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[性染色体三体综合征。五例报告及文献复习]

[Gonosomal trisomy syndrome. Five case reports and review of literature].

作者信息

Schwemmle C, Jungheim M, Ptok M

机构信息

Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover, Hannover.

出版信息

Laryngorhinootologie. 2013 Nov;92(11):725-31. doi: 10.1055/s-0033-1348249. Epub 2013 Aug 8.

Abstract

Gonosomal trisomies (GT) or so called sex chromosome trisomies (SCTs) are the most common chromosomal abnormalities in humans. The addition of extra X and/or Y chromosomes leads to neurodevelopmental differences, with increased risk for developmental delays, cognitive impairments, executive dysfunction, and behavioural and psychological disorders. Attentional problems, hyperactivity, autistic spectrum disorders and impulsivity are commonly described. Rates of language and communication problems are high in all 3 trisomies. Especially in cases of language impairment ENT specialists may be the main contact to rule out hearing loss. Here, we present 5 patients with SCT. In 2 boys and a young man, SCT was already known (47,XXY; 47,XYY; 47,XYY), in 2 cases we initiated genetic investigation (47,XXX; 47,XXY). Main symptom of the 4 children was a language delay; the young man reported had a history of mild language and motor coordination delay, too. Main complaints of the adult patient were problems with speech-in-noise perception. Furthermore 2 of the patients had mild facial dysmorphic features. The prognosis of the development in patients with SCT is variable, depending on severity of the manifestations and on quality and timing of treatment. Furthermore, in children with motor development/language delay a chromosomal analysis may be initiated at least at the request of the parents to clarify the etiology of developmental abnormalities. If the suspicion of hearing impairment as the cause of problems is not confirmed in a patient, ENT specialists should also consider SCA as a possible cause in the differential diagnosis.

摘要

性染色体三体(GT),即所谓的性染色体三体综合征(SCT),是人类最常见的染色体异常。额外的X和/或Y染色体的增加会导致神经发育差异,增加发育迟缓、认知障碍、执行功能障碍以及行为和心理障碍的风险。注意力问题、多动、自闭症谱系障碍和冲动行为是常见的表现。在所有这三种三体综合征中,语言和沟通问题的发生率都很高。特别是在语言障碍的病例中,耳鼻喉科专家可能是排除听力损失的主要联系人。在此,我们介绍5例性染色体三体综合征患者。在2名男孩和1名青年男性中,性染色体三体综合征已经确诊(47,XXY;47,XYY;47,XYY),在另外2例中我们启动了基因检测(47,XXX;47,XXY)。4名儿童的主要症状是语言发育迟缓;报告的那名青年男性也有轻度语言和运动协调发育迟缓的病史。成年患者的主要主诉是噪声环境下的言语感知问题。此外,2名患者有轻度面部畸形特征。性染色体三体综合征患者的发育预后各不相同,取决于表现的严重程度以及治疗的质量和时机。此外,对于有运动发育/语言发育迟缓的儿童,至少应在家长的要求下启动染色体分析,以明确发育异常的病因。如果患者听力障碍作为问题原因的怀疑未得到证实,耳鼻喉科专家在鉴别诊断中也应考虑性染色体三体综合征作为可能的病因。

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