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Okazaki T, Adachi K, Matsuura K, Oyama Y, Nose M, Shirahata E, Abe T, Hasegawa T, Maihara T, Maegaki Y, Nanba E. Clinical Characteristics of Fragile X Syndrome Patients in Japan. Yonago Acta Med 2021; 64:30-33. [PMID: 33642901 DOI: 10.33160/yam.2021.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/07/2020] [Indexed: 11/05/2022]
Abstract
Background Fragile X syndrome (FXS) is a well-known X-linked disorder clinically characterized by intellectual disability and autistic features. However, diagnosed Japanese FXS cases have been fewer than expected, and clinical features of Japanese FXS patients remain unknown. Methods We evaluated the clinical features of Japanese FXS patients using the results of a questionnaire-based survey. Results We presented the characteristics of seven patients aged 6 to 20 years. Long face and large ears were observed in five of seven patients. Macrocephaly was observed in four of five patients. The meaningful word was first seen at a certain time point between 18 and 72 months (median = 60 months). Developmental quotient or intellectual quotient ranged between 20 and 48 (median = 29). Behavioral disorders were seen in all patients (autistic spectrum disorder in six patients, hyperactivity in five patients). Five patients were diagnosed by polymerase chain reaction analysis, and two patients were diagnosed by the cytogenetic study. All physicians ordered FXS genetic testing for suspicious cases because of clinical manifestations. Conclusion In the present study, a long face, large ears, macrocephaly, autistic spectrum disorder, and hyperactivity were observed in almost cases, and these characteristics might be common features in Japanese FXS patients. Our finding indicated the importance of clinical manifestations to diagnosis FXS. However, the sample size of the present study is small, and these features are also seen to patients with other disorders. We consider that genetic testing for FXS should be performed on a wider range of intellectually disabled cases.
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Affiliation(s)
- Tetsuya Okazaki
- Division of Clinical Genetics, Tottori University Hospital, Yonago 680-8504, Japan
| | - Kaori Adachi
- Research Initiative Center, Organization for Research Initiative and Promotion, Tottori University, Yonago 680-8503, Japan
| | - Kaori Matsuura
- Division of Clinical Genetics, Tottori University Hospital, Yonago 680-8504, Japan
| | - Yoshitaka Oyama
- Department of Pediatrics, Yokohama City University Medical Center, Yokohama 232-0024, Japan
| | - Madoka Nose
- Department of Pediatrics, Nose Pediatric Clinic, Kobe 653-0004, Japan
| | - Emi Shirahata
- Department of Pediatrics, Yamagata Prefectural Rehabilitation Center for Children with Disabilities, Kaminoyama 990-8570, Japan
| | - Toshiaki Abe
- Department of Pediatrics, Ashikaganomori Hospital, Ashikaga 326-0011, Japan
| | - Takeshi Hasegawa
- Department of Pediatrics, Soka Municipal Hospital, Soka 340-0043, Japan
| | - Toshiro Maihara
- Department of Pediatrics, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki 660-8550, Japan
| | - Yoshihiro Maegaki
- Division of Clinical Genetics, Tottori University Hospital, Yonago 680-8504, Japan.,Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago 680-8504, Japan
| | - Eiji Nanba
- Division of Clinical Genetics, Tottori University Hospital, Yonago 680-8504, Japan.,Research Strategy Division, Organization for Research Initiative and Promotion, Tottori University, Yonago 680-8503, Japan
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Meyer GA, Blum NJ, Hitchcock W, Fortina P. Absence of the fragile X CGG trinucleotide repeat expansion in girls diagnosed with a pervasive developmental disorder. J Pediatr 1998; 133:363-5. [PMID: 9738717 DOI: 10.1016/s0022-3476(98)70270-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to determine the prevalence of the fragile X (FRAX) CGG trinucleotide expansion in a population of young girls (n = 45) diagnosed with pervasive developmental disorder (PDD). Their mean age was 43.7 months (range, 25 to 132 months). Diagnoses included autistic disorder (n = 20), PDD (n = 23), and Asperger's syndrome (n = 2). Molecular FRAX testing was performed on all patients by using the Southern gene blot technique. Genomic DNA was digested with both EcoRI and EagI, fractionated on agarose gel, and blotted and probed with the radiolabeled StB12.3 FMR-1 probe. None of the subjects were found to have an expansion of CGG in either the 2.8 kb or 5.2 kb fragments. A 95% CI, for the prevalence of the FRAX mutation in female subjects with PDD, has an upper bound of 2.9%. We conclude that the prevalence of FRAX positivity in girls with PDD is lower than previously reported. This raises the question of whether any association between FRAX and PDD in female subjects is specific to PDD or is related rather to the presence of mental retardation.
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Affiliation(s)
- G A Meyer
- Department of Pediatrics, Naval Medical Center, Portsmouth, Virginia 23708-2197, USA
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Abstract
Articles on pervasive developmental disorders (PDD) published mainly by Japanese child psychiatrists in international journals for the last 20 years were reviewed for the purpose of clarifying the accomplishment and aims of Japanese PDD research. Although Japanese child psychiatrists investigated PDD in various specialties, their contributions to international archives were much fewer than those of Japanese professionals in other branches of medical sciences. This may be accounted for by the absence of an authorized education system of child psychiatrists and strong clinical orientation together with some reluctance of Japanese child psychiatrists to perform research. However, the epidemiology of PDD subtypes, the speech loss in PDD and the psychopathology of persons with high-functioning PDD seem to be providing promising research areas for Japanese child psychiatrists based on their clinical experiences.
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Affiliation(s)
- H Kurita
- Department of Mental Health and Nursing, Faculty of Medicine, University of Tokyo, Japan
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Abstract
Chromosome analysis was performed in 105 Chinese children (96 boys, 9 girls) with autistic spectrum disorder to assess fragile X positivity. Seventy percent of these autistic children were mentally retarded. None of the children in the infantile autism group (N = 75) had fragile X positivity. Two boys in the autistic condition group (N = 30) had clinical features and chromosomal positivity for fragile X syndrome. The low (2%) prevalence rate of fragile X positivity in children with different degrees of expressivity of autistic features may be related to other factors rather than to pure autistic characteristics per se.
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Affiliation(s)
- V C Wong
- Department of Paediatrics, University of Hong Kong, Pokfulam
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Fisch GS. Is autism associated with the fragile X syndrome? AMERICAN JOURNAL OF MEDICAL GENETICS 1992; 43:47-55. [PMID: 1605228 DOI: 10.1002/ajmg.1320430107] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In addition to mental retardation (MR), fragile X [fra(X)] has been associated with other developmental disabilities, autism in particular. Recently, several studies have concluded that the association of fra(X) with autism is at best weak and perhaps nonexistent. This study examined reports of previously published data from an epidemiological perspective to determine if the prevalence of fra(X) among autistic males was significantly different from that among MR males. Nineteen studies of autistic males and 21 studies of MR males were analyzed from 59 examined. Of 5601 MR males tested, 307 (5.5%) were cytogenetically positive. Of 1006 autistic males, 54 (5.4%) were positive. Analysis indicated no statistical difference between these proportions (Z = 0.014; p greater than .50). An odds ratio (OR) was also computed to determine the risk of autism from fra(X). Estimated OR approximately 1.0 [0.73, 1.32]. Attributable risk (AR), the proportionate excess risk of autism associated with exposure to fra(X) was AR approximately 0.0. That is, there was no attributable risk of autism from fra(X). The association of fra(X) with autism may reflect the association with MR that generally accompanies autism, as several earlier reports have noted. However, the similarity in prevalence of fra(X) among autistic and MR males may be biased in the studies which find no instances of fra(X) among autistic males represent 12% of the pooled sample.
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Affiliation(s)
- G S Fisch
- Department of Psychiatry, Kings County Hospital, Brooklyn, New York 11203
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Spano LM, Opitz JM. Bibliography on X-linked mental retardation, the fragile X, and related subjects V (1991). AMERICAN JOURNAL OF MEDICAL GENETICS 1991; 38:173-85. [PMID: 2018055 DOI: 10.1002/ajmg.1320380203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- L M Spano
- Department of Medical Genetics, Shodair Children's Hospital, Helena, Montana 59604
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Stern LM, Walker MK, Sawyer MG, Oades RD, Badcock NR, Spence JG. A controlled crossover trial of fenfluramine in autism. J Child Psychol Psychiatry 1990; 31:569-85. [PMID: 2195054 DOI: 10.1111/j.1469-7610.1990.tb00798.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We report a 12 month double-blind randomized crossover trial of fenfluramine in 20 children with the syndrome of autism. On active drug most of the children lost weight and blood serotonin levels fell by an average of 60%. There was a fall in urinary dopamine (DA) and noradrenaline (NA) levels and increased excretion of homovanillic acid (HVA). Some of the children showed improvement in tests of cognitive and language function, although the results did not achieve overall statistical significance. Event-related brain potentials (ERPs) were obtained in seven subjects on an auditory choice reaction time task. Side effects of the drug included irritability and lethargy. Fenfluramine may have a limited place in the management of some patients with autistic disorder.
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Affiliation(s)
- L M Stern
- Regency Park Centre for Young Disabled, Kilkenny, S.A., Australia
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Millichap JG. Fragile X Syndrome. Pediatr Neurol Briefs 1987. [DOI: 10.15844/pedneurbriefs-1-6-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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