Sun Mingran, Zhang Han, Li Guiying, Wang Xianfu, Lu Xianglan, Sternenberger Andrea, Guy Carrie, Li Wenfu, Lee Jiyun, Zheng Lei, Li Shibo
Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104 USA ; Key Laboratory for Molecular Enzymology and Engineering, College of Life Sciences, Jilin University, Changchun, Jilin 130012 P. R. China.
Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104 USA ; Department of Obstetrics and Gynecology, Child and Family Research Institute, University of British Columbia, Vancouver, British Columbia V6T 1Z4 Canada.
Mol Cytogenet. 2014 Nov 25;7(1):76. doi: 10.1186/s13039-014-0076-5. eCollection 2014.
Pierre Robin sequence (PRS) is a condition present at birth. It is characterized by micrognathia, cleft palate, upper airway obstruction, and feeding problems. Multiple etiologies including genetic defects have been documented in patients with syndromic, non-syndromic, and isolated PRS.
We report a 4-year-old boy with a complex small supernumerary marker chromosome (sSMC) who had non-syndromic Pierre Robin sequence (PRS). The complex marker chromosome, der(14)t(14;16)(q11.2;p13.13), was initially identified by routine chromosomal analysis and subsequently characterized by array-comparative genomic hybridization (array CGH) and confirmed by fluorescence in situ hybridization (FISH). Clinical manifestations included micrognathia, U-type cleft palate, bilateral congenital ptosis, upslanted and small eyes, bilateral inguinal hernias, umbilical hernia, bilateral clubfoot, and short fingers and toes. To our best knowledge, this was the first case diagnosed with non-syndromic PRS associated with a complex sSMC, which involved a 3.8 Mb gain in the 14q11.2 region and an 11.8 Mb gain in the 16p13.13-pter region.
We suggest that the duplicated chromosome segment 16p13.3 possibly may be responsible for the phenotypes of our case and also may be a candidate locus of non-syndromic PRS. The duplicated CREBBP gene within chromosome 16p13.3 is associated with incomplete penetrance regarding the mandible development anomalies. Further studies of similar cases are needed to support our findings.
皮埃尔·罗宾序列征(PRS)是一种出生时就存在的病症。其特征为小颌畸形、腭裂、上呼吸道梗阻和喂养问题。已记录到综合征型、非综合征型和孤立性PRS患者存在多种病因,包括基因缺陷。
我们报告一名4岁男孩,患有复杂的小额外标记染色体(sSMC),伴有非综合征型皮埃尔·罗宾序列征(PRS)。复杂标记染色体der(14)t(14;16)(q11.2;p13.13)最初通过常规染色体分析得以识别,随后通过阵列比较基因组杂交(阵列CGH)进行特征描述,并通过荧光原位杂交(FISH)得以确认。临床表现包括小颌畸形、U型腭裂、双侧先天性上睑下垂、眼裂向上倾斜且眼小、双侧腹股沟疝、脐疝、双侧马蹄内翻足以及手指和脚趾短小。据我们所知,这是首例被诊断为与复杂sSMC相关的非综合征型PRS病例,该病例涉及14q11.2区域3.8 Mb的增益以及16p13.13 - pter区域11.8 Mb的增益。
我们认为重复的染色体片段16p13.3可能是导致我们该病例表型的原因,也可能是非综合征型PRS的一个候选基因座。染色体16p13.3内重复的CREBBP基因与下颌骨发育异常的不完全外显率相关。需要对类似病例进行进一步研究以支持我们 的发现。