Integrated analysis of the critical region 5p15.3-p15.2 associated with cri-du-chat syndrome

Cri-du-chat syndrome (CdCs) is one of the most common contiguous gene syndromes, with an incidence of 1:15,000 to 1:50,000 live births. To better understand the etiology of CdCs at the molecular level, we investigated theprotein-protein interaction (PPI) network within the critical chromosomal region 5p15.3-p15.2 associated with CdCs using systemsbiology. Data were extracted from cytogenomic findings from patients with CdCs. Based on clinical findings, molecular characterization of chromosomal rearrangements, and systems biology data, we explored possible genotype-phenotype correlations involving biological processes connected with CdCs candidate genes. We identified biological processes involving genes previously found to be associated with CdCs, such as TERT, SLC6A3, and CTDNND2, as well as novel candidate proteins with potential contributions to CdCs phenotypes, including CCT5, TPPP, MED10, ADCY2, MTRR, CEP72, NDUFS6, and MRPL36. Although further functional analyses of these proteins are required, we identified candidate proteins for the development of new multi-target genetic editing tools to study CdCs. Further research may confirm those that are directly involved in the development of CdCs phenotypes and improve our understanding of CdCs-associated molecular mechanisms

Novel duplication on chromosome 16 (q12.1-q21) associated with behavioral disorder, mild cognitive impairment, speech delay, and dysmorphic features: case report

We report on the 10-year follow-up and clinical, cytogenetic, and molecular investigation of a girl admitted for evaluation because of speech delay, learning difficulties, aggressive behavior, and dysmorphic facial features that included high forehead, round face, epicanthic folds, low-set dysplastic ears, flat nasal bridge, long flat philtrum, thin upper lip, small mouth, and short neck. The analysis of high-resolution GTG- and CTG-banding chromosomes suggested a de novo direct duplication of 16q12-q21 region and fluorescence in situ hybridization analysis with whole-chromosome specific 16 probe confirmed that the duplicated genetic material originated from the chromosome 16. Subsequently, array-based comparative genomic hybridization analysis with a ≈ 75 kb resolution showed a 9.92 Mb gain on the long arm of chromosome 16 at bands q12.1 through q21. To the best of our knowledge, this is the first case of duplication 16q12.1q21 described in literature. Several genes within the duplicated region are possibly correlated with clinical features present in our patient. Clinical and cytogenetic findings were compared with the small number of reported patients with pure duplications 16q, partially overlapping the one in our patient. Clinical phenotype seems to be distinctive between the proximal-intermediate and intermediate-distal regions of the long arm of the chromosome 16. In particular, we observed a set of dysmorphic features that could present a characteristic dup 16q11.2-q13 phenotype. The present study illustrates the advantages of an integrative approach using both conventional and molecular techniques for the precise characterization and genotype-phenotype correlation in patients with dysmorphism, behavioral problems, and learning difficulties

Rare disease landscape in Brazil : report of a successful experience in inborn errors of metabolism

Brazil is a country of continental dimensions, with many social inequalities. The latter are reflected on its health system, which comprises a large public component called SUS, a small paid health insurance component and a third very small private component, in which patients pay personally for medical services. Seventy five percent of the population depends on SUS, which thus far does not provide adequate coverage for genetic medical procedures. In 2014, SUS introduced the “Policy for the Integral Attention to Subjects with Rare Diseases”, establishing guidelines for offering diagnosis and treatment. The policy defines the two main axes, genetic and non-genetic rare diseases. In this fashion, public genetic services in SUS will be installed and funded not by themselves, but as part of the more general policy of rare diseases. Unfortunately, up to now this policy is still depending on financial allowances to be effectively launched. In this article, our intention was to describe activities developed in the area of inborn errors of metabolism by a Brazilian reference center. In spite of the lack of support of SUS, thousands of Brazilian families affected by rare genetic metabolic disorders, and many health professionals from all regions of Brazil, already have benefited from the services, training programs and research projects provided by this comprehensive center

Diabetes insipidus como manifestação inicial de leucemia mieloide aguda em paciente com monossomia do cromossomo 7

O diabetes insipidus (DI) central é uma síndrome caracterizada pela incapacidade de concentração urinária devido à deficiência do hormônio antidiurético. O envolvimento do sistema nervoso central é frequente nas leucemias, mas a ocorrência de DI é rara e confere pior prognóstico. A patogênese do DI na leucemia não é totalmente conhecida, mas a infiltração do eixo hipotálamo-hipofisário por células leucêmicas parece ser um fator responsável. O presente relato descreve o caso de um paciente que apresentou DI como primeira manifestação de leucemia mieloide aguda e que evoluiu com dificuldades de ajustes do sódio sérico, da poliúria e da reposição volêmica, necessitando de permanência prolongada em unidade de cuidados intensivos.Palavras-chave: diabetes insipidus; leucemia mieloide aguda; monossomia; cromossomo 7

Diabetes insipidus como manifestação inicial de leucemia mieloide aguda em paciente com monossomia do cromossomo 7

O diabetes insipidus (DI) central é uma síndrome caracterizada pela incapacidade de concentração urinária devido à deficiência do hormônio antidiurético. O envolvimento do sistema nervoso central é frequente nas leucemias, mas a ocorrência de DI é rara e confere pior prognóstico. A patogênese do DI na leucemia não é totalmente conhecida, mas a infiltração do eixo hipotálamo-hipofisário por células leucêmicas parece ser um fator responsável. O presente relato descreve o caso de um paciente que apresentou DI como primeira manifestação de leucemia mieloide aguda e que evoluiu com dificuldades de ajustes do sódio sérico, da poliúria e da reposição volêmica, necessitando de permanência prolongada em unidade de cuidados intensivos. Palavras-chave: diabetes insipidus; leucemia mieloide aguda; monossomia; cromossomo 7

TRISSOMIA DE PARTE DO BRAÇO LONGO DO CROMOSSOMO 6 COM INSERÇÃO EM 14Q EM PACIENTE COM RETARDO MENTAL LEVE E DISMORFIAS

This article presents the case of a male patient who presented mild mental retardation, clinodactyly, camptodactyly, abnormal pattern of the hand skinfolds and cleft palate. In addition to the clinical examination, conventional cytogenetic techniques with G-bands and fluorescence in situ hybridization (FISH) were used with probes WCP 14, WCP 6, and tel6p. Fif teen metaphases were analyzed through conventional cytogenetics. All cells presented additional material on chromosome 14 [46,XY,add(14)]. The patient’s mother presented karyotype 46,XX,t(6q;14q), and the patient’s father presented normal karyotype. The patient’s material was submitted to FISH technique with probe WCP 6. This procedure showed that the additional portion was originated in chromosome 6 inserted at 14q22. The subtelomeric probes 6p/q determined the four typical breakpoints. The patient’s clinical status is a consequence of a partial trisomy of chromosome 6. This additional material is inserted in chromosome 14 long arm. The chromosome originated from chromosome 14 has maternal origin.Descrevemos o paciente HP, do sexo masculino, o qual apresentava quadro clínico de retardo mental leve, clinodactilia, camptodactilia, padrão alterado das pregas nas mãos e fenda palatina incompleta. Além do exame clínico, foram utilizadas técnicas citogenéticas convencionais com bandas G e hibridização in situ por fluorescência (FISH) com as sondas WCP 14; WCP 6; tel6p; tel6q. Foram analisadas 15 metáfases por citogenética convencional (GTG), onde todas as células apresentaram material adicional no cromossomo 14 [46,XY,add(14)]. A mãe apresentou cariótipo 46,XX,t(6q;14q) e o pai, cariótipo normal. O material do paciente foi submetido à técnica de FISH com sonda WCP 6, evidenciando a porção adicional como sendo material do cromossomo 6 inserido em 14q22. As sondas subteloméricas 6p/q marcaram os quatro pontos normalmente esperados. O paciente apresenta quadro clínico que resultou de uma trissomia parcial do cromossomo 6. Este material adicional está inserido no braço longo do cromossomo 14. O cromossomo derivado de 14 tem origem materna