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Mariani M, Bettini LR, Cereda A, Maitz S, Gervasini C, Russo S, Masciadri M, Biondi A, Larizza L, Selicorni A. Germline mosaicism in cornelia de lange syndrome: Dilemmas and risk figures. Am J Med Genet A 2013; 161A:1825-6. [DOI: 10.1002/ajmg.a.35988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 03/10/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Milena Mariani
- Paediatric Department; S.Gerardo Hospital, Fondazione MBBM, University of Milano-Bicocca; Monza; Italy
| | - Laura R. Bettini
- Paediatric Department; S.Gerardo Hospital, Fondazione MBBM, University of Milano-Bicocca; Monza; Italy
| | - Anna Cereda
- Paediatric Department; S.Gerardo Hospital, Fondazione MBBM, University of Milano-Bicocca; Monza; Italy
| | - Silvia Maitz
- Paediatric Department; S.Gerardo Hospital, Fondazione MBBM, University of Milano-Bicocca; Monza; Italy
| | | | - Silvia Russo
- Laboratory of Medical Cytogenetics and Molecular Genetics; Istituto Auxologico Italiano; Milan; Italy
| | - Maura Masciadri
- Laboratory of Medical Cytogenetics and Molecular Genetics; Istituto Auxologico Italiano; Milan; Italy
| | - Andrea Biondi
- Paediatric Department; S.Gerardo Hospital, Fondazione MBBM, University of Milano-Bicocca; Monza; Italy
| | | | - Angelo Selicorni
- Paediatric Department; S.Gerardo Hospital, Fondazione MBBM, University of Milano-Bicocca; Monza; Italy
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Slavin TP, Lazebnik N, Clark DM, Vengoechea J, Cohen L, Kaur M, Konczal L, Crowe CA, Corteville JE, Nowaczyk MJ, Byrne JL, Jackson LG, Krantz ID. Germline mosaicism in Cornelia de Lange syndrome. Am J Med Genet A 2012; 158A:1481-5. [PMID: 22581668 DOI: 10.1002/ajmg.a.35381] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Accepted: 02/10/2012] [Indexed: 11/06/2022]
Abstract
Cornelia de Lange syndrome (CdLS) is a genetic disorder associated with delayed growth, intellectual disability, limb reduction defects, and characteristic facial features. Germline mosaicism has been a described mechanism for CdLS when there are several affected offspring of apparently unaffected parents. Presently, the recurrence risk for CdLS has been estimated to be as high as 1.5%; however, this figure may be an underrepresentation. We report on the molecularly defined germline mosaicism cases from a large CdLS database, representing the first large case series on germline mosaicism in CdLS. Of the 12 families, eight have been previously described; however, four have not. No one specific gene mutation, either in the NIPBL or the SMC1A gene, was associated with an increased risk for germline mosaicism. Suspected or confirmed cases of germline mosaicism in our database range from a conservative 3.4% up to 5.4% of our total cohort. In conclusion, the potential reproductive recurrence risk due to germline mosiacism should be addressed in prenatal counseling for all families who have had a previously affected pregnancy or child with CdLS.
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Affiliation(s)
- Thomas P Slavin
- Department of Genetics and Center for Human Genetics, University Hospitals of Cleveland, Case Medical Center, Cleveland, Ohio, USA.
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3
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Weichert J, Schröer A, Beyer DA, Gillessen-Kaesbach G, Stefanova I. Cornelia de Lange syndrome: antenatal diagnosis in two consecutive pregnancies due to rare gonadal mosaicism ofNIPBLgene mutation. J Matern Fetal Neonatal Med 2011; 24:978-82. [DOI: 10.3109/14767058.2010.531312] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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4
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Niu DM, Huang JY, Li HY, Liu KM, Wang ST, Chen YJ, Udaka T, Izumi K, Kosaki K. Paternal gonadal mosaicism of NIPBL
mutation in a father of siblings with Cornelia de Lange syndrome. Prenat Diagn 2006; 26:1054-7. [PMID: 16958143 DOI: 10.1002/pd.1554] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVES We report two siblings, a boy and a girl, with Cornelia de Lange syndrome (CdLS), born to unaffected parents, and attempt to delineate the underlying molecular mechanism leading to familial recurrence. METHODS Nipped-B-like (NIPBL) gene mutations were screened using in denaturing high-performance liquid chromatography and sequencing in peripheral blood samples, from one of the affected siblings and her parents, as well as from a sperm sample from the father. RESULTS A heterozygous missense NIPBL mutation, D2433G, was identified in the peripheral blood sample of the affected girl, but not in the peripheral blood samples of her parents. The D2433G mutation was also found in the sperm sample of the father. CONCLUSION Gonadal mosaicism represents an underappreciated feature of the inheritance pattern of CdLS. To our knowledge, the girl represents the first CdLS patient whose father was documented to have a population of mutant sperm. When a sperm analysis indicates the presence of a mutant allele, it may be reasonable to offer prenatal genetic testing to the family in subsequent pregnancies, given that the sensitivity of fetal ultrasonography is relatively low.
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Affiliation(s)
- Dau-Ming Niu
- Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
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5
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Gillis LA, McCallum J, Kaur M, DeScipio C, Yaeger D, Mariani A, Kline AD, Li HH, Devoto M, Jackson LG, Krantz ID. NIPBL mutational analysis in 120 individuals with Cornelia de Lange syndrome and evaluation of genotype-phenotype correlations. Am J Hum Genet 2004; 75:610-23. [PMID: 15318302 PMCID: PMC1182048 DOI: 10.1086/424698] [Citation(s) in RCA: 221] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2004] [Accepted: 07/21/2004] [Indexed: 11/03/2022] Open
Abstract
The Cornelia de Lange syndrome (CdLS) is a multisystem developmental disorder characterized by facial dysmorphia, upper-extremity malformations, hirsutism, cardiac defects, growth and cognitive retardation, and gastrointestinal abnormalities. Both missense and protein-truncating mutations in NIPBL, the human homolog of the Drosophila melanogaster Nipped-B gene, have recently been reported to cause CdLS. The function of NIPBL in mammals is unknown. The Drosophila Nipped-B protein facilitates long-range enhancer-promoter interactions and plays a role in Notch signaling and other developmental pathways, as well as being involved in mitotic sister-chromatid cohesion. We report the spectrum and distribution of NIPBL mutations in a large well-characterized cohort of individuals with CdLS. Mutations were found in 56 (47%) of 120 unrelated individuals with sporadic or familial CdLS. Statistically significant phenotypic differences between mutation-positive and mutation-negative individuals were identified. Analysis also suggested a trend toward a milder phenotype in individuals with missense mutations than in those with other types of mutations.
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Affiliation(s)
- Lynette A. Gillis
- Division of Human Genetics and Molecular Biology, The Children’s Hospital of Philadelphia, The University of Pennsylvania School of Medicine, and Division of Obstetrics and Gynecology, Drexel University School of Medicine, Philadelphia; Divisions of Gastroenterology and Genetics, The Vanderbilt University Medical Center, Nashville; The Harvey Institute of Human Genetics, Greater Baltimore Medical Center, Baltimore; Nemours Children’s Clinic, Wilmington, DE; and Department of Biology, Oncology, and Genetics, University of Genoa, Genoa
| | - Jennifer McCallum
- Division of Human Genetics and Molecular Biology, The Children’s Hospital of Philadelphia, The University of Pennsylvania School of Medicine, and Division of Obstetrics and Gynecology, Drexel University School of Medicine, Philadelphia; Divisions of Gastroenterology and Genetics, The Vanderbilt University Medical Center, Nashville; The Harvey Institute of Human Genetics, Greater Baltimore Medical Center, Baltimore; Nemours Children’s Clinic, Wilmington, DE; and Department of Biology, Oncology, and Genetics, University of Genoa, Genoa
| | - Maninder Kaur
- Division of Human Genetics and Molecular Biology, The Children’s Hospital of Philadelphia, The University of Pennsylvania School of Medicine, and Division of Obstetrics and Gynecology, Drexel University School of Medicine, Philadelphia; Divisions of Gastroenterology and Genetics, The Vanderbilt University Medical Center, Nashville; The Harvey Institute of Human Genetics, Greater Baltimore Medical Center, Baltimore; Nemours Children’s Clinic, Wilmington, DE; and Department of Biology, Oncology, and Genetics, University of Genoa, Genoa
| | - Cheryl DeScipio
- Division of Human Genetics and Molecular Biology, The Children’s Hospital of Philadelphia, The University of Pennsylvania School of Medicine, and Division of Obstetrics and Gynecology, Drexel University School of Medicine, Philadelphia; Divisions of Gastroenterology and Genetics, The Vanderbilt University Medical Center, Nashville; The Harvey Institute of Human Genetics, Greater Baltimore Medical Center, Baltimore; Nemours Children’s Clinic, Wilmington, DE; and Department of Biology, Oncology, and Genetics, University of Genoa, Genoa
| | - Dinah Yaeger
- Division of Human Genetics and Molecular Biology, The Children’s Hospital of Philadelphia, The University of Pennsylvania School of Medicine, and Division of Obstetrics and Gynecology, Drexel University School of Medicine, Philadelphia; Divisions of Gastroenterology and Genetics, The Vanderbilt University Medical Center, Nashville; The Harvey Institute of Human Genetics, Greater Baltimore Medical Center, Baltimore; Nemours Children’s Clinic, Wilmington, DE; and Department of Biology, Oncology, and Genetics, University of Genoa, Genoa
| | - Allison Mariani
- Division of Human Genetics and Molecular Biology, The Children’s Hospital of Philadelphia, The University of Pennsylvania School of Medicine, and Division of Obstetrics and Gynecology, Drexel University School of Medicine, Philadelphia; Divisions of Gastroenterology and Genetics, The Vanderbilt University Medical Center, Nashville; The Harvey Institute of Human Genetics, Greater Baltimore Medical Center, Baltimore; Nemours Children’s Clinic, Wilmington, DE; and Department of Biology, Oncology, and Genetics, University of Genoa, Genoa
| | - Antonie D. Kline
- Division of Human Genetics and Molecular Biology, The Children’s Hospital of Philadelphia, The University of Pennsylvania School of Medicine, and Division of Obstetrics and Gynecology, Drexel University School of Medicine, Philadelphia; Divisions of Gastroenterology and Genetics, The Vanderbilt University Medical Center, Nashville; The Harvey Institute of Human Genetics, Greater Baltimore Medical Center, Baltimore; Nemours Children’s Clinic, Wilmington, DE; and Department of Biology, Oncology, and Genetics, University of Genoa, Genoa
| | - Hui-hua Li
- Division of Human Genetics and Molecular Biology, The Children’s Hospital of Philadelphia, The University of Pennsylvania School of Medicine, and Division of Obstetrics and Gynecology, Drexel University School of Medicine, Philadelphia; Divisions of Gastroenterology and Genetics, The Vanderbilt University Medical Center, Nashville; The Harvey Institute of Human Genetics, Greater Baltimore Medical Center, Baltimore; Nemours Children’s Clinic, Wilmington, DE; and Department of Biology, Oncology, and Genetics, University of Genoa, Genoa
| | - Marcella Devoto
- Division of Human Genetics and Molecular Biology, The Children’s Hospital of Philadelphia, The University of Pennsylvania School of Medicine, and Division of Obstetrics and Gynecology, Drexel University School of Medicine, Philadelphia; Divisions of Gastroenterology and Genetics, The Vanderbilt University Medical Center, Nashville; The Harvey Institute of Human Genetics, Greater Baltimore Medical Center, Baltimore; Nemours Children’s Clinic, Wilmington, DE; and Department of Biology, Oncology, and Genetics, University of Genoa, Genoa
| | - Laird G. Jackson
- Division of Human Genetics and Molecular Biology, The Children’s Hospital of Philadelphia, The University of Pennsylvania School of Medicine, and Division of Obstetrics and Gynecology, Drexel University School of Medicine, Philadelphia; Divisions of Gastroenterology and Genetics, The Vanderbilt University Medical Center, Nashville; The Harvey Institute of Human Genetics, Greater Baltimore Medical Center, Baltimore; Nemours Children’s Clinic, Wilmington, DE; and Department of Biology, Oncology, and Genetics, University of Genoa, Genoa
| | - Ian D. Krantz
- Division of Human Genetics and Molecular Biology, The Children’s Hospital of Philadelphia, The University of Pennsylvania School of Medicine, and Division of Obstetrics and Gynecology, Drexel University School of Medicine, Philadelphia; Divisions of Gastroenterology and Genetics, The Vanderbilt University Medical Center, Nashville; The Harvey Institute of Human Genetics, Greater Baltimore Medical Center, Baltimore; Nemours Children’s Clinic, Wilmington, DE; and Department of Biology, Oncology, and Genetics, University of Genoa, Genoa
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6
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Russell KL, Ming JE, Patel K, Jukofsky L, Magnusson M, Krantz ID. Dominant paternal transmission of Cornelia de Lange syndrome: a new case and review of 25 previously reported familial recurrences. AMERICAN JOURNAL OF MEDICAL GENETICS 2001; 104:267-76. [PMID: 11754058 PMCID: PMC4894663 DOI: 10.1002/ajmg.10066] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The Cornelia de Lange syndrome (CdLS) is an autosomal dominant multisystem disorder characterized by somatic and cognitive retardation, characteristic facial features, limb abnormalities, hearing loss, and other organ system involvement. The vast majority of cases (99%) are sporadic, with rare familial occurrences having been reported. Most individuals with CdLS do not reproduce as a result of the severity of the disorder. Maternal transmission has been well documented, as have several cases of multiple-affected children being born to apparently unaffected parents. Paternal transmission has rarely been reported. A case is reported here of a father with classic features of CdLS with a similarly affected daughter. A review of the reported familial cases of CdLS is summarized.
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Affiliation(s)
- Karen L. Russell
- Division of Human Genetics and Molecular Biology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jeffrey E. Ming
- Division of Human Genetics and Molecular Biology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Ketan Patel
- Holly City Pediatrics, Millville, New Jersey
| | - Lori Jukofsky
- Division of Human Genetics and Molecular Biology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Mark Magnusson
- Division of Diagnostics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Ian D. Krantz
- Division of Human Genetics and Molecular Biology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Correspondence to: Dr. Ian D. Krantz, 1002 ARC, Division of Human Genetics and Molecular Biology, The Children’s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104.
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7
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Fernandez HH, Friedman JH, Famiglietti EV. Probable Cornelia de Lange syndrome with progressive parkinsonism and dystonia. Mov Disord 2000; 15:749-51. [PMID: 10928594 DOI: 10.1002/1531-8257(200007)15:4<749::aid-mds1028>3.0.co;2-p] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- H H Fernandez
- Department of Neurology, Brown University School of Medicine, Providence, Rhode Island, USA
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8
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Allanson JE, Hennekam RC, Ireland M. De Lange syndrome: subjective and objective comparison of the classical and mild phenotypes. J Med Genet 1997; 34:645-50. [PMID: 9279756 PMCID: PMC1051026 DOI: 10.1136/jmg.34.8.645] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Classical de Lange syndrome presents with a striking face, pronounced growth and mental retardation, and variable limb deficiencies. Over the past five years, a mild variant has been defined, with less significant psychomotor retardation, less marked pre- and postnatal growth deficiency, and an uncommon association with major malformations, although mild limb anomalies may be present. We have evaluated 43 subjects with de Lange syndrome, 30 with classical features, aged from birth to 21 years, and 13 with the mild phenotype, aged from 18 months to 30 years. In addition to assessment of gestalt and facial change with time, detailed craniofacial measurements have been obtained on each subject and composite pattern profiles compiled. The characteristic face of classical de Lange syndrome is present at birth and changes little throughout life, although there is some lengthening of the face with age and the jaw becomes squared. In mild de Lange syndrome, the characteristic classical appearance may be present at birth, but in some subjects it may be two or three years before the typical face is obvious. In general, the overall impression is less striking, perhaps because of increased facial expression and greater alertness. With age, the face loses the characteristic appearance, the nasal height increases, the philtrum does not seem as long, and the upper vermilion is full and everted, although the crescent shaped mouth with downturned corners remains. Eyebrows may be full and bushy. Objective comparison of the face in mild and classical de Lange syndrome, through the use of craniofacial pattern profiles, shows marked similarity of patterns at 4 to 9 years; both groups have microbrachycephaly, but the individual dimensions of the mild group are slightly closer to normal than their classical counterparts. The correlation coefficient is high (0.83). In the adult groups, similarity of patterns remains but is less marked. The normalisation of scores in the mild group is more dramatic. The correlation coefficient is lower (0.71). These objective findings substantiate clinical impressions of a phenotypic dichotomy. Early in life, the craniofacial features in mild de Lange syndrome may be indistinguishable from the classical phenotype and alternative discriminators must be sought in order to identify those subjects in whom the prognosis is more optimistic. Birth weight of more than 2500 g and absence of major limb anomalies may help in this regard.
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Affiliation(s)
- J E Allanson
- Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Canada
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9
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Ireland M. Cornelia de Lange syndrome: clinical features, common complications and long-term prognosis. ACTA ACUST UNITED AC 1996. [DOI: 10.1016/s0957-5839(96)80064-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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10
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Krajewska-Walasek M, Chrzanowska K, Tylki-Szymańska A, Białecka M. A further report of Brachmann-de Lange syndrome in two sibs with normal parents. Clin Genet 1995; 47:324-7. [PMID: 7554368 DOI: 10.1111/j.1399-0004.1995.tb03974.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
We report on a family in which a girl and a boy in the same sibship show variable manifestations of a less severe type of Brachmann-de Lange syndrome without significant prenatal growth deficiency and reduction deformities of the forearms. Both parents are healthy and phenotypically normal, and no other family members are affected. All the affected sibs except one described so far with normal parents presented the severe type of Brachmann-de Lange syndrome (now sometimes classified as type I: "classic" or "full" Brachmann-de Lange syndrome), with major upper limb anomalies, severe growth and mental retardation and, frequently, early death. We discuss the possible role of genomic imprinting in the etiology of this syndrome.
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Affiliation(s)
- M Krajewska-Walasek
- Department of Genetics, Memorial Hospital - Child Health Centre, Warsaw, Poland
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11
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Holder SE, Grimsley LM, Palmer RW, Butler LJ, Baraitser M. Partial trisomy 3q causing mild Cornelia de Lange phenotype. J Med Genet 1994; 31:150-2. [PMID: 8182724 PMCID: PMC1049680 DOI: 10.1136/jmg.31.2.150] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A brother and sister are reported with developmental delay and facial features suggestive of the Cornelia de Lange syndrome. Cytogenetic analysis showed them to be trisomic for the region 3q25.1-26.2 because of the inheritance of an unbalanced interchromosomal insertion from their father, who was a balanced insertion carrier. The clinical phenotype and cytogenetic analysis (including chromosome painting studies) in relation to the possible localisation of the Cornelia de Lange gene are discussed.
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Affiliation(s)
- S E Holder
- Mothercare Unit of Clinical Genetics, Institute of Child Health, London, UK
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12
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Van Allen MI, Filippi G, Siegel-Bartelt J, Yong SL, McGillivray B, Zuker RM, Smith CR, Magee JF, Ritchie S, Toi A. Clinical variability within Brachmann-de Lange syndrome: a proposed classification system. AMERICAN JOURNAL OF MEDICAL GENETICS 1993; 47:947-58. [PMID: 8291538 DOI: 10.1002/ajmg.1320470704] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Seven patients, including two sibs, with the Brachmann-de Lange syndrome (BDLS) are presented as representative of the different types of BDLS in a proposed classification system. Type I ("classic") patients have the characteristic facial and skeletal changes of BDLS using the criteria in the diagnostic index of Preus and Rex. Type I is distinguished from the other subtypes by prenatal growth deficiency (< 2.5 S.D. below mean for gestation) becoming more severe postnatally (< 3.5 S.D. below the mean), moderate to profound psychomotor retardation, and major malformations which result in severe disability or death. Type II ("mild") BDLS patients have similar facial and minor skeletal abnormalities to those seen in type I; however, these changes may develop with time or may be partially expressed. Patients with type II BDLS are distinguished from those with other types by mild to borderline psychomotor retardation, less severe pre- and postnatal growth deficiency, and the absence of (or loss severe) major malformations. Behavioral problems can be a significant clinical problem in type II BDLS. Type III ("phenocopies") BDLS includes patients who have phenotypic manifestations of BDLS which are causally related to chromosomal aneuploidies or teratogenic exposures.
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Affiliation(s)
- M I Van Allen
- Department of Medical Genetics, University Hospital-Shaughnessy Site, University of British Columbia, Vancouver, Canada
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13
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Jackson L, Kline AD, Barr MA, Koch S. de Lange syndrome: a clinical review of 310 individuals. AMERICAN JOURNAL OF MEDICAL GENETICS 1993; 47:940-6. [PMID: 8291537 DOI: 10.1002/ajmg.1320470703] [Citation(s) in RCA: 215] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Three hundred ten individuals with a clinical diagnosis of de Lange syndrome were seen and examined in conjunction with the parent support group. One hundred thirty-four males and 176 females whose ages ranged from birth to 37 years made up the study group. Examination findings were recorded for those features described by de Lange in her original report of the syndrome to determine the frequency and significance of each. In addition, questionnaires were completed by 128 of these families and medical, growth and developmental records were collected. The clinical diagnosis seems best supported by the facial features of the syndrome including the long eyelashes and confluent eyebrows (synophrys), although additional characteristics are needed. Only 27% had the upper limb deficiencies commonly associated with the syndrome. Growth was retarded in nearly all individuals, often of prenatal onset. Medical problems occurred frequently and most often involved the eye and ear, as well as the cardiac and gastrointestinal systems. Of 14 deaths, almost half were secondary to cardiac or gastrointestinal complications. The recurrence risk in 377 sibs of the patients was calculated to be less than 1%. Although development lagged significantly in speech, most individuals developed good self-help skills. The study demonstrated a higher proportion of patients affected mildly with the syndrome than is commonly appreciated. This underscores the importance of early recognition and appropriate medical and developmental support.
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Affiliation(s)
- L Jackson
- Department of Medicine, Jefferson Medical College, Philadelphia, Pennsylvania
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14
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Saul RA, Rogers RC, Phelan MC, Stevenson RE. Brachmann-de Lange syndrome: diagnostic difficulties posed by the mild phenotype. AMERICAN JOURNAL OF MEDICAL GENETICS 1993; 47:999-1002. [PMID: 8291544 DOI: 10.1002/ajmg.1320470712] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We describe 4 patients with facial changes of Brachmann-de Lange syndrome but without limb defects. Mental retardation ranged from moderate to severe and the degree of prenatal and postnatal growth deficiency was variable. These patients exemplify the diagnostic difficulties and counseling dilemmas posed by the mild Branchmann-de Lange phenotype. The relationship of the mild phenotype to the full syndrome will not be understood until the pathogenetic or causal factor(s) are delineated.
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Affiliation(s)
- R A Saul
- Greenwood Genetic Center, SC 29646
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15
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Feingold M, Lin AE. Familial Brachmann-de Lange syndrome: further evidence for autosomal dominant inheritance and review of the literature. AMERICAN JOURNAL OF MEDICAL GENETICS 1993; 47:1064-7. [PMID: 8291524 DOI: 10.1002/ajmg.1320470726] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We report on a mother and daughter with the Brachmann-de Lange syndrome which supports the view that in some families this disorder is due to autosomal dominant inheritance. A review of the literature concerning autosomal and recessive inheritance of this syndrome is presented.
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Affiliation(s)
- M Feingold
- Department of Genetics, Franciscan Children's Hospital, Brighton, MA 02135
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16
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Ireland M, English C, Cross I, Houlsby WT, Burn J. A de novo translocation t(3;17)(q26.3;q23.1) in a child with Cornelia de Lange syndrome. J Med Genet 1991; 28:639-40. [PMID: 1956066 PMCID: PMC1015799 DOI: 10.1136/jmg.28.9.639] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A female infant with Cornelia de Lange syndrome and severe limb reduction defects is described. Chromosome analysis showed a de novo translocation with breakpoints at 3q26.3 and 17q23.1. This is the first reported case of a de novo translocation associated with this syndrome.
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Affiliation(s)
- M Ireland
- Department of Human Genetics, University of Newcastle upon Tyne
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