ABSTRACT
OBJECTIVE: To evaluate the cardiovascular findings and clinical follow-up of patients with Williams-Beuren syndrome. METHODS: We studied 20 patients (11 males, mean age at diagnosis: 5.9 years old), assessed for cardiovascular abnormalities with electrocardiography and Doppler echocardiography. Fluorescence in situ hybridization (FISH) was used to confirm the diagnosis of the syndrome. RESULTS: Elastin gene locus microdeletion was detected in 17 patients (85 percent) (positive FISH), and in 3 patients deletion was not detected (negative FISH). Sixteen patients with a positive FISH (94 percent) had congenital cardiovascular disease (mean age at diagnosis: 2,3 years old). We observed isolated (2/16) supravalvular aortic stenosis and supravalvular aortic stenosis associated (11/16) with pulmonary artery stenosis (4/11); mitral valve prolapse (3/11); bicuspid aortic valve (3/11); aortic coarctation (2/11), thickened pulmonary valve (2/11); pulmonary valvular stenosis (1/11); supravalvular pulmonary stenosis (1/11); valvular aortic stenosis (1/11); fixed subaortic stenosis (1/11); pulmonary artery stenosis (2/16) associated with pulmonary valvar stenosis (1/2) and with mitral valve prolapse (1/2); and isolated mitral valve prolapse (1/16). Four patients with severe supravalvular aortic stenosis underwent surgery (mean age: 5.7 years old), and 2 patients had normal pressure gradients (mean follow-up: 8.4 years). CONCLUSION: A detailed cardiac evaluation must be performed in all patients with Williams-Beuren syndrome due to the high frequency of cardiovascular abnormalities
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Heart Defects, Congenital/diagnosis , Heart Defects, Congenital/genetics , In Situ Hybridization, Fluorescence , Williams Syndrome/genetics , Follow-Up Studies , Heart Defects, Congenital/etiology , Prospective Studies , Retrospective Studies , Williams Syndrome/complicationsABSTRACT
Objetivo: alertar pediatras, geneticistas e oftalmologistas para os aspectos oftalmologicos observados na sindrome de Williams-Beuren (SWB). Casuistica e metodos: realizou-se avaliacao...
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Chromosomes, Human , Eye Abnormalities , Williams Syndrome/diagnosis , Amblyopia , Cytogenetic Analysis , Elastin , In Situ Hybridization, Fluorescence , Iris , StrabismusABSTRACT
A síndrome de Williams-Beuren (SWB) é uma rara síndrome de deleçäo de genes contíguos que feta múltiplos sistemas. A doença é causada por uma deleçäo submicroscópica na regiäo 7q11.23, que é detectada pela análise de Fish em 90-95 por cento dos pacientes. Relatamos o estudo clínico e a análise citogenética por Fish realizados em 11 pacientes (6M:5F), todos esporádicos. Fácies típicos de "duende", atraso de desenvolvimento/retardo mental, anomalias dentárias e esqueléticas estavam presentes em todos os pacientes; anomalias oculares em dez (91 por cento); cardiopatias congênitas em oito (73 por cento), sendo metade, estenose supravalvar aórtica; baixa estatura em seis (54 por cento); hipercalcemia transitória em quatro (36 por cento); hérnia inguinal em três (27 por cento) e anomalias renais em dois (18 por cento). Analisanmos a hemizigosidade do gene da elastina por Fish, utilizando a sonda LSI Williams Syndrome Region DNA Fish (Vysis) nas células interfásicas e metafásicas. O paciente sem deleçäo apreentava fácies e comportamento tópico, exceto cardiopatia. A análise pelo Fish do locus da elastina é um teste útil para confirmaçäo diagnóstica da SWB, o que auxilia no seguimento clínico adequado e na prevençäo das complicaçöes