title: Deletion at 14q22-23 indicates a contiguous gene syndrome comprising anophthalmia, pituitary hypoplasia, and ear anomalies.
abstract: Anophthalmia and pituitary gland hypoplasia are both debilitating conditions where the underlying genetic defect is unknown in the majority of cases. We identified a patient with bilateral anophthalmia and absence of the optic nerves, chiasm and tracts, as well as pituitary gland hypoplasia and ear anomalies with a de novo apparently balanced chromosomal translocation, 46,XY,t(3;14)(q28;q23.2). Translocation breakpoint analysis using FISH and high-resolution microarray comparative genomic hybridization (CGH) has identified a 9.66 Mb deleted region on the long arm of chromosome 14 which includes the genes BMP4, OTX2, RTN1, SIX6, SIX1, and SIX4. Three other patients with interstitial deletions involving 14q22-23 have been described, all with bilateral anophthalmia, pituitary abnormalities, ear anomalies, and a facial phenotype similar to our patient. OTX2 is involved in ocular developmental defects, and the severity of the ocular phenotype in our patient and the other 14q22-23 deletion patients, suggests this genomic region harbors other gene/s involved in ocular development. BMP4 haploinsufficiency is predicted to contribute to the ocular phenotype on the basis of its expression pattern and observed murine mutant phenotypes. In addition, deletion of BMP4 and SIX6 is likely to contribute to the abnormal pituitary development, and SIX1 deletion may contribute to the ear and other craniofacial features. This indicates that contiguous gene deletion may contribute to the phenotypic features in the 14q22-23 deletion patients.
authors.affiliation: Eye Genetics Research Group, Children's Medical Research Institute, The Children's Hospital at Westmead and Save Sight Institute, Sydney, New South Wales, Australia.
authors.forename: Leisha D
authors.initials: LD
authors.lastname: Nolen
authors.forename: David
authors.initials: D
authors.lastname: Amor
authors.forename: Ashley
authors.initials: A
authors.lastname: Haywood
authors.forename: Luke
authors.initials: L
authors.lastname: St Heaps
authors.forename: Chris
authors.initials: C
authors.lastname: Willcock
authors.forename: Marija
authors.initials: M
authors.lastname: Mihelec
authors.forename: Patrick
authors.initials: P
authors.lastname: Tam
authors.forename: Frank
authors.initials: F
authors.lastname: Billson
authors.forename: John
authors.initials: J
authors.lastname: Grigg
authors.forename: Greg
authors.initials: G
authors.lastname: Peters
authors.forename: Robyn V
authors.initials: RV
authors.lastname: Jamieson
mesh_terms: D000015:Abnormalities, Multiple / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000235:genetics*; D000853:Anophthalmos / Q000235:genetics*; D002675:Child, Preschool; D002871:Chromosome Banding; D019457:Chromosome Breakage; D002872:Chromosome Deletion; D002883:Chromosomes, Human, Pair 14; D004423:Ear / Q000002:abnormalities*; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007621:Karyotyping; D008279:Magnetic Resonance Imaging; D008297:Male; D009693:Nucleic Acid Hybridization; D020161:Physical Chromosome Mapping; D010902:Pituitary Gland / Q000002:abnormalities*; D011859:Radiography; D013577:Syndrome