Acute lymphoblastic leukemia in a child with Leri-Weill syndrome and complete SHOX gene deletion: A Case Report

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2018 Mar;162(1):65-70. doi: 10.5507/bp.2018.002. Epub 2018 Feb 21.

Abstract

Background: Leri-Weill syndrome (LWS) ranks among conditions with short stature homeobox gene (SHOX) haploinsufficiency. Data on possible association of SHOX aberrations with malignant diseases are scarce.

Methods and results: We report a unique case of an 8-year-old girl who was successfully treated for acute lymphoblastic leukemia (pre-B ALL, intermediate risk) and was subsequently diagnosed with LWS due to characteristic clinical appearance (short disproportionate stature, Madelung deformity of the wrist) and molecular genetic examination (complete deletion of SHOX). An identical SHOX deletion was identified also in the patient's mother. Leukemic cells of the patient were retrospectively examined by array comparative genomic hybridization (aCGH), which revealed five regions of deletions at chromosome X, including the SHOX gene locus.

Conclusion: Growth retardation in children with hemato-oncologic malignancies cannot always be attributed to cytotoxic treatment and should be carefully evaluated, especially with regards to growth hormone therapy.

Keywords: Leri-Weill syndrome (LWS); SHOX gene; acute lymphoblastic leukemia (ALL); childhood; pseudoautosomal region (PAR1).

Publication types

  • Case Reports

MeSH terms

  • Child
  • Comparative Genomic Hybridization
  • Female
  • Gene Deletion*
  • Growth Disorders / complications*
  • Growth Disorders / genetics*
  • Humans
  • Lost to Follow-Up
  • Osteochondrodysplasias / complications*
  • Osteochondrodysplasias / genetics*
  • Pedigree
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / genetics*
  • Short Stature Homeobox Protein / genetics*

Substances

  • SHOX protein, human
  • Short Stature Homeobox Protein

Supplementary concepts

  • Leri-Weil syndrome
  • Madelung Deformity