Rasmussen Maria, Vestergaard Else Marie, Graakjaer Jesper, Petkov Yanko, Bache Iben, Fagerberg Christina, Kibaek Maria, Svaneby Dea, Petersen Olav Bjørn, Brasch-Andersen Charlotte, Sunde Lone
Department of Clinical Genetics, Aarhus University Hospital, Skejby, Denmark.
Department of Clinical Genetics, Vejle Hospital, Denmark.
Am J Med Genet A. 2016 Nov;170(11):2934-2942. doi: 10.1002/ajmg.a.37848. Epub 2016 Jul 13.
17q12 deletions and duplications are two distinct, recurrent chromosomal aberrations usually diagnosed by chromosomal microarray analysis (CMA). The aberrations encompass the genes, HNF1B, LHX1, and ACACA, among others. We here describe a large national cohort of 12 phenotyped patients with 17q12 deletions and 26 phenotyped patients with 17q12 duplications. The total cohort includes 19 index patients and 19 family members. We also reviewed the literature in order to further improve the basis for the counseling. We emphasize that renal disease, learning disability, behavioral abnormalities, epilepsy, autism, schizophrenia, structural brain abnormalities, facial dysmorphism, and joint laxity are features seen in both the 17q12 deletion syndrome and the reciprocal 17q12 duplication syndrome; and we extend the list of features seen in both patient categories to include strabismus, esophageal defects, and duodenal atresia. Delayed language development, learning disability, kidney involvement, and eye dysmorphism and strabismus were the most consistently shared features among patients with 17q12 deletion. Patients with 17q12 duplications were characterized by an extremely wide phenotypic spectrum, including a variable degree of learning disabilities, delayed language development, delayed motor milestones, and a broad range of psychiatric and neurological features. This patient group also included adults achieving an academic degree. Assessing index patients and non-index patients separately, our observations illustrate that an overall milder disease burden is seen, in particular in patients with 17q12 duplications who are ascertained on the duplication rather than the phenotype. This evidence may be useful in prenatal counseling. © 2016 Wiley Periodicals, Inc.
17q12缺失和重复是两种不同的、反复出现的染色体畸变,通常通过染色体微阵列分析(CMA)进行诊断。这些畸变包括HNF1B、LHX1和ACACA等基因。我们在此描述了一个大型的全国性队列,其中有12例有表型的17q12缺失患者和26例有表型的17q12重复患者。整个队列包括19例索引患者和19名家庭成员。我们还查阅了文献,以进一步完善咨询的依据。我们强调,肾脏疾病、学习障碍、行为异常、癫痫、自闭症、精神分裂症、脑结构异常、面部畸形和关节松弛是17q12缺失综合征和相互的17q12重复综合征中都可见的特征;并且我们将这两类患者中都可见的特征列表扩展到包括斜视、食管缺陷和十二指肠闭锁。语言发育迟缓、学习障碍、肾脏受累以及眼畸形和斜视是17q12缺失患者中最一致的共同特征。17q12重复患者的特征是表型谱极广,包括不同程度的学习障碍、语言发育迟缓、运动发育里程碑延迟以及广泛的精神和神经特征。该患者组还包括获得学术学位的成年人。分别评估索引患者和非索引患者,我们的观察结果表明,总体疾病负担较轻,特别是在因重复而非表型确诊的17q12重复患者中。这一证据可能对产前咨询有用。© 2016威利期刊公司