Cohen E, Chow E W, Weksberg R, Bassett A S
Schizophrenia Research Program, Queen Street Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Am J Med Genet. 1999 Oct 8;86(4):359-65. doi: 10.1002/(sici)1096-8628(19991008)86:4<359::aid-ajmg10>3.0.co;2-v.
22q11 deletion syndrome (22qDS) is due to microdeletions of chromosome region 22q11.2. Little is known about the phenotype of adults. We reviewed available case reports of adults (age >/=18 years) with 22qDS and compared the prevalence of key findings to those reported in a large European survey of 22qDS (497 children and 61 adults) [Ryan et al., 1997: J. Med. Genet. 34:798-804]. Fifty-five studies reported on 126 adults (83 women, 40 men, 3 unknown sex), mean age 29.6 years (SD = 8.7 years). Compared with the European survey, adults with 22qDS reviewed had a lower rate of CHD, 30% versus 75%; chi(2) = 88.65, df = 1, P < 0.0001, but higher rates of identified palate anomalies, 88% versus 15%; chi(2) = 37.45, df = 1, P < 0.0001, and learning difficulties, 94% versus 79%; chi(2) = 12.13, df = 1, P = < 0.0008. The most common finding reported was minor facial anomalies. Few reports provided details of minor physical anomalies. Psychiatric conditions were more prevalent, 36% versus 18%; chi(2)= 5.71, df = 1, P < 0.02, than in the survey: 60% of reviewed adults were transmitting parents (72% mothers) ascertained following diagnosis of affected offspring. They had lower rates of CHD, cleft palate, and psychiatric disorders but similar rates of learning disabilities, and other palate and facial anomalies compared with adults ascertained by other methods. The results suggest that learning disabilities and facial and palate anomalies may be key findings in 22qDS adults, but that ascertainment is a key factor in the observed phenotype. Comprehensive studies of adults with 22qDS identified independently of familial transmission are necessary to further delineate the phenotype of adults and to determine the natural history of the syndrome.
22q11缺失综合征(22qDS)是由染色体22q11.2区域的微缺失所致。关于成人的表型知之甚少。我们回顾了已有的关于成人(年龄≥18岁)22qDS的病例报告,并将主要发现的患病率与一项针对22qDS的大型欧洲调查(497名儿童和61名成人)[Ryan等人,1997年:《医学遗传学杂志》34:798 - 804]中报告的患病率进行了比较。55项研究报告了126名成人(83名女性,40名男性,3名性别未知),平均年龄29.6岁(标准差 = 8.7岁)。与欧洲调查相比,所回顾的22qDS成人患冠心病的比例较低,分别为30%和75%;卡方检验χ(2)= 88.65,自由度df = 1,P < 0.0001,但已确诊的腭裂异常比例较高,分别为88%和15%;卡方检验χ(2)= 37.45,自由度df = 1,P < 0.0001,学习困难比例也较高,分别为94%和79%;卡方检验χ(2)= 12.13,自由度df = 1,P = < 0.0008。报告中最常见的发现是轻微面部异常。很少有报告提供轻微身体异常的细节。精神疾病更为普遍,分别为36%和18%;卡方检验χ(2)= 5.71,自由度df = 1,P < 0.02。在所回顾的成人中,60%是在诊断出受影响的后代后确定的传递父母(72%是母亲)。与通过其他方法确定的成人相比,他们患冠心病、腭裂和精神疾病的比例较低,但学习障碍以及其他腭裂和面部异常的比例相似。结果表明,学习障碍以及面部和腭裂异常可能是22qDS成人的主要发现,但确诊是观察到的表型中的一个关键因素。有必要对独立于家族传递确定的22qDS成人进行全面研究,以进一步描述成人的表型并确定该综合征的自然病程。