Further delineation of Malan syndrome

Malan syndrome is an overgrowth disorder described in a limited number of individuals. We aim to delineate the entity by studying a large group of affected individuals. We gathered data on 45 affected individuals with a molecularly confirmed diagnosis through an international collaboration and compared data to the 35 previously reported individuals. Results indicate that height is > 2 SDS in infancy and childhood but in only half of affected adults. Cardinal facial characteristics include long, triangular face, macrocephaly, prominent forehead, everted lower lip, and prominent chin. Intellectual disability is universally present, behaviorally anxiety is characteristic. Malan syndrome is caused by deletions or point mutations of NFIX clustered mostly in exon 2. There is no genotype-phenotype correlation except for an increased risk for epilepsy with 19p13.2 microdeletions. Variants arose de novo, except in one family in which mother was mosaic. Variants causing Malan and Marshall-Smith syndrome can be discerned by differences in the site of stop codon formation. We conclude that Malan syndrome has a well recognizable phenotype that usually can be discerned easily from Marshall–Smith syndrome but rarely there is some overlap. Differentiation from Sotos and Weaver syndrome can be made by clinical evaluation only

Search for mutations in the CDKN2A gene in patients with clinical pattern of hereditary melanoma.

A incidência do melanoma, tumor maligno que se origina dos melanócitos, vem crescendo em todo o mundo. História familial positiva da doença tem sido relatada em 8 a 14% dos pacientes afetados. Muitos estudos sugeriram o envolvimento da região 9p21, onde se encontra o gene CDKN2A, no surgimento dessa neoplasia. Este é um gene supressor tumoral clássico e a inativação dos dois alelos tem sido detectadas em linhagens celulares tumorais de famílias com melanoma hereditário e esporádico. Mutações em linhagens germinativas do gene CDKN2A têm sido identificadas em aproximadamente 20% das famílias com melanoma familial. Utilizando técnicas de biologia molecular como Reação em Cadeia da Polimerase (PCR), Conformação Estrutural de Fita Simples (SSCP) e seqüenciamento, este projeto estudou 22 pacientes com critérios clínicos de melanoma hereditário e encontrou uma mutação (P48T) em um paciente numa família de três afetados. Em 13 casos foi identificado pelo menos um dos três polimorfismos: 500 C>G (31,9%), 540 C>T (27,3%) e A148T (4,5%). Os resultados demonstram a importância da pesquisa de mutações no gene CDKN2A principalmente em famílias com dois ou mais membros afetados pela doença.The incidence of melanoma, malign tumor that originates from melanocytes, is increasing all over the world. Positive familial history of disease has been related in 8 to 14% of affected patients. Several studies have suggest the 9p21 region evolvement, where is located the CDKN2A gene, in the arising of this neoplasia. It is a classic tumor suppressor gene and the inactivation of two alleles has been detected in tumor cells lines of families with hereditary and sporadic melanoma. Nowadays germeline mutations in CDKN2A gene have been identified in almost 20% of families with familial melanoma. Using molecular biology techniques like Polymerase Chain Reaction (PCR), Single Strand Conformational Polymorphism (SSCP) and sequencing, this project studied 22 patients with clinical pattern of hereditary melanoma and it found one mutation (P48T) in one patient belonged to a three affected family. Thirteen cases had at least one of the three polymorphisms: 500 C>G (31,9%), 540 C>T (27,3%) e A148T (4,5%). The results show the importance of the search for mutations in the CDKN2A gene mainly in families with two or more affected by disease

Search for mutations in the CDKN2A gene in patients with clinical pattern of hereditary melanoma.

A incidência do melanoma, tumor maligno que se origina dos melanócitos, vem crescendo em todo o mundo. História familial positiva da doença tem sido relatada em 8 a 14% dos pacientes afetados. Muitos estudos sugeriram o envolvimento da região 9p21, onde se encontra o gene CDKN2A, no surgimento dessa neoplasia. Este é um gene supressor tumoral clássico e a inativação dos dois alelos tem sido detectadas em linhagens celulares tumorais de famílias com melanoma hereditário e esporádico. Mutações em linhagens germinativas do gene CDKN2A têm sido identificadas em aproximadamente 20% das famílias com melanoma familial. Utilizando técnicas de biologia molecular como Reação em Cadeia da Polimerase (PCR), Conformação Estrutural de Fita Simples (SSCP) e seqüenciamento, este projeto estudou 22 pacientes com critérios clínicos de melanoma hereditário e encontrou uma mutação (P48T) em um paciente numa família de três afetados. Em 13 casos foi identificado pelo menos um dos três polimorfismos: 500 C>G (31,9%), 540 C>T (27,3%) e A148T (4,5%). Os resultados demonstram a importância da pesquisa de mutações no gene CDKN2A principalmente em famílias com dois ou mais membros afetados pela doença.The incidence of melanoma, malign tumor that originates from melanocytes, is increasing all over the world. Positive familial history of disease has been related in 8 to 14% of affected patients. Several studies have suggest the 9p21 region evolvement, where is located the CDKN2A gene, in the arising of this neoplasia. It is a classic tumor suppressor gene and the inactivation of two alleles has been detected in tumor cells lines of families with hereditary and sporadic melanoma. Nowadays germeline mutations in CDKN2A gene have been identified in almost 20% of families with familial melanoma. Using molecular biology techniques like Polymerase Chain Reaction (PCR), Single Strand Conformational Polymorphism (SSCP) and sequencing, this project studied 22 patients with clinical pattern of hereditary melanoma and it found one mutation (P48T) in one patient belonged to a three affected family. Thirteen cases had at least one of the three polymorphisms: 500 C>G (31,9%), 540 C>T (27,3%) e A148T (4,5%). The results show the importance of the search for mutations in the CDKN2A gene mainly in families with two or more affected by disease

Ambulatório de genética médica na Apae: experiência no ensino médico de graduação

Este trabalho relata uma experiência de ensino cujo objetivo foi oferecer formação significativa e integradora na área de genética médica aos graduandos de medicina do Centro Universitário Barão de Mauá. Para isto, em 2005, foi estruturado um ambulatório de genética médica na Associação de Pais e Amigos dos Excepcionais (Apae) do município de Jardinópolis (SP), como parte do estágio de internato em Saúde Coletiva e Medicina da Família e Comunidade, realizado nos serviços de saúde desse município. Desde então, os estudantes do sexto ano do curso médico avaliaram 140 pacientes, estabelecendo o grau de comprometimento intelectual, a etiologia da deficiência mental e oferecendo aconselhamento genético não-diretivo às famílias, sob orientação dos professores. A diversificação do cenário de ensino e aprendizagem aproximou os alunos da realidade dos pacientes com deficiência mental no País. Além disto, os estudantes puderam se apropriar de alguns fundamentos teóricos da genética médica a partir da constatação de suas implicações na prática clínica, tornando a aprendizagem significativa. Com esta experiência espera-se ter contribuído para a formação de médicos mais competentes na área da genética médica e saúde coletiva, e dispostos a trabalhar de forma integrada e integradora com a comunidade

Velocardiofacial syndrome with a rare t(2;22)

Rearrangements involving chromosomes 2 and 22 were described not only as acquired abnormalities in a variety of human neoplasias but also in the constitutional karyotype suggesting the existence of a greater fragility in some specific regions in these chromosomes. Patients with DiGeorge and Velocardiofacial syndromes have a deletion on 22q11 leading to haploinsufficiency for one or more gene(s). We report a patient with velocardiofacial syndrome in which cytogenetic and fluorescence in situ hybridization analysis showed a rare t(2;22) and deletion in the 22q11 region. © 2007 Lippincott Williams & Wilkins, Inc

Germline and Mosaic Variants in PRKACA and PRKACB Cause a Multiple Congenital Malformation Syndrome

PRKACA and PRKACB code for two catalytic subunits (Cα and Cβ) of cAMP-dependent protein kinase (PKA), a pleiotropic holoenzyme that regulates numerous fundamental biological processes such as metabolism, development, memory, and immune response. We report seven unrelated individuals presenting with a multiple congenital malformation syndrome in whom we identified heterozygous germline or mosaic missense variants in PRKACA or PRKACB. Three affected individuals were found with the same PRKACA variant, and the other four had different PRKACB mutations. In most cases, the mutations arose de novo, and two individuals had offspring with the same condition. Nearly all affected individuals and their affected offspring shared an atrioventricular septal defect or a common atrium along with postaxial polydactyly. Additional features included skeletal abnormalities and ectodermal defects of variable severity in five individuals, cognitive deficit in two individuals, and various unusual tumors in one individual. We investigated the structural and functional consequences of the variants identified in PRKACA and PRKACB through the use of several computational and experimental approaches, and we found that they lead to PKA holoenzymes which are more sensitive to activation by cAMP than are the wild-type proteins. Furthermore, expression of PRKACA or PRKACB variants detected in the affected individuals inhibited hedgehog signaling in NIH 3T3 fibroblasts, thereby providing an underlying mechanism for the developmental defects observed in these cases. Our findings highlight the importance of both Cα and Cβ subunits of PKA during human development.This work was partially supported by funding from the Spanish Ministry of Science, Innovation and Universities (SAF2016-75434-R [AEI/FEDER, UE] and PID2019-105620RB-I00/AEI/10.13039/501100011033) to V.L.R.-P. S.S.T. was supported by NIH grant R03TR002947, E.M.F.M. by Kassel graduate school “Clocks”, and A.D.L. by the Italian Ministry of Health (RC-2019). The University of Antwerp supported G.M. and W.V.H. with Methusalem funding (FFB190208) and S.P. with a predoctoral grant. E.B. was supported by The Research Foundation Flanders with a postdoctoral grant (12A3814N). The study was also funded by a National Health and Medical Research Council Program Grant (1091593) to I.E.S., a Practitioner Fellowship (1006110) to I.E.S., a Senior Research Fellowship (1102971) to M.B., and an R.D. Wright Career Development Fellowship (1063799) to M.S.H. B.S.S. and G.L. were supported by Throne Holst Foundation UiO (2019-2021) and Strategic PhD fund by UiO/IMB