Neurodevelopmental outcome in patients with terminal deletion of the short arm of chromosome 20
- Children`s Hospital, Boston, MA (United States); and others
Clinical geneticists and genetic counselors are often expected to provide information concerning anticipated neurodevelopmental outcome in children with chromosome abnormalities. Accurate prediction, however, may be impossible, and is at the least hampered by insufficient data and by natural variation in expression. Our experience with a now 27-month-old boy with terminal 20p- underscores this issue. A newborn male with multiple congenital anomalies, including pulmonary artery stenosis, vertebral anomalies, posterior ocular embryotoxon and multiple dysmorphic features was found to have 46,XY,del(20)(p11.23ter) de novo, including the location for Alagille Syndrome (AS). Early clinical course was also notable for obstructive apnea and cardiorespiratory arrests. Available literature suggested a poor neurodevelopmental prognosis. At age 27 months, he exhibits hypotonia and gross motor skills assessed at 12-15 months. However, cognitive and language skills were at the 20 months level. No structural neurological lesions have been identified. We attempted to obtain updated outcome information on previous cases for comparison. 11 previously published reports with similar extent of deletion of 20p demonstrated varied, but often more severe neurodevelopmental impairment. The majority described early global delays, with significant motor delay. However, little longitudinal or functional information was available. In contrast, our patient demonstrates good neurodevelopmental and functional progress. Caution should be exercised in counseling regarding neurodevelopmental outcome in cases of chromosomal anomaly, due to lack of information and natural variability. Standardized assessment and reporting of longitudinal neurodevelopmental follow-up are necessary for more appropriate counseling concerning outcome in chromosomal anomalies.
- OSTI ID:
- 134562
- Report Number(s):
- CONF-941009-; ISSN 0002-9297; TRN: 95:005313-1296
- Journal Information:
- American Journal of Human Genetics, Vol. 55, Issue Suppl.3; Conference: 44. annual meeting of the American Society of Human Genetics, Montreal (Canada), 18-22 Oct 1994; Other Information: PBD: Sep 1994
- Country of Publication:
- United States
- Language:
- English
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