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1.
Arch. argent. pediatr ; 115(6): 449-453, dic. 2017. ilus, tab
Artigo em Espanhol | LILACS (Américas), BINACIS | ID: biblio-887412

RESUMO

La microdeleción 16p11.2 se relaciona, habitualmente, con discapacidad intelectual y trastornos del espectro autista. El rango fenotípico incluye un espectro que se extiende desde discapacidad intelectual con o sin autismo, alteraciones del aprendizaje y del lenguaje hasta fenotipos normales. El diagnóstico de la microdeleción se realiza mediante estudios genómicos capaces de identificar variación en número de copias, como la hibridación genómica comparativa en microarreglos, conocida como arrayCGH. Sin embargo, la predicción del fenotipo de un individuo basada únicamente en la localización de dicha deleción sigue siendo un desafío, ya que la existencia de un gran número de variantes en el genoma dificulta la interpretación de posibles efectos funcionales de los genes que contribuyen a dicha región. Se describen dos casos clínicos de pacientes con microdeleción heterocigota en 16p11.2 y se destacan los hallazgos fenotípicos y conductuales que dificultaron la estrategia diagnóstica. También se discuten las implicancias del diagnóstico para el asesoramiento genético familiar.


The 16p11.2 recurrent microdeletion phenotype is characterized by developmental delay, intellectual disability, and/or autism spectrum disorder. This microdeletion is associated with variable clinical outcome, the phenotypical spectrum ranges from intellectual disability and/or multiple congenital anomalies, autism, learning and speech problems, to a normal phenotype. Genomic testing that determines copy number of sequences, such as chromosomal microarray, is used to identify this microdeletion. However, the prediction of the individual phenotype of a patient based only on the location of such deletion remains a challenge, regarding the existence of many genomic variants that might hinder the interpretation of possible functional effects between most of the contributing genes to that region. We describe the clinical findings in two subjects with heterozygous microdeletions at 16p11.2, highlighting the phenotypic and behavioural findings that conditioned the diagnostic strategy. We also discuss the implications of diagnosis, in practical counselling situations.


Assuntos
Humanos , Masculino , Pré-Escolar , Adolescente , Transtorno Autístico/genética , Cromossomos Humanos Par 16/genética , Deleção Cromossômica , Deficiência Intelectual/genética , Fenótipo
2.
Einstein (Säo Paulo) ; 14(1): 30-34, Jan.-Mar. 2016. tab, graf
Artigo em Inglês | LILACS (Américas) | ID: lil-778498

RESUMO

ABSTRACT Objective To investigate chromosomal abnormalities by CGH-array in patients with dysmorphic features and intellectual disability with normal conventional karyotype. Methods Retrospective study, carried out from January 2012 to February 2014, analyzing the CGH-array results of 39 patients. Results Twenty-six (66.7%) patients had normal results and 13 (33.3%) showed abnormal results - in that, 6 (15.4%) had pathogenic variants, 6 (15.4%) variants designated as uncertain and 1 (2.5%) non-pathogenic variants. Conclusion The characterization of the genetic profile by CGH-array in patients with intellectual disability and dysmorphic features enabled making etiologic diagnosis, followed by genetic counseling for families and specific treatment.


RESUMO Objetivo Avaliar microalterações cromossômicas por CGH-array em portadores de dismorfias e deficiência intelectual com cariótipo normal. Métodos Estudo retrospectivo, realizado no período de janeiro de 2012 a fevereiro de 2014, analisando os resultados de CGH-array de 39 pacientes. Resultados Apresentaram resultados normais 26 (66,7%) pacientes; 13 (33,3%) tiveram resultados alterados, a saber: 6 (15,4%) com variantes patogênicas, 6 (15,4%) com variantes pertencentes à categoria designada como incerta, e 1 (2,5%) com variantes não patogênicas. Conclusão A caracterização do perfil genético por CGH-array nos pacientes com deficiência intelectual e dismorfias possibilitou complementar o diagnóstico etiológico, permitindo a realização do aconselhamento genético para as famílias e tratamento específico.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Cromossomos Humanos Par 6/genética , Aberrações Cromossômicas/classificação , Hibridização Genômica Comparativa/métodos , Deficiência Intelectual/genética , Estudos Retrospectivos , Cariótipo
3.
Egyptian Journal of Medical Human Genetics [The]. 2016; 17 (2): 165-172
em Inglês | IMEMR (Mediterrâneo Oriental) | ID: emr-180234

RESUMO

Background: Fragile X syndrome [FXS] is the most common form of inherited mental retardation. Frequency of fragile X syndrome among male siblings and relatives of mentally retarded patients is relatively high. Cytogenetic diagnosis of FXS is unreliable since it is ineffective for the diagnosis of premutated males or females. Proper molecular diagnosis is a pre-requisite for providing proper counseling advice


Subjects and methods: Sixty-four males with idiopathic mental retardation, ranging in age from 4.2 to 19 years [10.92+/- 4.00] were clinically pre-selected, based on scoring protocol comprising eight features of the syndrome, before molecular testing. A rapid polymerase chain reactionbased screening was applied for detection of expanded FMR1 alleles. Samples that did not yield the normal band lengths were subjected to a second PCR screen. The secondary screen utilizes a chimeric primer demonstrating the presence or absence of an expanded allele


Results: Amplification of FMRI gene by PCR of tested patients revealed that 8 cases [12.5%] have full mutation and 6 cases [9.4%] have premutation. A wide range of Fra X-scoring ranging from 1 to 7 features was detected in examined cases. Significant clinical features included large prominent ears, hyperextensibility of joints and macroorchidism in post pubertal males


Conclusions: A simplified checklist of fragile X should be used for patients with idiopathic MR and those patients above score 3 should be tested for FXS. The diagnostic assay may be used as a screening method for fragile X syndrome being rapid and cost effective compared to other techniques. In addition, screening of all relatives of proven patients should be performed to detect clinically unidentified cases for provision of proper counseling and optimal management of detected cases


Assuntos
Adolescente , Criança , Pré-Escolar , Humanos , Masculino , Proteína do X Frágil de Retardo Mental/genética , Deficiência Intelectual/genética , Cromossomo X , Fragilidade Cromossômica , Ligação Genética , Fenótipo
4.
Säo Paulo med. j ; 133(4): 377-380, July-Aug. 2015. tab, graf
Artigo em Inglês | LILACS (Américas) | ID: lil-763371

RESUMO

CONTEXT: The autosomal recessive form of microcephaly-chorioretinopathy syndrome is a rare genetic condition that is considered to be an important differential diagnosis with congenital toxoplasmosis.CASE REPORT: Our patient was a seven-year-old white boy who was initially diagnosed with congenital toxoplasmosis. However, his serological tests for congenital infections, including toxoplasmosis, were negative. He was the first child of young, healthy and consanguineous parents (fourth-degree relatives). The parents had normal head circumferences and intelligence. The patient presented microcephaly and specific abnormalities of the retina, with multiple diffuse oval areas of pigmentation and patches of chorioretinal atrophy associated with diffuse pigmentation of the fundus. Ophthalmological evaluations on the parents were normal. A computed tomography scan of the child's head showed slight dilation of lateral ventricles and basal cisterns without evidence of calcifications. We did not find any lymphedema in his hands and feet. He had postnatal growth retardation, severe mental retardation and cerebral palsy.CONCLUSIONS: The finding of chorioretinal lesions in a child with microcephaly should raise suspicions of the autosomal recessive form of microcephaly-chorioretinopathy syndrome, especially in cases with an atypical pattern of eye fundus and consanguinity. A specific diagnosis is essential for an appropriate clinical evaluation and for genetic counseling for the patients and their families.


CONTEXTO: A forma autossômica recessiva da síndrome de microcefalia-coriorretinopatia é condição genética rara, considerada um importante diagnóstico diferencial com toxoplasmose congênita.RELATO DO CASO: O paciente era um menino branco de sete anos de idade, inicialmente diagnosticado com toxoplasmose congênita. No entanto, suas sorologias para infecções congênitas, incluindo a toxoplasmose, eram negativas. Ele foi o primeiro filho de pais jovens, hígidos e consanguíneos (parentes de quarto grau). Os pais apresentavam perímetro cefálico e inteligência normais. O paciente apresentava microcefalia e anormalidades específicas da retina com áreas ovais de pigmentação múltiplas e difusas, além de manchas de atrofia coriorretiniana associadas à pigmentação difusa do fundo de olho. A avaliação oftalmológica dos pais foi normal. A tomografia computadorizada de crânio da criança mostrou discreta dilatação dos ventrículos laterais e cisternas basais, sem evidência de calcificações. Nós não verificamos a presença de linfedema em suas mãos e pés. Ele possuía retardo do crescimento pós-natal, deficiência mental grave e paralisia cerebral.CONCLUSÃO: O achado de lesões coriorretinianas em uma criança com microcefalia deve aumentar a suspeita da forma autossômica recessiva da síndrome de microcefalia-coriorretinopatia, principalmente em casos com padrão atípico de fundo de olho e consanguinidade. O diagnóstico preciso é essencial para correta avaliação clínica e aconselhamento genético dos pacientes e suas famílias.


Assuntos
Criança , Humanos , Masculino , Microcefalia/genética , Epitélio Pigmentado da Retina/anormalidades , Consanguinidade , Paralisia Cerebral/genética , Deficiência Intelectual/genética , Linhagem , Síndrome
5.
Arq. neuropsiquiatr ; 73(1): 12-17, 01/2015. tab, graf
Artigo em Inglês | LILACS (Américas) | ID: lil-732211

RESUMO

Objective To present a seven-cases serie of Mowat-Wilson syndrome (MWS). Method All patients with positive mutation for the ZEB2 were evaluated by a geneticist and a neurologist, with clinical and laboratorial characterization. Results A peculiar facies and mental retardation were present in all patients. The Denver II scale showed intense delay in all aspects, especially fine motor and adaptive. Acquired microcephaly was observed in five patients. Only one patient did not present epilepsy. Epilepsy was focal and predominating in sleep, with status epilepticus in three patients. The initial seizure was associated with fever in most patients (4/6). The EEG showed epileptic focal activity (5/7). The imaging studies revealed total agenesis (4/7) and partial agenesis of the corpus callosum (1/7). Conclusion Physicians who care for patients with mental retardation and epilepsy should be aware of SMW. .


Objetivo Apresentar uma série de sete casos da síndrome de Mowat-Wilson (SMW). Método Todos os pacientes com estudo positivo para a mutação ZEB2 foram avaliados por um geneticista e um neurologista, com a caracterização clínica e laboratorial. Resultados Todos apresentavam fácies peculiar e retardo mental. A escala de Denver II evidenciou intenso atraso em todos os aspectos, sobretudo motor fino e adaptativo. Microcefalia adquirida foi observada em cinco pacientes. Apenas um paciente não apresentava epilepsia, sendo esta focal e predominando no sono, sendo relatado estado de mal em três pacientes. A crise inicial estava associada à febre na maioria dos pacientes (4/6). O EEG evidenciou atividade epiléptica focal na maioria (5/7). Ao estudo de imagem foi observada agenesia total (4/7) e parcial do corpo caloso (1/7). Conclusão Médicos que lidam com pacientes com retardo mental e epilepsia devem saber distinguir as características peculiares da SMW. .


Assuntos
Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Doença de Hirschsprung/genética , Proteínas de Homeodomínio/genética , Deficiência Intelectual/genética , Mutação , Microcefalia/genética , Proteínas Repressoras/genética , Facies , Doença de Hirschsprung/fisiopatologia , Deficiência Intelectual/fisiopatologia , Microcefalia/fisiopatologia , Estudos Retrospectivos
6.
J. pediatr. (Rio J.) ; 90(2): 155-160, Mar-Apr/2014. tab
Artigo em Inglês | LILACS (Américas) | ID: lil-709809

RESUMO

OBJECTIVE: this study aimed to investigate the cognitive and behavioral profiles, as well as the psychiatric symptoms and disorders in children with three different genetic syndromes with similar sociocultural and socioeconomic backgrounds. METHODS: thirty-four children aged 6 to 16 years, with Williams-Beuren syndrome (n = 10), Prader-Willi syndrome (n = 11), and Fragile X syndrome (n = 13) from the outpatient clinics of Child Psychiatry and Medical Genetics Department were cognitively assessed through the Wechsler Intelligence Scale for Children (WISC-III). Afterwards, a full-scale intelligence quotient (IQ), verbal IQ, performance IQ, standard subtest scores, as well as frequency of psychiatric symptoms and disorders were compared among the three syndromes. RESULTS: significant differences were found among the syndromes concerning verbal IQ and verbal and performance subtests. Post-hoc analysis demonstrated that vocabulary and comprehension subtest scores were significantly higher in Williams-Beuren syndrome in comparison with Prader-Willi and Fragile X syndromes, and block design and object assembly scores were significantly higher in Prader-Willi syndrome compared with Williams-Beuren and Fragile X syndromes. Additionally, there were significant differences between the syndromes concerning behavioral features and psychiatric symptoms. The Prader-Willi syndrome group presented a higher frequency of hyperphagia and self-injurious behaviors. The Fragile X syndrome group showed a higher frequency of social interaction deficits; such difference nearly reached statistical significance. CONCLUSION: the three genetic syndromes exhibited distinctive cognitive, behavioral, and psychiatric patterns. .


OBJETIVO: investigar o perfil cognitivo e comportamental, sintomas e transtornos psiquiátricos em crianças com três diferentes síndromes genéticas, com antecedentes socioculturais e socioeconômicos semelhantes. MÉTODOS: trinta e quatro crianças, entre 6 e 16 anos, com as síndromes de Williams-Beuren (n = 10), de Prader-Willi (n = 11) e do X-Frágil (n = 13), dos ambulatórios de Psiquiatria Infantil e Genética Médica, foram avaliadas cognitivamente pela Escala Wechsler de Inteligência para Crianças (WISC-III). Posteriormente, o QI total, o QI Verbal, o QI de Execução, os escores ponderados dos subtestes e a frequência de sintomas e transtornos psiquiátricos foram comparados entre as síndromes. RESULTADOS: diferenças significativas foram encontradas entre as síndromes quanto ao QI Verbal e os subtestes verbais e de execução. A análise Post-hoc demonstrou que os escores dos subtestes vocabulário e compreensão foram significativamente superiores na síndrome de Williams-Beuren em relação às síndromes de Prader-Willi e do X-Frágil, e os escores dos subtestes cubos e armar objetos foram significativamente superiores na síndrome de Prader-Willi em relação às síndromes de Williams-Beuren e do X-Frágil. Além disso, houve diferença significativa entre as síndromes quanto às características comportamentais e os sintomas psiquiátricos. O grupo com síndrome de Prader-Willi apresentou maior frequência de hiperfagia e comportamentos autolesivos. Já o grupo com síndrome do X-Frágil apresentou maior frequência do déficit da interação social. Esta diferença quase alcançou a significância estatística. CONCLUSÃO: as três síndromes genéticas ...


Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Transtornos Cognitivos/psicologia , Síndrome do Cromossomo X Frágil/psicologia , Deficiência Intelectual/psicologia , Transtornos Mentais/psicologia , Síndrome de Prader-Willi/psicologia , Síndrome de Williams/psicologia , Cognição , Estudos Transversais , Transtornos Cognitivos/genética , Escolaridade , Síndrome do Cromossomo X Frágil/diagnóstico , Renda , Deficiência Intelectual/genética , Transtornos Mentais/genética , Síndrome de Prader-Willi/diagnóstico , Escalas de Wechsler , Síndrome de Williams/diagnóstico
7.
Indian J Hum Genet ; 2014 Apr-Jun ; 20 (2): 203-205
Artigo em Inglês | IMSEAR (Sudeste Asiático), GHL | ID: sea-156663

RESUMO

Patients with 13q deletion syndrome are characterized with different phenotypical features depending on the size and location of the deleted region on chromosome 13. These patients fall into three groups: In Group 1, deleted region is in the proximal and does not extend into q32; in Group 2, deleted region involves proximal to the q32 and in Group 3 q33‑q34 is deleted. We present two cases with 13q syndrome with two different deleted region and different severity on clinical features: One case with interstitial deletion belongs to the Group 1 with mild mental retardation and minor malformations and the other case with terminal deletion belongs to Group 3 with moderate to severe mental retardation and major malformations.


Assuntos
Anormalidades Múltiplas/genética , Criança , Pré-Escolar , Cromossomos Humanos Par 13/genética , Deleção Cromossômica , Transtornos Cromossômicos/genética , Feminino , Humanos , Deficiência Intelectual/genética , Masculino , Fenótipo
8.
Clin. biomed. res ; 34(4): 357-365, 2014. ilus, tab
Artigo em Inglês | LILACS (Américas) | ID: biblio-834483

RESUMO

Introduction: During the past few decades, the number of diseases identified to be caused by chromosomal microdeletions has increased quickly, bringing a new and crucial role for cytogenetics on the diagnosis of these conditions. The purpose of this study was to identify and characterize chromosomal microdeletions associated with malformation syndromes and intellectual disability. Methods: We retrospectively evaluated a consecutive series of samples from a cohort of 598 subjects with clinical symptoms of a microdeletion syndrome, including the deletion of chromosomes 4p16.3, 5p15.2, 5q35, 7q11.23, 8q24.12, 15q11.2, 16p13.3, 17p13.3, 17p11.2,2, and 22q11.2, as investigated by fluorescence in situ hybridization (FISH). Array-based comparative genomic hybridization (array-CGH) was performed on 25 samples with microdeletions. Results: A total of 598 samples were evaluated from patients whose clinical phenotypes were most indicative of 22q11.2 deletion syndrome (29.10%), Prader-Willi syndrome (23.41%), Angelman syndrome (16.89%), and Williams-Beuren syndrome (14.72%). In 142 of the samples (23.75%), a chromosomal imbalance associated with phenotypic abnormalities was found. The deletion of 7q11.23 was the most frequent (8.03%), followed by del22q11.2 (5.68%) and del15q11.2 (5%). Conclusion: Our study reinforces the idea that the effort to improve the capacity to perform molecular cytogenetic investigations associated with a qualified clinical evaluation is crucial for the detection and precise characterization of submicroscopic chromosome deletions, bringing benefits to patients, relatives, and genetic counselors. It also contributes to the continuing education of cytogeneticists and to the knowledge of chromosomal rearrangements associated with genomic disorders.


Assuntos
Humanos , Aberrações Cromossômicas , Deleção Cromossômica , Anormalidades Congênitas , Análise Citogenética , Deficiência Intelectual/genética , Predisposição Genética para Doença , Transtornos Cromossômicos/diagnóstico , Citogenética/educação , Síndrome de Angelman/genética , Síndrome de Prader-Willi/genética , Síndrome de Williams/genética
10.
Indian J Hum Genet ; 2013 Oct-Dec ;19 (4): 443-448
Artigo em Inglês | IMSEAR (Sudeste Asiático), GHL | ID: sea-156611

RESUMO

BACKGROUND: Mental retardation (MR) has a prevalence of 1‑3% and genetic causes are present in more than 50% of patients. Chromosomal abnormalities are one of the most common genetic causes of MR and are responsible for 4‑28% of mental retardation. However, the smallest loss or gain of material visible by standard cytogenetic is about 4 Mb and for smaller abnormalities, molecular cytogenetic techniques such as array comparative genomic hybridization (array CGH) should be used. It has been shown that 15‑25% of idiopathic MR (IMR) has submicroscopic rearrangements detectable by array CGH. In this project, the genomic abnormalities were investigated in 32 MR patients using this technique. MATERIALS AND METHODS: Patients with IMR with dysmorphism were investigated in this study. Karyotype analysis, fragile X and metabolic tests were first carried out on the patients. The copy number variation was then assessed in a total of 32 patients with normal results for the mentioned tests using whole genome oligo array CGH. Multiple ligation probe amplification was carried out as a confirmation test. RESULTS: In total, 19% of the patients showed genomic abnormalities. This is reduced to 12.5% once the two patients with abnormal karyotypes (upon re‑evaluation) are removed. CONCLUSION: The array CGH technique increased the detection rate of genomic imbalances in our patients by 12.5%. It is an accurate and reliable method for the determination of genomic imbalances in patients with IMR and dysmorphism.


Assuntos
Adolescente , Pré-Escolar , Criança , Transtornos Cromossômicos/genética , Hibridização Genômica Comparativa/métodos , Anormalidades Congênitas/genética , Feminino , Variação Estrutural do Genoma , Humanos , Deficiência Intelectual/epidemiologia , Deficiência Intelectual/genética , Irã (Geográfico)/epidemiologia , Masculino , Transtornos Mentais/classificação , Transtornos Mentais/epidemiologia , Transtornos Mentais/genética
11.
Indian J Hum Genet ; 2013 July-Sept ;19 (3): 363-365
Artigo em Inglês | IMSEAR (Sudeste Asiático), GHL | ID: sea-156595

RESUMO

Congenital hypoparathyroidism, growth retardation and facial dysmorphism is a rare autosomal recessive disorder seen among children born to consanguineous couple of Arab ethnicity. This syndrome is commonly known as Sanjad- Sakati or hypoparathyroidism‑retardation‑dysmorphism syndrome (HRD). We report 13‑year‑old Hindu boy with hypoparathyroidism, tetany, facial dysmorphism and developmental delay, compatible with HRD syndrome.


Assuntos
Anormalidades Múltiplas/epidemiologia , Anormalidades Múltiplas/genética , Adolescente , Adulto , Consanguinidade , Feminino , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/genética , Humanos , Masculino , Hipoparatireoidismo/epidemiologia , Hipoparatireoidismo/genética , Deficiência Intelectual/epidemiologia , Deficiência Intelectual/genética , Pessoa de Meia-Idade , Osteocondrodisplasias/epidemiologia , Osteocondrodisplasias/genética , Pais , Convulsões/epidemiologia , Convulsões/genética
12.
Ciênc. saúde coletiva ; 18(6): 1717-1729, Jun. 2013. ilus
Artigo em Inglês | LILACS (Américas) | ID: lil-676395

RESUMO

Mental retardation (MR) is a definition which comprises a series of conditions whose common feature is an intellectual handicap that develops before the age of 18, afflicting 2-3% of the world's population. The classification of MR into different categories is determined by the extent of the handicap instead of its cause, which often remains unrecognized. Sometimes, MR runs in a family, characterizing familial MR, and those cases permit an in-depth look into the genetic causes and consequences of the problem. However, almost no work is available on the prevalence of familial MR among the registered MR cases, possibly because familial MR is a term with no clear definition. The scope of this work is to review the topic and discuss the implications of different genetic and environmental factors, which characterize particular categories of familial cases, suggesting a practical classification of familial MR, which is important for epidemiologic studies and also for counseling in the clinic. Some of the aspects are discussed under the perspective of a newly-developed country like Brazil.


Retardo mental (RM) é uma definição que compreende uma série de condições cuja característica em comum é um déficit intelectual que se desenvolve antes dos 18 anos, afetando 2-3% da população mundial. A classificação do RM em diferentes categorias é determinada pela gravidade do déficit ao invés de sua causa, que com frequência permanece obscura. O RM pode segregar na família, caracterizando RM familiar, e estes casos permitem um olhar mais aprofundado para as causas genéticas e as consequências do problema. Porém, praticamente não existem dados disponíveis sobre a prevalência do RM familiar dentre os casos registrados, possivelmente por ser um termo sem definição clara. O presente trabalho objetiva rever o tópico e discutir as implicações de diferentes fatores genéticos e ambientais que caracterizam categorias particulares de casos familiares, sugerindo uma classificação prática para o RM familiar, importante para estudos epidemiológicos e também na clínica, para aconselhamento. Alguns dos aspectos são discutidos na perspectiva de um país emergente, como o Brasil.


Assuntos
Humanos , Deficiência Intelectual/classificação , Deficiência Intelectual/genética , Linhagem
13.
Indian J Hum Genet ; 2013 Apr; 19(2): 262-265
Artigo em Inglês | IMSEAR (Sudeste Asiático), GHL | ID: sea-149439

RESUMO

The presence of derivative chromosome in a child with phenotypic features necessitates the need of parental karyotyping to ascertain the exact amount of loss or gain of the genetic material. The aim of this study was to emphasize the importance of parental karyotyping. Cytogenetic evaluation of the proband and his father were carried out at Laboratory. Cytogenetic analysis was performed on phytohemagglutinin stimulated cultures. The derivative chromosome 11 in proband was ascertained to have additional material from chromosome 6p arising from complex chromosomal rearrangement in the father. Karyotyping is the basic, cost-effective preliminary investigation in a child with mental subnormality or congenital anomalies.


Assuntos
Adulto , Pré-Escolar , Cromossomos Humanos Par 3/genética , Cromossomos Humanos Par 6/genética , Cromossomos Humanos Par 11/genética , Aconselhamento Genético , Humanos , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/epidemiologia , Deficiência Intelectual/genética , /métodos , Masculino , Translocação Genética
14.
Indian J Hum Genet ; 2013 Apr; 19(2): 171-178
Artigo em Inglês | IMSEAR (Sudeste Asiático), GHL | ID: sea-149425

RESUMO

CONTEXT: Unbalanced subtelomeric chromosomal rearrangements are often associated with intellectual disability (ID) and malformation syndromes. The prevalence of such rearrangements has been reported to be 5-9% in ID populations. AIMS: To study the prevalence of subtelomeric rearrangements in the Indonesian ID population. MATERIALS AND METHODS: We tested 436 subjects with unexplained ID using multiplex ligation dependent probe amplification (MLPA) using the specific designed sets of probes to detect human subtelomeric chromosomal imbalances (SALSA P070 and P036D). If necessary, abnormal findings were confirmed by other MLPA probe kits, fluorescent in situ hybridization or Single Nucleotide Polymorphism array. RESULTS: A subtelomeric aberration was identified in 3.7% of patients (16/436). Details on subtelomeric aberrations and confirmation analyses are discussed. CONCLUSION: This is the first study describing the presence of subtelomeric rearrangements in individuals with ID in Indonesia. Furthermore, it shows that also in Indonesia such abnormalities are a prime cause of ID and that in developing countries with limited diagnostic services such as Indonesia, it is important and feasible to uncover the genetic etiology in a significant number of cases with ID.


Assuntos
Aberrações Cromossômicas/genética , Efeito de Coortes , Feminino , Rearranjo Gênico , Humanos , Indonésia , Deficiência Intelectual/epidemiologia , Deficiência Intelectual/etiologia , Deficiência Intelectual/genética , Masculino , Reação em Cadeia da Polimerase Multiplex/métodos , Telômero/genética
15.
Indian J Hum Genet ; 2013 Apr; 19(2): 165-170
Artigo em Inglês | IMSEAR (Sudeste Asiático), GHL | ID: sea-149424

RESUMO

BACKGROUND: Mental retardation (MR) is a heterogeneous dysfunction of the central nervous system exhibiting complex phenotypes and has an estimated prevalence of 1-3% in the general population. However, in about 50% of the children diagnosed with any form of intellectual disability or developmental delay the cause goes undetected contributing to idiopathic intellectual disability. MATERIALS AND METHODS: A total of 122 children with developmental delay/MR were studied to identify the microscopic and submicroscopic chromosome rearrangements by using the conventional cytogenetics and multiplex ligation dependent probe amplification (MLPA) analysis using SALSA MLPA kits from Microbiology Research Centre Holland [MRC] Holland. RESULTS: All the recruited children were selected for this study, after thorough clinical assessment and metaphases prepared were analyzed by using automated karyotyping system. None was found to have chromosomal abnormality; MLPA analysis was carried out in all subjects and identified in 11 (9%) patients. CONCLUSION: Karyotype analysis in combination with MLPA assays for submicroscopic micro-deletions may be recommended for children with idiopathic MR.


Assuntos
Adolescente , Criança , Pré-Escolar , Deleção Cromossômica , Deficiências do Desenvolvimento/genética , Feminino , Humanos , Índia/epidemiologia , Deficiência Intelectual/epidemiologia , Deficiência Intelectual/genética , Masculino , Reação em Cadeia da Polimerase Multiplex , Proteínas do Tecido Nervoso/genética , Deleção de Sequência
17.
Rio de Janeiro; s.n; 2013. 89 p. ilus, tab.
Tese em Português | LILACS (Américas) | ID: lil-711961

RESUMO

O retardo mental (RM) representa um problema de saúde pública mundial ainda negligenciado no Brasil e, em especial nas regiões mais pobres como o Nordeste. A síndrome do X frágil (SXF) é uma das formas mais estudadas de RM hereditário em seres humanos. Esta doença monogênica, de herança ligada ao X dominante, é decorrente de uma mutação no exon 1 do gene FMR1, localizado na região Xq27.3. A mutação no FMR1 se caracteriza pelo aumento de repetições de trinucleotídios CGG em tandem na região 5’ UTR desse gene, sendo a expansão dessas trincas o principal evento mutacional responsável pela SXF. De maneira geral, os fenótipos cognitivos de indivíduos do sexo masculino com a síndrome incluem deficiência intelectual de moderada à grave. No presente trabalho, realizamos um estudo transversal da SXF em indivíduos portadores de retardo mental de causa desconhecida, engajados em Programas de Educação Especial e em instituições psiquiátricas de São Luís-MA, rastreando amplificações de sequências trinucleotídicas no gene FMR1. A amostra foi composta por 238 indivíduos do sexo masculino, não aparentados, na faixa etária de 4 a 60 anos (média = 21 ± 9 anos). O DNA dos participantes foi obtido a partir de 5 mL de sangue coletados em tubos com anti-coagulante EDTA e a análise molecular da região gênica de interesse foi realizada através da reação em cadeia da polimerase, utilizando-se três primers. Dentre os indivíduos triados quanto à presença de mutações no gene FMR1, apenas um apresentou um resultado inconclusivo e 2 (0,84%) foram positivos para a SXF, sendo que um deles (3503) apresentou mais de 200 repetições CGG no locus FRAXA e o outro indivíduo (3660) apresentou uma deleção de ~197 pb envolvendo parte das repetições CGG e uma região proximal às repetições CGG. Ambos possuíam história familiar de RM ligado ao X. No indivíduo 3503 observamos as seguintes características clínicas: temperamento dócil, orelhas grandes, mandíbula proeminente e flacidez ligamentar ...


Mental retardation (MR) is considered a global public health problem in Brazil and it is still ignored mainly in poor regions like Northeast Brazil. The fragile X syndrome (FXS) is one of the most common heritable disease in humans. it is a monogenic disease with X-linked dominant inheritance due to a mutation in exon 1 of the FMR1 gene, located at Xq27.3 region. The mutation in FMR1 is characterized by the increase in number of CGG repeats in the 5 'UTR of the gene. This expansion of CGG triplets in the first exon of the FMR1 gene is the main mutational event responsible for FXS. In general, the cognitive phenotypes of males with this syndrome include intellectual disabilities from moderate to severe. In this work, we conducted a cross-sectional study of FXS in individuals with MR of unknown cause, in Especial Education Programs and Psyquiatric Instituitions in São Luís-MA, by screening for amplifications of trinucleotide sequences within the FMR1 gene. The sample consisted of 238 unrelated males, which ages were from 4 to 60 years (mean = 21 ± 9 years). The DNA of all individuals was obtained from 5 mL of peripheral blood which was colected in EDTA-anticoagulated tubes. The molecular analysis of the genetic region of interest was performed by polimerase chain reaction using three primers. Of the individuals screened for the presence of the mutation in the FMR1 gene, only one was inconclusive and two (0.84%) were positive for FXS. One (3503) presented more than 200 CGG repeats in FRAXA locus, and the other (3660) presented with a ~ 197 bp deletion involving part of CGG repeats and a proximal region to the CGG repeats. Both of these individuals have family history of X-linked Mental Retardation. The individual 3503 has the following clinical features: docile temperament, large ears, prominent jaw and ligamentous laxity. The individual 3660 presents hyperactivity, poor contact with eyes, large ears, prominent jaw, pectus excavatum, macroorchidism and little ...


Assuntos
Humanos , Masculino , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/genética , Síndrome do Cromossomo X Frágil/diagnóstico , Síndrome do Cromossomo X Frágil/genética , Diagnóstico Diferencial , Éxons/genética , Mutação/genética , Proteína do X Frágil de Retardo Mental/genética , Reação em Cadeia da Polimerase/métodos , Análise de Sequência de DNA , Expansão das Repetições de Trinucleotídeos
18.
Yonsei Medical Journal ; : 1463-1470, 2013.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-100952

RESUMO

PURPOSE: This study analyzed and evaluated the demographic, clinical, and cytogenetic data [G-banded karyotyping and array-based comparative genomic hybridization (array CGH)] of patients with unexplained developmental delay or intellectual disability at a single Korean institution. MATERIALS AND METHODS: We collected clinical and cytogenetic data based on retrospective charts at Ajou University Medical Center, Suwon, Korea from April 2008 to March 2012. RESULTS: A total of 190 patients were identified. Mean age was 5.1+/-1.87 years. Array CGH yielded abnormal results in 26 of 190 patients (13.7%). Copy number losses were about two-fold more frequent than gains. A total of 61.5% of all patients had copy number losses. The most common deletion disorders included 22q11.2 deletion syndrome, 15q11.2q12 deletion and 18q deletion syndrome. Copy number gains were identified in 34.6% of patients, and common diseases among these included Potocki-Lupski syndrome, 15q11-13 duplication syndrome and duplication 22q. Abnormal karyotype with normal array CGH results was exhibited in 2.6% of patients; theses included balanced translocation (n=2), inversion (n=2) and low-level mosaicism (n=1). Facial abnormalities (p<0.001) and failure to thrive were (p<0.001) also more frequent in the group of patients with abnormal CGH findings. CONCLUSION: Array CGH is a useful diagnostic tool in clinical settings in patients with developmental delay or intellectual disability combined with facial abnormalities or failure to thrive.


Assuntos
Adolescente , Adulto , Criança , Pré-Escolar , Hibridização Genômica Comparativa/métodos , Feminino , Dosagem de Genes/genética , Humanos , Lactente , Deficiência Intelectual/genética , Cariótipo , Masculino , República da Coreia , Estudos Retrospectivos , Atenção Terciária à Saúde/estatística & dados numéricos , Adulto Jovem
19.
Arq. bras. endocrinol. metab ; 56(8): 564-569, Nov. 2012. ilus
Artigo em Inglês | LILACS (Américas) | ID: lil-660267

RESUMO

Genetic defects resulting in deficiency of thyroid hormone synthesis can be found in about 10% of the patients with permanent congenital hypothyroidism, but the identification of genetic abnormalities in association with the transient form of the disease is extremely rare. We report the case of a boy with transient neonatal hypothyroidism that was undiagnosed in the neonatal screening, associated with extrathyroid malformations and mental retardation. The boy carries an unbalanced translocation t(8;16), and his maternal uncle had a similar phenotype. Chromosomal analysis defined the patient's karyotype as 46,XY,der(8)t(8;16)(q24.3;q22)mat,16qh+. Array-CGH with patient's DNA revealed a ~80 kb terminal deletion on chromosome 8q24.3qter, and a ~21 Mb duplication on chromosome 16q22qter. ZNF252 gene, mapped to the deleted region on patient's chromosome 8, is highly expressed in the thyroid, and may be a candidate gene for our patient's transient neonatal thyroid dysfunction. This is the first report on the association of a chromosomal translocation with the transient form of congenital hypothyroidism. This description creates new hypothesis for the physiopathology of transient congenital hypothyroidism, and may also contribute to the definition of the unbalanced translocation t(8;16)(q24.3;q22) phenotype, which has never been described before. Arq Bras Endocrinol Metab. 2012;56(8):564-9.


Defeitos genéticos resultando em deficiência hormonal tireoidiana podem ser encontrados em cerca de 10% dos pacientes com hipotireoidismo congênito permanente, porém a identificação de anormalidades genéticas associadas à forma transitória da doença é extremamente rara. Relatamos o caso de um menino com hipotireoidismo neonatal transitório não diagnosticado no teste de triagem neonatal, associado a malformações extratireoidianas e retardo mental. O paciente é portador de translocação não balanceada t(8;16), e seu tio materno tinha fenótipo similar. A análise cromossômica definiu o cariótipo do paciente como 46,XY,der(8)t(8;16)(q24.3;q22)mat,16qh+. A análise cromossômica array-CGH com o DNA do paciente revelou deleção terminal de ~80 kb no cromossomo 8q24.3qter, e duplicação de ~21 Mb no cromossomo 16q22qter. O gene ZNF252, mapeado na região da deleção no cromossomo 8 do paciente, é altamente expresso na tireoide e pode ser um gene candidato no hipotireoidismo neonatal transitório do paciente. Esse é o primeiro relato de associação de uma translocação cromossômica com a forma transitória do hipotireoidismo congênito. Essa descrição descortina novas hipóteses para a fisiopatologia do hipotireoidismo congênito transitório e também pode contribuir para a definição do fenótipo da translocação não balanceada t(8;16)(q24.3;q22), nunca descrito anteriormente. Arq Bras Endocrinol Metab. 2012;56(8):564-9.


Assuntos
Criança , Humanos , Masculino , Hipotireoidismo Congênito/genética , Deficiência Intelectual/genética , Translocação Genética/genética , Cariótipo , Fenótipo
20.
Clinics ; 67(8): 917-921, Aug. 2012. graf, tab
Artigo em Inglês | LILACS (Américas) | ID: lil-647796

RESUMO

OBJECTIVE: Prader-Willi Syndrome is a common etiology of syndromic obesity that is typically caused by either a paternal microdeletion of a region in chromosome 15 (microdeletions) or a maternal uniparental disomy of this chromosome. The purpose of this study was to describe the most significant clinical features of 35 Brazilian patients with molecularly confirmed Prader-Willi syndrome and to determine the effects of growth hormone treatment on clinical outcomes. METHODS: A retrospective study was performed based on the medical records of a cohort of 35 patients diagnosed with Prader-Willi syndrome. The main clinical characteristics were compared between the group of patients presenting with microdeletions and the group presenting with maternal uniparental disomy of chromosome 15. Curves for height/length, weight and body mass index were constructed and compared between Prader-Willi syndrome patients treated with and without growth hormone to determine how growth hormone treatment affected body composition. The curves for these patient groups were also compared with curves for the normal population. RESULTS: No significant differences were identified between patients with microdeletions and patients with maternal uniparental disomy for any of the clinical parameters measured. Growth hormone treatment considerably improved the control of weight gain and body mass index for female patients but had no effect on either parameter in male patients. Growth hormone treatment did not affect height/length in either gender. CONCLUSION: The prevalence rates of several clinical features in this study are in agreement with the rates reported in the literature. Additionally, we found modest benefits of growth hormone treatment but failed to demonstrate differences between patients with microdeletions and those with maternal uniparental disomy. The control of weight gain in patients with Prader-Willi syndrome is complex and does not depend exclusively on growth hormone treatment.


Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Hormônio do Crescimento Humano/uso terapêutico , Síndrome de Prader-Willi/tratamento farmacológico , Fatores Etários , Composição Corporal , Índice de Massa Corporal , Brasil , Deleção Cromossômica , /genética , Seguimentos , Deficiência Intelectual/genética , Obesidade/complicações , Obesidade/genética , Síndrome de Prader-Willi/genética , Síndrome de Prader-Willi/patologia , Estudos Retrospectivos , Fatores Sexuais , Convulsões/genética , Resultado do Tratamento
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