Hancarova Miroslava, Malikova Marcela, Kotrova Michaela, Drabova Jana, Trkova Marie, Sedlacek Zdenek
Department of Biology and Medical Genetics, 2nd Faculty of Medicine and University Hospital Motol, Charles University, Prague, Czech Republic.
CLIP, Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine and University Hospital Motol, Charles University, Prague, Czech Republic.
Am J Med Genet A. 2018 Jun;176(6):1438-1442. doi: 10.1002/ajmg.a.38711. Epub 2018 Apr 25.
Microdeletions of 17q24.2-q24.3 have been described in several patients with developmental and speech delay, growth retardation, and other features. The relatively large size and limited overlap of the deletions complicate the genotype-phenotype correlation. We identified a girl with intellectual disability, growth retardation, dysmorphic features, and a de novo 2.8 Mb long deletion of 17q24.2-q24.3. Her phenotype was strikingly similar to one previously described boy with Dubowitz syndrome (MIM 223370) and a de novo 3.9 Mb long deletion encompassing the deletion of our patient. In addition, both patients had the shortest telomeres among normal age-matched controls. Our review of all 17q24.2-q24.3 deletion patients revealed additional remarkable phenotypic features shared by the patients, some of which have consequences for their management. Proposed novel genotype-phenotype correlations based on new literature information on the region include the role of PSMD12 and BPTF, the genes recently associated with syndromic neurodevelopmental disorders, and a possible role of the complex topologically associated domain structure of the region, which may explain some of the phenotypic discrepancies observed between patients with similar but not identical deletions. Nevertheless, although different diagnoses including the Dubowitz, Nijmegen breakage (MIM 251260), Silver-Russell (MIM 180860), or Myhre (MIM 139210) syndromes were originally considered in the 17q24.2-q24.3 deletion patients, they clearly belong to one diagnostic entity defined by their deletions and characterized especially by developmental delay, specific facial dysmorphism, abnormalities of extremities and other phenotypes, and possibly also short telomere length.
在一些患有发育和语言迟缓、生长发育迟缓及其他特征的患者中,已发现存在17q24.2 - q24.3微缺失。这些缺失相对较大且重叠有限,使得基因型与表型的相关性变得复杂。我们鉴定出一名患有智力残疾、生长发育迟缓、畸形特征且存在17q24.2 - q24.3新发2.8 Mb长缺失的女孩。她的表型与之前描述的一名患有杜波维茨综合征(MIM 223370)且有新发3.9 Mb长缺失(包含我们患者的缺失区域)的男孩极为相似。此外,这两名患者在年龄匹配的正常对照中具有最短的端粒。我们对所有17q24.2 - q24.3缺失患者的回顾揭示了患者共有的其他显著表型特征,其中一些特征对他们的治疗有影响。基于该区域新文献信息提出的新基因型 - 表型相关性包括PSMD12和BPTF的作用,这两个基因最近与综合征性神经发育障碍相关,以及该区域复杂的拓扑相关结构域结构可能发挥作用,这或许可以解释在具有相似但不完全相同缺失的患者之间观察到的一些表型差异。然而,尽管最初在17q24.2 - q24.3缺失患者中考虑了不同的诊断,包括杜波维茨、奈梅亨断裂(MIM 251260)、西尔弗 - 拉塞尔(MIM 180860)或迈尔(MIM 139210)综合征,但他们显然属于由其缺失所定义的一个诊断实体,其特征尤其包括发育迟缓、特定面部畸形、四肢异常及其他表型,并且可能还包括端粒长度缩短。