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了解16p11.2缺失综合征的临床表现:一系列儿童发育病例报告

Understanding the clinical manifestations of 16p11.2 deletion syndrome: a series of developmental case reports in children.

作者信息

Fetit Rana, Price David J, Lawrie Stephen M, Johnstone Mandy

机构信息

Simons Initiative for the Developing Brain, Centre for Discovery Brain Sciences, University of Edinburgh, Hugh Robson Building, George Square.

Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.

出版信息

Psychiatr Genet. 2020 Oct;30(5):136-140. doi: 10.1097/YPG.0000000000000259.

Abstract

BACKGROUND

Copy number variants (CNVs) are genetic rearrangements, such as deletions and duplications, which result in a deviation from the normal number of copies of a given gene segment. CNVs are implicated in many neuropsychiatric disorders. Deletions of the human chromosomal region 16p11.2 are one of the most common genetic linkages to autism spectrum disorders (ASD). However, ASD is not the only presenting feature, and many patients with 16p11.2 deletions present with a variable clinical spectrum.

METHODS

To better understand the nature and presentation of the syndrome throughout development, we present three different, unrelated clinical cases of children with 16p11.2 deletion and provide a detailed description of their clinical manifestations.

RESULTS

Cognitive and motor impairments were characteristic of all three patients with 16p11.2 deletion, despite the differences in the extent and clinical presentation of impairment. Two patients had a clinical diagnosis of ASD and one showed several ASD traits. In addition, two patients also had severe speech and language impairments, which is in line with previous reports on 16p11.2 phenotypes. Although epilepsy and obesity have been frequently associated with 16p11.2 deletion, only one patient had a diagnosis of epilepsy and none of the three cases were obese.

CONCLUSION

This variation in clinical phenotype renders correct clinical interpretation and diagnosis challenging. Therefore, it is critical to elucidate the variable clinical phenotypes of rare CNVs, including 16p11.2 deletions, to help guide clinical monitoring and counselling of patients and families.

摘要

背景

拷贝数变异(CNV)是一种基因重排,如缺失和重复,会导致给定基因片段的拷贝数偏离正常数量。CNV与许多神经精神疾病有关。人类染色体区域16p11.2的缺失是自闭症谱系障碍(ASD)最常见的遗传关联之一。然而,ASD并非唯一的表现特征,许多16p11.2缺失的患者临床表现多样。

方法

为了更好地了解该综合征在整个发育过程中的本质和表现,我们展示了三例不同的、无亲缘关系的16p11.2缺失儿童临床病例,并详细描述了他们的临床表现。

结果

尽管三名16p11.2缺失患者的损伤程度和临床表现存在差异,但认知和运动障碍是其共同特征。两名患者临床诊断为ASD,一名表现出一些ASD特征。此外,两名患者还存在严重的言语和语言障碍,这与先前关于16p11.2表型的报道一致。虽然癫痫和肥胖经常与16p11.2缺失相关,但只有一名患者被诊断为癫痫,三例患者均无肥胖。

结论

这种临床表型的差异使得正确的临床解读和诊断具有挑战性。因此,阐明包括16p11.2缺失在内的罕见CNV的可变临床表型对于指导患者及其家庭的临床监测和咨询至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab60/7497286/66caf8d4a954/pg-30-136-g001.jpg

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