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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
"first year"
symptom
22q11.2 deletion syndrome
achondroplasia
alpha-thalassemia
aniridia
benign recurrent intrahepatic cholestasis
child syndrome
cohen syndrome
congenital adrenal hyperplasia
congenital diaphragmatic hernia
congenital toxoplasmosis
cowden syndrome
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erythropoietic protoporphyria
gm1 gangliosidosis
hirschsprung disease
homocystinuria without methylmalonic aciduria
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
krabbe disease
lymphangioleiomyomatosis
megacystis-microcolon-intestinal hypoperistalsis syndrome
neonatal adrenoleukodystrophy
phenylketonuria
pleomorphic liposarcoma
pyruvate dehydrogenase deficiency
severe combined immunodeficiency
sneddon syndrome
waldenström macroglobulinemia
wolf-hirschhorn syndrome
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