Lee Kyung Yeon, Shin Eunsim
Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Korea Clinical Laboratory, Molecular Diagnostics Team, Seoul, Korea.
Korean J Pediatr. 2017 Sep;60(9):282-289. doi: 10.3345/kjp.2017.60.9.282. Epub 2017 Sep 21.
Recent advancements in molecular techniques have greatly contributed to the discovery of genetic causes of unexplained developmental delay. Here, we describe the results of array comparative genomic hybridization (CGH) and the clinical features of 27 patients with global developmental delay.
We included 27 children who fulfilled the following criteria: Korean children under 6 years with global developmental delay; children who had at least one or more physical or neurological problem other than global developmental delay; and patients in whom both array CGH and G-banded karyotyping tests were performed.
Fifteen male and 12 female patients with a mean age of 29.3±17.6 months were included. The most common physical and neurological abnormalities were facial dysmorphism (n=16), epilepsy (n=7), and hypotonia (n=7). Pathogenic copy number variation results were observed in 4 patients (14.8%): 18.73 Mb dup(2)(p24.2p25.3) and 1.62 Mb del(20p13) (patient 1); 22.31 Mb dup(2) (p22.3p25.1) and 4.01 Mb dup(2)(p21p22.1) (patient 2); 12.08 Mb del(4)(q22.1q24) (patient 3); and 1.19 Mb del(1)(q21.1) (patient 4). One patient (3.7%) displayed a variant of uncertain significance. Four patients (14.8%) displayed discordance between G-banded karyotyping and array CGH results. Among patients with normal array CGH results, 4 (16%) revealed brain anomalies such as schizencephaly and hydranencephaly. One patient was diagnosed with Rett syndrome and one with Möbius syndrome.
As chromosomal microarray can elucidate the cause of previously unexplained developmental delay, it should be considered as a first-tier cytogenetic diagnostic test for children with unexplained developmental delay.
分子技术的最新进展极大地推动了不明原因发育迟缓遗传病因的发现。在此,我们描述了27例全面发育迟缓患者的阵列比较基因组杂交(CGH)结果及临床特征。
我们纳入了27名符合以下标准的儿童:6岁以下的韩国全面发育迟缓儿童;除全面发育迟缓外至少有一个或多个身体或神经问题的儿童;以及同时进行了阵列CGH和G带核型分析检测的患者。
纳入了15名男性和12名女性患者,平均年龄为29.3±17.6个月。最常见的身体和神经异常为面部畸形(n = 16)、癫痫(n = 7)和肌张力低下(n = 7)。4例患者(14.8%)观察到致病性拷贝数变异结果:18.73 Mb dup(2)(p24.2p25.3)和1.62 Mb del(20p13)(患者1);22.31 Mb dup(2) (p22.3p25.1)和4.01 Mb dup(2)(p21p22.1)(患者2);12.08 Mb del(4)(q22.1q24)(患者3);以及1.19 Mb del(1)(q21.1)(患者4)。1例患者(3.7%)显示意义未明的变异。4例患者(14.8%)在G带核型分析和阵列CGH结果之间显示不一致。在阵列CGH结果正常的患者中,4例(16%)显示脑异常,如脑裂畸形和积水性无脑畸形。1例患者被诊断为雷特综合征,1例被诊断为莫比乌斯综合征。
由于染色体微阵列可阐明先前不明原因发育迟缓的病因,对于不明原因发育迟缓儿童,应将其视为一线细胞遗传学诊断检测。