性骨骼疾病在妊娠早期就能被发现。如果这些疾病被认为是致命的,建议终止妊娠。这项研究揭示了在葡萄牙里斯本圣多明戈斯修道院回廊的一次发掘中发现的一具 17 至 19 世纪的围产期(出生 ± 2 周)婴儿骨骼中发现的罕见病例。该婴孩的骨骼有明显的变形,其中包括上下肢长骨严重缩短(小畸形)和弯曲。主要的骨骼检查结果表明,推测的一般诊断是骨骼发育不良,而鉴别诊断包括低磷酸盐症、胼胝体发育不良、软骨发育不良、比软骨发育不良和严重软骨发育不良伴发育迟缓和黑棘皮症(SADDAN),这些都是导致所观察到的骨骼变化的最合理原因。尽管仅凭骨骼的宏观分析无法做出准确诊断,但在该患者身上观察到的表型特征更符合比骨发育不良 1 型。
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来源期刊
CiteScore
2.40
自引率
10.00%
发文量
105
期刊介绍: The aim of the International Journal of Osteoarchaeology is to provide a forum for the publication of papers dealing with all aspects of the study of human and animal bones from archaeological contexts. The journal will publish original papers dealing with human or animal bone research from any area of the world. It will also publish short papers which give important preliminary observations from work in progress and it will publish book reviews. All papers will be subject to peer review. The journal will be aimed principally towards all those with a professional interest in the study of human and animal bones. This includes archaeologists, anthropologists, human and animal bone specialists, palaeopathologists and medical historians.
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