Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN, 55414, USA.
Division of Pediatric Genetics and Metabolism, Department of Pediatrics, University of Minnesota, 606 24th Avenue S, Suite 500, Minneapolis, MN, 55454, USA.
J Med Case Rep. 2021 Jan 25;15(1):28. doi: 10.1186/s13256-020-02590-8.
Developmental disabilities (DD) are an umbrella term for conditions associated with functional impairments in physical, learning, language, or behavior areas. Intellectual disability (ID) is a type of developmental disability that results in delays in cognitive or intellectual functioning, such as reasoning, learning, and problem-solving, and adaptive behaviors including social and practical life skills. DD can be due to a variety of factors, ranging from environmental exposures to genetic mutations, and studies suggest that up to 40% of DDs may be caused by genetic issues.
In this case study, we present an 18-year-old internationally adopted female Chinese American patient with a known history of developmental delay, intellectual disability, strabismus, and a congenital heart defect who had not been tested for genetic causes of her delay prior to presentation. When evaluated with chromosomal microarray, the patient demonstrated a deletion on the short arm of chromosome 5, an area associated with Cri-du-chat syndrome. This chromosomal deletion was a likely explanation for her history of developmental delays, intellectual disability, and congenital heart defect, in addition to her history of institutionalization and the trauma of multiple caregiver transitions in early childhood. The patient was referred for further evaluation by a geneticist and genetic counselor.
This case highlights that the underlying cause of developmental delay is often multifactorial, and underscores the importance of a full medical evaluation, including genetic testing, for children with intellectual disability. Using this approach, healthcare professionals can identify potential diagnoses and provide more targeted resources to families.
发育障碍(DD)是一组与身体、学习、语言或行为领域功能障碍相关的病症。智力障碍(ID)是一种发育障碍,导致认知或智力功能延迟,例如推理、学习和解决问题,以及包括社交和实际生活技能在内的适应行为。DD 可能由多种因素引起,从环境暴露到基因突变不等,研究表明,高达 40%的 DD 可能由遗传问题引起。
在本病例研究中,我们介绍了一位 18 岁的国际收养的美籍华裔女性患者,她有发育迟缓、智力障碍、斜视和先天性心脏病的病史,在就诊前从未接受过导致其发育迟缓的遗传原因的检查。当进行染色体微阵列分析时,患者在 5 号染色体短臂上显示出缺失,该区域与猫叫综合征有关。该染色体缺失可能是导致她发育迟缓、智力障碍和先天性心脏病的原因,此外,她还曾被机构收养,并在童年早期经历了多次照顾者的转换,这给她带来了创伤。患者被转介给遗传学家和遗传咨询师进行进一步评估。
本病例强调了发育迟缓的根本原因通常是多因素的,并强调了对智力障碍儿童进行全面医学评估的重要性,包括基因测试。通过这种方法,医疗保健专业人员可以确定潜在的诊断,并为家庭提供更有针对性的资源。