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Li Y, Liu P, Wang W, Jia H, Bai Y, Yuan Z, Yang Z. A novel genotype-phenotype between persistent-cloaca-related VACTERL and mutations of 8p23 and 12q23.1. Pediatr Res 2024; 95:1246-1253. [PMID: 38135728 DOI: 10.1038/s41390-023-02928-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/02/2023] [Accepted: 11/16/2023] [Indexed: 12/24/2023]
Abstract
The mechanism underlying anorectal malformations (ARMs)-related VACTERL (vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, and renal and limb abnormalities) remains unclear. Copy number variation (CNV) contributed to VACTERL pathogenicity. Here, we report a novel CNV in 8p23 and 12q23.1 identified in a case of ARMs-related VACTERL association. This 12-year-old girl presented a cloaca (urethra, vagina, and rectum opening together and sharing a single tube length), an isolated kidney, and a perpetuation of the left superior vena cava at birth. Her intelligence, growth, and development were slightly lower than those of normal children of the same age. Array comparative genomic hybridization revealed a 9.6-Mb deletion in 8p23.1-23.3 and a 0.52-Mb duplication in 12q23.1 in her genome. Furthermore, we reviewed the cases involving CNVs in patients with VACTERL, 8p23 deletion, and 12q23.1 duplication, and our case was the first displaying ARMs-related VACTERL association with CNV in 8p23 and 12q23.1. These findings enriched our understanding between VACTERL association and the mutations of 8p23 deletion and 12q23.1 duplication. IMPACT: This is a novel case of a Chinese girl with anorectal malformations (ARMs)-related VACTERL with an 8p23.1-23.3 deletion and 12q23.1 duplication. Cloaca malformation is presented with novel copy number variation in 8p23.1-23.3 deletion and 12q23.1 duplication.
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Affiliation(s)
- Yue Li
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Peiqi Liu
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Weilin Wang
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Huimin Jia
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yuzuo Bai
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
| | - Zhengwei Yuan
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
| | - Zhonghua Yang
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
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Nayak SS, Harkness R, Shukla A, Banka S, Newman WG, Girisha KM. Clinically diverse and perinatally lethal syndromes with urorectal septum malformation sequence. Am J Med Genet A 2023; 191:730-741. [PMID: 36478354 PMCID: PMC7615864 DOI: 10.1002/ajmg.a.63067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/17/2022] [Accepted: 11/20/2022] [Indexed: 12/12/2022]
Abstract
Urorectal septum malformation sequence (URSMS) is characterized by a spectrum of anomalies of the urogenital system, hindgut and perineum. It is presumed to be a constellation of an embryonic defect. Herein, we analyzed the clinically diverse syndromes associated with URSMS in our perinatal evaluation unit. We reviewed fetuses with URSMS in referrals for perinatal autopsy over a period of 3 years. Chromosomal microarray and genome sequencing were performed whenever feasible. Literature was reviewed for syndromes or malformations with URSMS. We ascertained URSMS in 12 of the 215 (5%) fetuses. Nine fetuses (75%) had complete URSMS and remainder had partial/intermediate URSMS. Eleven fetuses had malformations of other systems that included: cerebral ventriculomegaly; right aortic arch with double outlet right ventricle; microcephaly with fetal akinesia deformation sequence; ventricular septal defect and radial ray anomaly; thoraco-abdominoschisis and limb defects; myelomeningocele; spina bifida and fused iliac bones; omphalocele; occipital encephalocele; lower limb amelia and cleft foot. We report on six fetuses with recurrent and five fetuses with unique malformations/patterns where URSMS is a component. Exome sequencing (one family) and genome sequencing (eight families) were performed and were nondiagnostic. Additionally, we review the literature for genetic basis of this condition. URMS is a clinically heterogeneous condition and is a component of several multiple malformation syndromes. We describe several unique and recurrent malformations associated with URSMS.
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Affiliation(s)
- Shalini S. Nayak
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Robert Harkness
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, UK
- Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Anju Shukla
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Siddharth Banka
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, UK
- Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - William G. Newman
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, UK
- Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Katta M. Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Department of Genetics, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
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Keppler-Noreuil KM, Conway KM, Shen D, Rhoads AJ, Carey JC, Romitti PA. Clinical and risk factor analysis of cloacal defects in the National Birth Defects Prevention Study. Am J Med Genet A 2017; 173:2873-2885. [PMID: 28960693 DOI: 10.1002/ajmg.a.38469] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 08/02/2017] [Accepted: 08/12/2017] [Indexed: 12/20/2022]
Abstract
Cloacal exstrophy (CE) and persistent cloaca (PC) (alternatively termed urorectal septum malformation sequence [URSMS]), represent two major cloacal defects (CDs). Clinical characteristics and risk factors often are studied for both defects combined, rather than exploring if these defects have different etiologies. We enumerated clinical features for 47 CE and 54 PC (inclusive of URSMS) cases from the National Birth Defects Prevention Study. Thirty-three CE cases were classified as isolated and 14 as multiple (presence of unassociated major defects); respective totals for PC cases were 26 and 28. We compared selected child and maternal characteristics between 11,829 non-malformed controls and CE and PC cases using chi-square or Fisher's exact tests. Compared to controls, CE and PC cases were statistically more likely (p < 0.05) to be preterm; CE cases were more likely to be multiple births. We conducted logistic regression analysis to estimate odds ratios and 95% confidence intervals for any CD, CE, and PC with selected self-reported maternal prepregnancy and periconceptional (one month prior to 3 months following conception) exposures. In crude and adjusted analyses, we observed significant positive associations for any CD, CE, and PC with use of any fertility medication or assisted reproductive technology procedure. Significant positive associations observed only in crude analyses were any CD with maternal obesity or use of progesterone, any CD and CE with any x-ray, and any CD and PC with use of folate antagonist medications. Our findings provide some of the first insights into potential differing etiologies for CE and PC.
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Affiliation(s)
- Kim M Keppler-Noreuil
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Kristin M Conway
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
| | - Dereck Shen
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
| | - Anthony J Rhoads
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
| | - John C Carey
- Division of Medical Genetics, Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, Utah
| | - Paul A Romitti
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
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Selenti N, Tzetis M, Braoudaki M, Gianikou K, Kitsiou-Tzeli S, Fryssira H. An interstitial deletion at 8q23.1-q24.12 associated with Langer-Giedion syndrome/ Trichorhinophalangeal syndrome (TRPS) type II and Cornelia de Lange syndrome 4. Mol Cytogenet 2015; 8:64. [PMID: 26269715 PMCID: PMC4534011 DOI: 10.1186/s13039-015-0169-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 07/30/2015] [Indexed: 11/26/2022] Open
Abstract
Background There are three distinct subtypes of Trichorhinophalangeal syndrome (TRPS); TRPS type I, TRPS type II and TRPS type III. Features common to all three subtypes include sparse, slowly growing scalp hair, laterally sparse eyebrows, a bulbous tip of the nose (pear-shaped), and protruding ears. Langer–Giedion syndrome (LGS) or TRPS type II is a contiguous gene syndrome on 8q24.1, involving loss of functional copies of the TRPS1 and EXT1 genes. We report a male patient that was referred to the Department of Medical Genetics due to hypotonia and dysmorphic facial features. Results Cytogenetic and array- Comparative Genomic Hybridization (aCGH) analysis revealed that the patient was a carrier of an interstitial deletion at 8q23.1-q24.12 of 12,5 Mb. Parental karyotype indicated that the father carried an apparently balanced insertion: 46, ΧΥ, der(10)ins(10;8)(q22;q23q24). Conclusions This is the first report of an apparently balanced insertion including chromosomes 8 and 10 contributing to the etiology of LGS/ TRPS type II. Τimely diagnosis of parental balanced chromosomal rearrangements can reduce the risk of subsequent miscarriages as well as abnormal offspring.
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Affiliation(s)
- Nikoletta Selenti
- Department of Medical Genetics, Aghia Sophia Childrens' Hospital, Athens University, School of Medicine, Thivon and Levadeias 11527, Goudi, Athens, Greece
| | - Maria Tzetis
- Department of Medical Genetics, Aghia Sophia Childrens' Hospital, Athens University, School of Medicine, Thivon and Levadeias 11527, Goudi, Athens, Greece
| | - Maria Braoudaki
- Department of Medical Genetics, Aghia Sophia Childrens' Hospital, Athens University, School of Medicine, Thivon and Levadeias 11527, Goudi, Athens, Greece
| | - Krinio Gianikou
- Department of Medical Genetics, Aghia Sophia Childrens' Hospital, Athens University, School of Medicine, Thivon and Levadeias 11527, Goudi, Athens, Greece
| | - Sofia Kitsiou-Tzeli
- Department of Medical Genetics, Aghia Sophia Childrens' Hospital, Athens University, School of Medicine, Thivon and Levadeias 11527, Goudi, Athens, Greece
| | - Helen Fryssira
- Department of Medical Genetics, Aghia Sophia Childrens' Hospital, Athens University, School of Medicine, Thivon and Levadeias 11527, Goudi, Athens, Greece
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Shawky RM, Elkhalek HSA, Elghawaby AES, Mohammad SA, Seifeldin NS. Trichorhinophalangeal syndrome II, expanding the clinical spectrum. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2015. [DOI: 10.1016/j.ejmhg.2014.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Plaza-Benhumea L, Valdes-Miranda J, Toral-López J, Pérez-Cabrera A, Cuevas-Covarrubias S. Trichorhinophalangeal syndrome type II due to a novel 8q23.3-q24.12 deletion associated with imperforate hymen and vaginal stenosis. Br J Dermatol 2014; 171:1581-3. [DOI: 10.1111/bjd.13177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- L. Plaza-Benhumea
- Departamento de Genética; Hospital para el Niño IMIEM; Edomex México
| | - J.M. Valdes-Miranda
- Departamento de Genética Médica; Facultad de Medicina; Hospital General de México; Facultad de Medicina; Universidad Nacional Autónoma de México; México
| | - J. Toral-López
- Departamento de Genética Médica; Centro Médico Ecatepec; ISSEMYM; Edomex México
| | - A. Pérez-Cabrera
- Departamento de Genética Médica; Facultad de Medicina; Hospital General de México; Facultad de Medicina; Universidad Nacional Autónoma de México; México
| | - S. Cuevas-Covarrubias
- Departamento de Genética Médica; Facultad de Medicina; Hospital General de México; Facultad de Medicina; Universidad Nacional Autónoma de México; México
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Harrison SM, Seideman C, Baker LA. DNA copy number variations in patients with persistent cloaca. J Urol 2014; 191:1543-6. [PMID: 24679878 DOI: 10.1016/j.juro.2013.09.056] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE Persistent cloaca is a devastating female anomaly associated with renal insufficiency/failure, urinary and fecal incontinence and müllerian dysfunction. Genetically engineered murine models of persistent cloaca suggest that this anomaly could have a genetic component in humans. Genomic copy number variations account for previously unexplained genetic diseases by identifying candidate genes in various disorders. We assessed whether novel copy number variations are present in patients with persistent cloaca. MATERIALS AND METHODS With institutional review board approval we performed a retrospective chart review to identify patients with persistent cloaca. Lymphocyte DNA was prospectively tested by whole genome array comparative genomic hybridization. HHAT was Sanger sequenced from genomic DNA. RESULTS At study recruitment mean age was 12 years (range 0.5 to 23) in 17 females with cloaca. Seven females (41%) had a solitary functioning kidney and 2 each had renal insufficiency and renal replacement therapy. The common cloaca channel was 1.5 to 6 cm long in 6 newborns. Six patients (35%) had vaginal duplication and 4 had spinal anomalies. Array comparative genomic hybridization revealed copy number variations in 7 patients (41%), including 5 gains and 2 losses. Two copy number variations were novel, including a paternally inherited duplication on 16p13.2 and a de novo deletion on 1q32.1q32.3. Subsequent sequencing of the candidate gene HHAT identified no causal mutations. CONCLUSIONS Persistent cloaca is a rare but morbid birth defect. Copy number variations are common in these females but HHAT mutations are not common. Further investigation of these genomic rearrangements may lead to the identification of genetic causes of persistent cloaca.
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Affiliation(s)
- Steven M Harrison
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Casey Seideman
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Linda A Baker
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas; McDermott Center for Human Growth and Development, University of Texas Southwestern Medical Center, Dallas, Texas.
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Tasic V, Gucev Z, Ristoska-Bojkovska N, Janchevska A, Lüdecke HJ. Tricho-rhino-phalangeal syndrome in a 13-year-old girl with chronic renal failure and severe growth retardation. Ren Fail 2014; 36:619-22. [PMID: 24502542 DOI: 10.3109/0886022x.2014.882237] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The tricho-rhino-phalangeal syndrome type III (TRPS III) is a rare autosomal dominantly inherited condition. The main clinical features are sparse and slow-growing hair and nails, a pear-shaped nose with a bulbous tip, elongated and flat philtrum, thin upper lip, cone-shaped epiphyses of the phalanges, and short stature. All patients have a point mutation in the TRPS1 gene. CASE REPORT In this paper, we present a 13-year-old female with the typical clinical features of TRPS III, extreme growth retardation, severe deformities of both proximal radii resulting in limited extension of the elbows, and chronic renal failure (CRF) in addition. Molecular diagnostics revealed a missense mutation in exon 6 of TRPS1 that she inherited from her father who is also affected with TRPS III, but does not have CRF. In the index patient, the CRF was found to be due to bilateral renal hypodysplasia (RHD). CONCLUSION Beside the renal dysplasia, the girl had severe deformities of the proximal radii - findings which have not been reported so far in TRPS III.
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Affiliation(s)
- Velibor Tasic
- Medical Faculty Skopje, University Children's Hospital , Skopje , Macedonia and
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Schinzel A, Riegel M, Baumer A, Superti-Furga A, Moreira LMA, Santo LDE, Schiper PP, Carvalho JHD, Giedion A. Long-term follow-up of four patients with Langer-Giedion syndrome: clinical course and complications. Am J Med Genet A 2013; 161A:2216-25. [PMID: 23913778 DOI: 10.1002/ajmg.a.36062] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 04/25/2013] [Indexed: 11/08/2022]
Abstract
Long-term observations of individuals with the so-called Langer-Giedion (LGS) or tricho-rhino-phalangeal type II (TRPS2) are scarce. We report here a on follow-up of four LGS individuals, including one first described by Andres Giedion in 1969, and review the sparse publications on adults with this syndrome which comprises ectodermal dysplasia, multiple cone-shaped epiphyses prior to puberty, multiple cartilaginous exostoses, and mostly mild intellectual impairment. LGS is caused by deletion of the chromosomal segment 8q24.11-q24.13 containing among others the genes EXT1 and TRPS1. Most patients with TRPS2 are only borderline or mildly cognitively delayed, and few are of normal intelligence. Their practical skills are better than their intellectual capability, and, for this reason and because of their low self-esteem, they are often underestimated. Some patients develop seizures at variable age. Osteomas on processes of cervical vertebrae may cause pressure on cervical nerves or dissection of cerebral arteries. Joint stiffness is observed during childhood and changes later to joint laxity causing instability and proneness to trauma. Perthes disease is not rare. Almost all males become bald at or soon after puberty, and some develop (pseudo) gynecomastia. Growth hormone deficiency was found in a few patients, TSH deficiency so far only in one. Puberty and fertility are diminished, and no instance of transmission of the deletion from a non-mosaic parent to a child has been observed so far. Several affected females had vaginal atresia with consequent hydrometrocolpos.
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Affiliation(s)
- Albert Schinzel
- Institute of Medical Genetics, Department of Pediatrics, University of Zürich, Zürich, Switzerland.
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Pereza N, Severinski S, Ostojić S, Volk M, Maver A, Dekanić KB, Kapović M, Peterlin B. Third case of 8q23.3-q24.13 deletion in a patient with Langer-Giedion syndrome phenotype without TRPS1 gene deletion. Am J Med Genet A 2012; 158A:659-63. [PMID: 22315192 DOI: 10.1002/ajmg.a.35201] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Accepted: 11/07/2011] [Indexed: 11/06/2022]
Abstract
Langer-Giedion syndrome (LGS) is a contiguous gene syndrome caused by a hemizygous deletion on chromosome 8q23.3-q24.11 involving TRPS1 and EXT1 genes. We report on a girl with LGS phenotype and a 7.5 Mb interstitial deletion at chromosome 8q23.3-q24.13. Array-comparative genomic hybridization (a-CGH) revealed a deletion encompassing only the EXT1 and not the TRPS1 gene. Even though the deletion of TRPS1 and EXT1 genes is responsible for craniofacial and skeletal features of LGS, there have been previous reports of patients with LGS phenotype and 8q24 deletions leaving the TRPS1 gene intact. To our knowledge, this is the third such case. Our patient differs from previously reported LGS patients without TRPS1 gene deletion in that she has the typical LGS facial dysmorphism and skeletal abnormalities. However, the girl is of normal height and has only a mild developmental delay. Additionally, she has dyslalia and premature adrenarche classified as Tanner stage 3 premature pubarche which have not yet been described as features of LGS. We examine the molecular breakpoints and phenotypes of our patient and previously reported cases.
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Affiliation(s)
- Nina Pereza
- Department of Biology and Medical Genetics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.
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Fairweather P. Postmortem findings at 36 weeks gestation in trichorhinophalangeal syndrome: a case report. Pathology 2006; 38:170-2. [PMID: 16581659 DOI: 10.1080/00313020600561740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Donahue ML, Ryan RM. Interstitial deletion of 8q21-->22 associated with minor anomalies, congenital heart defect, and Dandy-Walker variant. AMERICAN JOURNAL OF MEDICAL GENETICS 1995; 56:97-100. [PMID: 7747796 DOI: 10.1002/ajmg.1320560122] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We describe an infant with a deletion of 8q21-->22 who had distinct clinical manifestations including minor facial anomalies, a congenital heart defect, a Dandy-Walker variant, and mild to moderate developmental delay. Her facial characteristics included small, wide-spaced eyes, asymmetric bilateral epicanthal folds, a broad nasal bridge, a "carp-shaped" mouth, micrognathia, and prominent, apparently low-set ears. Three other reports describe children with larger proximal deletions of 8q that include 8q21 and q22. These four children all have similar facial appearance. Of the others reported, one had a congenital heart defect and one had craniosynostosis. This case, in addition to the previously noted three cases, helps in delineating a recognizable syndrome.
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Affiliation(s)
- M L Donahue
- Medical University of South Carolina, Children's Hospital, Charleston, South Carolina, USA
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