Clinico-epidemiologic characteristics of spinal muscular atrophy among Egyptians

Spinal muscular atrophy [SMA] is characterized by progressive hypotonia and muscular weakness because of progressive degeneration of alpha motor neuron from anterior horn cells in the spinal cord. It is inherited by an autosomal recessive pattern. The precise frequency of SMA in Egypt has not been determined. We tried to estimate the frequency, clinical and molecular characteristics of SMAin Egypt. The study included all patients withSMAattended the Pediatric Hospital, Ain-Shams University during the period [year 1966-2009]. The study included 117 patients with SMA out of 660,280 patients attending the Pediatric Hospital. Patients selection was based on clinical examination, CPK, EMG, nerve conduction velocity, histopathology and molecular diagnosis. Frequency of SMA was 17.7/100,000, which is considered high. Type I was the commonest type [60.6%], followed by type II [26.79%], and type III [8.8%]. Consanguinity was reported in 45.5 and family history in 47.8% of patients. Molecular study was done and 54.5% of patients [types I and II] have homozygous deletion of exon 7, 36.3% of whom had also homozygous deletion of exon 8 of SMN1gene which is considered lower than that reported in other countries. SMA is more prevalent in Egypt than in many other countries. Forty-five percent of patients were chromosome 5-unlinked. We should continue to search for other mutation in Egypt to facilitate detection of carriers and prenatal diagnosis

Corpus callosum defect with dilated lateral ventricles and an occipital cyst in an Egyptian child with Diamond-Blackfan anemia

Diamond-Blackfan anemia [DBA], an inherited bone marrow failure syndrome characterized by anemia that usually presents before the first birthday or in early childhood, is associated with birth defects and an increased risk of cancer. Although anemia is the most prominent feature of DBA, the disease is also characterized by growth retardation and congenital malformations, in particular craniofacial, upper limb, heart, and urinary system defects that are present in approximately 30%-50%of patients. Herein, we present a patient with Diamond-Blackfan anemia associated craniofacial anomalies, pyramidal manifestations and corpus callosum defect and dilated lateral ventricles opening with each other and opening with a posterior occipital cyst, an association that to date has not been reported

Clinico-epidemiologic features of oculocutaneous albinism in northeast section of Cairo - Egypt

Oculocutaneous albinism [OCA] is a genetically heterogeneous group of disorders characterized by the absence or reduced pigmentation of the skin, hair and eyes. To assess the clinico-epidemiologic features of different forms of OCA among Egyptian patients, we performed a retrospective study to determine the frequency, types, clinical presentation and associated genomic errors in albino patients and their relatives consulting the Genetics Clinic, Pediatric Hospital, Ain Shams University, Cairo, Egypt. We used the outpatients index files to identify diagnosed cases of albinism referred from the dermatologic and ophthalmologic departments with different genodermatoses over 43 year period. We used specifically designed data collection protocol forms to extract epidemiological and clinical data from the patients medical records. These were entered into a computer database and analyzed using standard statistical software. The occurrence rate of albinism in our study was 20.4% of genodermatoses patients and 1 per 5843 patients attending the Pediatric hospital. Consanguineous marriage was reported among parents of 66.37% of patients and positive family history was reported in 46.01% of patients. Complete OCA was detected in 48.59% of patients, partial albinism in 41.59% of patients and syndromic albinism was detected in 7.96%. Associated genomic errors were detected in 36.28% of our albino patients and seventy one multiple mutant genomic errors were defined among relatives of thirty seven index families of oculocutaneous albinism patients. To the best of our knowledge, this preliminary study is the first report of its kind from Egypt. The high rate of parental consanguinity among the parents of our Egyptian albino patients may account for the frequency of this genodermatosis in Egypt

Gene analysis and carrier detection of Duchenne muscle dystrophy in Egyptian families

Duchenne and Becker muscular dystrophy [D/BMD] are X-linked recessive disorders resulting from mutations in the DMD gene. Since there is no cure or effective treatment for progressive muscular dystrophy, prevention of the disease is important and strongly depends on carrier status in-formation. Two-thirds of DMD/BMD cases are familial, thus female relatives are candidates for carrier-risk assessment. Segregation analysis of polymorphic short tandem [CA]n repeats [STR-[CA]n] was used to establish and compare the haplotypes of DMD patients with those of their at-risk relatives in order to determine the carrier status. However, 59 D/BMD index families and 35 of their at-risk female relatives were analyzed using the ion-pair reversed phase high performance liquid chromatography [IP-RP-HPLC] method. Comparison between the results of CPK of the carriers and linkage analysis revealed that values higher than the normal level were compatible in 100% of the cases with the carrier status. On the other hand, normal values do not distinguish between the healthy and carrier populations. In conclusion, the unlabeled IP-RP-HPLC-STR assay represents an excellent molecular tool for carrier-status identification and consequently the genetic counseling for the early prevention of such diseases

Comprehensive rapid identification of female carriers of DMD/BMD by ion-pair reversed-phase high performance liquid chromatography

The unlabeled ion-pair reversed-phase high performance liquid chromatography [IP-RP-HPLC] was used in this study to develop a simple and rapid method for rapid identification of female carriers of the dystrophin gene. DNA molecular size markers were efficiently used to type the 2-bp short tandem repeat [STR]. In an Egyptian sample of 98 chromosomes, the most common alleles within the DMD gene were 200, 176, 245 and 243 bp due to STR44, 45, 49, and 50 markers, respectively. The true heterozygosity values of these markers ranged from 73.5 to 90.9% and observed allele numbers ranged from 8 to 17 in 98 chromosomes, revealing high polymorphism of the four [CA]n system of the DMD gene