Feeding difficulty is the dominant feature in 12 Chinese newborns with CHD7 pathogenic variants

Xiang Chen; Kai Yan; Yanyan Gao; Huijun Wang; Guoqiang Chen; Bingbing Wu; Qian Qin; Lin Yang; Wenhao Zhou

doi:10.1186/s12881-019-0813-z

Feeding difficulty is the dominant feature in 12 Chinese newborns with CHD7 pathogenic variants

BMC Med Genet. 2019 May 30;20(1):93. doi: 10.1186/s12881-019-0813-z.

Authors

Xiang Chen¹, Kai Yan¹, Yanyan Gao², Huijun Wang³, Guoqiang Chen¹, Bingbing Wu³, Qian Qin⁴, Lin Yang⁵, Wenhao Zhou^{1

3}

Affiliations

¹ Departments of Neonatology, Children's Hospital of Fudan University, Shanghai, 201102, China.
² Ultrasonography Unit, Children's Hospital of Fudan University, Shanghai, 201102, China.
³ Shanghai Key Laboratory of Birth Defects, The Translational Medicine Center of Children Development and Disease of Fudan University, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, 201102, China.
⁴ Shanghai Key Laboratory of Birth Defects, The Translational Medicine Center of Children Development and Disease of Fudan University, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, 201102, China. qingqian89@outlook.com.
⁵ Departments of Endocrinology, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, 201102, China. yanglin_fudan@163.com.

Abstract

Background: CHARGE syndrome is characterized by coloboma, heart defects, choanal atresia, growth retardation, genitourinary malformation and ear abnormalities. The chromodomain helicase DNA-binding protein 7 (CHD7) gene is the major cause of CHARGE syndrome and is inherited in an autosomal dominant manner. Currently, the phenotype spectrum of CHARGE syndrome in neonatal population remain elusive. We aimed to investigate the phenotype spectrum of neonatal patients suspected to have CHARGE syndrome with pathogenic or likely pathogenic variants in the CHD7 gene.

Methods: We pooled next-generation sequencing data from the Neonatal Birth Defects Cohort (NBDC, ClinicalTrials.gov Identifier: NCT02551081) in Children's Hospital of Fudan University. The pathogenicity of novel variants was analyzed by bioinformatic and genetic analyses. Clinical information collection, Sanger sequencing and follow-up interviews were performed when possible. Cranial MRI of these patients was performed, the volumes of different regions of the brain were analyzed.

Results: A total of 12 unrelated patients in our cohort were found with CHD7 variants. Eight patients received a firm clinical diagnosis of CHARGE syndrome (Bergmann criteria, Blake criteria, Verloes criteria and Hale criteria). Three patients did not match any diagnostic criteria, and no patients matched the Verloes criteria. Phenotype spectrum analysis found that feeding difficulty was the dominant feature among this neonatal cohort. Six novel variants in the CHD7 gene (Glu2408*, Lys651*, c.5607 + 1G > T, Leu373Val, Lys2005Asnfs*37 and Gln1991*) were identified, expanding the variant database of the CHD7 gene. Cranial MRI analysis revealed significant volume loss in cingulate gyrus, occipital lobe, and cerebellum and volume gain in the left medial and inferior temporal gyri anterior white matter parts.

Conclusions: Based on a relatively unbiased neonatal cohort, we concluded that CHARGE syndrome and CHD7 gene variants should be suspected in newborns who have feeding difficulty, and one or more malformations.

Trial registration: Neonatal Birth Defects Cohort (NBDC, ClinicalTrials.gov identifier: NCT02551081 ).

Keywords: CHARGE syndrome; CHD7 gene; Feeding difficulty; Newborn; Variant.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Asian People / genetics
CHARGE Syndrome / diagnosis
CHARGE Syndrome / ethnology
CHARGE Syndrome / genetics*
China
Cohort Studies
DNA Helicases / genetics*
DNA-Binding Proteins / genetics*
Feeding and Eating Disorders / diagnosis
Feeding and Eating Disorders / ethnology
Feeding and Eating Disorders / genetics*
Female
Genetic Predisposition to Disease / ethnology
Genetic Predisposition to Disease / genetics*
High-Throughput Nucleotide Sequencing / methods
Humans
Infant, Newborn
Male
Mutation*
Neonatal Screening / methods
Phenotype
ROC Curve

Substances

DNA-Binding Proteins
DNA Helicases
CHD7 protein, human

Associated data

ClinicalTrials.gov/NCT02551081