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病例报告:五名兄弟姐妹患波托基-卢普斯基综合征

Case Report: Potocki-Lupski Syndrome in Five Siblings.

作者信息

Grama Alina, Sîrbe Claudia, Miclea Diana, Cǎinap Simona Sorana, Huniadi Delia, Bulata Bogdan, Pop Tudor Lucian

机构信息

Second Pediatric Discipline, Department of Mother and Child, University of Medicine and Pharmacy Iuliu Hațieganu, Cluj-Napoca, Romania.

Second Pediatric Clinic, Emergency Clinical Hospital for Children, Cluj-Napoca, Romania.

出版信息

Front Pediatr. 2021 Nov 8;9:698629. doi: 10.3389/fped.2021.698629. eCollection 2021.

DOI:10.3389/fped.2021.698629
PMID:34820340
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8606827/
Abstract

Potocki-Lupski syndrome (PTLS) is a rare developmental disorder resulting from the partial duplication of the short arm of chromosome 17. Affected children may have hypotonia, facial dysmorphism, or neurological abnormalities. PTLS is also frequently associated with failure to thrive due to swallowing difficulties or growth hormone deficiency. We report the first Romanian family (a mother and her five children) diagnosed with PTLS (17p11.2 microduplication). Fortunately, they present a less severe form of the disease. The neurological manifestations (speech delay, mild intellectual disability) are associated with craniofacial dysmorphism (microcephaly, micrognathia, triangular face, broad forehead, long chin, prominent ears, dolichocephaly, down slanting palpebral fissures). The diagnostic was established using a multiplex ligation-dependent probe amplification technique (MLPA) test, which detected the duplication of three regions of the 17p11.2 chromosome (RAI1, DRC3-6, LLGL1-4RA). Children with PTLS have specific phenotypes (craniofacial dysmorphism or neurological manifestations), which must draw the pediatrician's attention to a possible genetic condition. However, every child with this disease is unique and may have a different clinical presentation. A multi-disciplinary team is needed for the management of these patients. The parent's counseling and genetic advice are essential for a family with children with PTLS.

摘要

波托基-卢普斯基综合征(PTLS)是一种罕见的发育障碍,由17号染色体短臂部分重复所致。患病儿童可能有肌张力减退、面部畸形或神经异常。PTLS还常因吞咽困难或生长激素缺乏而出现生长发育迟缓。我们报告了首例被诊断为PTLS(17p11.2微重复)的罗马尼亚家庭(一位母亲和她的五个孩子)。幸运的是,他们所患疾病的形式较轻。神经学表现(语言发育迟缓、轻度智力残疾)与颅面部畸形(小头畸形、小颌畸形、三角脸、宽额头、长下巴、耳朵突出、长头畸形、睑裂下斜)相关。诊断通过多重连接依赖探针扩增技术(MLPA)检测得以确立,该检测发现17p11.2染色体的三个区域(RAI1、DRC3 - 6、LLGL1 - 4RA)存在重复。患有PTLS的儿童有特定的表型(颅面部畸形或神经学表现),这必须引起儿科医生对可能的遗传状况的关注。然而,每个患有这种疾病的儿童都是独特的,可能有不同的临床表现。这些患者的管理需要一个多学科团队。对于有PTLS患儿的家庭,对家长的咨询和遗传建议至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb02/8606827/e32c9a8a0a5a/fped-09-698629-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb02/8606827/13fafa892e98/fped-09-698629-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb02/8606827/7eb7492e267b/fped-09-698629-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb02/8606827/e32c9a8a0a5a/fped-09-698629-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb02/8606827/13fafa892e98/fped-09-698629-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb02/8606827/7eb7492e267b/fped-09-698629-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb02/8606827/e32c9a8a0a5a/fped-09-698629-g0003.jpg

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本文引用的文献

1
Neurological phenotype of Potocki-Lupski syndrome.波托茨基-卢普斯基综合征的神经表型。
Am J Med Genet A. 2020 Oct;182(10):2317-2324. doi: 10.1002/ajmg.a.61789. Epub 2020 Aug 15.
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A New Patient with Potocki-Lupski Syndrome: A Literature Review.一位患有波托基-卢普斯基综合征的新患者:文献综述。
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Potocki-Lupski Syndrome in Ethiopian Child: A Case Report.埃塞俄比亚儿童的波托基-卢普斯基综合征:一例报告
Pediatric Health Med Ther. 2024 Mar 26;15:129-131. doi: 10.2147/PHMT.S451161. eCollection 2024.
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Family case of Potocki-Lupski syndrome.波托基-卢普斯基综合征家族病例。
Mol Cytogenet. 2024 Mar 22;17(1):6. doi: 10.1186/s13039-024-00673-5.
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A unique Smith-Magenis patient with a de novo intragenic deletion on the maternally inherited overexpressed RAI1 allele.一位独特的 Smith-Magenis 患者,其母源性过度表达的 RAI1 等位基因上存在从头的基因内缺失。
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Duplication 17p11.2 (Potocki-Lupski Syndrome) in a child with developmental delay.一名发育迟缓儿童存在17p11.2重复(波托基-卢普斯基综合征)。
Malays J Pathol. 2017 Apr;39(1):77-81.
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17p11.2 and Xq28 duplication detected in a girl diagnosed with Potocki-Lupski syndrome.在一名被诊断为波托基-卢普斯基综合征的女孩中检测到17号染色体短臂11.2区和X染色体长臂28区重复。
BMC Res Notes. 2015 Sep 29;8:506. doi: 10.1186/s13104-015-1439-7.
6
Prenatal diagnosis of Potocki-Lupski syndrome in a fetus with hypoplastic left heart and aberrant right subclavian artery.胎儿左心发育不良伴右锁骨下动脉异常的 Potocki-Lupski 综合征的产前诊断。
J Perinatol. 2013 May;33(5):394-6. doi: 10.1038/jp.2012.77.
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The severe end of the spectrum: Hypoplastic left heart in Potocki-Lupski syndrome.严重类型:Potocki-Lupski 综合征中的左心发育不良。
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Potocki-Lupski syndrome: a microduplication syndrome associated with oropharyngeal dysphagia and failure to thrive.波托茨基-卢普斯基综合征:一种与口咽吞咽困难和生长发育不良相关的微重复综合征。
J Pediatr. 2011 Apr;158(4):655-659.e2. doi: 10.1016/j.jpeds.2010.09.062. Epub 2010 Dec 17.
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Abnormal social behaviors and altered gene expression rates in a mouse model for Potocki-Lupski syndrome.波托基-卢普斯基综合征小鼠模型中的异常社会行为和基因表达率改变
Hum Mol Genet. 2008 Aug 15;17(16):2486-95. doi: 10.1093/hmg/ddn148. Epub 2008 May 10.