Department of Paediatrics, Federico II University, Naples, Italy.
Am J Med Genet A. 2012 Apr;158A(4):832-5. doi: 10.1002/ajmg.a.34133. Epub 2012 Mar 9.
Haploinsufficiency of a region located distal to 10p14 designated HDR1, is responsible for hypoparathyroidism, sensorineural deafness, and renal anomalies (HDR syndrome). Haploinsufficiency of a more proximal region, located on 10p13-10p14, designated as DGCR2 is associated with congenital heart defects and thymus hypoplasia/aplasia or T cell defect. We describe a patient showing facial dysmorphisms, delayed psychomotor development and bilateral sensorineural hearing loss and carrying a 10p14 deletion, the smallest deletion found in the literature so far. Our patient, carrying a partial deletion of the DGCR2 region and of the HDR1 region, including the GATA3 gene, showed, unexpectedly, only few of the clinical features of DiGeorge 2 syndrome (psychomotor retardation, palpebral ptosis, epicanthic folds, anteverted nares, cryptorchidism, hand/foot abnormalities) and did not show other typical signs, such as cardiac defect, cleft palate, and abnormal T cell levels. Of the three characteristic features of the HDR syndrome, our patient had only sensorineural deafness. On the basis of the revision of the other cases reported in the literature with a deletion including the 10p14 region, we suggest that GATA3 haploinsufficiency, although not recorded for each patient, is responsible for deafness. The present case shows that even this small 10p deletion is responsible for a specific phenotype. We also underline the importance of CGH-array, in order to obtain a more precise physical mapping of the 10p deletions and an accurate genotype-phenotype correlation.
10p14 远端一个区域的杂合性缺失导致甲状旁腺功能减退、感觉神经性耳聋和肾脏异常(HDR 综合征)。位于 10p13-10p14 上的更近端区域的杂合性缺失,被指定为 DGCR2,与先天性心脏缺陷、胸腺发育不全/发育不良或 T 细胞缺陷有关。我们描述了一名患者,其表现为面部畸形、精神运动发育迟缓、双侧感觉神经性听力损失,并携带 10p14 缺失,这是迄今为止文献中发现的最小缺失。我们的患者携带 DGCR2 区域和 HDR1 区域的部分缺失,包括 GATA3 基因,除了少数 2 型 DiGeorge 综合征(精神运动迟缓、眼睑下垂、内眦赘皮、前鼻孔、隐睾、手/脚异常)的临床特征外,表现出令人意外的特征,并且未显示其他典型特征,如心脏缺陷、腭裂和异常 T 细胞水平。在 HDR 综合征的三个特征中,我们的患者只有感觉神经性耳聋。基于对包括 10p14 区域缺失的文献中报道的其他病例的修订,我们提出 GATA3 杂合性缺失,尽管未在每个患者中记录,但负责耳聋。本病例表明,即使是这种小的 10p 缺失也会导致特定的表型。我们还强调了 CGH-array 的重要性,以便更精确地对 10p 缺失进行物理作图,并进行准确的基因型-表型相关性分析。