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Pentalogy of Cantrell(THAS)

MedGen UID:
107540
Concept ID:
C0559483
Disease or Syndrome
Synonyms: Cantrell deformity; Cantrell Haller Ravitsch syndrome; Cantrell pentalogy; Cantrell syndrome; THAS; THORACOABDOMINAL SYNDROME
SNOMED CT: Pentalogy of Cantrell (281587000)
Modes of inheritance:
Not genetically inherited
MedGen UID:
988794
Concept ID:
CN307044
Finding
Source: Orphanet
clinical entity without genetic inheritance.
 
Monarch Initiative: MONDO:0010742
OMIM®: 313850
Orphanet: ORPHA1335

Definition

Pentalogy of Cantrell (POC) is a lethal multiple congenital anomalies syndrome, characterized by the presence of 5 major malformations: midline supraumbilical abdominal wall defect, lower sternal defect, diaphragmatic pericardial defect, anterior diaphragmatic defect and various intracardiac malformations. Ectopia cordis (EC) is often found in fetuses with POC. [from ORDO]

Clinical features

From HPO
Renal agenesis
MedGen UID:
154237
Concept ID:
C0542519
Congenital Abnormality
Agenesis, that is, failure of the kidney to develop during embryogenesis and development.
Hypospadias
MedGen UID:
163083
Concept ID:
C0848558
Congenital Abnormality
Abnormal position of urethral meatus on the ventral penile shaft (underside) characterized by displacement of the urethral meatus from the tip of the glans penis to the ventral surface of the penis, scrotum, or perineum.
Patent ductus arteriosus
MedGen UID:
4415
Concept ID:
C0013274
Congenital Abnormality
In utero, the ductus arteriosus (DA) serves to divert ventricular output away from the lungs and toward the placenta by connecting the main pulmonary artery to the descending aorta. A patent ductus arteriosus (PDA) in the first 3 days of life is a physiologic shunt in healthy term and preterm newborn infants, and normally is substantially closed within about 24 hours after bith and completely closed after about three weeks. Failure of physiologcal closure is referred to a persistent or patent ductus arteriosus (PDA). Depending on the degree of left-to-right shunting, PDA can have clinical consequences.
Ectopia cordis
MedGen UID:
41703
Concept ID:
C0013580
Congenital Abnormality
Congenital malformation of the ventral wall with partial or total evisceration of the heart outside the thoracic cavity and through the defect in the ventral wall.
Transposition of the great arteries
MedGen UID:
21245
Concept ID:
C0040761
Congenital Abnormality
Critical congenital heart disease (CCHD) is a term that refers to a group of serious heart defects that are present from birth. These abnormalities result from problems with the formation of one or more parts of the heart during the early stages of embryonic development. CCHD prevents the heart from pumping blood effectively or reduces the amount of oxygen in the blood. As a result, organs and tissues throughout the body do not receive enough oxygen, which can lead to organ damage and life-threatening complications. Individuals with CCHD usually require surgery soon after birth.\n\nAlthough babies with CCHD may appear healthy for the first few hours or days of life, signs and symptoms soon become apparent. These can include an abnormal heart sound during a heartbeat (heart murmur), rapid breathing (tachypnea), low blood pressure (hypotension), low levels of oxygen in the blood (hypoxemia), and a blue or purple tint to the skin caused by a shortage of oxygen (cyanosis). If untreated, CCHD can lead to shock, coma, and death. However, most people with CCHD now survive past infancy due to improvements in early detection, diagnosis, and treatment.\n\nSome people with treated CCHD have few related health problems later in life. However, long-term effects of CCHD can include delayed development and reduced stamina during exercise. Adults with these heart defects have an increased risk of abnormal heart rhythms, heart failure, sudden cardiac arrest, stroke, and premature death.\n\nEach of the heart defects associated with CCHD affects the flow of blood into, out of, or through the heart. Some of the heart defects involve structures within the heart itself, such as the two lower chambers of the heart (the ventricles) or the valves that control blood flow through the heart. Others affect the structure of the large blood vessels leading into and out of the heart (including the aorta and pulmonary artery). Still others involve a combination of these structural abnormalities.\n\nPeople with CCHD have one or more specific heart defects. The heart defects classified as CCHD include coarctation of the aorta, double-outlet right ventricle, D-transposition of the great arteries, Ebstein anomaly, hypoplastic left heart syndrome, interrupted aortic arch, pulmonary atresia with intact septum, single ventricle, total anomalous pulmonary venous connection, tetralogy of Fallot, tricuspid atresia, and truncus arteriosus.
Anencephaly
MedGen UID:
8068
Concept ID:
C0002902
Congenital Abnormality
Anencephaly is a condition that prevents the normal development of the brain and the bones of the skull. This condition results when a structure called the neural tube fails to close during the first few weeks of embryonic development. The neural tube is a layer of cells that ultimately develops into the brain and spinal cord. Because anencephaly is caused by abnormalities of the neural tube, it is classified as a neural tube defect.\n\nBecause the neural tube fails to close properly, the developing brain and spinal cord are exposed to the amniotic fluid that surrounds the fetus in the womb. This exposure causes the nervous system tissue to break down (degenerate). As a result, people with anencephaly are missing large parts of the brain called the cerebrum and cerebellum. These brain regions are necessary for thinking, hearing, vision, emotion, and coordinating movement. The bones of the skull are also missing or incompletely formed.\n\nBecause these nervous system abnormalities are so severe, almost all babies with anencephaly die before birth or within a few hours or days after birth.
Hydrocephalus
MedGen UID:
9335
Concept ID:
C0020255
Disease or Syndrome
Hydrocephalus is an active distension of the ventricular system of the brain resulting from inadequate passage of CSF from its point of production within the cerebral ventricles to its point of absorption into the systemic circulation.
Ventral hernia
MedGen UID:
5531
Concept ID:
C0019326
Anatomical Abnormality
Ventral hernia refers to a condition in which abdominal contents protrude through a weakened portion of the abdominal wall.
Congenital diaphragmatic hernia
MedGen UID:
68625
Concept ID:
C0235833
Congenital Abnormality
The presence of a hernia of the diaphragm present at birth.
Congenital omphalocele
MedGen UID:
162756
Concept ID:
C0795690
Congenital Abnormality
An omphalocele is an abdominal wall defect limited to an open umbilical ring, and is characterized by the herniation of membrane-covered internal organs into the open base of the umbilical cord. Omphalocele is distinguished from gastroschisis (230750), in which the abdominal wall defect is located laterally to a normally closed umbilical ring with herniation of organs that are uncovered by membranes (summary by Bugge, 2010). On the basis of clinical manifestations, epidemiologic characteristics, and the presence of additional malformations, Yang et al. (1992) concluded that omphalocele and gastroschisis are casually and pathogenetically distinct abdominal wall defects. Omphalocele can be a feature of genetic disorders, such as Beckwith-Wiedemann syndrome (130650) and the Shprintzen-Goldberg syndrome (182210).
Pulmonary hypoplasia
MedGen UID:
78574
Concept ID:
C0265783
Congenital Abnormality
A congenital abnormality in which the lung parenchyma is not fully developed. It may be associated with other congenital abnormalities.
Cleft upper lip
MedGen UID:
40327
Concept ID:
C0008924
Congenital Abnormality
A gap or groove in the upper lip. This is a congenital defect resulting from nonfusion of tissues of the lip during embryonal development.
Cystic hygroma
MedGen UID:
60195
Concept ID:
C0206620
Neoplastic Process
A cystic lymphatic lesion of the neck.
Cleft palate
MedGen UID:
756015
Concept ID:
C2981150
Congenital Abnormality
Cleft palate is a developmental defect of the palate resulting from a failure of fusion of the palatine processes and manifesting as a separation of the roof of the mouth (soft and hard palate).

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVPentalogy of Cantrell
Follow this link to review classifications for Pentalogy of Cantrell in Orphanet.

Professional guidelines

PubMed

Araujo Júnior E, Coutinho LG, Bravo-Valenzuela NJ, Aquino P, Rocha LAD, Rizzo G, Tonni G, Respondek-Liberska M, Slodki M, Wolter A, Axt-Fliedner R
J Matern Fetal Neonatal Med 2023 Dec;36(1):2203791. doi: 10.1080/14767058.2023.2203791. PMID: 37080921
Liu K, Zhu M, Dong SZ
Prenat Diagn 2022 Dec;42(13):1636-1642. Epub 2022 Nov 4 doi: 10.1002/pd.6254. PMID: 36307940
Türkyilmaz G, Avcı S, Sıvrıkoz T, Erturk E, Altunoglu U, Turkyilmazlmaz SE, Kalelioglu IH, Has R, Yuksel A
Fetal Pediatr Pathol 2019 Apr;38(2):127-137. Epub 2019 Jan 2 doi: 10.1080/15513815.2018.1556367. PMID: 30600745

Recent clinical studies

Etiology

Wang G, Xi L, Li H, Wang Y, Wu C, Pan Z, Li Y, Wang Q, Dai J
Eur J Pediatr Surg 2022 Feb;32(1):50-55. Epub 2021 Nov 25 doi: 10.1055/s-0041-1739421. PMID: 34823268
Smith BJ, Flyer JN, Edwards EM, Soll RF, Horbar JD, Yeager SB
J Pediatr 2020 Jan;216:67-72. Epub 2019 Oct 24 doi: 10.1016/j.jpeds.2019.09.014. PMID: 31668886
Syngelaki A, Hammami A, Bower S, Zidere V, Akolekar R, Nicolaides KH
Ultrasound Obstet Gynecol 2019 Oct;54(4):468-476. doi: 10.1002/uog.20844. PMID: 31408229
Jnah AJ, Newberry DM, England A
Adv Neonatal Care 2015 Aug;15(4):261-8. doi: 10.1097/ANC.0000000000000209. PMID: 26225594
Opitz JM, Zanni G, Reynolds JF Jr, Gilbert-Barness E
Am J Med Genet 2002 Dec 30;115(4):269-86. doi: 10.1002/ajmg.10983. PMID: 12503120

Diagnosis

Adams AD, Stover S, Rac MW
Prenat Diagn 2021 Mar;41(4):486-496. Epub 2021 Feb 4 doi: 10.1002/pd.5886. PMID: 33540475
Syngelaki A, Hammami A, Bower S, Zidere V, Akolekar R, Nicolaides KH
Ultrasound Obstet Gynecol 2019 Oct;54(4):468-476. doi: 10.1002/uog.20844. PMID: 31408229
Williams AP, Marayati R, Beierle EA
Semin Pediatr Surg 2019 Apr;28(2):106-110. Epub 2019 Apr 9 doi: 10.1053/j.sempedsurg.2019.04.006. PMID: 31072457Free PMC Article
Prefumo F, Izzi C
Best Pract Res Clin Obstet Gynaecol 2014 Apr;28(3):391-402. Epub 2013 Dec 3 doi: 10.1016/j.bpobgyn.2013.10.003. PMID: 24342556
Katranci AO, Görk AS, Rizalar R, Günaydin M, qritürk E, Bernay F, Gürses N
Indian J Pediatr 1998 Jan-Feb;65(1):149-53. doi: 10.1007/BF02849710. PMID: 10771959

Therapy

Chen CP, Huang MC, Chern SR, Wu PS, Su JW, Wang W
Taiwan J Obstet Gynecol 2013 Jun;52(2):297-9. doi: 10.1016/j.tjog.2013.04.029. PMID: 23915871
Wheeler DS, St Louis JD
Pediatr Cardiol 2007 Jul-Aug;28(4):311-3. Epub 2007 Jun 11 doi: 10.1007/s00246-007-0016-9. PMID: 17563826
Plavka R, Dokoupilová M, Pazderová L, Kopecký P, Sebron V, Zapadlo M, Keszler M
Am J Perinatol 2006 Nov;23(8):467-72. Epub 2006 Nov 8 doi: 10.1055/s-2006-954821. PMID: 17094040
Polat I, Gül A, Aslan H, Cebeci A, Ozseker B, Caglar B, Ceylan Y
J Clin Ultrasound 2005 Jul-Aug;33(6):308-11. doi: 10.1002/jcu.20134. PMID: 16134161

Prognosis

Adams AD, Stover S, Rac MW
Prenat Diagn 2021 Mar;41(4):486-496. Epub 2021 Feb 4 doi: 10.1002/pd.5886. PMID: 33540475
Smith BJ, Flyer JN, Edwards EM, Soll RF, Horbar JD, Yeager SB
J Pediatr 2020 Jan;216:67-72. Epub 2019 Oct 24 doi: 10.1016/j.jpeds.2019.09.014. PMID: 31668886
Jnah AJ, Newberry DM, England A
Adv Neonatal Care 2015 Aug;15(4):261-8. doi: 10.1097/ANC.0000000000000209. PMID: 26225594
Prefumo F, Izzi C
Best Pract Res Clin Obstet Gynaecol 2014 Apr;28(3):391-402. Epub 2013 Dec 3 doi: 10.1016/j.bpobgyn.2013.10.003. PMID: 24342556
Puvabanditsin S, Di Stefano V, Garrow E, Wong R, Eng J, Balbin J
Hong Kong Med J 2013 Oct;19(5):447-50. doi: 10.12809/hkmj133737. PMID: 24088589

Clinical prediction guides

Liao Y, Wen H, Ouyang S, Yuan Y, Bi J, Guan Y, Fu Q, Yang X, Guo W, Huang Y, Zeng Q, Qin Y, Xiang H, Li S
Am J Obstet Gynecol 2021 Apr;224(4):396.e1-396.e15. Epub 2020 Oct 27 doi: 10.1016/j.ajog.2020.10.037. PMID: 33127430
Engels AC, Debeer A, Russo FM, Aertsen M, Aerts K, Miserez M, Deprest J, Lewi L, Devlieger R
Fetal Diagn Ther 2017;41(2):152-156. Epub 2017 Feb 15 doi: 10.1159/000457122. PMID: 28196368
Zhang X, Xing Q, Sun J, Hou X, Kuang M, Zhang G
J Pediatr Surg 2014 Aug;49(8):1335-40. doi: 10.1016/j.jpedsurg.2014.06.003. PMID: 25092102
Prefumo F, Izzi C
Best Pract Res Clin Obstet Gynaecol 2014 Apr;28(3):391-402. Epub 2013 Dec 3 doi: 10.1016/j.bpobgyn.2013.10.003. PMID: 24342556
Carmi R, Boughman JA
Am J Med Genet 1992 Jan 1;42(1):90-5. doi: 10.1002/ajmg.1320420118. PMID: 1308371

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