Два клинични случая на синдром на Pitt-Hopkins

Резюме

Синдромът на Pitt-Hopkins е рядко генетично заболяване, характеризиращо се с тежко забавяне в психомоторното развитие с умерено до тежко интелектуално изоставане, дълбоко ограничена или напълно липсваща реч, характерен лицев дисморфизъм, поведенчески отклонения, дисрегулация на автономната нервна система. Най-често се причинява от de novo варианти и делеции в TCF4 гена. Клиничната диагноза нерядко е предизвикателство за лекуващия екип поради фенотипното припокриване със синдрома на Angelman, както и Angelman-like синдромите. Диагнозата се потвърждава чрез молекулярно-генетичен анализ. Към момента няма дефинитивно лечение. Представяме два генетично верифицирани случая от нашата практика с типичен фенотип и клинична изява за синдрома на Pitt-Hopkins.

Ключови думи: синдром на Pitt-Hopkins, PTHS, TCF4, Angelman-like синдром

To access this content, you must purchase Годишен абонамент.

Библиография

  1. Goodspeed K, Newsom C, Morris MA, et al. Pitt-Hopkins Syndrome: A Review of Current Literature, Clinical Approach, and 23-Patient Case Series. J Child Neurol. 2018;33(3):233–44.
  2. Amiel J, Rio M, Pontual LD, et al. Mutations in TCF4, Encoding a Class I Basic Helix-Loop-Helix Transcription Factor, Are Responsible for Pitt-Hopkins Syndrome, a Severe Epileptic Encephalopathy Associated with Autonomic Dysfunction. Am J Hum Genet. 2007;80(5):988–93.
  3. Zweier C, Peippo MM, Hoyer J, et al. Haploinsufficiency of TCF4 Causes Syndromal Mental Retardation with Intermittent Hyperventilation (Pitt-Hopkins Syndrome). Am J Hum Genet. 2007;80(5):994–1001.
  4. Brockschmidt A, Todt U, Ryu S, et al. Severe mental retardation with breathing abnormalities (Pitt–Hopkins syndrome) is caused by haploinsufficiency of the neuronal bHLH transcription factor TCF4. Hum Mol Genet. 2007;16(12):1488–94.
  5. De Winter CF, Baas M, Bijlsma EK, et al. Phenotype and natural history in 101 individuals with Pitt-Hopkins syndrome through an internet questionnaire system. Orphanet J Rare Dis. 2016;11(1):37.
  6. Forrest MP, Waite AJ, Martin-Rendon E, et al. Knockdown of Human TCF4 Affects Multiple Signaling Pathways Involved in Cell Survival, Epithelial to Mesenchymal Transition and Neuronal Differentiation. Bardoni B, editor. PLoS ONE. 2013;8(8):e73169.
  7. De Pontual L, Mathieu Y, Golzio C, et al. Mutational, functional, and expression studies of the TCF4 gene in Pitt-Hopkins syndrome. Hum Mutat. 2009;30(4):669–76.
  8. Rosenfeld JA, Leppig K, Ballif BC, et al. Genotype–phenotype analysis of TCF4 mutations causing Pitt-Hopkins syndrome shows increased seizure activity with missense mutations. Genet Med. 2009;11(11):797–805.
  9. Wieben ED, Aleff RA, Eckloff BW, et al. Comprehensive Assessment of Genetic Variants Within TCF4 in Fuchs’ Endothelial Corneal Dystrophy. Investig Opthalmology Vis Sci. 2014;55(9):6101.
  10. Zollino M, Zweier C, Van Balkom ID, et al. Diagnosis and management in Pitt‐Hopkins syndrome: First international consensus statement. Clin Genet. 2019;95(4):462–78.
  11. Whalen S, Héron D, Gaillon T, et al. Novel comprehensive diagnostic strategy in Pitt-Hopkins syndrome: Clinical score and further delineation of the TCF4 mutational spectrum. Hum Mutat. 2012;33(1):64–72.
  12. Marangi G, Ricciardi S, Orteschi D, et al. Proposal of a clinical score for the molecular test for Pitt–Hopkins syndrome. Am J Med Genet A. 2012;158A(7):1604–11.
  13. Dagli AI, Mathews J, Williams CA. Angelman Syndrome. In: Adam MP, Feldman J, Mirzaa GM, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993 [cited 2025]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK1144/
  14. Tan WH, Bird LM, Thibert RL, et al. If not Angelman, what is it? A review of Angelman-like syndromes. Am J Med Genet A. 2014;164A(4):975–92.
  15. Hong SY, Chou IC, Lin WD, et al. A case of Pitt-Hopkins syndrome presented with Angelman-like syndromic phenotypes. BioMedicine. 2016;6(4):25.
  16. Williams CA, Lossie A, Driscoll D. Angelman syndrome: Mimicking conditions and phenotypes. Am J Med Genet. 2001;101(1):59–64.
  17. Williams CA. Looks like Angelman syndrome but isn’t—What is in the differential. RCPU Newsl. 2011;22(1):1–5.
  18. Luk HM. Angelman-Like Syndrome: A Genetic Approach to Diagnosis with Illustrative Cases. Case Rep Genet. 2016;2016:9790169.
  19. Peippo MM, Simola KOJ, Valanne LK, et al. Pitt-Hopkins syndrome in two patients and further definition of the phenotype. Clin Dysmorphol. 2006;15(2):47–54.
  20. Giurgea I, Missirian C, Cacciagli P, et al. TCF4 deletions in Pitt-Hopkins Syndrome. Hum Mutat. 2008;29(11):E242-251.

Адрес за кореспонденция:

Т. Александрова

Kлиника за лечение на деца с генетични заболявания

СБАЛДБ „Проф. Иван Митев“

София

България

е-mail: teodora.aleksandrova14@gmail.com