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Conway KS, Ghafoor F, Gottschalk AC, Laakman J, Eigsti RL, Nashelsky M, Blau J, Hefti MM. The Neuropathology of 1p36 Deletion Syndrome: An Autopsy Case Series. J Neuropathol Exp Neurol 2021; 80:856-860. [PMID: 34363665 DOI: 10.1093/jnen/nlab072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
1p36 deletion syndrome is the most common terminal deletion syndrome, manifesting clinically as abnormal facies and developmental delay with frequent cardiac, skeletal, urogenital, and renal abnormalities. Limited autopsy case reports describe the neuropathology of 1p36 deletion syndrome. The most extensive single case report described a spectrum of abnormalities, mostly related to abnormal neuronal migration. We report the largest published series of 1p36 autopsy cases, with an emphasis on neuropathologic findings. Our series consists of 3 patients: 2 infants (5-hours old and 23-days old) and 1 older child (11 years). Our patients showed abnormal cortical gyration together with a spectrum of neuronal migration abnormalities, including heterotopias and hippocampal abnormalities, as well as cerebellar hypoplasia. Our findings thus support the role of neuronal migration defects in the pathogenesis of cognitive defects in 1p36 deletion syndrome and broaden the reported neuropathologic spectrum of this common syndrome.
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Affiliation(s)
- Kyle S Conway
- Department of Pathology, University of Iowa, Iowa City, Iowa, USA (KSC, JL, RLE, MN, JB, MMH)
| | - Fozia Ghafoor
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa, USA (FG)
| | - Amy C Gottschalk
- College of Liberal Arts and Sciences, University of Iowa, Iowa City, Iowa, USA (ACG)
| | - Joseph Laakman
- Department of Pathology, University of Iowa, Iowa City, Iowa, USA (KSC, JL, RLE, MN, JB, MMH)
| | - Renee L Eigsti
- Department of Pathology, University of Iowa, Iowa City, Iowa, USA (KSC, JL, RLE, MN, JB, MMH)
| | - Marcus Nashelsky
- Department of Pathology, University of Iowa, Iowa City, Iowa, USA (KSC, JL, RLE, MN, JB, MMH)
| | - John Blau
- Department of Pathology, University of Iowa, Iowa City, Iowa, USA (KSC, JL, RLE, MN, JB, MMH)
| | - Marco M Hefti
- Department of Pathology, University of Iowa, Iowa City, Iowa, USA (KSC, JL, RLE, MN, JB, MMH).,Interdisciplinary Neuroscience Graduate Program, University of Iowa, Iowa City, Iowa, USA (MMH).,Iowa Neuroscience Institute, Iowa City, Iowa, USA (MMH)
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Greco M, Ferrara P, Farello G, Striano P, Verrotti A. Electroclinical features of epilepsy associated with 1p36 deletion syndrome: A review. Epilepsy Res 2017; 139:92-101. [PMID: 29212048 DOI: 10.1016/j.eplepsyres.2017.11.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 11/21/2017] [Accepted: 11/28/2017] [Indexed: 11/19/2022]
Abstract
1p36 terminal deletion is a recently recognized syndrome with multiple congenital anomalies and intellectual disability. It occurs approximately in 1 out of 5000 to 10,000 live births and is the most common subtelomeric microdeletion observed in human. Medical problems commonly caused by terminal deletions of 1p36 include developmental delay, intellectual disability, seizures, vision problems, hearing loss, short stature, brain anomalies, congenital heart defects, cardiomyopathy, renal anomalies and distinctive facial features. Although the syndrome is considered clinically recognizable, there is significant phenotypic variation among affected individuals. Genotype-phenotype correlation in this syndrome is complicated, because of the similar clinical evidence seen in patients with different deletion sizes. We review 34 scientific articles from 1996 to 2016 that described 315 patients with 1p36 delection syndrome. The aim of this review is to find a correlation between size of the 1p36-deleted segments and the neurological clinical phenotypes with the analysis of electro-clinical patterns associated with chromosomal aberrations, that is a major tool in the identification of epilepsy susceptibility genes. Our finding suggest that developmental delay and early epilepsy are frequent findings in 1p36 deletion syndrome that can contribute to a poor clinical outcome for this reason this syndrome should be searched for in patients presenting with infantile spasms associated with a hypsarrhythmic EEG, particulary if they are combined with dismorphic features, severe hypotonia and developmental delay.
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Affiliation(s)
- M Greco
- Department of Pediatrics, University of L'Aquila, L'Aquila, Italy.
| | - P Ferrara
- Institute of pediatrics, Catholic University of Sacred Hearth, Rome, Italy,.
| | - G Farello
- Department of Pediatrics, University of L'Aquila, L'Aquila, Italy,.
| | - P Striano
- Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 'G. Gaslini' Institute, Genova, Italy,.
| | - A Verrotti
- Department of Pediatrics, University of L'Aquila, L'Aquila, Italy,.
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Šumanović-Glamuzina D, Lozić B, Iwanowski PS, Zemunik T, Bilinovac Z, Stasiewicz-Jarocka B, Panasiuk B, Midro AT. Limited survivability of unbalanced progeny of carriers of a unique t(4;19)(p15.32;p13.3): a study in multiple generations. Mol Cytogenet 2017; 10:29. [PMID: 28785312 PMCID: PMC5545035 DOI: 10.1186/s13039-017-0330-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 07/26/2017] [Indexed: 11/22/2022] Open
Abstract
Background Carriership of a reciprocal chromosomal translocation (RCT) involving the short arm of chromosome 4 (4p) may result in birth of a child with Wolf-Hirschhorn syndrome (WHS) due to monosomy 4p, a priori modified by the impact of the partner chromosome imbalance. Familial transmission studies of RCT enable obtaining empirical risk figures that are essential for genetic counseling. In this study, pedigree data from carriers of a unique t(4;19)(p15.32;p13.3), ascertained by two children with WHS phenotype, were collected through five generations and empirical risk for different pregnancy outcomes was assessed. In addition, the phenotype-karyotype correlation was studied in two unbalanced children against the phenotypes of children (literature data) with pure monosomy 4p15.32 → pter and pure trisomy 19p13.3 → pter, accordingly. The phenotype analysis was conducted using the catalogue of traits according to the Munich Dysmorphology Database. Pedigree segregation analysis was conducted by the direct method according to Stengel- Rutkowski et al. Results A double segment imbalance, trisomy 19p13.3 → pter with monosomy 4p15.32 → pter, was diagnosed in WHS progeny at birth. No essential modification of WHS phenotype by the additional trisomy 19p was observed, except for a limited survivability (death in infancy). Pedigree segregation analysis covered 39 relatives showed the probability rate for liveborn with unbalanced karyotype of 3.7 ± 3.6% (1/27), for stillbirth/neonatal death at 7.4 ± 5.0% (2/27), for miscarriage at 22.2 ± 8.0% (6/27), for the chance of having a baby without unbalanced karyotype was estimated at 66.7 ± 9.1% (18/27). In addition, the value of 7.4% for genetic counseling for any carrier of RCT at risk for single segment 19p13.3 → pter imbalance at birth was evaluated as such value have not been estimated so far. Conclusion Carriership of a t(4;19)(p15.32;p13.3) is at low risk for an unbalanced child at birth and for stillbirth/neonatal death but high for miscarriages. The chance of having a baby without unbalanced karyotype was estimated to be high. Monosomy 4p15.32 → pter together with trisomy 19p13.3 → pter as a double segment imbalance in children with WHS may be connected with a limited survivability in infancy. Electronic supplementary material The online version of this article (doi:10.1186/s13039-017-0330-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Bernarda Lozić
- Department of Pediatrics, University Hospital Centre Split, Split, Croatia
| | - Piotr S Iwanowski
- Department of Clinical Genetics, Medical University of Bialystok, Waszyngtona St. 13, PO Box 22, 15-089 Białystok, Poland
| | - Tatijana Zemunik
- Department of Medical Biology, School of Medicine Split, University of Split, Split, Croatia
| | - Zeljka Bilinovac
- Department of Pediatrics, University Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Beata Stasiewicz-Jarocka
- Department of Clinical Genetics, Medical University of Bialystok, Waszyngtona St. 13, PO Box 22, 15-089 Białystok, Poland
| | - Barbara Panasiuk
- Department of Clinical Genetics, Medical University of Bialystok, Waszyngtona St. 13, PO Box 22, 15-089 Białystok, Poland
| | - Alina T Midro
- Department of Clinical Genetics, Medical University of Bialystok, Waszyngtona St. 13, PO Box 22, 15-089 Białystok, Poland
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Shimada S, Shimojima K, Okamoto N, Sangu N, Hirasawa K, Matsuo M, Ikeuchi M, Shimakawa S, Shimizu K, Mizuno S, Kubota M, Adachi M, Saito Y, Tomiwa K, Haginoya K, Numabe H, Kako Y, Hayashi A, Sakamoto H, Hiraki Y, Minami K, Takemoto K, Watanabe K, Miura K, Chiyonobu T, Kumada T, Imai K, Maegaki Y, Nagata S, Kosaki K, Izumi T, Nagai T, Yamamoto T. Microarray analysis of 50 patients reveals the critical chromosomal regions responsible for 1p36 deletion syndrome-related complications. Brain Dev 2015; 37:515-26. [PMID: 25172301 DOI: 10.1016/j.braindev.2014.08.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 08/01/2014] [Accepted: 08/05/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Monosomy 1p36 syndrome is the most commonly observed subtelomeric deletion syndrome. Patients with this syndrome typically have common clinical features, such as intellectual disability, epilepsy, and characteristic craniofacial features. METHOD In cooperation with academic societies, we analyzed the genomic copy number aberrations using chromosomal microarray testing. Finally, the genotype-phenotype correlation among them was examined. RESULTS We obtained clinical information of 86 patients who had been diagnosed with chromosomal deletions in the 1p36 region. Among them, blood samples were obtained from 50 patients (15 males and 35 females). The precise deletion regions were successfully genotyped. There were variable deletion patterns: pure terminal deletions in 38 patients (76%), including three cases of mosaicism; unbalanced translocations in seven (14%); and interstitial deletions in five (10%). Craniofacial/skeletal features, neurodevelopmental impairments, and cardiac anomalies were commonly observed in patients, with correlation to deletion sizes. CONCLUSION The genotype-phenotype correlation analysis narrowed the region responsible for distinctive craniofacial features and intellectual disability into 1.8-2.1 and 1.8-2.2 Mb region, respectively. Patients with deletions larger than 6.2 Mb showed no ambulation, indicating that severe neurodevelopmental prognosis may be modified by haploinsufficiencies of KCNAB2 and CHD5, located at 6.2 Mb away from the telomere. Although the genotype-phenotype correlation for the cardiac abnormalities is unclear, PRDM16, PRKCZ, and RERE may be related to this complication. Our study also revealed that female patients who acquired ambulatory ability were likely to be at risk for obesity.
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Affiliation(s)
- Shino Shimada
- Tokyo Women's Medical University Institute for Integrated Medical Sciences, Tokyo, Japan; Department of Pediatrics, Tokyo Women's Medical University, Tokyo, Japan
| | - Keiko Shimojima
- Tokyo Women's Medical University Institute for Integrated Medical Sciences, Tokyo, Japan
| | - Nobuhiko Okamoto
- Department of Medical Genetics, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan
| | - Noriko Sangu
- Tokyo Women's Medical University Institute for Integrated Medical Sciences, Tokyo, Japan; Department of Oral and Maxillofacial Surgery, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Kyoko Hirasawa
- Department of Pediatrics, Tokyo Women's Medical University, Tokyo, Japan
| | - Mari Matsuo
- Institute of Medical Genetics, Tokyo Women's Medical University, Tokyo, Japan
| | - Mayo Ikeuchi
- Department of Pediatrics and Child Neurology, Oita University Faculty of Medicine, Oita, Japan
| | | | - Kenji Shimizu
- Division of Medical Genetics, Saitama Children's Medical Center, Saitama, Japan
| | - Seiji Mizuno
- Department of Pediatrics, Central Hospital, Aichi Human Service Center, Kasugai, Japan
| | - Masaya Kubota
- Division of Neurology, National Center for Child Health and Development, Tokyo, Japan
| | - Masao Adachi
- Department of Pediatrics, Kakogawa Hospital Organization, Kakogawa West-City Hospital, Kakogawa, Japan
| | - Yoshiaki Saito
- Department of Child Neurology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kiyotaka Tomiwa
- Department of Pediatrics, Medical Center for Children, Osaka City General Hospital, Osaka, Japan
| | - Kazuhiro Haginoya
- Department of Pediatric Neurology, Takuto Rehabilitation Center for Children, Sendai, Japan
| | - Hironao Numabe
- Department of Genetic Counseling, Graduate School of Humanities and Sciences, Ochanomizu University, Tokyo, Japan
| | - Yuko Kako
- Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan
| | - Ai Hayashi
- Department of Neonatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Haruko Sakamoto
- Department of Pediatrics, Osaka Red Cross Hospital, Osaka, Japan
| | - Yoko Hiraki
- Hiroshima Municipal Center for Child Health and Development, Hiroshima, Japan
| | - Koichi Minami
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | | | - Kyoko Watanabe
- Department of Pediatrics, National Hospital Organization Kokura Medical Center, Kitakyushu, Japan
| | - Kiyokuni Miura
- Developmental Disability Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomohiro Chiyonobu
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tomohiro Kumada
- Department of Pediatrics, Shiga Medical Center for Children, Moriyama, Japan
| | - Katsumi Imai
- National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan
| | - Yoshihiro Maegaki
- Division of Child Neurology, Tottori University School of Medicine, Yonago, Japan
| | - Satoru Nagata
- Department of Pediatrics, Tokyo Women's Medical University, Tokyo, Japan
| | - Kenjiro Kosaki
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
| | - Tatsuro Izumi
- Department of Pediatrics and Child Neurology, Oita University Faculty of Medicine, Oita, Japan
| | - Toshiro Nagai
- Department of Pediatrics, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan
| | - Toshiyuki Yamamoto
- Tokyo Women's Medical University Institute for Integrated Medical Sciences, Tokyo, Japan.
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Accurate, fast and cost-effective diagnostic test for monosomy 1p36 using real-time quantitative PCR. DISEASE MARKERS 2014; 2014:836082. [PMID: 24839341 PMCID: PMC4009252 DOI: 10.1155/2014/836082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 02/11/2014] [Indexed: 01/08/2023]
Abstract
Monosomy 1p36 is considered the most common subtelomeric deletion syndrome in humans and it accounts for 0.5–0.7% of all the cases of idiopathic intellectual disability. The molecular diagnosis is often made by microarray-based comparative genomic hybridization (aCGH), which has the drawback of being a high-cost technique. However, patients with classic monosomy 1p36 share some typical clinical characteristics that, together with its common prevalence, justify the development of a less expensive, targeted diagnostic method. In this study, we developed a simple, rapid, and inexpensive real-time quantitative PCR (qPCR) assay for targeted diagnosis of monosomy 1p36, easily accessible for low-budget laboratories in developing countries. For this, we have chosen two target genes which are deleted in the majority of patients with monosomy 1p36: PRKCZ and SKI. In total, 39 patients previously diagnosed with monosomy 1p36 by aCGH, fluorescent in situ hybridization (FISH), and/or multiplex ligation-dependent probe amplification (MLPA) all tested positive on our qPCR assay. By simultaneously using these two genes we have been able to detect 1p36 deletions with 100% sensitivity and 100% specificity. We conclude that qPCR of PRKCZ and SKI is a fast and accurate diagnostic test for monosomy 1p36, costing less than 10 US dollars in reagent costs.
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Shiba N, Daza RAM, Shaffer LG, Barkovich AJ, Dobyns WB, Hevner RF. Neuropathology of brain and spinal malformations in a case of monosomy 1p36. Acta Neuropathol Commun 2013; 1:45. [PMID: 24252393 PMCID: PMC3893467 DOI: 10.1186/2051-5960-1-45] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 07/18/2013] [Indexed: 11/10/2022] Open
Abstract
Monosomy 1p36 is the most common subtelomeric chromosomal deletion linked to mental retardation and seizures. Neuroimaging studies suggest that monosomy 1p36 is associated with brain malformations including polymicrogyria and nodular heterotopia, but the histopathology of these lesions is unknown. Here we present postmortem neuropathological findings from a 10 year-old girl with monosomy 1p36, who died of respiratory complications. The findings included micrencephaly, periventricular nodular heterotopia in occipitotemporal lobes, cortical dysgenesis resembling polymicrogyria in dorsolateral frontal lobes, hippocampal malrotation, callosal hypoplasia, superiorly rotated cerebellum with small vermis, and lumbosacral hydromyelia. The abnormal cortex exhibited “festooned” (undulating) supragranular layers, but no significant fusion of the molecular layer. Deletion mapping demonstrated single copy loss of a contiguous 1p36 terminal region encompassing many important neurodevelopmental genes, among them four HES genes implicated in regulating neural stem cell differentiation, and TP73, a monoallelically expressed gene. Our results suggest that brain and spinal malformations in monosomy 1p36 may be more extensive than previously recognized, and may depend on the parental origin of deleted genes. More broadly, our results suggest that specific genetic disorders may cause distinct forms of cortical dysgenesis.
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Ishikawa A, Enomoto K, Tominaga M, Saito T, Nagai JI, Furuya N, Ueno K, Ueda H, Masuno M, Kurosawa K. Pure duplication of 19p13.3. Am J Med Genet A 2013; 161A:2300-4. [DOI: 10.1002/ajmg.a.36041] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Accepted: 04/15/2013] [Indexed: 01/01/2023]
Affiliation(s)
- Aki Ishikawa
- Division of Medical Genetics; Kanagawa Children's Medical Center; Yokohama Japan
| | - Keisuke Enomoto
- Division of Medical Genetics; Kanagawa Children's Medical Center; Yokohama Japan
| | - Makiko Tominaga
- Division of Medical Genetics; Kanagawa Children's Medical Center; Yokohama Japan
| | - Toshiyuki Saito
- Department of Clinical Laboratory; Kanagawa Children's Medical Center; Yokohama Japan
| | - Jun-ichi Nagai
- Department of Clinical Laboratory; Kanagawa Children's Medical Center; Yokohama Japan
| | - Noritaka Furuya
- Division of Medical Genetics; Kanagawa Children's Medical Center; Yokohama Japan
| | - Kentaro Ueno
- Department of Pediatric Cardiology; Kanagawa Children's Medical Center; Yokohama Japan
| | - Hideaki Ueda
- Department of Pediatric Cardiology; Kanagawa Children's Medical Center; Yokohama Japan
| | - Mitsuo Masuno
- Genetic Counseling Program, Graduate School of Health and Welfare; Kawasaki University of Medical Welfare; Kurashiki Japan
| | - Kenji Kurosawa
- Division of Medical Genetics; Kanagawa Children's Medical Center; Yokohama Japan
- Institute for Clinical Research; Kanagawa Children's Medical Center; Yokohama Japan
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Giannikou K, Fryssira H, Oikonomakis V, Syrmou A, Kosma K, Tzetis M, Kitsiou-Tzeli S, Kanavakis E. Further delineation of novel 1p36 rearrangements by array-CGH analysis: narrowing the breakpoints and clarifying the "extended" phenotype. Gene 2012; 506:360-8. [PMID: 22766398 DOI: 10.1016/j.gene.2012.06.060] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 06/19/2012] [Indexed: 11/15/2022]
Abstract
High resolution oligonucleotide array Comparative Genome Hybridization technology (array-CGH) has greatly assisted the recognition of the 1p36 contiguous gene deletion syndrome. The 1p36 deletion syndrome is considered to be one of the most common subtelomeric microdeletion syndromes and has an incidence of ~1 in 5000 live births, while respectively the "pure" 1p36 microduplication has not been reported so far. We present seven new patients who were referred for genetic evaluation due to Developmental Delay (DD), Mental Retardation (MR), and distinct dysmorphic features. They all had a wide phenotypic spectrum. In all cases previous standard karyotypes were negative. Array-CGH analysis revealed five patients with interstitial 1p36 microdeletion (four de novo and one maternal) and two patients with de novo reciprocal duplication of different sizes. These were the first reported "pure" 1p36 microduplication cases so far. Three of our patients carrying the 1p36 microdeletion syndrome were also found to have additional pathogenetic aberrations. These findings (del 3q27.1; del 4q21.22-q22.1; del 16p13.3; dup 21q21.2-q21.3; del Xp22.12) might contribute to the patients' severe phenotype, acting as additional modifiers of their clinical manifestations. We review and compare the clinical and array-CGH findings of our patients to previously reported cases with the aim of clearly delineating more accurate genotype-phenotype correlations for the 1p36 syndrome that could allow for a more precise prognosis.
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Affiliation(s)
- Krinio Giannikou
- Department of Medical Genetics, Medical School, University of Athens, Greece.
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