Two cases of deletion 2q37 associated with segregation of an unbalanced translocation 2;21: choanal atresia leading to misdiagnosis of CHARGE syndrome

Eur J Endocrinol. 2009 Apr;160(4):711-7. doi: 10.1530/EJE-08-0865.

Abstract

Context: The phenotypic variability of patients with syndromes presenting with dysmorphism makes clinical diagnosis difficult, leading to an exhaustive genetic study to determine the underlying mechanism so that a proper diagnosis could be established.

Objective: To genetically characterize siblings, the older sister diagnosed with Albright hereditary osteodystrophy and the younger one with CHARGE syndrome.

Design: Clinical case report.

Methods: Clinical, biochemical, and radiological studies were performed on the family. In addition, molecular genetic studies including sequencing of GNAS, typing of microsatellites on 2q and 21q, and multiplex ligation-dependent probe amplification of subtelomeric regions were performed, as well as confirmatory fluorescent in situ hybridization analysis.

Results: The genetic analysis revealed that both sisters presented a 2q37 deletion due to the maternal unbalanced segregation of a 2;21 translocation.

Conclusions: This is the first report of a 2q37 deletion where differential diagnosis of CHARGE syndrome is needed due to the appearance of choanal atresia.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abnormalities, Multiple / diagnosis
  • Abnormalities, Multiple / genetics*
  • Adolescent
  • Body Weight / physiology
  • Choanal Atresia / diagnosis
  • Choanal Atresia / genetics*
  • Chromogranins
  • Chromosome Deletion*
  • Chromosomes, Human, Pair 2 / genetics*
  • Diagnosis, Differential
  • Female
  • GTP-Binding Protein alpha Subunits, Gs / genetics
  • Genetic Markers
  • Humans
  • In Situ Hybridization, Fluorescence
  • Male
  • Obesity / genetics
  • Phenotype
  • Syndrome
  • Translocation, Genetic / genetics*
  • Translocation, Genetic / physiology

Substances

  • Chromogranins
  • Genetic Markers
  • GNAS protein, human
  • GTP-Binding Protein alpha Subunits, Gs