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Bayat A, Grimes H, de Boer E, Herlin MK, Dahl RS, Lund ICB, Bayat M, Bolund ACS, Gjerulfsen CE, Gregersen PA, Zilmer M, Juhl S, Cebula K, Rahikkala E, Maystadt I, Peron A, Vignoli A, Alfano RM, Stanzial F, Benedicenti F, Currò A, Luk HM, Jouret G, Zurita E, Heuft L, Schnabel F, Busche A, Veenstra-Knol HE, Tkemaladze T, Vrielynck P, Lederer D, Platzer K, Ockeloen CW, Goel H, Low KJ. Natural history of adults with KBG syndrome: A physician-reported experience. Genet Med 2024; 26:101170. [PMID: 38818797 DOI: 10.1016/j.gim.2024.101170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/22/2024] [Accepted: 05/22/2024] [Indexed: 06/01/2024] Open
Abstract
PURPOSE KBG syndrome (KBGS) is a rare neurodevelopmental syndrome caused by haploinsufficiency of ANKRD11. The childhood phenotype is extensively reported but limited for adults. Thus, we aimed to delineate the clinical features of KBGS. METHODS We collected physician-reported data of adults with molecularly confirmed KBGS through an international collaboration. Moreover, we undertook a systematic literature review to determine the scope of previously reported data. RESULTS The international collaboration identified 36 adults from 31 unrelated families with KBGS. Symptoms included mild/borderline intellectual disability (n = 22); gross and/or fine motor difficulties (n = 15); psychiatric and behavioral comorbidities including aggression, anxiety, reduced attention span, and autistic features (n = 26); nonverbal (n = 3), seizures with various seizure types and treatment responses (n = 10); ophthalmological comorbidities (n = 20). Cognitive regression during adulthood was reported once. Infrequent features included dilatation of the ascending aorta (n = 2) and autoimmune conditions (n = 4). Education, work, and residence varied, and the diversity of professional and personal roles highlighted the range of abilities seen. The literature review identified 154 adults reported across the literature, and we have summarized the features across both data sets. CONCLUSION Our study sheds light on the long-term neurodevelopmental outcomes, seizures, behavioral and psychiatric features, and education, work, and living arrangements for adults with KBGS.
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Affiliation(s)
- Allan Bayat
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Department of Epilepsy Genetics and Personalized Medicine, Danish Epilepsy Center, Dianalund, Denmark; Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark.
| | - Hannah Grimes
- Department of Clinical Genetics, University Hospital Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Elke de Boer
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands; Department of Clinical Genetics, Erasmus Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Morten Krogh Herlin
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
| | - Rebekka Staal Dahl
- Department of Epilepsy Genetics and Personalized Medicine, Danish Epilepsy Center, Dianalund, Denmark
| | - Ida Charlotte Bay Lund
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Michael Bayat
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark; Center for Rare Diseases, Department of Pediatric and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | | | | | - Pernille Axél Gregersen
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Center for Rare Diseases, Department of Pediatric and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Monica Zilmer
- Department of Child Neurology, Danish Epilepsy Center, Dianalund, Denmark
| | - Stefan Juhl
- Department of Neurology, Danish Epilepsy Center, Dianalund, Denmark
| | - Katarzyna Cebula
- Department of Neurology, Danish Epilepsy Center, Dianalund, Denmark
| | - Elisa Rahikkala
- Dept of Clinical Genetics, Research Unit of Clinical Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Isabelle Maystadt
- Center for Human Genetics, Institute for Pathology and Genetics, Gosselies, Belgium; URPhyM, Faculty of Medicine, University of Namur, Namur, Belgium
| | - Angela Peron
- Medical Genetics, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy; Division of Medical Genetics, Meyer Children's Hospital IRCCS, Florence, Italy; Department of Experimental and Clinical Biomedical Sciences "Mario Serio," Università degli Studi di Firenze, Florence, Italy
| | - Aglaia Vignoli
- Child Neuropsychiatry Unit, Grande Ospedale Metropolitano Niguarda, University of Milan, Milan, Italy
| | - Rosa Maria Alfano
- Medical Genetics, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy
| | - Franco Stanzial
- Genetic Counseling Service, Department of Pediatrics, Regional Hospital of Bolzano, Bolzano, Italy
| | - Francesco Benedicenti
- Genetic Counseling Service, Department of Pediatrics, Regional Hospital of Bolzano, Bolzano, Italy
| | - Aurora Currò
- Genetic Counseling Service, Department of Pediatrics, Regional Hospital of Bolzano, Bolzano, Italy
| | - Ho-Ming Luk
- Clinical Genetics Service Unit, Hong Kong Children's Hospital, HKSAR, Hong Kong
| | - Guillaume Jouret
- National Center of Genetics, Laboratoire National de Santé, Dudelange, Luxembourg
| | - Ella Zurita
- Hunter Genetics, New South Wales Health, Waratah, NSW, Australia
| | - Lara Heuft
- Institute for Human Genetics, University of Leipzig Medical Center, Leipzig, Germany
| | - Franziska Schnabel
- Institute for Human Genetics, University of Leipzig Medical Center, Leipzig, Germany
| | - Andreas Busche
- Department of Medical Genetics, University Hospital Münster, Germany
| | | | - Tinatin Tkemaladze
- Department of Molecular and Medical Genetics, Tbilisi State Medical University, Tbilisi, Georgia; Givi Zhvania Pediatric Academic Clinic, Tbilisi State Medical University, Tbilisi, Georgia
| | - Pascal Vrielynck
- Reference Center for Refractory Epilepsy, Catholic University of Louvain, William Lennox Neurological Hospital, Ottignies, Belgium
| | - Damien Lederer
- Institute for Pathology and Genetics, 6040, Gosselies, Belgium
| | - Konrad Platzer
- Institute for Human Genetics, University of Leipzig Medical Center, Leipzig, Germany
| | | | - Himanshu Goel
- Hunter Genetics, New South Wales Health, Waratah, NSW, Australia
| | - Karen Jaqueline Low
- Department of Clinical Genetics, University Hospital Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom; Centre for Academic Child Health, Bristol Medical School, University of Bristol, United Kingdom
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Kierzkowska O, Sarino K, Carter D, Guo L, Marchi E, Voronova A, Lyon GJ. Documentation and prevalence of prenatal and neonatal outcomes in a cohort of individuals with KBG syndrome. Am J Med Genet A 2023; 191:2364-2375. [PMID: 37226940 DOI: 10.1002/ajmg.a.63311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/24/2023] [Accepted: 05/15/2023] [Indexed: 05/26/2023]
Abstract
Ankyrin Repeat Domain 11 (ANKRD11) gene mutations are associated with KBG syndrome, a developmental disability that affects multiple organ systems. The function of ANKRD11 in human growth and development is not clear, but gene knockout or mutation are lethal in mice embryos and/or pups. In addition, it plays a vital role in chromatin regulation and transcription. Individuals with KBG syndrome are often misdiagnosed or remain undiagnosed until later in life. This is largely due to KBG syndrome's varying and nonspecific phenotypes as well as a lack of accessible genetic testing and prenatal screening. This study documents perinatal outcomes for individuals with KBG syndrome. We obtained data from 42 individuals through videoconferences, medical records, and emails. 45.2% of our cohort was born by C-section, 33.3% had a congenital heart defect, 23.8% were born prematurely, 23.8% were admitted to the NICU, 14.3% were small for gestational age, and 14.3% of the families had a history of miscarriage. These rates were higher in our cohort compared to the overall population, including non-Hispanic and Hispanic populations. Other reports included feeding difficulties (21.4%), neonatal jaundice (14.3%), decreased fetal movement (7.1%), and pleural effusions in utero (4.7%). Comprehensive perinatal studies about KBG syndrome and updated documentation of its phenotypes are important in ensuring prompt diagnosis and can facilitate correct management.
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Affiliation(s)
- Ola Kierzkowska
- Department of Human Genetics, NYS Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
| | - Kathleen Sarino
- Department of Human Genetics, NYS Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
| | - Drake Carter
- Department of Human Genetics, NYS Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
| | - Lily Guo
- Department of Human Genetics, NYS Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
| | - Elaine Marchi
- Department of Human Genetics, NYS Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
| | - Anastassia Voronova
- Department of Medical Genetics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Department of Cell Biology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Gholson J Lyon
- Department of Human Genetics, NYS Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
- George A. Jervis Clinic, NYS Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
- Biology PhD Program, The Graduate Center, The City University of New York, New York, USA
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