Beckwith-Wiedemann spectrum (BWSp): an update on diagnosis, management, and follow-up from the scientific committee of the Italian BWSp association.

Journal: Italian journal of pediatrics

This comprehensive review from the Italian BWSp Association updates the 2018 international consensus on Beckwith-Wiedemann spectrum (BWSp), a congenital imprinting disorder characterized by overgrowth and cancer risk due to alterations at chromosome 11p15.5.

Incorporating evidence up to 2024, the review revises:

  • Diagnosis
  • Prenatal testing
  • Molecular strategies
  • Tumor surveillance
  • Management of clinical features such as macroglossia and limb-length discrepancy

Key advances include:

  • Addressing diagnostic challenges in cases with negative blood methylation tests by using alternative tissue analysis
  • Introducing a prenatal scoring system
  • Refining tumor screening protocols, including universal α-fetoprotein monitoring for hepatoblastoma and genotype-guided Wilms tumor surveillance

The review also discusses multi-locus imprinting disturbances (MLID) and their genetic implications.

Additional highlights include:

  • Cognitive and psychosocial concerns that warrant routine assessment
  • Calls for improved transition care from pediatric to adult services

The authors emphasize a multidisciplinary, personalized approach to enhance lifelong management and encourage ongoing research into diagnostics and long-term outcomes.

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