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        Microdeletion Syndromes: Characteristics and Diagnosis

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        Schmickel first defined the Contiguous Gene syndromes in 1986. These are syndromes that involve the deletion of a contiguous stretch of DNA, including multiple genes, on a chromosome. They are also referred to as microdeletion syndromes or segmental aneusomy. These syndromes are clinically recognized with distinct physical, behavioral, and mental characteristics and often involve some individual features that can be inherited in a Mendelian fashion (i.e., lissencephaly, heart defects, etc.). No other type of cytogenetic abnormality has benefited more from the introduction of fluorescence in situ hybridization (FISH) than these syndromes. While some of the abnormalities can be detected cytogenetically, FISH has added dramatically to the detection of these disorders and should be used whenever possible to confirm the deletions (Table 1 ).
        Table 1  Microdeletion Syndromes

        Syndrome

        Phenotypic features

        Cytogenetic location

        FISH probes a

        Prader-Willi Syndrome

        Hypotonia, Hyperphagia, Obesity, Short Stature, Small Hands and Feet, Hypopigmentation, Mental Retardation

        15qll-ql3

        Commercial (SNRPN)

        Angelman Syndrome

        Hypotonia, Microcephaly, Ataxic Gait, Inappropriate Laughter, Seizures, Hypopigmentation, Mental Retardation

        15qll-ql3

        Commercial (D15S10)

        Miller-Dieker Syndrome

        Type I Lissencephaly, Dysmorphic Facies

        17pl3.3

        Commercial (D17S379)

        Velo-Cardio Facial Syndrome (Del-22q)

        Abnormal Facies, Cleft Palate, Thymic Hypoplasia, Hypocalcemia, Heart Defect (Conotruncal Defect)

        22qll

        Commercial (TUPLE 1)

        Langer-Giedion Syndrome

        Trichorhinophalangeal Syndrome (Sparse Hair, Bulbous nose, Cone-shaped Phalangeal epiphyses), Multiple Exostoses, Mental Retardation

        8q24.1

        Investigator

        AWTA (WAGR)

        Aniridia, Wilms Tumor, Genitourinary Dysplasia, Mental Retardation

        11pl3

        Investigator

        Smith-Magenis Syndrome

        Dysmorphic Facial Features, Behavioral Abnormalities, Self Destructive Behavior, Peripheral Neuropathy, Mental Retardation

        17p11.2 (FLII, TOP3, SHMT1)

        Commercial

        Smith-Magenis Syndrome

        Dysmorphic Facial Features, Behavioral Abnormalities, Self Destructive Behavior, Peripheral Neuropathy, Mental Retardation

        17p11.2 (FLII, TOP3, SHMT1)

        Commercial

        Williams Syndrome

        Dysmorphic Facial Features, Infantile Hypercalcemia, Congenital Heart Disease, Gregarious Personality, Premature Aging of the Skin, Mental Retardation

        7qll.23

        Commercial (ELN)

        Rubinstein-Taybi Syndrome b

        Dysmorphic Facial Features, Broad Thumbs and First Toes, Mental Retardation

        16pl3.3

        Investigator

        Alpha-Thalassemia and Mental Retardation (ATR-16)

        Dysmorphic Facial Features, Alpha-Thalassemia, Mental Retardation

        16pl3.3

        Investigator

        Alagille Syndrome b

        Dysmorphic Facial Features, Chronic Cholestasis, Vertebral Arch Defects, Pulmonic Stenosis

        20pll.23-pl2.2

        Investigator

        Greig-Cephalopoly-syndactyly Syndrome b

        Craniosynostosis, Polysyndactyly, Mental Retardation

        7pl3

        Investigator

        Albrights Hereditary Osteodystrophy-Like Syndrome

        Short stocky build, Abnormal Facies, Brachymetaphalangism, Seizures, Developmental Delay

        2q37

        Investigator

        1p36 Deletion Syndrome

        Hypotonia, Developmental Delay, Growth Abnormalities, Craniofacial Dysmorphism, Minor Cardiac Malformations

        1p36

        Investigator

        Xp22.3 Deletion

        X-Linked Ichthyosis, Mental Retardation, Epilepsy, Ocular Albinism, Kallman Syndrome

        Xp22.3

        Investigator

        Xp21 Deletion

        Muscular Dystrophy, Glycerol Kinase Deficiency, Congenital Adrenal Hypoplasia, Mental Retardation

        Xp21

        Investigator

        Saethre-Chotzen Syndrome b

        Saethre-Chotzen Syndrome, Learning Difficulties

        7p21.1

        Investigator

        Y Chromosome Deletion

        Unilateral Cryptorchidism,Idiopathic Infertility

        Yql3

        Commercial (PCR Primers)

        van der Woude Syndrome

        Cleft Lip With or Without Cleft Palate; Bilateral Lip Pits; Hypodontia

        1q32-lq1

        Investigator

        Diamond-Blackfan Anemia

        Red Blood Cell Hypoplasia, Macrocephalia, Hypotonia and Psychomotor Retardation

        19ql3.2

        Investigator

        NF1 Microdeletion Syndrome b

        Neurofibromatosis, Early Age Onset of Cutaneous Neurofibromas, Facial Dysmorphism, Learning Disabilities, Mental Retardation

        17qll.2

        Investigator

        Distal 22q Microdeletion

        Hypotonia, Severe Language Delay, Mild Facial Dysmorphism

        22ql3-22qter

        Commercial(D22S39, ARSA)

        17pll.2 Duplication

        Charcot-Marie-Tooth (CMT) Disease, Developmental Delay

        17pll.2

        Commercial (FLII, TOP 3, SHMT1)

        Cat-Eye Syndrome

        Coloboma, Choanal Atresia, Learning Disabilities, Mental Retardation

        22qll.2

        Investigator

        Dicenteric (15)

        Seizures, Autism, Mental Retardation, Mild Facial Dysmorphism

        15qll-15ql3

        Commercial (SNRPN)

        a FISH probes are available either from Commercial Companies or through Investigators/Published Articles.
        b The occurrences of these syndromes are primarily owing to mutations, not chromosomal deletions.
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