Presentation
Molecular analysis based on 15 short tandem repeats confirmed the size of the duplications and indicated that at least 1 of 15 loci has three alleles present. [ncbi.nlm.nih.gov]
These individuals present with nearly the same spectrum of findings as those individuals with the standard deletion. Chromosomes, which are present in the nucleus of human cells, carry the genetic information for each individual. [rarediseases.org]
Present On Admission POA Help "Present On Admission" is defined as present at the time the order for inpatient admission occurs — conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery [icd10data.com]
Entire Body System
- Crying
[…] anxiety, depression, or schizophrenia in adulthood Facial features of children with 22q11.2 deletion syndrome may include the following: Small ears with squared upper ear Hooded eyelids Cleft lip and/or palate Asymmetric (uneven) facial appearance when crying [stanfordchildrens.org]
At birth the patient had a weak cry, poor respiratory effort, and decreased air entry. Positive pressure ventilation was started for a heart rate < 100 bpm and low O2 saturation. By 1 minute, HR was > 100 bpm but still with poor respiratory effort. [academic.oup.com]
It involves failure of the palate to meet the throat during crying, swallowing and speech. This often results in nasal-sounding speech and nasal regurgitation, in which fluid comes through the nose during feeding. [sickkids.ca]
Reduced facial affect (Gerdes et al., 1999) and/or animation are often seen as well as asymmetric crying facies (Pasick et al., 2013). [pubs.asha.org]
Infants often have a high-pitched cry and low birth weight. [portal.bsc.gwu.edu]
Respiratoric
- Nasal Voice
[…] speech Nasal voice 0001611 Neurological speech impairment Speech disorder Speech impairment Speech impediment [ more ] 0002167 5%-29% of people have these symptoms Abnormality of immune system physiology 0010978 Anterior creases of earlobe Earlobe crease [rarediseases.info.nih.gov]
Gastrointestinal
- Failure to Thrive
Some babies and children with 22q11.2 duplication are diagnosed with "failure to thrive" which means that they are not gaining weight at the expected rate, regardless of how much food they eat. [thinkgenetic.com]
[…] to thrive (ie, poor growth) in about half of reported probands Velopharyngeal insufficiency/hypernasal speech/cleft palate Absent thymus in one patient (Ensenauer 2003) Asplenia in one patient (Ensenauer 2003) Heart defects: In Ensenauer 2003, 2/12 of [c22c.org]
Patient 4 is a 3-year-old female child with failure to thrive, speech delay, hypernasal speech, dysmorphic features, and splenomegaly. [doi.org]
While some palatal abnormalities that occur with 22q11.2 deletion syndrome are obvious, such as cleft palate, others can go undetected and lead to feeding difficulties and failure to thrive. Congenital heart defects. [natera.com]
Group 2 1. del(2)(q13q13): a Group 2 deletion of 1.62 Mb from the proximal long arm of chromosome 2 between base pairs 111,155,700 to 112,776,503 was ascertained in a boy with birth asphyxia and failure to thrive at 6 months of age (Family 3 in Bisgaard [ngrl.org.uk]
Cardiovascular
- Heart Disease
Recognition and Stabilization of Neonates with Congenital Heart Disease. Newborn and Infant Nursing Reviews, Vol. 6, Issue. 3, p. 137. CrossRef Google Scholar Cotter, Philip D Nguyen, Hieu Tung, Gloria and Rauen, Katherine A 2005. [cambridge.org]
Conclusion: Chromosome 22q11.2 is a hot spot for copy number variation with both deletions and duplications having similar structural and functional differences reported such as congenital heart disease, palatal differences, intellectual deficits and [ashg.org]
This list includes but is not limited to the following: growth delays, feeding problems, congenital heart disease, gastrointestinal difficulties, serious breathing concerns, cleft and craniofacial issues, calcium deficiencies, immune deficiencies, kidney [22qfamilyfoundation.org]
Patients No. 45–54 commonly presented with congenital heart diseases and palatal abnormality, and some of them showed other features too. [journals.plos.org]
According to a study in GeneReviews, 74 percent of people will have congenital heart disease which includes several heart problems that can be mild, or life threatening in newborns and require surgery. [foxnews.com]
Ears
- Hearing Impairment
Lundin, Johanna, et al. "22q11. 2 microduplication in two patients with bladder exstrophy and hearing impairment." European journal of medical genetics 53.2 (2010): 61-65. Motavalli Mukaddes, Nahit, and Sabri Herguner. [thinkgenetic.com]
impairment Deafness Hearing defect [ more ] 0000365 Hydronephrosis 0000126 Hypoplastic left heart Underdeveloped left heart 0004383 Interrupted aortic arch 0011611 Microcephaly Abnormally small skull Decreased circumference of cranium Decreased size [rarediseases.info.nih.gov]
Johanna Lundin, Cilla Söderhäll, Lina Lundén, Anna Hammarsjö, Iréne White, Jacqueline Schoumans, Göran Läckgren, Christina Clementson Kockum and Agneta Nordenskjöld, 22q11.2 microduplication in two patients with bladder exstrophy and hearing impairment [doi.org]
Psychiatrical
- Anxiety Disorder
Behavioral and psychiatric problems may include autism spectrum disorder, anxiety disorder, depression, schizophrenia, bipolar disorder, or other mental health problems. [portal.bsc.gwu.edu]
Although psychotic disorders are chronic in most cases, they can also be transient. Anxiety disorders are a major risk factor for psychosis in patients with 22q11DS. [dovepress.com]
Hypocalcemia 55 64 Genitourinary anomalies 24 41 Autism spectrum disorder 19 16 ADHD 32–52 16–35 Anxiety disorder ~35 25 Psychotic disorder 15 40–58 Schizophrenia 2 ~25 The syndrome has been identified in the majority of individuals with DiGeorge syndrome [pubs.asha.org]
- Behavior Disorder
All the cognitive or behavioral disorders in VCFS patients were mild. Figure 1. Characteristic face of VCFS. [journals.plos.org]
The presence of delayed language or severely disordered speech, as well as behavioral challenges such as anxiety, may delay or, rarely, preclude completion of VPD studies. [pubs.asha.org]
- Psychiatric Symptoms
Robel, PDD-NOS, psychotic features and executive function deficits in a boy with proximal 22q11.2 microduplication: Evolution of the psychiatric symptom profile from childhood to adolescence, European Journal of Medical Genetics, (2018). [doi.org]
Neurologic
- Global Developmental Delay
These syndromes are manifested by the presence of growth deficiency, global developmental delay, heart defect, and hearing loss. The major birth defects include palatal clefting or insufficiency and thymus aplasia. [mayomedicallaboratories.com]
developmental delays and epilepsy 2q24.2-32.2 deletion 2q37.3 deletion Duplication at 2q37.3 of 2.3 mb and a deletion2q37.3 of 2.4 mb P Arm 2p16.3 deletion DUPLICATIONS Q Arm 2q37.3 duplication DELETIONS P Arm 3p21 Microduplication 3 p26.3-p26.2 Deletion [arcan.org.au]
Prominent eye folds [ more ] 0000286 Global developmental delay 0001263 High forehead 0000348 Hypertelorism Wide-set eyes Widely spaced eyes [ more ] 0000316 Intellectual disability Mental deficiency Mental retardation Mental retardation, nonspecific [rarediseases.info.nih.gov]
The degree of developmental delay varied from mild global developmental delay to isolated speech delay or normal cognition. [doi.org]
- Ataxia
Ataxia-telangiectasia A-T is a progressive, life-limiting, multi-system disorder caused by mutatations to the ATM gene. [geneticdisordersuk.org]
Workup
When outer ear abnormalities are encountered, an additional workup including audiometry and computed tomography with 3-D reconstructions is required. [journals.lww.com]
Preoperative Medical Evaluation A comprehensive preoperative workup, including cardiac and airway factors, assessment of cervical spine stability, and carotid artery position, is paramount (Kirschner & Baylis, 2014). [pubs.asha.org]
Treatment
Treatments may range from heart surgery to educational program tailored for an individual's needs. [thinkgenetic.com]
CLOSE Medical Disclaimer The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. [diseaseinfosearch.org]
You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments. [rarediseases.info.nih.gov]
Treatment for 22q11.2 deletion syndrome varies depending on your child’s symptoms. Because your child’s genetic makeup can't be changed, doctors can't "cure" the 22q11.2 deletion. [chop.edu]
Prognosis
Genetic services offer families who have experienced a birth problem (including the 22q11.2 deletion) valuable information, including: Information about the problem's cause Your chances of having another child with the same problem Information about prognosis [chop.edu]
Some features not presenting at birth may have a late onset; thus, an early identification can lead to more effective therapeutic regimen with better prognosis [15]. [journals.plos.org]
Etiology
Elsevier Health Sciences, ١٨/٠٨/٢٠١٣ - 979 من الصفحات Smith’s Recognizable Patterns of Human Malformation has long been known as the source to consult on multiple malformation syndromes of environmental and genetic etiology as well as recognizable disorders [books.google.com]
A genetic etiology for DiGeorge syndrome: consistent deletions and microdeletions of 22q11. Am J Hum Genet 1992 ; 50 : 924 – 933. Stankiewicz P, Lupski JR. Genome architecture, rearrangements and genome disorders. Trends Genet 2002 ; 18 : 74. [cambridge.org]
But maternal age does not act as an etiologic factor for the finding of enhanced maternal origin of the deletion. [dovepress.com]
Moreover, a small number of VCFS-like cases harboring a microduplication on 22q11.2 or CNVs on other chromosomes (4q, 8p, 10p, and 17p), such as partial monosomies and trisomies, have also been reported as etiologic heterogeneity that causes clinical [journals.plos.org]
Proposed etiologies include chronotropic impairment, cardiovascular limitations, restrictive pulmonary function and more recently, deficient habitual exercise.22,31–34 In our cohort, maximal heart rate was not associated with mVO2, measures of cardiac [ahajournals.org]
Epidemiology
Thus, little is known of the clinical and epidemiological consequences at the population level, including the clinical manifestations and disease trajectories. [newsroom.au.dk]
Hoeffding and Werge said by email that the study "offers an example of the power of merging nationwide records of clinical genomics analyses performed over several decades with unbiased, population-wide, register epidemiology in a country where healthcare [psychcongress.com]
A population-based study of epidemiology, associated malformations and survival in western Denmark 1984-1992.Scand Cardiovasc J. 1999; 33:45–48.CrossrefMedlineGoogle Scholar 7. [ahajournals.org]
22q11DS. 25 Several other genes in the 22q11 region, such as histone cell cycle regulator gene ( HIRA ), ubiquitin fusion degradation 1-like gene ( UFD1L ), and Crk-like protein gene ( CRKL ), have been implicated in the pathogenesis of 22q11DS. 7, 19 Epidemiology [dovepress.com]
In the absence of an epidemiological sample, the absolute rate of ASD in different disorders must be interpreted with caution and attention to the sampling and assessment methods that were used to determine the prevalence. [molecularautism.biomedcentral.com]
Pathophysiology
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test The 22q deletion syndrome and 22q duplication syndrome have overlapping phenotypes. [mayomedicallaboratories.com]
Prevention
Parent Training and Caregiver Consultation Suggestions specific to 22q Deletion Syndrome: Prevent the establishment of compensatory articulation substitutions, particularly glottal stops. [sickkids.ca]
Rarely, children need to take antibiotics or other treatments to prevent infection. Need extra doses of vaccines to build enough protection against disease. [seattlechildrens.org]
[…] deletion15 and strong association with fetal loss (stillbirths and miscarriages).34,35 In addition, because of restrictions related to de-identified dried blood spot samples set by the research ethics boards, minimal clinical data were available, which prevented [cmajopen.ca]
In addition, the technical limitations of testing by fluorescence in situ hybridization (FISH) may prevent the identification of many affected individuals in that duplications may only be visualized by FISH using interphase cells. [doi.org]
Centers for Disease Control and Prevention. Prevalence of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 sites, United States, 2010. MMWR Surveill Summ. 2014;63:1–21. [molecularautism.biomedcentral.com]