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Ensenauer RE, Adeyinka A, Flynn HC, Michels VV, Lindor NM, Dawson DB, Thorland EC, Lorentz CP, Goldstein JL, McDonald MT, Smith WE, Simon-Fayard E, Alexander AA, Kulharya AS, Ketterling RP, Clark RD, Jalal SM. Microduplication 22q11.2, an emerging syndrome: clinical, cytogenetic, and molecular analysis of thirteen patients. Am J Hum Genet 2003; 73:1027-40. [PMID: 14526392 PMCID: PMC1180483 DOI: 10.1086/378818] [Citation(s) in RCA: 253] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2003] [Accepted: 07/29/2003] [Indexed: 11/03/2022] Open
Abstract
Chromosome 22, particularly band 22q11.2, is predisposed to rearrangements due to misalignments of low-copy repeats (LCRs). DiGeorge/velocardiofacial syndrome (DG/VCFS) is a common disorder resulting from microdeletion within the same band. Although both deletion and duplication are expected to occur in equal proportions as reciprocal events caused by LCR-mediated rearrangements, very few microduplications have been identified. We have identified 13 cases of microduplication 22q11.2, primarily by interphase fluorescence in situ hybridization (FISH). The size of the duplications, determined by FISH probes from bacterial artificial chromosomes and P(1) artificial chromosomes, range from 3-4 Mb to 6 Mb, and the exchange points seem to involve an LCR. Molecular analysis based on 15 short tandem repeats confirmed the size of the duplications and indicated that at least 1 of 15 loci has three alleles present. The patients' phenotypes ranged from mild to severe, sharing a tendency for velopharyngeal insufficiency with DG/VCFS but having other distinctive characteristics, as well. Although the present series of patients was ascertained because of some overlapping features with DG/VCF syndromes, the microduplication of 22q11.2 appears to be a new syndrome.
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Affiliation(s)
- Regina E. Ensenauer
- Department of Medical Genetics, and Cytogenetics Laboratory and Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; Department of Pediatrics, Duke University Medical Center, Durham, NC; Division of Genetics, Barbara Bush Children’s Hospital, Maine Medical Center, Portland, ME; Department of Pediatrics, Division of Neonatology, Loma Linda University Medical Center, and Division of Genetics, Loma Linda University Children’s Hospital, Loma Linda, CA; Desert Pediatrics, Inc., Palm Desert, CA; and Department of Pediatrics and Pathology, Medical College of Georgia, Augusta, GA
| | - Adewale Adeyinka
- Department of Medical Genetics, and Cytogenetics Laboratory and Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; Department of Pediatrics, Duke University Medical Center, Durham, NC; Division of Genetics, Barbara Bush Children’s Hospital, Maine Medical Center, Portland, ME; Department of Pediatrics, Division of Neonatology, Loma Linda University Medical Center, and Division of Genetics, Loma Linda University Children’s Hospital, Loma Linda, CA; Desert Pediatrics, Inc., Palm Desert, CA; and Department of Pediatrics and Pathology, Medical College of Georgia, Augusta, GA
| | - Heather C. Flynn
- Department of Medical Genetics, and Cytogenetics Laboratory and Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; Department of Pediatrics, Duke University Medical Center, Durham, NC; Division of Genetics, Barbara Bush Children’s Hospital, Maine Medical Center, Portland, ME; Department of Pediatrics, Division of Neonatology, Loma Linda University Medical Center, and Division of Genetics, Loma Linda University Children’s Hospital, Loma Linda, CA; Desert Pediatrics, Inc., Palm Desert, CA; and Department of Pediatrics and Pathology, Medical College of Georgia, Augusta, GA
| | - Virginia V. Michels
- Department of Medical Genetics, and Cytogenetics Laboratory and Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; Department of Pediatrics, Duke University Medical Center, Durham, NC; Division of Genetics, Barbara Bush Children’s Hospital, Maine Medical Center, Portland, ME; Department of Pediatrics, Division of Neonatology, Loma Linda University Medical Center, and Division of Genetics, Loma Linda University Children’s Hospital, Loma Linda, CA; Desert Pediatrics, Inc., Palm Desert, CA; and Department of Pediatrics and Pathology, Medical College of Georgia, Augusta, GA
| | - Noralane M. Lindor
- Department of Medical Genetics, and Cytogenetics Laboratory and Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; Department of Pediatrics, Duke University Medical Center, Durham, NC; Division of Genetics, Barbara Bush Children’s Hospital, Maine Medical Center, Portland, ME; Department of Pediatrics, Division of Neonatology, Loma Linda University Medical Center, and Division of Genetics, Loma Linda University Children’s Hospital, Loma Linda, CA; Desert Pediatrics, Inc., Palm Desert, CA; and Department of Pediatrics and Pathology, Medical College of Georgia, Augusta, GA
| | - D. Brian Dawson
- Department of Medical Genetics, and Cytogenetics Laboratory and Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; Department of Pediatrics, Duke University Medical Center, Durham, NC; Division of Genetics, Barbara Bush Children’s Hospital, Maine Medical Center, Portland, ME; Department of Pediatrics, Division of Neonatology, Loma Linda University Medical Center, and Division of Genetics, Loma Linda University Children’s Hospital, Loma Linda, CA; Desert Pediatrics, Inc., Palm Desert, CA; and Department of Pediatrics and Pathology, Medical College of Georgia, Augusta, GA
| | - Erik C. Thorland
- Department of Medical Genetics, and Cytogenetics Laboratory and Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; Department of Pediatrics, Duke University Medical Center, Durham, NC; Division of Genetics, Barbara Bush Children’s Hospital, Maine Medical Center, Portland, ME; Department of Pediatrics, Division of Neonatology, Loma Linda University Medical Center, and Division of Genetics, Loma Linda University Children’s Hospital, Loma Linda, CA; Desert Pediatrics, Inc., Palm Desert, CA; and Department of Pediatrics and Pathology, Medical College of Georgia, Augusta, GA
| | - Cindy Pham Lorentz
- Department of Medical Genetics, and Cytogenetics Laboratory and Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; Department of Pediatrics, Duke University Medical Center, Durham, NC; Division of Genetics, Barbara Bush Children’s Hospital, Maine Medical Center, Portland, ME; Department of Pediatrics, Division of Neonatology, Loma Linda University Medical Center, and Division of Genetics, Loma Linda University Children’s Hospital, Loma Linda, CA; Desert Pediatrics, Inc., Palm Desert, CA; and Department of Pediatrics and Pathology, Medical College of Georgia, Augusta, GA
| | - Jennifer L. Goldstein
- Department of Medical Genetics, and Cytogenetics Laboratory and Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; Department of Pediatrics, Duke University Medical Center, Durham, NC; Division of Genetics, Barbara Bush Children’s Hospital, Maine Medical Center, Portland, ME; Department of Pediatrics, Division of Neonatology, Loma Linda University Medical Center, and Division of Genetics, Loma Linda University Children’s Hospital, Loma Linda, CA; Desert Pediatrics, Inc., Palm Desert, CA; and Department of Pediatrics and Pathology, Medical College of Georgia, Augusta, GA
| | - Marie T. McDonald
- Department of Medical Genetics, and Cytogenetics Laboratory and Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; Department of Pediatrics, Duke University Medical Center, Durham, NC; Division of Genetics, Barbara Bush Children’s Hospital, Maine Medical Center, Portland, ME; Department of Pediatrics, Division of Neonatology, Loma Linda University Medical Center, and Division of Genetics, Loma Linda University Children’s Hospital, Loma Linda, CA; Desert Pediatrics, Inc., Palm Desert, CA; and Department of Pediatrics and Pathology, Medical College of Georgia, Augusta, GA
| | - Wendy E. Smith
- Department of Medical Genetics, and Cytogenetics Laboratory and Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; Department of Pediatrics, Duke University Medical Center, Durham, NC; Division of Genetics, Barbara Bush Children’s Hospital, Maine Medical Center, Portland, ME; Department of Pediatrics, Division of Neonatology, Loma Linda University Medical Center, and Division of Genetics, Loma Linda University Children’s Hospital, Loma Linda, CA; Desert Pediatrics, Inc., Palm Desert, CA; and Department of Pediatrics and Pathology, Medical College of Georgia, Augusta, GA
| | - Elba Simon-Fayard
- Department of Medical Genetics, and Cytogenetics Laboratory and Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; Department of Pediatrics, Duke University Medical Center, Durham, NC; Division of Genetics, Barbara Bush Children’s Hospital, Maine Medical Center, Portland, ME; Department of Pediatrics, Division of Neonatology, Loma Linda University Medical Center, and Division of Genetics, Loma Linda University Children’s Hospital, Loma Linda, CA; Desert Pediatrics, Inc., Palm Desert, CA; and Department of Pediatrics and Pathology, Medical College of Georgia, Augusta, GA
| | - Alan A. Alexander
- Department of Medical Genetics, and Cytogenetics Laboratory and Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; Department of Pediatrics, Duke University Medical Center, Durham, NC; Division of Genetics, Barbara Bush Children’s Hospital, Maine Medical Center, Portland, ME; Department of Pediatrics, Division of Neonatology, Loma Linda University Medical Center, and Division of Genetics, Loma Linda University Children’s Hospital, Loma Linda, CA; Desert Pediatrics, Inc., Palm Desert, CA; and Department of Pediatrics and Pathology, Medical College of Georgia, Augusta, GA
| | - Anita S. Kulharya
- Department of Medical Genetics, and Cytogenetics Laboratory and Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; Department of Pediatrics, Duke University Medical Center, Durham, NC; Division of Genetics, Barbara Bush Children’s Hospital, Maine Medical Center, Portland, ME; Department of Pediatrics, Division of Neonatology, Loma Linda University Medical Center, and Division of Genetics, Loma Linda University Children’s Hospital, Loma Linda, CA; Desert Pediatrics, Inc., Palm Desert, CA; and Department of Pediatrics and Pathology, Medical College of Georgia, Augusta, GA
| | - Rhett P. Ketterling
- Department of Medical Genetics, and Cytogenetics Laboratory and Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; Department of Pediatrics, Duke University Medical Center, Durham, NC; Division of Genetics, Barbara Bush Children’s Hospital, Maine Medical Center, Portland, ME; Department of Pediatrics, Division of Neonatology, Loma Linda University Medical Center, and Division of Genetics, Loma Linda University Children’s Hospital, Loma Linda, CA; Desert Pediatrics, Inc., Palm Desert, CA; and Department of Pediatrics and Pathology, Medical College of Georgia, Augusta, GA
| | - Robin D. Clark
- Department of Medical Genetics, and Cytogenetics Laboratory and Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; Department of Pediatrics, Duke University Medical Center, Durham, NC; Division of Genetics, Barbara Bush Children’s Hospital, Maine Medical Center, Portland, ME; Department of Pediatrics, Division of Neonatology, Loma Linda University Medical Center, and Division of Genetics, Loma Linda University Children’s Hospital, Loma Linda, CA; Desert Pediatrics, Inc., Palm Desert, CA; and Department of Pediatrics and Pathology, Medical College of Georgia, Augusta, GA
| | - Syed M. Jalal
- Department of Medical Genetics, and Cytogenetics Laboratory and Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; Department of Pediatrics, Duke University Medical Center, Durham, NC; Division of Genetics, Barbara Bush Children’s Hospital, Maine Medical Center, Portland, ME; Department of Pediatrics, Division of Neonatology, Loma Linda University Medical Center, and Division of Genetics, Loma Linda University Children’s Hospital, Loma Linda, CA; Desert Pediatrics, Inc., Palm Desert, CA; and Department of Pediatrics and Pathology, Medical College of Georgia, Augusta, GA
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