Association between pectus excavatum and congenital genetic disorders: a systematic review and practical guide for the treating physician
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Read the article on jpedsurg.org ↗Article · Apr 2021 · 1 min read
In brief
In brief
Systematic review identifying 20 genetic disorders associated with pectus excavatum and presenting a standardized clinical scoring protocol to guide referral decisions. The protocol emphasizes family history screening and recognition of subtle syndromic features that may indicate underlying genetic conditions requiring specialized evaluation before surgical intervention.
Written by the GCMD Library team from the article.
Background
Pectus excavatum (PE) could be part of a genetic disorder, which then has implications regarding comorbidity, the surgical correction of PE, and reproductive choices. However, referral of a patient presenting with PE for genetic analysis is often delayed because additional crucial clinical signs may be subtle or even missed in syndromic patients. We reviewed the literature to inventory known genetic disorders associated with PE and create a standardized protocol for clinical evaluation.
Methods
A systematic literature search was performed in electronic databases. Genetic disorders were considered associated with PE if studies reported at least five cases with PE. Characteristics of each genetic disorder were extracted from the literature and the OMIM database in order to create a practical guide for the clinician.
Results
After removal of duplicates from the initial search, 1632 citations remained. Eventually, we included 119 full text articles, representing 20 different genetic disorders. Relevant characteristics and important clinical signs of each genetic disorder were summarized providing a standardized protocol in the form of a scoring list. The most important clinical sign was a positive family history for PE and/or congenital heart defect.
Conclusions
Twenty unique genetic disorders have been found associated with PE. We have created a scoring list for the clinician that systematically evaluates crucial clinical signs, thereby facilitating decision making for referral to a clinical geneticist.