Lowry R B, Chernos J E, Connelly M S, Wyse J P H
Department of Medical Genetics, University of Calgary, Alta., Canada ; Department of Pediatrics, University of Calgary, Alta., Canada ; Department of Alberta Children's Hospital Research Institute, Calgary, Alta., Canada.
Mol Syndromol. 2013 Sep;4(6):280-4. doi: 10.1159/000354038. Epub 2013 Aug 1.
There are a number of reports of interstitial deletions of the long arm of chromosome 6 that have developmental delay and obesity suggesting that this is a distinct phenotype almost like Prader-Willi syndrome. Here we report a patient with a similar deletion but a strikingly different phenotype, one more in keeping with Marfan syndrome, although he does not fulfil the criteria for that syndrome. Array comparative genomic hybridization was performed to investigate a patient with a striking phenotype. This revealed an interstitial deletion of 6q14.1q15. Parental FISH studies were normal, indicating that this is a de novo deletion. Our patient has a completely different phenotype compared to other patients reported to have similar deletions. The common feature is developmental delay, but the body features are quite different in that our patient is tall, strikingly thin with pectus excavatum, scoliosis, skin striae, arachnodactyly, pes planus, cataracts, and a high-arched palate. This contrasts with other patients who have a similar deletion but have short stature and obesity. 6q14.1q15 interstitial deletions can have a very variable phenotype and do not necessarily conform to a clinical recognizable microdeletion syndrome caused by haploinsufficiency of dosage-sensitive genes in that region as proposed by others.
有许多关于6号染色体长臂间质性缺失的报告,这些患者存在发育迟缓与肥胖问题,这表明这是一种几乎类似于普拉德-威利综合征的独特表型。在此,我们报告一名患有类似缺失但表型截然不同的患者,其表型更符合马凡综合征,尽管他并不满足该综合征的诊断标准。我们对一名具有显著表型的患者进行了阵列比较基因组杂交检测。结果显示存在6q14.1q15的间质性缺失。对其父母进行的荧光原位杂交研究结果正常,表明这是一个新发缺失。与其他报告的具有类似缺失的患者相比,我们的患者具有完全不同的表型。共同特征是发育迟缓,但身体特征差异很大,我们的患者身材高大、极为消瘦,伴有漏斗胸、脊柱侧弯、皮肤条纹、蜘蛛指、扁平足、白内障以及高拱腭。这与其他具有类似缺失但身材矮小且肥胖的患者形成对比。6q14.1q15间质性缺失可具有非常多变的表型,不一定符合其他人所提出的由该区域剂量敏感基因单倍剂量不足导致的临床可识别的微缺失综合征。