El Chehadeh-Djebbar Salima, Callier Patrick, Masurel-Paulet Alice, Bensignor Candace, Méjean Nathalie, Payet Muriel, Ragon Clémence, Durand Christine, Marle Nathalie, Mosca-Boidron Anne-Laure, Huet Frédéric, Mugneret Francine, Faivre Laurence, Thauvin-Robinet Christel
Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs, Hôpital d'Enfants, CHU de Dijon, France.
Eur J Med Genet. 2011 May-Jun;54(3):369-73. doi: 10.1016/j.ejmg.2011.03.001. Epub 2011 Mar 30.
We report the case of a 26-month-old boy with mental retardation, facial dysmorphism, childhood feeding difficulties, short stature, bilateral cryptorchidism, micropenis, and heart defect. Endocrinal evaluation revealed complete growth hormone deficiency (GHD) and gonadotropic deficiency, and pituitary magnetic resonance imaging showed partial pituitary stalk interruption syndrome (PSIS). A de novo 493 kb microdeletion on chromosome 17q21.31 was identified using array comparative genomic hybridization (array-CGH) analysis. This is the first report of PSIS in the phenotypical spectrum of 17q21.31 microdeletion syndrome, although other midline abnormalities have previously been described. Our report suggests that GHD should be investigated in patients with 17q21.31 microdeletion syndrome and short stature, defined by a body height below - 2 standard deviation scores (SDS) for age and sex. This finding also opens new avenues of research on the etiopathogenesis of PSIS, for which the genetic mechanisms remain unknown.
我们报告了一名26个月大男孩的病例,该男孩患有智力发育迟缓、面部畸形、儿童喂养困难、身材矮小、双侧隐睾、小阴茎和心脏缺陷。内分泌评估显示完全性生长激素缺乏(GHD)和促性腺激素缺乏,垂体磁共振成像显示部分垂体柄中断综合征(PSIS)。使用阵列比较基因组杂交(array-CGH)分析在17q21.31染色体上鉴定出一个493 kb的新生微缺失。这是17q21.31微缺失综合征表型谱中PSIS的首次报告,尽管此前已描述过其他中线异常。我们的报告表明,对于17q21.31微缺失综合征且身材矮小(定义为身高低于年龄和性别的-2标准差评分[SDS])的患者,应进行GHD调查。这一发现也为PSIS的发病机制研究开辟了新途径,其遗传机制仍然未知。