Université Pierre et Marie Curie, Hôpital Pitié-Salpêtrière, Paris, France.
Université Pierre et Marie Curie, Hôpital Pitié-Salpêtrière, Paris, France.
J Am Acad Child Adolesc Psychiatry. 2018 Jul;57(7):518-525.e1. doi: 10.1016/j.jaac.2018.03.020.
Pediatric catatonia is a rare and severe neuropsychiatric syndrome. We previously reported, in 58 children and adolescents with catatonia, a high prevalence (up to 20%) of medical conditions, some of which have specific treatments. Here we extend the cohort inclusion and report the first systematic molecular genetic data for this syndrome. Among the 89 patients consecutively admitted for catatonia (according to the pediatric catatonia rating scale) between 1993 and 2014, we identify 51 patients (57.3%) who had genetic laboratory testing, of whom 37 had single nucleotide polymorphism (SNP) microarray tests for CNVs and 14 had routine genetic explorations (karyotyping and searches for specific chromosomal abnormalities by fluorescence in situ hybridization [FISH]) or a specific diagnosis test based on clinical history. To assess the causality of observed genetic findings in each patient, we used a causality assessment score (CAUS) including 5 causality-support criteria on a 3-point scale (0 = absent; 1 = moderate; 2 = high): the existence of similar cases in the literature; the presence of a clinical contributing factor; the presence of a biological contributing factor; the presence of other paraclinical symptoms; and response to a specific treatment related to the suspected genetic or medical condition.
儿科紧张症是一种罕见且严重的神经精神综合征。我们之前报道过,在 58 名紧张症儿童和青少年中,高达 20%(最高达 20%)的患者存在医疗状况,其中一些具有特定的治疗方法。在这里,我们扩大了队列纳入范围,并报告了该综合征的首个系统分子遗传学数据。在 1993 年至 2014 年间连续收治的 89 名紧张症患者(根据儿科紧张症评定量表)中,我们确定了 51 名(57.3%)接受了遗传实验室检测的患者,其中 37 名患者进行了 SNP 微阵列检测以检测 CNV,14 名患者进行了常规遗传探索(核型分析和通过荧光原位杂交[FISH]寻找特定染色体异常)或基于临床病史的特定诊断测试。为了评估每个患者观察到的遗传发现的因果关系,我们使用了因果关系评估评分(CAUS),该评分包括 5 个因果关系支持标准,每个标准的评分范围为 3 分(0=不存在;1=中度;2=高):文献中存在类似病例;存在临床促成因素;存在生物学促成因素;存在其他临床症状;以及对与可疑遗传或医疗状况相关的特定治疗的反应。