コルネリア・デ・ランゲ症候群、Cornelia de Lange症候群
出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2015/07/19 12:04:35」(JST)
Cornelia de Lange Syndrome | |
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Classification and external resources | |
ICD-10 | Q87.1 (ILDS Q87.170) |
ICD-9-CM | 759.89 |
OMIM | 122470 |
DiseasesDB | 29651 |
eMedicine | ped/482 |
MeSH | C10.597.606.643.210 |
Cornelia de Lange Syndrome (CdLS) is a genetic disorder present from birth, but not always diagnosed at birth. It causes a range of physical, cognitive and medical challenges and affects both genders equally. The syndrome is named after Dutch pediatrician Cornelia Catharina de Lange, who described it.
It is often termed Bushy Syndrome and is also known as Amsterdam dwarfism. It is a genetic disorder that can lead to severe developmental anomalies. It affects the physical and intellectual development of a child. Exact incidence is unknown, but it is estimated at 1 in 10,000 to 30,000.[1]
The vast majority of cases are due to spontaneous genetic mutations.[citation needed]
It can be associated with mutations affecting the cohesin complex.[2]
Multiple genes have been associated with the condition. In 2004, researchers at the Children's Hospital of Philadelphia (United States) and the University of Newcastle upon Tyne (England), identified a gene (NIPBL) on chromosome 5 that causes CdLS when it is mutated. Since then, additional genes have been found (SMC1A, SMC3 and HDAC8) that cause CdLS when changed. There are likely other genes as well. Researchers hope to gain a better understanding of why CdLS varies so widely from one individual to another and what can be done to improve the quality of life for people with the syndrome. (For more information visit: http://www.cdlsusa.org/research/genetic-information.htm)
Name | OMIM | Gene | Appx. % | Notes |
---|---|---|---|---|
CDLS1 | 122470 | NIPBL | 50% | A gene responsible for CdLS on Chromosome 5 was discovered in 2004 jointly by researchers at the Children's Hospital of Philadelphia, USA[3] and researchers at Newcastle University, UK.[4] |
CDLS2 | 300590 | SMC1A | 5% | In 2006, a second gene, on the X chromosome, was found by Italian scientists. |
CDLS3 | 610759 | SMC3 | 1% | A third gene discovery was announced in 2007. The gene is on chromosome 10 and was also discovered by the research team in Philadelphia. |
The latter two genes seem to correlate with a milder form of the syndrome.
In July 2012, the fourth “CdLS gene”—HDAC8—was announced. Many parents and professionals have questions about this latest finding and what it means. HDAC8 is an X-linked gene, meaning it is located on the X chromosome. Individuals with CdLS who have the gene change in HDAC8 make up just a small portion of all people with CdLS.[5]
Evidence of a linkage at chromosome 3q26.3 is mixed.[6]
This section does not cite any references or sources. Please help improve this section by adding citations to reliable sources. Unsourced material may be challenged and removed. (July 2011) |
Following are the features and characteristics that help in spotting this disorder: [7]
Children with this syndrome are often found to have long eyelashes, bushy eyebrows and synophrys (joined eyebrows). Body hair can be excessive and affected individuals are often shorter than their immediate family members.
CdLS can give rise to its own array of complexities. Children with CdLS often suffer from gastrointestinal tract difficulties, particularly gastroesophageal reflux. Vomiting, intermittent poor appetite, constipation, diarrhea or gaseous distention are known to be a regularity in cases where the GE tract problems are acute. Symptoms may range from mild to severe.
CdLS may include behavior problems, including self-stimulation, aggression, self-injury or strong preference to a structured routine. Many children with CdLS exhibit autistic-like behaviors.
Behavior problems in CdLS are not inevitable. Many behavior issues associated with CdLS are reactive (i.e., something happens within the person's body or environment to bring on the behavior) and cyclical (comes and goes). Often, an underlying medical issue causes a change in behavior. Once the medical issue is treated, the behavior diminishes.
The diagnosis of CdLS is primarily a clinical one, based on medical signs that are evident in a medical history, physical examination, and laboratory tests. Since 2006, testing for NIPBL and SMC1A has been available through the University of Chicago.[1] This is best accomplished through a referral to a genetics specialist or clinic.
CdLS is thought to be underdiagnosed and frequently misdiagnosed.[citation needed]
Often, an interdisciplinary approach to therapy and treatment of any medical issues that arise is recommended. A team for promoting the child's well-being often includes speech, occupational and physical therapists, teachers, physicians and the parent(s).[9]
The Cornelia de Lange Syndrome (CdLS) Foundation[10] is a nonprofit, family support organization based in Avon, Connecticut, that exists to ensure early and accurate diagnosis of CdLS, promote research into the causes and manifestations of the syndrome, and help people with a diagnosis of CdLS, and others with similar characteristics, make informed decisions throughout their lives.
The first ever documented case was in 1916 by Winfried Robert Clemens Brachmann[11] followed up by Cornelia Catherina de Lange,[12] a Dutch pediatrician, in 1933 after whom the disorder has been named.[13]
Wikimedia Commons has media related to Cornelia de Lange Syndrome. |
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リンク元 | 「コルネリア・デ・ランゲ症候群」「de Lange syndrome」 |
関連記事 | 「DE」「syndrome」 |
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