Pinsard Loic, Touboul David, Vu Yen, Lacombe Didier, Leger Francois, Colin Joseph
Ophthalmology Department, Keratoconus National Reference Center (CNRK), Bordeaux Hospital, Bordeaux University.
Ophthalmic Genet. 2010 Dec;31(4):252-6. doi: 10.3109/13816810.2010.523038.
To report two memorable clinical comorbid cases of Williams-Beuren syndrome (WBS) associated with keratoconus (KC). WBS is known to be an abnormal systemic development caused by a microdeletion of contiguous genes in chromosome 7q11.23, which includes the elastin gene. KC is currently suspected to have a genetic origin but the responsible gene has not been clearly identified.
KC and WBS is described for two cases. Risk factors for KC were investigated by interviewing parents, and WBS was confirmed by fluorescence in-situ hybridization (FISH). Histological analysis with Orcein (coloring specific to elastin) on the receiver corneal button of patient 1 was carried out.
Because of the rarity of both pathologies and the absence of other risk factors for developing keratoconus, we considered a possible genetic link. The association had never been reported in the literature. The first histological investigation could not confirm the presence of abnormal elastin in the cornea, but another gene could be responsible.
This report highlights the first cases of this association. Further histological and cytogenetic investigation on the deletion should be interesting in order to argue a possible physiopathological or genomic link.
报告两例与圆锥角膜(KC)相关的威廉姆斯-伯伦综合征(WBS)的难忘临床合并病例。已知WBS是由7号染色体q11.23区域连续基因的微缺失引起的一种异常全身性发育疾病,其中包括弹性蛋白基因。目前怀疑KC有遗传起源,但相关致病基因尚未明确。
描述了两例KC和WBS病例。通过询问父母调查KC的危险因素,并通过荧光原位杂交(FISH)确诊WBS。对患者1的受体角膜植片进行了弹性蛋白特异性染色(orcein染色)的组织学分析。
由于这两种疾病都很罕见,且不存在其他导致圆锥角膜的危险因素,我们认为可能存在遗传联系。此前文献中从未报道过这种关联。首次组织学检查未能证实角膜中存在异常弹性蛋白,但可能另有基因与之相关。
本报告首次报道了这种关联病例。对该缺失进行进一步的组织学和细胞遗传学研究,对于论证可能的生理病理或基因组联系将很有意义。