Chowdhury Shimul, Bandholz Anne M, Parkash Sandhya, Dyack Sarah, Rideout Andrea L, Leppig Kathleen A, Thiese Heidi, Wheeler Patricia G, Tsang Marilyn, Ballif Blake C, Shaffer Lisa G, Torchia Beth S, Ellison Jay W, Rosenfeld Jill A
Providence Sacred Heart Medical Center, Molecular Diagnostics, Spokane, Washington.
Am J Med Genet A. 2014 Jan;164A(1):62-9. doi: 10.1002/ajmg.a.36201. Epub 2013 Nov 15.
A syndrome associated with 19q13.11 microdeletions has been proposed based on seven previous cases that displayed developmental delay, intellectual disability, speech disturbances, pre- and post-natal growth retardation, microcephaly, ectodermal dysplasia, and genital malformations in males. A 324-kb critical region was previously identified as the smallest region of overlap (SRO) for this syndrome. To further characterize this microdeletion syndrome, we present five patients with deletions within 19q12q13.12 identified using a whole-genome oligonucleotide microarray. Patients 1 and 2 possess deletions overlapping the SRO, and Patients 3-5 have deletions proximal to the SRO. Patients 1 and 2 share significant phenotypic overlap with previously reported cases, providing further definition of the 19q13.11 microdeletion syndrome phenotype, including the first presentation of ectrodactyly in the syndrome. Patients 3-5, whose features include developmental delay, growth retardation, and feeding problems, support the presence of dosage-sensitive genes outside the SRO that may contribute to the abnormal phenotypes observed in this syndrome. Multiple genotype-phenotype correlations outside the SRO are explored, including further validation of the deletion of WTIP as a candidate for male hypospadias observed in this syndrome. We postulate that unique patient-specific deletions within 19q12q13.1 may explain the phenotypic variability observed in this emerging contiguous gene deletion syndrome.
基于此前报道的7例病例,有人提出了一种与19q13.11微缺失相关的综合征。这些病例表现出发育迟缓、智力残疾、言语障碍、产前和产后生长迟缓、小头畸形、外胚层发育不良以及男性生殖器畸形。先前已确定一个324 kb的关键区域为此综合征的最小重叠区域(SRO)。为进一步明确这种微缺失综合征,我们报告了5例通过全基因组寡核苷酸微阵列鉴定出19q12q13.12区域存在缺失的患者。患者1和患者2的缺失区域与SRO重叠,患者3至患者5的缺失区域位于SRO近端。患者1和患者2与先前报道的病例有显著的表型重叠,进一步明确了19q13.11微缺失综合征的表型,包括该综合征中首次出现的缺指畸形。患者3至患者5的特征包括发育迟缓、生长迟缓和喂养问题,这支持了SRO之外存在剂量敏感基因,这些基因可能导致该综合征中观察到的异常表型。我们探讨了SRO之外的多个基因型 - 表型相关性,包括进一步验证WTIP缺失作为该综合征中观察到的男性尿道下裂候选基因。我们推测,19q12q13.1区域内独特的患者特异性缺失可能解释了这种新出现的相邻基因缺失综合征中观察到的表型变异性。