[20q11.2 microdeletion syndrome: a phenotypic spectrum expansion. Case report].

Israel Enrique Crisanto-López, Renato García-González, María Patricia Saldaña-Guerrero, Rosa María Hernández-Camacho, Dulce María Castro-Coyotl
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Abstract

Background: 20q11.2 microdeletion syndrome [ORPHA: 444051] is a rare disease, since 16 patients have been reported in literature worldwide. Prevalence ratio is < 1:1,000,000 individuals. Haploinsufficiency on GDF5, SAMHD1 and EPB41L1 genes is important due to phenotypic manifestations in patients. Clinical features can be grouped into craniofacial abnormalities, limb abnormalities, neurological and perinatal disorders. The aim of this report is to present a clinical case of 20q11.21-q11.23 microdeletion, to describe clinical manifestations found, to compare them with features reported in literature, and to contribute to the phenotypic spectrum expansion.

Clinical case: 5-year-old female patient who presented hypotonia, psychomotor retardation, microcephaly, facial dysmorphia, pectus excavatum, thoracolumbar scoliosis, right hip subluxation, camptodactyly and clinodactyly. Karyotype test was normal and SNP microarray test reported deletion of chromosomal region 20q11.21-q11.23.

Conclusions: It was presented a 20q11.2 microdeletion syndrome confirmed case that shares the features reported in literature, in addition to previously unreported features, such as blepharoptosis, pectus excavatum, scoliosis and hip dysplasia. Interdisciplinary management is important to improve the patient's condition (in her 3 spheres), in order to achieve her best possible health status.

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[20q11.2微缺失综合征:表型谱扩展。病例报告]。
背景:20q11.2微缺失综合征[ORPHA: 444051]是一种罕见病,全世界已有16例患者的文献报道。发病率小于 1:1,000,000。由于患者的表型表现,GDF5、SAMHD1 和 EPB41L1 基因的单倍缺失非常重要。临床特征可分为颅面畸形、肢体畸形、神经系统疾病和围产期疾病。本报告旨在介绍一例 20q11.21-q11.23 微缺失的临床病例,描述所发现的临床表现,将其与文献报道的特征进行比较,并为表型谱的扩展做出贡献:5岁女性患者,表现为肌张力低下、精神运动迟滞、小头畸形、面部畸形、鸡胸、胸腰椎侧弯、右髋关节脱位、驼背和挛缩。核型检测正常,SNP 微阵列检测显示染色体 20q11.21-q11.23 区缺失:本病例是一个 20q11.2 微缺失综合征确诊病例,除具有文献报道的特征外,还具有以前未报道过的特征,如眼睑外翻、鸡胸、脊柱侧弯和髋关节发育不良。跨学科管理对改善患者的病情(3 个方面)非常重要,以尽可能改善患者的健康状况。
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