Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, Netherlands.
Post-Graduate School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.
Eur J Pediatr. 2023 Jun;182(6):2607-2614. doi: 10.1007/s00431-023-04937-x. Epub 2023 Mar 22.
Genetic syndromes often show facial features that provide clues for the diagnosis. However, memorizing these features is a challenging task for clinicians. In the last years, the app Face2Gene proved to be a helpful support for the diagnosis of genetic diseases by analyzing features detected in one or more facial images of affected individuals. Our aim was to evaluate the performance of the app in patients with Silver-Russell syndrome (SRS) and Prader-Willi syndrome (PWS). We enrolled 23 pediatric patients with clinically or genetically diagnosed SRS and 29 pediatric patients with genetically confirmed PWS. One frontal photo of each patient was acquired. Top 1, top 5, and top 10 sensitivities were analyzed. Correlation with the specific genetic diagnosis was investigated. When available, photos of the same patient at different ages were compared. In the SRS group, Face2Gene showed top 1, top 5, and top 10 sensitivities of 39%, 65%, and 91%, respectively. In 41% of patients with genetically confirmed SRS, SRS was the first syndrome suggested, while in clinically diagnosed patients, SRS was suggested as top 1 in 33% of cases (p = 0.74). Face2Gene performed better in younger patients with SRS: in all patients in whom a photo taken at a younger age than the age of enrollment was available, SRS was suggested as top 1, albeit with variable degree of probability. In the PWS group, the top 1, top 5, and top 10 sensitivities were 76%, 97%, and 100%, respectively. PWS was suggested as top 1 in 83% of patients genetically diagnosed with paternal deletion of chromosome 15q11-13 and in 60% of patients presenting with maternal uniparental disomy of chromosome 15 (p = 0.17). The performance was uniform throughout the investigated age range (1-15 years).
In addition to a thorough medical history and detailed clinical examination, the Face2Gene app can be a useful tool to support clinicians in identifying children with a potential diagnosis of SRS or PWS.
• Several genetic syndromes present typical facial features that may provide clues for the diagnosis. • Memorizing all syndromic facial characteristics is a challenging task for clinicians.
• Face2Gene may represent a useful support for pediatricians for the diagnosis of genetic syndromes. • Face2Gene app can be a useful tool to integrate in the diagnostic path of patients with SRS and PWS.
评估应用程序 Face2Gene 在银-罗素综合征(SRS)和普拉德-威利综合征(PWS)患者中的表现。
我们招募了 23 名经临床或基因诊断为 SRS 的儿科患者和 29 名经基因证实的 PWS 儿科患者。获取每位患者的正面照片。分析了前 1、前 5 和前 10 的敏感性。调查了与特定基因诊断的相关性。当有相同患者的不同年龄的照片时,进行比较。
在 SRS 组中,Face2Gene 的前 1、前 5 和前 10 的敏感性分别为 39%、65%和 91%。在 41%的基因确诊 SRS 患者中,SRS 是首先提示的综合征,而在临床诊断患者中,SRS 在 33%的病例中提示为前 1(p=0.74)。Face2Gene 在较年轻的 SRS 患者中表现更好:在所有可获得较登记年龄更早的照片的患者中,SRS 被提示为前 1,尽管概率不同。在 PWS 组中,前 1、前 5 和前 10 的敏感性分别为 76%、97%和 100%。在基因诊断为 15q11-13 染色体父系缺失的患者中,PWS 作为前 1 提示占 83%,在表现为 15 号染色体母系单亲二体性的患者中占 60%(p=0.17)。在研究的年龄范围内(1-15 岁),表现均匀。
除了详细的病史和详细的临床检查外,Face2Gene 应用程序还可以成为支持临床医生识别有潜在 SRS 或 PWS 诊断的儿童的有用工具。
• 几种遗传综合征表现出典型的面部特征,这些特征可能为诊断提供线索。• 记住所有综合征的面部特征对临床医生来说是一项具有挑战性的任务。
• Face2Gene 可能代表儿科医生诊断遗传综合征的有用支持。• Face2Gene 应用程序可以作为患者 SRS 和 PWS 诊断路径中的有用工具。