Salpietro Vincenzo, Ruggieri Martino, Mankad Kshitij, Di Rosa Gabriella, Granata Francesca, Loddo Italia, Moschella Emanuela, Calabro Maria Pia, Capalbo Anna, Bernardini Laura, Novelli Antonio, Polizzi Agata, Seidler Daniela G, Arrigo Teresa, Briuglia Silvana
Department of Paediatric Neurology, Chelsea and Westminster Hospital, London, United Kingdom.
Unit of Genetics and Paediatric Immunology, Department of Paediatrics, University of Messina, Messina, Italy.
Am J Med Genet A. 2015 Sep;167A(9):2042-51. doi: 10.1002/ajmg.a.37118. Epub 2015 May 1.
Deletions of the long arm of chromosome 6 are rare and are characterized by great clinical variability according to the deletion breakpoint. We report a on 6-year-old girl with a de novo 0.63 Mb deletion on chromosome 6q25.1 who demonstrated multiple congenital anomalies including a ventricular septal defect and an underdeveloped cerebellar vermis. She presented with severe pre- and post-natal growth failure, hyperextensible small joints (Beighton scores = 8/9; with normal parental scores), and an abnormally elastic, redundant skin. Abnormally high upper/lower segment ratio (i.e., 1.34 = > 3SD), mild dysmorphic facial features and developmental delay were also present. The girl's phenotype was compared with: (i) two girls, each previously reported by Bisgaard et al. and Caselli et al. with similar albeit larger (2.6-7.21 Mb) deletions; (ii) seven additional individuals (6 M; 1 F) harboring deletions within the 6q25.1 region reported in the literature; and (iii) ten further patients (5 M; 4 F; 1 unrecorded sex) recorded in the DECIPHER 6.0 database. We reported on the present girl as her findings could contribute to advance the phenotype of 6q deletions. In addition, the present deletion is the smallest so far recorded in the 6q25 region encompassing eight known genes [vs. 41 of Bisgaard et al., and 23 of Caselli et al.,], including the TAB2 (likely responsible for the girl's congenital heart defect), LATS1 gene, and the UST gene (a regulator of the homeostasis of proteoglycans, which could have played a role in the abnormal dermal and cartilage elasticity).
6号染色体长臂缺失较为罕见,根据缺失断点不同,临床表现差异很大。我们报告了一名6岁女孩,其6号染色体q25.1区域发生了0.63 Mb的新发缺失,该女孩表现出多种先天性异常,包括室间隔缺损和小脑蚓部发育不全。她在出生前和出生后均出现严重生长发育迟缓,小关节过度伸展(Beighton评分=8/9;其父母评分正常),皮肤异常弹性且冗余。还存在异常高的上下身比例(即1.34 => 3SD)、轻度面部畸形特征和发育迟缓。将该女孩的表型与以下情况进行了比较:(i) Bisgaard等人和Caselli等人先前报道的两名女孩,她们有类似但更大(2.6 - 7.21 Mb)的缺失;(ii) 文献中报道的另外7名6q25.1区域存在缺失的个体(6名男性;1名女性);(iii) DECIPHER 6.0数据库中记录的另外10名患者(5名男性;4名女性;1名性别未记录)。我们报告了这名女孩的情况,因为她的发现可能有助于推进对6q缺失表型的认识。此外,目前的缺失是6q25区域迄今为止记录到的最小缺失,该区域包含8个已知基因[相比之下,Bisgaard等人报道的有41个,Caselli等人报道的有23个],包括TAB2基因(可能与女孩的先天性心脏缺陷有关)、LATS1基因和UST基因(一种蛋白聚糖稳态调节剂,可能在皮肤和软骨异常弹性中起作用)。