Ann Child Neurol.  2020 Oct;28(4):131-137. 10.26815/acn.2020.00108.

Deep Phenotyping in 1p36 Deletion Syndrome

Affiliations
  • 1Department of Pediatrics, Pediatric Clinical Neuroscience Center, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea
  • 2Research Center for Rare Diseases, Seoul National University Hospital, Seoul, Korea
  • 3Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
  • 4Department of Pediatrics, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea

Abstract

Purpose
Although 1p36 deletion syndrome is the most common terminal deletion syndrome, unexplained phenotypic variability still occurs. We aimed to delineate the phenotype of this syndrome in detail and to characterize the phenotype-genotype correlation.
Methods
We retrospectively reviewed 15 patients diagnosed with 1p36 deletion syndrome.
Results
All 15 patients revealed delayed attainment of motor milestones and speech. Seven patients (46.7%) never walked alone and only two (13.3%) could express a simple two-word sentence. They all showed subsequent intellectual disability. Two patients with large deletions of both distal and proximal critical regions of the 1p36 region shared severe intellectual disability with Rett syndrome-like behavioral features. Seizures, although frequent (73.3%), were well-controlled except in one patient with infantile spasms. Facial dysmorphism (92.9%) and ventricular mild dilatation with corpus callosum anomaly (46.7%) were common. Heart problems were identified in 14 patients, including structural abnormalities and/or functional problems associated with the gene encoding PR domain-containing protein 16. Two patients developed severe cardiac dysfunction requiring heart transplantation in their late teens. One patient with a small interstitial deletion (400 kb) partly overlapping with the gene encoding calmodulin-binding transcription activator 1 did not have facial dysmorphism and presented with mild developmental delay and ataxic gait. One patient had a choledochal cyst, which was resected due to neonatal cholestasis.
Conclusion
Although the phenotype of 1p36 deletion syndrome is quite consistent with previous reports, additional manifestations such as certain behavioral features, ataxic gait, and severe cardiac dysfunction at an early age should be considered.

Keyword

Chromosome 1p36 deletion syndrome; Phenotype; Genotype
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