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Bader I, Decker E, Mayr JA, Lunzer V, Koch J, Boltshauser E, Sperl W, Pietsch P, Ertl-Wagner B, Bolz H, Bergmann C, Rittinger O. MKS1 mutations cause Joubert syndrome with agenesis of the corpus callosum. Eur J Med Genet 2016; 59:386-91. [PMID: 27377014 DOI: 10.1016/j.ejmg.2016.06.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 06/25/2016] [Accepted: 06/28/2016] [Indexed: 11/17/2022]
Abstract
Joubert syndrome (JS) is a clinically and genetically heterogeneous ciliopathy characterized by episodic hyperpnea and apnea, hypotonia, ataxia, cognitive impairment and ocular motor apraxia. The "molar tooth sign" is pathognomonic of this condition. Mutations in the MKS1 gene are a major cause of Meckel-Gruber syndrome (MKS), the most common form of syndromic neural tube defects, frequently resulting in perinatal lethality. We present the phenotype and genotype of a child with severe JS and agenesis of the corpus callosum (ACC). In our patient, a next generation sequencing (NGS) approach revealed the following two variants of the MKS1 gene: first, a novel missense variant [ c.240G > T (p.Trp80Cys)], which affects a residue that is evolutionarily highly conserved in mammals and ciliates; second, a 29 bp deletion in intron 15 [c.1408-35_1408-7del29], a founder mutation, which in a homozygous state constitutes the major cause of MKS in Finland. We review the MKS1-variants in all of the eleven JS patients reported to date and compare these patients to our case. To our knowledge, this is the first patient with Joubert syndrome and agenesis of the corpus callosum where a potentially causal genotype is provided.
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Affiliation(s)
- Ingrid Bader
- Clinical Genetics Unit, Children's Hospital, Paracelsus Medical University, Salzburg, Austria; kbo-Kinderzentrum, Technische Universität München, Germany.
| | - E Decker
- Bioscientia, Center for Human Genetics, Ingelheim, Germany
| | - J A Mayr
- Children's Hospital, Paracelsus Medical University, Salzburg, Austria
| | - V Lunzer
- Children's Hospital, Paracelsus Medical University, Salzburg, Austria
| | - J Koch
- Children's Hospital, Paracelsus Medical University, Salzburg, Austria
| | | | - W Sperl
- Children's Hospital, Paracelsus Medical University, Salzburg, Austria
| | - P Pietsch
- kbo-Kinderzentrum, Technische Universität München, Germany
| | - B Ertl-Wagner
- Institute for Clinical Radiology, Ludwig-Maximilians-University Munich, Germany
| | - H Bolz
- Bioscientia, Center for Human Genetics, Ingelheim, Germany
| | - C Bergmann
- Bioscientia, Center for Human Genetics, Ingelheim, Germany; Children's University Hospital, Zürich, Switzerland
| | - O Rittinger
- Clinical Genetics Unit, Children's Hospital, Paracelsus Medical University, Salzburg, Austria
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Schaarschmidt J, Jaeschke H, Eszlinger M, Huth S, Puttinger R, Rittinger O, Meiler J, Paschke R. A newly discovered TSHR variant (L665F) associated with non-autoimmune hyperthyroidism in an Austrian family induces constitutive TSHR activation by steric repulsion between TM1 and TM7. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Höckner M, Spreiz A, Frühmesser A, Tzschach A, Dufke A, Rittinger O, Kalscheuer V, Singer S, Erdel M, Fauth C, Grossmann V, Utermann G, Zschocke J, Kotzot D. Parental origin of de novo cytogenetically balanced reciprocal non-Robertsonian translocations. Cytogenet Genome Res 2012; 136:242-5. [PMID: 22516930 DOI: 10.1159/000337923] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2012] [Indexed: 11/19/2022] Open
Abstract
De novo cytogenetically balanced reciprocal non-Robertsonian translocations are rare findings in clinical cytogenetics and might be associated with an abnormal phenotype. Knowledge of the parental origin and mechanisms of formation is still limited. By microdissection of the derivative chromosomes and their normal homologs from metaphases followed by microsatellite-mediated marker analysis we identified 7 cases of paternal and 3 cases of maternal origin in a cohort of 10 patients with de novo cytogenetically balanced reciprocal non-Robertsonian translocations. Neither in the maternal nor in the paternal group of our study parental age seems to be increased. Together with the data from the literature our results confirm that the majority of de novo cytogenetically balanced reciprocal translocations are of paternal origin, but the preponderance does not appear to be as distinct as previously thought and the paternal age does not seem to be necessarily a major contributing factor.
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Affiliation(s)
- M Höckner
- Division of Human Genetics, Department of Medical Genetics, Molecular and Clinical Pharmacology, Innsbruck Medical University, Austria
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Furthner D, Biebl A, Weinzettel R, Schmitt K, Lahr G, Ebetsberger G, Rittinger O, Schulz AS. Osteopetrosis due to Homozygous Chloride Channel ClCN7 Mutation Mimicking Metabolic Disease with Haematological and Neurological Impairment. Klin Padiatr 2009; 222:180-3. [DOI: 10.1055/s-0029-1233492] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Rittinger O, Sander G, Schaller A, Gallati S, Mayr H, Sperl W. [Menkes' disease: heterozygosity testing by quantitative real-time PCR and the dilemma of therapeutic support]. Klin Padiatr 2005; 217:286-90. [PMID: 16167277 DOI: 10.1055/s-2005-832314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Menkes' disease is a rare X-linked multisystemic lethal disorder of copper transport metabolism. Failure of synthesis of several copper enzymes explains most of the clinical features, which were characterised by neurodegenerative symptoms and connective tissue manifestations. Most cases are still prone to rapidly progressive cerebral degeneration and early death in the first few years. Since CNS-dysfunction usually preceeds development of the pathognomonic "steely" hair, delay of clinical diagnosis and onset of therapeutic intervention precludes longlasting neurological benefit. This is particularly true for patients with large deletions or severe truncations of the responsible ATP7A gene. We report on our own experience with a patient, who was diagnosed to be affected by Menkes' syndrome at the age of one year, due to the specific hair texture and biochemical abnormalities. Molecular investigation revealed a total deletion of exon 15 of the ATP7A gene. Heterozygosity was confirmed by means of real-time PCR in the child's mother, but could be excluded in the grandmother and other female relatives at risk. Therapeutic support with subcutaneous injection of copper-histidinate normalised diminished copper and coeruloplasmin serum levels, but was unable to influence the clinical course and to prevent the fatal outcome at the age of two years. This observation is in line with the experience of the literature claiming that currently available medication will hardly be able to normalise brain copper levels. However, observations of clinical variants of Menkes' disease with quite a different outcome and, more importantly, emerging of alternative copper transport pathways might still justify this time-limited therapeutic intervention.
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Affiliation(s)
- O Rittinger
- Universitätsklinik für Kinder- und Jugendheilkunde, Paracelsus Medizinische Privatuniversität Salzburg, Osterreich.
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Rittinger O, Kotzot D. Epigenetik und pädiatrische Krankheitsbilder. Monatsschr Kinderheilkd 2005. [DOI: 10.1007/s00112-005-1169-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Messmer EM, Kenyon KR, Rittinger O, Janecke AR, Kampik A. Ocular manifestations of keratitis– ichthyosis–deafness (KID) syndrome. Ophthalmology 2005; 112:e1-6. [PMID: 15691545 DOI: 10.1016/j.ophtha.2004.07.034] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2004] [Accepted: 07/20/2004] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE Keratitis-ichthyosis-deafness (KID) syndrome is a rare congenital ectodermal dysplasia characterized by the association of hyperkeratotic skin lesions, moderate to profound sensorineural hearing loss and vascularizing keratitis. Mutations in the GJB2 gene coding for connexin 26, a component of gap junctions in epithelial cells, have been observed in several KID patients. Variable ocular manifestations of the disease in 3 patients with molecular genetically confirmed KID syndrome are reported. DESIGN Retrospective case series. METHODS Clinical examination and molecular genetic analysis for mutations in the GJB2 gene were performed in 3 patients with KID syndrome ages 5, 13, and 41 years. RESULTS Visual acuity ranged from normal to severe visual loss. The ocular signs included loss of eyebrows and lashes, thickened and keratinized lids, trichiasis, recurrent corneal epithelial defects, superficial and deep corneal stromal vascularization with scarring, keratoconjunctivitis sicca, and, in one patient, presumed limbal insufficiency. Whereas ocular surface integrity could be maintained with artificial tears in one patient, and an epithelial defect healed under conservative treatment in the second patient, multiple surgical procedures including superficial keratectomies, limbal allograft transplantation with systemic immunosuppression, amniotic membrane transplantation, lateral tarsorrhaphies, and lamellar keratoplasty could not preserve useful vision in the third patient. CONCLUSIONS KID syndrome may affect the ocular adnexae and surface with variable severity independent of the age of the patient. Lid abnormalities, corneal surface instability, limbal stem cell deficiency with resulting corneal complications, and dry eye are the main ocular manifestations.
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Affiliation(s)
- E M Messmer
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
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Weise A, Rittinger O, Starke H, Ziegler M, Claussen U, Liehr T. De novo 9-break-event in one chromosome 21 combined with a microdeletion in 21q22.11 in a mentally retarded boy with short stature. Cytogenet Genome Res 2004; 103:14-6. [PMID: 15004457 DOI: 10.1159/000076284] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2003] [Accepted: 09/02/2003] [Indexed: 11/19/2022] Open
Abstract
We report on a moderately mentally retarded 12-year-old boy of short stature showing the most complex chromosomal rearrangement (CCR) within a single chromosome ever described. A de novo derivative chromosome 21 was recognized in GTG-banding shortly after birth. However, the nature of the rearrangement remained obscure up to the application of the chromosome 21-specific centromere-near multicolor-FISH (subcenM-FISH) probe set and of six selected locus-specific probes along chromosome 21. An unbalanced 9-break-event was uncovered with breakpoints in 21p13, 21p13-->12, 21q11.2, 21q21.1, 21q22.11, 21q22.11, 21q22.12, 21q22.22 and 21q22.3. A deletion of 21q22.11 was detected by application of the BAC probe bk249H10. The karyotype can be described as 46,XY,der(21)(:p13-->p1213::q22.3-->q22.22:: q11.2-->p1213::q11.2-->q21.1::q22.11-->q21.1::q22.12--> q22.22::p13-->p13). The clinical signs can either be due to gene inactivation in connection with structural changes at the break and fusion regions, to the building of new fusion genes within the CCR and/or to the deletion of genes in 21q22.11.
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Affiliation(s)
- A Weise
- Institut für Humangenetik und Anthropologie, Jena, Germany
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Abstract
Craniopharyngioma is the third most common intracranial tumor in childhood. Following surgery, virtually all patients present with hypopituitarism and are at considerable risk of tumor recurrence. Secondary tumors, however, are rare, occurring usually 10 years after diagnosis and associated with poor prognosis. We report on a 5 year-old boy in whom craniopharyngioma was diagnosed due to unilateral visual loss. After surgery he underwent conventional radiation therapy with a total tumor dose of 55 Gy, and had hormonal support with DDAVP, thyroxine, and a variable dose of hydrocortisone. Growth velocity declined slowly in the first 4 years, but improved later on again without GH therapy despite abnormal provocative tests. At the age of 15 years he developed peripheral facial nerve palsy due to a malignant astrocytoma (WHO grade III/IV). Repeated conventional radiation therapy with an additional stereotactic boost and chemotherapy could not prevent the fatal outcome. This observation may temper the use of radiosurgery in benign intracranial tumors.
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Affiliation(s)
- O Rittinger
- Clinical Genetics, Children's Hospital, Landeskliniken Salzburg, Austria.
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Abidi FE, Holinski-Feder E, Rittinger O, Kooy F, Lubs HA, Stevenson RE, Schwartz CE. A novel 2 bp deletion in the TM4SF2 gene is associated with MRX58. J Med Genet 2002; 39:430-3. [PMID: 12070254 PMCID: PMC1735161 DOI: 10.1136/jmg.39.6.430] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
Monosomy 1p36 is a recently delineated contiguous gene syndrome, which is now considered to be one of the most common subtelomeric microdeletion syndromes. We report four unrelated patients with subtle deletions within 1p36 confirmed by high resolution karyotyping and FISH. All exhibited severe psychomotor retardation. Microcephaly, seizures, and visual impairment occurred in three subjects. Results of a first routine karyotyping were unrevealing in three probands. The diagnosis was primarily suggested on the basis of a distinct pattern of facial anomalies in all except the first case. This report illustrates that monosomy 1p36 may be recognized clinically, at least in some patients, whereas the diagnosis is easily missed on routine karyotype.
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Affiliation(s)
- M Zenker
- Institut für Humangenetik der Universität Erlangen-Nürnberg, Germany.
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Fauth C, Zhang H, Harabacz S, Brown J, Saracoglu K, Lederer G, Rittinger O, Rost I, Eils R, Kearney L, Speicher MR. A new strategy for the detection of subtelomeric rearrangements. Hum Genet 2001; 109:576-83. [PMID: 11810269 DOI: 10.1007/s00439-001-0629-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2001] [Accepted: 09/13/2001] [Indexed: 10/28/2022]
Abstract
We present a new strategy for the detection of subtelomeric rearrangements. This approach is based on two hybridizations with different probe sets. The first set consists of microdissected subtelomeric probes (each 5-10 megabases in size) labeled combinatorially employing 7 different fluorochromes. With this set, subtelomeric interchromosomal exchanges can be detected in a 24-color experiment. The second set comprises a second generation of subtelomeric PAC-, P1- and BAC-clones. Probes for p- and q-arms are labeled with two different colors. This second set detects small deletions; in addition it provides regional information, so that translocated material identified by the first probe set can be assigned to the p- or q-arm of a chromosome. The test has been evaluated in a blind study on a series of subtle translocations and deletions.
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Affiliation(s)
- C Fauth
- Institut für Humangenetik, Technische Universität München, Trogerstr. 32, D-81675 München, Germany.
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Abstract
UNLABELLED Prader-Willi syndrome (PWS) is considered to be a rare neurogenetic disorder, nevertheless it represents the most common syndromatic obesity. Main features are severe hypotonia in the newborn period with feeding difficulty and failure to thrive in the first few months, and improvement in later infancy. Between 1 and 6 years the development of a marked truncal obesity is observed, sometimes later on reaching a life-threatening degree. Apart from retarded motor development speech ability is also hampered due to dysfunction of oropharyngeal muscles. Moreover, intellectual impairment is observed that leads to mostly moderate learning difficulty due to deficits in short term memory and abstract thinking. The genetic background of PWS is loss of function of a paternally inherited gene cluster on chromosome 15q11.2, therefore representing a paradigm of an epigenetic phenomenon with silencing and activating of genes depending on their parental origin. Together with the Angelman-Syndrome (AS), genetically located in the same region but clinically different PWS was identified as one of the first human disorders to be caused by the mechanism of genomic imprinting. There are some different genotypes in PWS leading to a quite similar phenotype with small differences e.g. in the pigment expression. An early diagnosis is important because the neuromuscular dysfunction improves with appropriate physiotherapy. Even more, dietary programs with periodical calorie restricted meals can counteract development of morbid obesity with subsequent complications of cardiovascular disorders and diabetes. Clinical diagnosis remains difficult especially in the newborn period and is considered mostly because of the marked hypotonia. Today, the availability of molecular testing of loss of function in the paternal inherited PWS candidate gene makes a definitive diagnosis possible as a prerequisite of symptomatic therapy. One of the most recommended therapeutic interventions is the application of recombinant human growth hormone (rhGH) which has been shown to be useful for improvement of length, physical ability and favourable influence on respiratory problems by a lot of clinical studies. SUMMARY Early diagnosis by means of molecular methods is helpful for comprehensive genetic counseling. It may avoid unnecessary investigations like computed tomography of the brain and muscle biopsy and it enables parents and professionals to start a purposeful therapy. Although it remains a symptomatic tool, GH therapy appears to be useful for most of the patients. Considering the multimorbidity in PWS a multidisciplinary approach seems appropriate for this still mystical condition.
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Affiliation(s)
- O Rittinger
- Klinische Genetik am Kinderspital, St.-Johanns-Spital, Salzburg
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Kranzinger M, Jones N, Rittinger O, Pilz P, Piotrowski WP, Manzl M, Galvan G, Kogelnik HD. Malignant glioma as a secondary malignant neoplasm after radiation therapy for craniopharyngioma: report of a case and review of reported cases. Onkologie 2001; 24:66-72. [PMID: 11441284 DOI: 10.1159/000050285] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The development of a secondary neoplasm in childhood cancer survivors attains growing importance due to the reported excellent survival and therefore the long exposure to potentially carcinogenic effects of treatment. CASE REPORT We report a 14-year-old girl in whom a large craniopharyngioma (CP) was diagnosed. After surgery, radiation therapy (RT) was given for residual tumour. Discrete progression necessitated further surgery, resulting in permanent tumour control. Soon after the second surgery hypothalamic-pituitary dysfunction developed together with obesity. Supportive hormone therapy was initiated. Growth hormone (GH) therapy was also given for 15 months. Four years after the diagnosis, a cerebropontine anaplastic astrocytoma WHO grade III was detected, with the main lesion being at the dorsal edge of the irradiated area. The girl died 1 month later from this secondary presumably radiation-induced tumour. Only recently a second child with RT for a CP was diagnosed with malignant glioma in our hospital. CASE REPORTS IN THE LITERATURE: 12 other cases of malignant glioma have been reported after RT for CP. Including our present cases, the mean latency period was 10.7 years (median 9.6 years). However, the shortest latency periods were found in patients who had received GH therapy. In numerous cases, the secondary tumour was seen at the edge of the irradiated volume, and not in the region with the highest absorbed dose. CONCLUSIONS Therapy-induced secondary gliomas after treatment of CP or other intracranial tumours are rare but dramatic late events with a very poor prognosis. Including our own 2 patients, we reviewed 14 cases of CP with occurrence of a secondary, probably radiation-induced malignant glioma. The short latency periods for patients treated with GH is remarkable. We therefore suspect that GH therapy may accelerate the development of a secondary brain tumour. We are reluctant to recommend GH therapy in conventionally irradiated CP patients. In order to seriously answer the questions about therapy-induced secondary neoplasms, a life-long follow-up is mandatory for all patients who are survivors of childhood cancer.
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Affiliation(s)
- M Kranzinger
- Institut für Radiotherapie und Radio-Onkologie, St.-Johannes-Spital, Landeskliniken Salzburg, Salzburg.
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Bohring A, Lewin SO, Reynolds JF, Voigtländer T, Rittinger O, Carey JC, Köpernik M, Smith R, Zackai EH, Leonard NJ, Gritter HL, Bamforth JS, Okun N, McLeod DR, Super M, Powell P, Mundlos S, Hennekam RC, van Langen IM, Viskochil DH, Wiedemann HR, Opitz JM. Polytopic anomalies with agenesis of the lower vertebral column. Am J Med Genet 1999; 87:99-114. [PMID: 10533024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
We describe clinical, pathological and radiological findings in 15 cases of sporadic and familial lower spine agenesis with additional anomalies of the axial skeleton and internal organs and speculate about the cause and pathogenesis of this malformation complex. We show that all of these findings are defects of blastogenesis, originate in the primary developmental field and/or the progenitor fields, thus representing polytopic field defects. This concept appears applicable in our cases and makes such terms such as "caudal regression syndrome" or "axial mesodermal dysplasia spectrum" redundant.
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Affiliation(s)
- A Bohring
- Department of Pediatrics, Ostholstein Kliniken, Eutin, Germany.
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Rittinger O, Weiss-Wichert P, Hasenöhrl G. Bilateral hydronephrosis due to megacalicosis as a prenatal sonographic finding in a female with Schinzel-Giedion syndrome. Clin Dysmorphol 1999; 8:291-3. [PMID: 10532180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
A case of Schinzel-Giedion syndrome, a rare malformation syndrome with a life expectancy of less than 2 years is described. Features present in this and previous cases are discussed. The association of agenesis of the corpus callosum with the Arnold-Chiari malformation found in this patient has not previously been described.
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Holinski-Feder E, Chahrockh-Zadeh S, Rittinger O, Jedele KB, Gasteiger M, Lenski C, Murken J, Golla A. Nonsyndromic X-linked mental retardation: mapping of MRX58 to the pericentromeric region. Am J Med Genet 1999; 86:102-6. [PMID: 10449641 DOI: 10.1002/(sici)1096-8628(19990910)86:2<102::aid-ajmg2>3.0.co;2-c] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
An Austrian family with nonsyndromic X-linked mental retardation (MRX) is reported in which the obligatory carrier females are normal, and 5 affected males have mild to moderate mental retardation. Linkage analysis indicated an X pericentromeric localization, with flanking markers DXS989 and DXS1111 and a maximum multipoint LOD score of 2.09 (straight theta = 0) for the 7 cosegregating markers DXS1243, CybB, MAOB, DXS988, ALAS2, DXS991, and AR. MRX58 thus mapped within a 50-cM interval between Xp11.3 and Xq13.1 and overlapped with 23 other MRX families already described. This pericentromeric clustering of MRX families suggests allelism, with a minimum of 2 X-linked mental retardation (XLMR) genes in this region.
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Affiliation(s)
- E Holinski-Feder
- Abteilung Medizinische Genetik der Kinderpoliklinik, München, Germany.
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18
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Plöchl E, Vlasak I, Rittinger O, Bergendi E, Stopar M, Kurnik P, Nachtigall M, Zierler H, Rappold GA, Schiebel K. Clinical, cytogenetic and molecular analysis of three 46,XX males. J Pediatr Endocrinol Metab 1999; 12:389-95. [PMID: 10821218 DOI: 10.1515/jpem.1999.12.3.389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cytogenetic analysis, fluorescent in situ hybridization (FISH) and polymerase chain reaction (PCR) were applied to characterize the Y-chromosomal breakpoints of three XX male patients. Two of these patients show a breakpoint within a protein kinase gene, PRKY, previously described as a hotspot of ectopic recombination between homologous regions on X and Y chromosomes during male meiosis. The slightly different clinical phenotypes of the three patients cannot be correlated with the localization of the breakpoints.
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Affiliation(s)
- E Plöchl
- Clinical Genetics, Children's Hospital, Salzburg, Austria
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19
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Vlasak I, Plöchl E, Kronberger G, Bergendi E, Rittinger O, Hagemann M, Schmitt K, Blümel P, Glatzl J, Fekete G, Kadrnka-Lovrencic M, Borkenstein M, Häusler G, Frisch H. Screening of patients with Turner syndrome for "hidden" Y-mosaicism. Klin Padiatr 1999; 211:30-4. [PMID: 10067216 DOI: 10.1055/s-2008-1043759] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The presence of Y-chromosomal sequences in the cells of patients with Turner-Syndrome (TS) is a risk factor for the development of gonadal tumors. Therefore and since demonstration of Y-material usually results in prophylactic gonadectomy optimal sensitivity and specificity of the diagnosis have to be attempted. We wanted to evaluate the diagnostic potential of cytogenetic investigations as routinely employed in TS. In the most comprehensive study published so far we screened 208 TS patients for the presence of Y-chromosomal sequences by polymerase chain reaction (PCR) specific for eight different loci along the Y-chromosome. Six patients (3%) without cytogenetic evidence of Y-chromosome were found to be Y-positive. Among 12 cases with marker chromosomes two more Y-chromosomal fragments were identified. Thus, PCR-screening for Y-specific sequences was shown to be a valuable tool in the clinical management of Turner patients.
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Affiliation(s)
- I Vlasak
- Klinische Genetik am Kinderspital, Landeskrankenanstalten Salzburg, Austria
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20
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Bergendi E, Plöchl E, Vlasak I, Rittinger O, Muss W. A Turner-like phenotype in a girl with an isodicentric fluorescent Y chromosome mosaicism. Klin Padiatr 1997; 209:133-6. [PMID: 9183775 DOI: 10.1055/s-2008-1043943] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The Ullrich-Turner syndrome (UTS) demonstrates a great clinical variability according to the cytogenetic and molecular genetic findings in various tissues. In few cases the karyotype reveals the presence of an additional Y-bearing cell line which is referred to as a borderline case of mixed gonadal dysgenesis. In this condition, Turner specific stigmata occur in about half of the cases. PATIENT A 10 year-old girl with short stature and only a few other signs of Turner syndrome and hypertrophic clitoris revealed 45,X/46,X,idic(Yq) mosaicism with 41% 46,X,idic(Yq) cells in a blood lymphocyte culture. METHODS AND RESULTS Fluorescence in situ hybridisation (FISH) technique, using alpha-satellite Y-chromosome specific probe for locus DYZ3, confirmed the isodicentric character of this structurally abnormal Y chromosome. Polymerase chain reaction (PCR) analysis using primers for eight loci along the Y chromosome including SRY (Sex determining Region, Y gene) were positive for all loci tested, indicating that sequences from the long arm, centromere and most of the short arm of the Y chromosome are present. CONCLUSIONS As patients with normal or rearranged Y chromosome have an increased risk of developing gonadal neoplasia prophylactic gonadectomy was performed in our patient. No evidence for gonadoblastoma was found on her streak-like gonads, but they showed some evidence of tubular formation. This paper points out the impact of cytogenetic and molecular genetic investigations in the definition of mosaicism in Turner's syndrome.
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Affiliation(s)
- E Bergendi
- Klinische Genetik am Kinderspital, Salzburg, Austria
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21
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Abstract
Two genes responsible for a nonspecific form of X-linked mental retardation (MRX28 and MRX33) were localized by linkage analysis with 40 highly polymorphic DNA markers situated along the entire the X chromosome. In family 1, the gene could be mapped within a 14-cM interval at Xq28, distal to the recombining marker DXS1113 (MRX28). The maximum LOD score was 2.75, with DXS52 at phi = .0. In family 2, the gene was localized within a 30-cM interval at Xp11.4-22.12 between the recombining markers DXS365 and MAOB, including the DMD gene (MRX33). Maximum LOD scores of 2.82 were obtained with markers DMD-STR49, DMD-DysII, CYBB, and DXS1068.
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Affiliation(s)
- E Holinski-Feder
- Abteilung Pädiatrische Genetik an der Kinderpoliklinik der Ludwig-Maximilians-Universität München, Germany
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22
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Abstract
Klinefelter's syndrome with karyotype 47,XXY in patients with primary extragonadal germ cell tumors rarely occurs. The endocrinology of Klinefelter's syndrome is changed; elevated beta-human choriomic gonadotropin levels are present. Chemotherapy and thoracic surgery brought complete remission in a patient with lung metastases.
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Affiliation(s)
- H Joos
- Department of Urology, General Hospital, Salzburg, Austria
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23
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Plöchl E, Rittinger O, Doringer E, Laubichler W. [Neonatal form of a nonketotic hyperglycinemia in consanguinous parents]. Klin Padiatr 1991; 203:455-7. [PMID: 1758150 DOI: 10.1055/s-2007-1025473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This is a report of the neonatal form of nonketotic hyperglycinemia with rapid progressing neurological symptoms, respiratory distress and seizures. The EEG pattern is characteristic, the ratio of cerebrospinal fluid to plasma glycine abnormally high. The result of cranial computerized tomography demonstrates also in our patient that nonketotic hyperglycinemia joins a growing list of inborn errors of metabolism associated with brain malformations. The consanguinity of parents supports the known autosomal recessive form of inheritance.
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Affiliation(s)
- E Plöchl
- Kinderspital Landeskrankenanstalten Salzburg
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Irnberger T, Plöchl E, Rittinger O, Bachmann C, Pilz P, Walter GF, Wendel U. [Cranial computed tomography in maple syrup urine disease]. ROFO-FORTSCHR RONTG 1986; 144:413-7. [PMID: 3008253 DOI: 10.1055/s-2008-1048814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Cranial computed tomography in the initial stage of the intermediate phenotype of maple syrup urine disease (MSUD) demonstrates diffuse, symmetric hypodensities in white and grey matter, which show a complete return to normal after early introduction of an adequate protein-restrictive diet. If diagnosis of this disease is missed or delayed, progressive global (end-stage) atrophy will take place over several years. A decrease in density values correlates well with the total cerebral lipid and water content (closely related to myelinisation), whereas progression and grade of atrophy show a relationship with the severity of pathological white and grey matter changes that are not demonstrable with computed tomography but can be proven histologically. Analysis of both morphological parameters corresponds well with clinical-neurological outcome and therapeutic success.
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Rittinger O, Bachmann C, Irnberger T, Pilz P, Walter GF, Wendel U, Plöchl E. [The intermediate form of maple syrup disease]. Klin Padiatr 1986; 198:37-43. [PMID: 3959487 DOI: 10.1055/s-2008-1026850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A severely retarded and tetraspastic child died at the age of four years upon a respiratory infection with acidosis, disturbances of serum electrolytes and lactic aciduria. Brain autopsy showed a spongy degeneration and led to suspect an inborn error of amino-acid metabolism. These findings corresponded with the results of computer-tomography and were supported by post mortem amino-acid analysis. An intermediate variant of leucinosis was detected in an younger sister at the age of five months after cerebral convulsions and opisthotonic posture. The activity of the branched chain ketoacid decarboxylase in fibroblasts was reduced to 3-4% of normal. A protein restricted diet allowed a nearly normal cerebral development and improvement of computer-tomographic results. The similarity of clinical and biochemical data in both children indicate that a maple syrup urine disease was most likely the underlying disease in the older sister. Later performed electron-microscopical examinations of the older sister indicate that spongy degeneration of the central nervous system in leucinoisis is caused by a spongy myelinopathy, which is different from the alterations found in Canavan's disease, what could be pointed out for the first time.
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26
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Rittinger O, Plöchl E, Jarosch E. [Maternal phenylketonuria]. Padiatr Padol 1984; 19:87-92. [PMID: 6701000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
We report about the child of a mother with phenylketonuria, which is not suffering from PKU, but is microcephalic and mentally retarded. This retardation is probably a sequel of an intrauterine Hyper-Phenylalanine-status. It is supposed that an intrauterine damage of the offspring even in cases with low Phenylalanine-levels of the mother is possible.
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