Vieira Társis P, Monteiro Fabíola P, Sgardioli Ilária C, Souza Josiane, Fett-Conte Agnes C, Monlleó Isabella L, Fontes Marshall B, Félix Têmis M, Leal Gabriela F, Ribeiro Erlane Marques, Gil-da-Silva-Lopes Vera L
Cleft Palate Craniofac J. 2015 Jul;52(4):411-6. doi: 10.1597/13-233. Epub 2014 May 7.
The aim of this study was to describe clinical features in subjects with palatal abnormalities and to assess the distribution of these features among those with and without 22q11.2 deletion.
Descriptive cohort.
One hundred patients with palatal abnormalities and suspicion of 22q11.2 DS were included.
All patients were evaluated by a clinical geneticist, who completed a standardized clinical protocol. The 22q11.2 deletion screening was performed with fluorescence in situ hybridization using the TUPLE1 probe and multiplex ligation-dependent probe amplification using the P250-A1 kit.
The 22q11.2 deletion was detected in 35 patients, in whom the most frequent clinical features were congenital heart disease (15/30 - 50%), developmental delay (19/35 - 54%), speech delay (20/35 - 57%), learning disabilities (27/35 - 77%), immunologic alterations (18/29 - 62%). In addition, the most common facial dysmorphisms in this group were long face (27/35 - 77%), typical nose (24/35 - 69%), and hooded eyelids (19/35 - 54%). Comparing features in patients with or without the deletion revealed significant differences (positively correlated with the deletion) for speech delay, learning disabilities, conductive hearing loss, number of dysmorphisms, long face, and hooded eyelids. Cleft lip and palate was negatively correlated with the deletion.
The presence of speech delay, learning disabilities, conductive hearing loss, long face, and hooded eyelids should reinforce the suspicion of 22q11.2 DS in patients with palatal abnormalities and would help professionals direct clinical follow-up of these patients.
本研究旨在描述腭部异常患者的临床特征,并评估这些特征在有和没有22q11.2缺失的患者中的分布情况。
描述性队列研究。
纳入了100名有腭部异常且怀疑患有22q11.2缺失综合征(DS)的患者。
所有患者均由临床遗传学家进行评估,该遗传学家完成了标准化的临床方案。使用TUPLE1探针通过荧光原位杂交以及使用P250 - A1试剂盒进行多重连接依赖探针扩增来进行22q11.2缺失筛查。
在35名患者中检测到22q11.2缺失,其中最常见的临床特征为先天性心脏病(15/30 - 50%)、发育迟缓(19/35 - 54%)、语言发育迟缓(20/35 - 57%)、学习障碍(27/35 - 77%)、免疫改变(18/29 - 62%)。此外,该组中最常见的面部畸形为长脸(27/35 - 77%)、典型鼻(24/35 - 69%)和眼睑下垂(19/35 - 54%)。比较有或无缺失患者的特征发现,语言发育迟缓、学习障碍、传导性听力损失、畸形数量、长脸和眼睑下垂存在显著差异(与缺失呈正相关)。唇腭裂与缺失呈负相关。
对于腭部异常患者,出现语言发育迟缓、学习障碍、传导性听力损失、长脸和眼睑下垂应增加对22q11.2缺失综合征的怀疑,并有助于专业人员指导对这些患者的临床随访。