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中国普拉德-威利综合征的临床和遗传特征

Clinical and genetic features of Prader-Willi syndrome in China.

作者信息

Lu Wei, Qi Yan, Cui Bing, Chen Xiu-Li, Wu Bing-Bing, Chen Chao, Cao Yun, Zhou Wen-Hao, Xu Hong, Luo Fei-Hong

机构信息

Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China.

出版信息

Eur J Pediatr. 2014 Jan;173(1):81-6. doi: 10.1007/s00431-013-2124-2. Epub 2013 Aug 11.

Abstract

UNLABELLED

We set out to delineate the phenotypic and genotypic characteristics of Prader-Willi syndrome (PWS), a congenital neurodevelopmental disorder caused by the lack of expression of the paternally inherited imprinted genes on chromosome 15q11-13 in 31 Chinese patients. They were genotyped to identify deletions using methylation-specific polymerase chain reaction analysis and subsequent methylation-specific multiplex ligation-dependent probe amplification analysis. Microsatellite linkage analysis was performed to distinguish maternal uniparental disomy (UPD) from imprinting defect. Clinical manifestations were recorded and compared between patients with paternal 15q11-13 deletion and UPD. Deletions in the 15q11-13 region were present in 26 (83.9 %) patients, and UPD was observed in 5 (16.1 %) patients. The mean maternal age at the time of childbirth for mUPD children (32.8 ± 5.1 years) was significantly higher than that of children with paternal 15q11-13 deletion (27.1±3.2 years, P < 0.05). All patients had neonatal hypotonia, feeding difficulties in infancy, and decreased fetal activity, but only 12.9 % of the patients showed short stature, 54.8 % presented typical facial features, and 35.5 % showed skin picking lesions.

CONCLUSION

Significant heterogeneity in clinical phenotypes and genotypes in PWS were observed between Chinese and Western populations in this study. This suggests that ethnic differences may be relevant to the diagnostic criteria for PWS.

摘要

未标注

我们着手描绘31例中国普拉德-威利综合征(PWS)患者的表型和基因型特征,该综合征是一种先天性神经发育障碍,由父源15号染色体q11-13区域印记基因表达缺失所致。通过甲基化特异性聚合酶链反应分析及随后的甲基化特异性多重连接依赖探针扩增分析对他们进行基因分型以鉴定缺失情况。进行微卫星连锁分析以区分母源单亲二倍体(UPD)与印记缺陷。记录并比较父源15q11-13缺失患者与UPD患者的临床表现。15q11-13区域缺失见于26例(83.9%)患者,5例(16.1%)患者观察到UPD。母源单亲二倍体儿童出生时母亲的平均年龄(32.8±5.1岁)显著高于父源15q11-13缺失儿童(27.1±3.2岁,P<0.05)。所有患者均有新生儿肌张力减退、婴儿期喂养困难及胎动减少,但仅12.9%的患者身材矮小,54.8%有典型面容,35.5%有皮肤搔抓损伤。

结论

本研究观察到中国人群与西方人群PWS的临床表型和基因型存在显著异质性。这表明种族差异可能与PWS的诊断标准相关。

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