Ferreirós-Martínez Raquel, López-Manzanares Lydia, Alonso-Cerezo Concepción
Hospital Universitario de la Princesa, 28006 Madrid, Espana.
Rev Neurol. 2014 Jul 16;59(2):71-6.
The cri du chat syndrome (CDCS) come from a partial or total deletion of the short arm of chromosome 5, being one of the most common deletion syndromes in human beings. The great majority of patients are diagnosed between the first month and first year of life, but herein we report a finding of a CDCS in a woman with a suspect of spinocerebellar ataxia, and a family medical record of ataxia and bipolar disorder. We pay special attention to the clinical features as well as the diagnostics tests, used to identify the CDCS.
We report a case of a 46 years-old woman showing a borderline intelligence and bilateral cataract surgery at the age of 43. Beginning of symptoms in childhood included hypoacusia, ataxia, dysarthria, dysphagia, depression, cognitive impairment and bipolar disorder. Physical examination showed microcephaly, micrognathia, talipes equinovarus and ataxia. Karyotype and array-CGH were carried out on peripheral blood. The patient showed a rearrangement involving chromosomes 5 and 15, as well as an inversion of chromosome 9: 45,XX,inv9(p11q13);t(5,15)(p15.33;q11.2). Array comparative genomic hybridization was performed showing a 2.91 Mb deletion at 5p15.33, genomic formula arr 5p15.33 (151537-3057771)x1. The deletion involved 20 genes, including TERT gene.
The multiple gene deletions confirmed the CDCS diagnosis, being responsible for the patient phenotype. It has been showed up the importance of using the correct diagnosis techniques (array-CGH, peripheral blood karyotype) as well as their appropriate choice.
猫叫综合征(CDCS)源于5号染色体短臂的部分或全部缺失,是人类最常见的缺失综合征之一。绝大多数患者在出生后第一个月至第一年被诊断出来,但在此我们报告一例疑似患有脊髓小脑共济失调的女性患者被诊断为猫叫综合征,其家族有共济失调和双相情感障碍病史。我们特别关注用于识别猫叫综合征的临床特征和诊断测试。
我们报告一例46岁女性患者,其智力处于临界水平,43岁时接受了双侧白内障手术。童年时期开始出现的症状包括听力减退、共济失调、构音障碍、吞咽困难、抑郁、认知障碍和双相情感障碍。体格检查显示小头畸形、小颌畸形、马蹄内翻足和共济失调。对外周血进行了核型分析和阵列比较基因组杂交(array-CGH)。患者显示出涉及5号和15号染色体的重排,以及9号染色体倒位:45,XX,inv9(p11q13);t(5,15)(p15.33;q11.2)。阵列比较基因组杂交显示5p15.33处有2.91 Mb的缺失,基因组公式为arr 5p15.33(151537 - 3057771)x1。该缺失涉及20个基因,包括TERT基因。
多个基因缺失证实了猫叫综合征的诊断,这与患者的表型有关联。已经表明了使用正确的诊断技术(阵列比较基因组杂交、外周血核型分析)及其适当选择的重要性。