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Re: C.R.E.S.T. Syndrome With Elevated MSAFP In Pregnant Patient From: Lynn Montgomery (lmontgomery@communitymed.org) Tue Apr 4 17:25:15 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: DoctorJoe@aol.com: "Re: patient choice c/s" Previous message: Braun, R. Daniel: "Re: patient choice c/s" Maybe in reply to: DGH: "C.R.E.S.T. Syndrome With Elevated MSAFP In Pregnant Patient" Next in thread: art fougner, md: "Re: C.R.E.S.T. Syndrome With Elevated MSAFP In Pregnant Patient" ? Congenital Nephrosis (Finnish Nephrosis ?sp) -- Lynn D. Montgomery, M.D. Director, Maternal-Fetal Medicine Rocky Mountain Perinatal Center 2825 Fort Missoula Road, Suite 130 Missoula, Montana, 59804 406-327-4094 fax 406-327-4154 e-mail: lmontgomery@communitymed.org website: http://www.communitymed.org/rmpc/ -----Original Message----- From: DGH <jth@springnet1.com> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@forum.obgyn.net> Date: Tuesday, April 04, 2000 1:45 PM Subject: C.R.E.S.T. Syndrome With Elevated MSAFP In Pregnant Patient >I have an interesting patient, G1P0, mid 2o's with an elevated maternal >serum alphafetoprotein of 23 multiples of the median. Repeat by the >same lab is similar. A sample sent to a reference laboratory is >pending. She has C.R.E.S.T. (calcinosis, Raynauds, esophageal >dysfunction, scleroderma, and telangectasias). The HCG and estriol are >in the normal range. She is at 17 weeks with a normal appearing fetus, >no evidence of open neural tube defect or abdominal wall defect. > >There is amniotic fluid present, enough for an amniocentesis, but the it >is markedly diminished. > >She has never had an alphafetoprotein done before (no reason to do so). >She has no evidence of liver or other GI disease and LFT's are all >normal. > >Genetics and rheumatology have seen her, but have no added suggestions. > >I have done an amniocentesis for chromosomes, amniotic alphafetoprotein, >and acetylcholinesterase. I could obtain only 20 cc. of fluid. It was >a medium to darkish brown in color. > >I have done a literature search. There are no articles in the >literature that match both to C.R.E.S.T. syndrome and pregnancy. There >is one article where there is an elevated alphafetoprotein, but the >patient had a lung tumor that was thought to be of yolk sac origin. >Presumably the patient in question was not pregnant. > >Does anybody have previous experience with a similar problem? Any >suggestions on any additional laboratory work to run on the amniotic >fluid? On the patient? I have considered getting a GI consultation. > >I am leaving my name off this post to try to help preserve the patient's >privacy. > >DGH. > Next message: DoctorJoe@aol.com: "Re: patient choice c/s" Previous message: Braun, R. Daniel: "Re: patient choice c/s" Maybe in reply to: DGH: "C.R.E.S.T. Syndrome With Elevated MSAFP In Pregnant Patient" Next in thread: art fougner, md: "Re: C.R.E.S.T. Syndrome With Elevated MSAFP In Pregnant Patient"

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