Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Horm Res Paediatr. 2013;79(4):243-9. doi: 10.1159/000346411. Epub 2013 Jan 25.
Chromosome 22q11.2 microduplications are extremely rarely detected; in comparison, the deletion of same region, known as the DiGeorge/velocardiofacial syndrome, occurs more frequently. Thyroid anomalies commonly occur in patients with 22q11.2 deletion syndrome, however few reports of thyroid anomalies associated with 22q11.2 microduplication have been published thus far.
We present a case of a male infant who was prenatally diagnosed with 22q11.2 microduplication and was found to have congenital hypothyroidism due to thyroid hemiagenesis after birth. Moreover, the baby had bilateral hearing impairment, bilateral cryptorchidism, and a rotated penis. At the age of 2 years, the infant was euthyroid with levothyroxine replacement, but he showed significant developmental delay.
To our knowledge, this is the first case of congenital hypothyroidism with thyroid hemiagenesis in a patient showing 22q11.2 microduplication. Thyroid dysgenesis could be an additional clinical feature shared by the 22q11.2 microduplication and deletion syndrome, suggesting that the duplication and deletion of a gene may result in a common phenotype. Thyroid dysgenesis should be considered in the evaluation and management of patients with this genomic disorder.
染色体 22q11.2 微重复极为罕见;相比之下,同一区域的缺失,即 DiGeorge/心脏面部综合征,更为常见。22q11.2 缺失综合征患者常伴有甲状腺异常,但迄今鲜有 22q11.2 微重复相关甲状腺异常的报道。
我们报告了一例男性婴儿,其在产前被诊断为 22q11.2 微重复,并在出生后因甲状腺单侧发育不全而患有先天性甲状腺功能减退症。此外,该婴儿还伴有双侧听力障碍、双侧隐睾和阴茎旋转。2 岁时,患儿在甲状腺素替代治疗下甲状腺功能正常,但存在明显的发育迟缓。
据我们所知,这是首例表现为 22q11.2 微重复的先天性甲状腺功能减退伴甲状腺单侧发育不全的病例。甲状腺发育不全可能是 22q11.2 微重复和缺失综合征共有的另一个临床特征,提示基因的重复和缺失可能导致相同的表型。在评估和管理此类基因组疾病的患者时,应考虑甲状腺发育不全。