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Ann Saudi MedAnn Saudi MedAnnals of Saudi Medicine0256-49470975-4466King Faisal Specialist Hospital and Research Centre 10.5144/0256-4947.2014.270basm-3-270bLettersRe: Consanguinity and isolated atrial septal defect in the North East of Iran Al-Mendalawi Mahmood Dhahir From Al-Kindy College of Medicine, Baghdad University, Baghdad, IraqCorrespondence: Mahmood Dhahir Al-Mendalawi, Al-Kindy College of Medicine, Baghdad University, PO Box 55302, Baghdad 1111, Iraq, mdalmendalawi@yahoo.comMay-Jun 2014 34 3 270 271 Copyright © 2014, Annals of Saudi Medicine2014This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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To the Editor: I read with interest the study by Moghaddam et al1 on the consanguinity and isolated atrial septal defect (ASD) in the North East of Iran. It is well known that congenital heart diseases (CHDs), particularly ASD, generally tend to follow multifactorial inheritance. However, autosomal dominant inheritance of ASD has been increasingly reported.2,3 This genetic form of inheritance together with the fact that consanguinity increases the risk of couples to have offspring with CHDs could result in the familial aggregation of ASD. It is expected for the familial aggregation of ASD to be prevailed in Iran. This is based on the following 3 points. (1) Among various types of CHDs, ASD has been reported to be predominant in Iran.4 (2) Consanguineous marriage is culturally preferable in Iran, and its trend has been noticed to be significantly on rise.5 (3) A total of 44% of ASD patients in the study by Moghaddam et al1 had parents with either the third-degree relationship or far relationship. Since associated cardiac, atrioventricular conduction, and skeletal anomalies are not uncommon in ASD, and in the view of potentially high occurrence of familial ASD in Iran based on the aforementioned 3 points, I presume that large-scale multicenter studies are needed to verify the requirement to screen ASD parents and their first-degree and second-degree relatives for associated anomalies.
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REFERENCES
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4 Nikyar B  Sedehi M  Mirfazeli A  Qorbani M  Golalipour MJ   Prevalence and Pattern of Congenital Heart Disease among Neonates in Gorgan, Northern Iran (2007–2008) Iran J Pediatr 2011 21 307 12 23056806 
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