van Os E, Niemarkt H J, Verreussel M J T, Cruysberg J R M, Bok L A, Spruijt L
Máxima Medisch Centrum, locatie Veldhoven, afd. Kindergeneeskunde, Postbus 7777, 5500 MB Veldhoven.
Ned Tijdschr Geneeskd. 2008 Mar 8;152(10):569-73.
Two female neonates were diagnosed post partum with bilateral aniridia. The first patient had the familial form, caused by a point mutation in the paired box 6 (PAX6) gene. The second patient had a sporadic aniridia caused by a de novo microdeletion involving both the PAX6 gene as well as the Wilms tumour suppressor-I (WT1) gene. This made screening for the presence of a Wilms tumour necessary. The second patient died several months after birth, due to respiratory insufficiency. Aniridia is a rare developmental disorder of the eye, with absence of most of the iris tissue, caused by an abnormality in the PAX6 gene on chromosome 11p13. Familial aniridia is usually due to a point mutation of the PAX6 gene, which causes solely ocular abnormalities. Sporadic aniridia is caused by a de novo deletion or microdeletion of chromosome 11p13, which affects not only the PAX6 gene but also the adjacent WT1 gene. In these patients, the Wilms tumour, aniridia, genitourinary anomalies, and mental retardation (WAGR) syndrome can be present, and screening for a Wilms tumour is indicated. Unless previous investigation of a family member has demonstrated the WT1 gene to be normal, chromosome studies should always be performed in patients with aniridia.
两名女新生儿产后被诊断为双眼无虹膜。首例患者为家族性无虹膜,由配对盒6(PAX6)基因的点突变引起。第二例患者为散发性无虹膜,由涉及PAX6基因和威尔姆斯肿瘤抑制基因-1(WT1)基因的新发微缺失所致。这使得筛查威尔姆斯肿瘤的存在成为必要。第二例患者出生后数月因呼吸功能不全死亡。无虹膜是一种罕见的眼部发育障碍,因11号染色体p13区域的PAX6基因异常导致大部分虹膜组织缺失。家族性无虹膜通常由于PAX6基因的点突变引起,仅导致眼部异常。散发性无虹膜由11号染色体p13区域的新发缺失或微缺失引起,不仅影响PAX6基因,还影响相邻的WT1基因。在这些患者中,可能存在威尔姆斯肿瘤、无虹膜、泌尿生殖系统异常和智力发育迟缓(WAGR)综合征,因此需要筛查威尔姆斯肿瘤。除非先前对家庭成员的调查已证明WT1基因正常,否则对无虹膜患者应始终进行染色体研究。