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2例22q13缺失综合征的临床表型及遗传学研究

[Clinical phenotypes and genetic study of 2 cases with 22q13 deletion syndrome].

作者信息

Luo Jihang, Fang Di, Qiu Wenjuan, Xiao Bing, Fan Yanjie, Ye Jun, Han Lianshu, Zhang Huiwen, Yu Yongguo, Liang Lili, Gu Xuefan

机构信息

Department of Pediatric Endocrinology and Genetics, Shanghai Institute of Pediatric Research, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China.

出版信息

Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2018 Jun 10;35(3):361-365. doi: 10.3760/cma.j.issn.1003-9406.2018.03.012.

Abstract

OBJECTIVE

To determine the genetic etiology and clinical characteristics of 2 boys featuring development delay (DD).

METHODS

Routine chromosomal banding was performed to analyze the karyotypes of the patients and their parents. Single nucleotide polymorphism array (SNP array) analysis was employed to identify pathogenic deletion/duplication of chromosomes, and quantitative real-time PCR (qPCR) was performed to confirm the results.

RESULTS

Patient 1 showed a global developmental delay, especially impaired language development, seizures, behavioral problems belonging to the autism spectrum and mild facial dysmorphism. Patient 2 mainly presented with severely delayed speech and moderate intellectual disability, but did not have obvious facial dysmorphism and autistic-like behavior. The diagnosis of 22q13 syndrome was established based on identification of a heterozygous microdeletion at chromosome 22q13.33 in both patients (69 kb and 587 kb, respectively) by the SNP array analysis. Both patients had deletions of SHANK3 and ACR, which are located at the end of 22q. Quantitative real-time PCR verified that the deletion of SHANK3 gene in both patients were de novo in origin.

CONCLUSION

Two cases of 22q13 deletion syndrome have been diagnosed by SNP array analysis. Deletion of SHANK3 gene may be the major contributor to the clinical manifestations of the patients. SNP array analysis can facilitate discovery of microdeletions, which has played an important role in the diagnosis and genetic counseling for the family.

摘要

目的

确定两名发育迟缓(DD)男孩的遗传病因及临床特征。

方法

进行常规染色体显带分析患者及其父母的核型。采用单核苷酸多态性阵列(SNP阵列)分析来识别染色体的致病性缺失/重复,并进行定量实时PCR(qPCR)以确认结果。

结果

患者1表现为全面发育迟缓,尤其是语言发育受损、癫痫发作、属于自闭症谱系的行为问题以及轻度面部畸形。患者2主要表现为严重的语言发育迟缓及中度智力障碍,但无明显面部畸形及自闭症样行为。通过SNP阵列分析在两名患者中均鉴定出22号染色体22q13.33处的杂合微缺失(分别为69 kb和587 kb),从而确立了22q13综合征的诊断。两名患者均有位于22q末端的SHANK3和ACR缺失。定量实时PCR证实两名患者中SHANK3基因的缺失均为新发。

结论

通过SNP阵列分析诊断出两例22q13缺失综合征。SHANK3基因的缺失可能是患者临床表现的主要原因。SNP阵列分析有助于发现微缺失,在该家族的诊断和遗传咨询中发挥了重要作用。

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