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三例因印记中心微缺失导致普拉德-威利综合征的同胞病例及文献综述

Three siblings with Prader-Willi syndrome caused by imprinting center microdeletions and review.

作者信息

Hartin Samantha N, Hossain Waheeda A, Weisensel Nicolette, Butler Merlin G

机构信息

Departments of Psychiatry and Behavioral Sciences and Pediatrics, University of Kansas Medical Center, Kansas City, Kansas.

Prader-Willi Homes of Oconomowoc (PWHO), Oconomowoc, Wisconsin.

出版信息

Am J Med Genet A. 2018 Apr;176(4):886-895. doi: 10.1002/ajmg.a.38627. Epub 2018 Feb 13.

Abstract

Prader-Willi syndrome (PWS) is a complex genetic imprinting disorder characterized by childhood obesity, short stature, hypogonadism/hypogenitalism, hypotonia, cognitive impairment, and behavioral problems. Usually PWS occurs sporadically due to the loss of paternally expressed genes on chromosome 15 with the majority of individuals having the 15q11-q13 region deleted. Examples of familial PWS have been reported but rarely. To date 13 families have been reported with more than one child with PWS and without a 15q11-q13 deletion secondary to a chromosome 15 translocation, inversion, or uniparental maternal disomy 15. Ten of those 13 families were shown to carry microdeletions in the PWS imprinting center. The microdeletions were found to be of paternal origin in nine of the ten cases in which family studies were carried out. Using a variety of techniques, the microdeletions were identified in regions within the complex SNRPN gene locus encompassing the PWS imprinting center. Here, we report the clinical and genetic findings in three adult siblings with PWS caused by a microdeletion in the chromosome 15 imprinting center inherited from an unaffected father that controls the activity of genes in the 15q11-q13 region and summarize the 13 reported cases in the literature.

摘要

普拉德-威利综合征(PWS)是一种复杂的基因印记疾病,其特征为儿童期肥胖、身材矮小、性腺功能减退/生殖器发育不全、肌张力减退、认知障碍和行为问题。通常情况下,PWS是由于15号染色体上父系表达基因的缺失而散发发生的,大多数个体的15q11-q13区域存在缺失。虽然有家族性PWS的病例报道,但极为罕见。迄今为止,已报道了13个家庭,这些家庭中有不止一个孩子患有PWS,且不存在因15号染色体易位、倒位或单亲二体性导致的15q11-q13缺失。在这13个家庭中,有10个家庭的PWS印记中心存在微缺失。在进行家系研究的10个病例中,有9个病例的微缺失被发现源自父系。通过多种技术手段,在包含PWS印记中心的复杂SNRPN基因座区域内鉴定出了微缺失。在此,我们报告了3名成年同胞因15号染色体印记中心微缺失而患PWS的临床和基因学发现,该微缺失由未受影响的父亲遗传而来,控制着15q11-q13区域基因的活性,并总结了文献中报道的13个病例。

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