{"id":2405,"date":"2025-12-18T11:11:14","date_gmt":"2025-12-18T09:11:14","guid":{"rendered":"https:\/\/pediatria-spisanie.eu\/2025\/12\/18\/sindrom-pitt-hopkins\/"},"modified":"2025-12-18T13:53:59","modified_gmt":"2025-12-18T11:53:59","slug":"sindrom-pitt-hopkins","status":"publish","type":"post","link":"https:\/\/pediatria-spisanie.eu\/en\/2025\/12\/18\/sindrom-pitt-hopkins\/","title":{"rendered":"Two clinical cases of Pitt-Hopkins syndrome"},"content":{"rendered":"\n\n\t\t<div class=\"icon-box featured-box icon-box-left text-left is-small\"  >\n\t\t\t\t\t<div class=\"icon-box-img\" style=\"width: 20px\">\n\t\t\t\t<div class=\"icon\">\n\t\t\t\t\t<div class=\"icon-inner\" >\n\t\t\t\t\t\t<img decoding=\"async\" width=\"48\" height=\"48\" src=\"https:\/\/pediatria-spisanie.eu\/wp-content\/uploads\/2024\/12\/icons8-user-48.png\" class=\"attachment-medium size-medium\" alt=\"\" \/>\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t<div class=\"icon-box-text last-reset\">\n\t\t\t\t\t\t\t\t\t\n<h3> T. Aleksandrova1, T. Delchev1,2, Ts. Veleva1,2, D. Avdjieva-Tzavella1,2 <\/h3>\n<p> 1Department of Clinical genetics, SBAL Children&#8217;s Hospital \u201eProf. Dr. Ivan Mitev\u201c\n2Medical University \u2013 Sofia <\/br>\n<\/p>\n\t\t<\/div>\n\t<\/div>\n\t\n\t\n<div class=\"is-divider divider clearfix\" ><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Abstract<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Pitt-Hopkins syndrome (PTHS) is a rare genetic disorder characterized by significant developmental delay with moderate-to-severe intellectual disability, severely limited-to-absent speech, distinctive facial dysmorphism, behavioral abnormalities and autonomic dysregulation. The condition is predominantly associated with de novo variants and deletions affecting the TCF4 gene. Clinical diagnosis is often challenging due to significant phenotypic overlap with Angelman syndrome and Angelman-like syndromes. A conclusive diagnosis is established through molecular genetic testing. \u0422o date, no curative therapy has been established. Here, we present two genetically confirmed cases from our practice, both demonstrating the typical phenotype and clinical features of Pitt-Hopkins syndrome.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Key words:<\/strong> Pitt-Hopkins syndrome, PTHS, TCF4, Angelman-like syndrome<\/p>\n\n\n<div class=\"is-divider divider clearfix\" ><\/div>\n\n\n\t\t<div class=\"wp-block-woocommerce-memberships-member-content\">\n\t\t\t\t\t<div class=\"woocommerce\">\n\t\t\t<div class=\"woocommerce-info wc-memberships-restriction-message wc-memberships-message wc-memberships-content-restricted-message\">\n\t\t\t\tTo access this content, you must purchase <span class=\"wc-memberships-products-grant-access\"><a href=\"https:\/\/pediatria-spisanie.eu\/en\/produkt\/godishen-abonament\/\">\u0413\u043e\u0434\u0438\u0448\u0435\u043d \u0430\u0431\u043e\u043d\u0430\u043c\u0435\u043d\u0442<\/a><\/span>.\t\t    <\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\n\n\n<h2 class=\"wp-block-heading\"><strong>Bibliography<\/strong><\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li>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\u201344.<\/li>\n\n\n\n<li>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\u201393.<\/li>\n\n\n\n<li>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\u20131001.<\/li>\n\n\n\n<li>Brockschmidt A, Todt U, Ryu S, et al. Severe mental retardation with breathing abnormalities (Pitt\u2013Hopkins syndrome) is caused by haploinsufficiency of the neuronal bHLH transcription factor TCF4. Hum Mol Genet. 2007;16(12):1488\u201394.<\/li>\n\n\n\n<li>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.<\/li>\n\n\n\n<li>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.<\/li>\n\n\n\n<li>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\u201376.<\/li>\n\n\n\n<li>Rosenfeld JA, Leppig K, Ballif BC, et al. Genotype\u2013phenotype analysis of TCF4 mutations causing Pitt-Hopkins syndrome shows increased seizure activity with missense mutations. Genet Med. 2009;11(11):797\u2013805.<\/li>\n\n\n\n<li>Wieben ED, Aleff RA, Eckloff BW, et al. Comprehensive Assessment of Genetic Variants Within TCF4 in Fuchs\u2019 Endothelial Corneal Dystrophy. Investig Opthalmology Vis Sci. 2014;55(9):6101.<\/li>\n\n\n\n<li>Zollino M, Zweier C, Van Balkom ID, et al. Diagnosis and management in Pitt\u2010Hopkins syndrome: First international consensus statement. Clin Genet. 2019;95(4):462\u201378.<\/li>\n\n\n\n<li>Whalen S, H\u00e9ron 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\u201372.<\/li>\n\n\n\n<li>Marangi G, Ricciardi S, Orteschi D, et al. Proposal of a clinical score for the molecular test for Pitt\u2013Hopkins syndrome. Am J Med Genet A. 2012;158A(7):1604\u201311.<\/li>\n\n\n\n<li>Dagli AI, Mathews J, Williams CA. Angelman Syndrome. In: Adam MP, Feldman J, Mirzaa GM, et al., editors. GeneReviews\u00ae [Internet]. Seattle (WA): University of Washington, Seattle; 1993 [cited 2025]. Available from: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK1144\/<\/li>\n\n\n\n<li>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\u201392.<\/li>\n\n\n\n<li>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.<\/li>\n\n\n\n<li>Williams CA, Lossie A, Driscoll D. Angelman syndrome: Mimicking conditions and phenotypes. Am J Med Genet. 2001;101(1):59\u201364.<\/li>\n\n\n\n<li>Williams CA. Looks like Angelman syndrome but isn\u2019t\u2014What is in the differential. RCPU Newsl. 2011;22(1):1\u20135.<\/li>\n\n\n\n<li>Luk HM. Angelman-Like Syndrome: A Genetic Approach to Diagnosis with Illustrative Cases. Case Rep Genet. 2016;2016:9790169.<\/li>\n\n\n\n<li>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\u201354.<\/li>\n\n\n\n<li>Giurgea I, Missirian C, Cacciagli P, et al. TCF4 deletions in Pitt-Hopkins Syndrome. Hum Mutat. 2008;29(11):E242-251.<\/li>\n<\/ol>\n\n\n<div class=\"is-divider divider clearfix\" ><\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Address for correspondence:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u0422. \u0410leksansdrova <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Department of Clinical genetics, SBAL Children\u2018s Hospital \u201cProf. Dr. Ivan Mitev\u201d &#8211; Sofia<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">11, \u201cAcad. Ivan Evstatiev Geshov\u201d, Blvd. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">1606, Sofia <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u0435-mail: teodora.aleksandrova14@gmail.com<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>T. Aleksandrova1, T. Delchev1, 2, Ts. Veleva1, 2, D. Avdjieva-Tzavella1, 2<br \/>\n1Department of Clinical genetics, SBAL Children&#8217;s Hospital \u201eProf. Dr. Ivan Mitev\u201c<br \/>\n2Medical University \u2013 Sofia<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_pediatria_doi":"","footnotes":""},"categories":[2681,2676,1],"tags":[1352,2842,2843,2835,2841,2840,2836,2787,2839],"class_list":["post-2405","post","type-post","status-publish","format-standard","hentry","category-issue-4-2025","category-broj-4-2025","category-statii","tag-2-en","tag-d-avdjieva-tzavella","tag-pitt-hopkins-syndrome","tag-pths","tag-t-aleksandrova1","tag-t-delchev1","tag-tcf4","tag-ts-veleva1","tag-two-clinical-cases-of-pitt-hopkins-syndrome"],"_links":{"self":[{"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/posts\/2405","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/comments?post=2405"}],"version-history":[{"count":2,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/posts\/2405\/revisions"}],"predecessor-version":[{"id":2408,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/posts\/2405\/revisions\/2408"}],"wp:attachment":[{"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/media?parent=2405"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/categories?post=2405"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/tags?post=2405"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}