Brazil Ashley, Stanford Kevin, Smolarek Teresa, Hopkin Robert
University of Cincinnati, Cincinnati, Ohio; Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Am J Med Genet A. 2014 Oct;164A(10):2496-503. doi: 10.1002/ajmg.a.36657. Epub 2014 Jul 8.
1p36 deletion is the most common telomeric deletion syndrome, with an incidence of 1/5,000-1/10,000. A variety of clinical complications have been reported including seizures, hypotonia, heart malformations, cardiomyopathy, vision problems, and hearing loss. Approximately 90% are reported to have severe to profound intellectual disability and 75% to have absent expressive language. Little is known about long-term outcomes. The current literature suggests a poor prognosis for most patients. This study attempted to assess medical conditions and function of adolescent and adult patients with 1p36 deletion. A survey was distributed through three support groups to identify patients >12 years of age to assess functional status and medical problems in older patients with 1p36 deletion syndrome. 40 patients were identified between 12 and 46 years old. Among our survey sample, medical complications including seizures, hypotonia, structural heart defects, hearing loss, and vision problems, were similar to previous reports. However, functional skills were better than anticipated, with an overwhelming majority reported to independently sit, walk, and receive the majority of nutrition orally. Forty-four percent were reported to use complex speech abilities. While medical problems in patients with 1p36 deletion were similar to those that have been previously reported, we also demonstrated these same concerns persist into adolescence and adulthood. Additionally, patients were reported to have better functional skills than anticipated. Thus, quality of life and level of function appear to be better than anticipated from previous studies. © 2014 Wiley Periodicals, Inc.
1p36缺失是最常见的端粒缺失综合征,发病率为1/5000 - 1/10000。已报道多种临床并发症,包括癫痫发作、肌张力减退、心脏畸形、心肌病、视力问题和听力丧失。据报道,约90%的患者有重度至极重度智力残疾,75%的患者无表达性语言。关于长期预后知之甚少。目前的文献表明大多数患者预后不良。本研究试图评估1p36缺失的青少年和成年患者的健康状况和功能。通过三个支持小组进行了一项调查,以确定年龄大于12岁的患者,评估1p36缺失综合征老年患者的功能状态和健康问题。确定了40名年龄在12至46岁之间的患者。在我们的调查样本中,包括癫痫发作、肌张力减退、结构性心脏缺陷、听力丧失和视力问题在内的健康并发症与先前报道相似。然而,功能技能比预期的要好,绝大多数患者据报道能够独立坐立、行走,并通过口服摄取大部分营养。据报道,44%的患者具备复杂的语言能力。虽然1p36缺失患者的健康问题与先前报道的相似,但我们也证明这些问题在青少年和成年期依然存在。此外,据报道患者的功能技能比预期的要好。因此,生活质量和功能水平似乎比先前研究预期的要好。© 2014威利期刊公司