Revah-Politi Anya, Sands Tristan T, Colombo Sophie, Goldstein David B, Anyane-Yeboa Kwame
Institute for Genomic Medicine and Precision Genomics Laboratory, Columbia University Irving Medical Center, New York, New York
Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, New York
encephalopathy (-E) is characterized by moderate-to-severe developmental delay / intellectual disability, structural brain abnormalities, and often infantile hypotonia and seizures. Other less common findings include dystonia, reduced vision, behavior issues, growth delay, gastrointestinal (GI) problems, genitourinary (GU) abnormalities in males, and cutaneous mastocytosis.
DIAGNOSIS/TESTING: The diagnosis of encephalopathy (-E) is established in a proband by identification of a heterozygous pathogenic variant by molecular genetic testing.
Developmental delay / intellectual disability, hypotonia, seizures, poor vision, behavior issues, growth delay, GI problems, GU abnormalities in males, and cutaneous mastocytosis are managed as per standard care. Follow up of the common manifestations at each clinic visit.
-E is inherited in an autosomal dominant manner and is typically caused by a pathogenic variant. If the pathogenic variant identified in the proband is not identified in one of the parents, the risk to sibs is low but greater than that of the general population because of the possibility of parental germline mosaicism. Once the pathogenic variant has been identified in an affected family member, prenatal testing for a pregnancy at increased risk and preimplantation genetic testing are possible.
脑病(-E)的特征为中度至重度发育迟缓/智力残疾、脑结构异常,常伴有婴儿期肌张力减退和癫痫发作。其他较不常见的表现包括肌张力障碍、视力下降、行为问题、生长发育迟缓、胃肠道(GI)问题、男性泌尿生殖系统(GU)异常以及皮肤肥大细胞增多症。
诊断/检测:通过分子遗传学检测鉴定出杂合致病变异,在先证者中确立脑病(-E)的诊断。
按照标准护理对发育迟缓/智力残疾、肌张力减退、癫痫发作、视力不佳、行为问题、生长发育迟缓、胃肠道问题、男性泌尿生殖系统异常以及皮肤肥大细胞增多症进行管理。每次门诊就诊时对常见表现进行随访。
-E以常染色体显性方式遗传,通常由致病变异引起。如果在先证者中鉴定出的致病变异在父母一方中未被鉴定出,由于父母生殖系嵌合体的可能性,同胞的风险较低但高于一般人群。一旦在受影响的家庭成员中鉴定出致病变异,对于风险增加的妊娠可进行产前检测和植入前基因检测。