Vilchis Zacil, Najera Nayelli, Pérez-Duran Javier, Najera Zenyesen, Gonzalez Lourdes, del Refugio Rivera Maria, Queipo Gloria
Human Genetic Department, Hospital General de México Eduardo Liceaga-Facultad de Medicina Universidad Nacional Autónoma de México, Mexico City, Mexico.
Am J Med Genet A. 2014 Jul;164A(7):1702-5. doi: 10.1002/ajmg.a.36543. Epub 2014 Apr 8.
Neonatal hypotonia is a relatively common cause of consultation in daily pediatric practice. It is part of the clinical presentation of a large group of heterogeneous diseases, many of which have an important and classifiable genetic background. Identification of the specific disorder can help optimize the management and treatment of the patient and inform genetic counseling for the family, and therefore input from clinical geneticists is critical at the earliest stages of medical management. Here we present 30 patients with hypotonia of unknown etiology referred by a neuropediatrician to clinical genetics. Clinical, genetic, and molecular evaluation of each patient was performed. Sixty-nine percent of the patients included in the study had a genetic disease, including eight with Prader-Willi syndrome, three with spinal muscular atrophy, one with Rett syndrome, and one with Sotos syndrome harboring a previously undescribed mutation. Our data demonstrate that a multidisciplinary approach used from the outset that includes molecular analysis can help improve diagnosis and management of hypotonic infants.
新生儿低张力是日常儿科诊疗中较为常见的会诊原因。它是一大类异质性疾病临床表现的一部分,其中许多疾病具有重要且可分类的遗传背景。明确具体疾病有助于优化患者的管理和治疗,并为家庭提供遗传咨询,因此临床遗传学家在医疗管理的早期阶段提供的意见至关重要。在此,我们介绍30例病因不明的低张力患者,这些患者由神经儿科医生转诊至临床遗传学部门。对每位患者进行了临床、遗传和分子评估。纳入研究的患者中有69%患有遗传性疾病,其中8例患有普拉德-威利综合征,3例患有脊髓性肌萎缩症,1例患有雷特综合征,1例患有索托斯综合征且携带一种先前未描述的突变。我们的数据表明,从一开始就采用包括分子分析在内的多学科方法有助于改善低张力婴儿的诊断和管理。