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Kabuki syndrome: clinical and molecular diagnosis in the first year of life.
[kabuki syndrome]
To
review
the
clinical
and
molecular
genetic
characteristics
of
16
patients
presenting
a
suspected
diagnosis
of
Kabuki
syndrome
(
KS
)
in
the
first
year
of
life
,
to
evaluate
the
clinical
handles
leading
to
a
prompt
diagnosis
of
KS
in
newborns
.
Clinical
diagnosis
of
KS
can
be
challenging
during
the
first
year
of
life
,
as
many
diagnostic
features
become
evident
only
in
subsequent
years
.
All
patients
were
clinically
investigated
by
trained
clinical
geneticists
.
A
literature
review
was
performed
using
the
Pubmed
online
database
and
diagnostic
criteria
suggested
by
DYSCERNE-Kabuki
Syndrome
Guidelines
(
2010
)
were
used
(
a
European
Network
of
Centres
of
Expertise
for
Dysmorphology
,
funded
by
the
European
Commission
Executive
Agency
for
Health
and
Consumers
(
DG
Sanco
)
,
Project
2006
122
)
.
Molecular
analysis
of
the
known
causative
genes
of
KS
,
KMT
2
D
/
MLL
2
and
KDM
6
A
,
was
performed
through
MiSeq-targeted
sequencing
platform
.
All
mutations
identified
were
validated
by
Sanger
sequencing
protocols
.
Mutations
in
KMT
2
D
gene
were
identified
in
10
/
16
(
62
%
)
of
the
patients
,
whereas
none
of
the
patients
had
KDM
6
A
mutations
.
Facial
dysmorphisms
(
94
%
)
,
feeding
difficulties
(
100
%
)
and
hypotonia
(
100
%
)
suggested
the
clinical
diagnosis
of
KS
.
No
significative
differences
in
terms
of
facial
features
were
noticed
between
mutation
positive
and
negative
patients
of
the
cohort
.
Brachydactyly
,
joint
laxity
and
nail
dysplasia
were
present
in
about
80
%
of
the
patients
.
Other
congenital
anomalies
were
most
commonly
present
in
the
mutated
group
of
patients
,
including
left-sided
cardiac
abnormalities
,
skeletal
,
renal
and
anorectal
malformations
and
hypertricosis
.
We
present
an
overview
of
patients
with
KS
diagnosed
during
the
first
year
of
life
.
Early
diagnosis
is
serviceable
in
terms
of
clinical
management
and
for
targeted
genetic
counselling
.
Diseases
Validation
Diseases presenting
"facial features"
symptom
22q11.2 deletion syndrome
alpha-thalassemia
cadasil
cohen syndrome
dentinogenesis imperfecta
gm1 gangliosidosis
harlequin ichthyosis
hirschsprung disease
homocystinuria without methylmalonic aciduria
kabuki syndrome
kallmann syndrome
monosomy 21
neuralgic amyotrophy
severe combined immunodeficiency
triple a syndrome
wolf-hirschhorn syndrome
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