title: Review of disrupted sleep patterns in Smith-Magenis syndrome and normal melatonin secretion in a patient with an atypical interstitial 17p11.2 deletion.
abstract: Smith-Magenis syndrome (SMS) is a disorder characterized by multiple congenital anomalies and behavior problems, including abnormal sleep patterns. It is most commonly due to a 3.5 Mb interstitial deletion of chromosome 17 band p11.2. Secretion of melatonin, a hormone produced by the pineal gland, is the body's signal for nighttime darkness. Published reports of 24-hr melatonin secretion patterns in two independent SMS cohorts (US and France) document an inverted endogenous melatonin pattern in virtually all cases (96%), suggesting that this finding is pathognomic for the syndrome. We report on a woman with SMS due to an atypical large proximal deletion ( approximately 6Mb; cen<->TNFRSFproteinB) of chromosome band (17)(p11.2p11.2) who presents with typical sleep disturbances but a normal pattern of melatonin secretion. We further describe a melatonin light suppression test in this patient. This is the second reported patient with a normal endogenous melatonin rhythm in SMS associated with an atypical large deletion. These two patients are significant because they suggest that the sleep disturbances in SMS cannot be solely attributed to the abnormal diurnal melatonin secretion versus the normal nocturnal pattern.
authors.affiliation: Department of Neurology, Oregon Health & Science University, Portland, Oregon 97207, USA.
authors.forename: Eilis A
authors.initials: EA
authors.lastname: Boudreau
authors.forename: Kyle P
authors.initials: KP
authors.lastname: Johnson
authors.forename: Angela R
authors.initials: AR
authors.lastname: Jackman
authors.forename: Jan
authors.initials: J
authors.lastname: Blancato
authors.forename: Marjan
authors.initials: M
authors.lastname: Huizing
authors.forename: Claude
authors.initials: C
authors.lastname: Bendavid
authors.forename: Marypat
authors.initials: M
authors.lastname: Jones
authors.forename: Settara C
authors.initials: SC
authors.lastname: Chandrasekharappa
authors.forename: Alfred J
authors.initials: AJ
authors.lastname: Lewy
authors.forename: Ann C M
authors.initials: AC
authors.lastname: Smith
authors.forename: R Ellen
authors.initials: RE
authors.lastname: Magenis
mesh_terms: D000015:Abnormalities, Multiple / Q000235:genetics* / Q000378:metabolism; D002872:Chromosome Deletion; D002886:Chromosomes, Human, Pair 17; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000150:complications / Q000235:genetics; D008487:Medical History Taking; D008550:Melatonin / Q000378:metabolism*; D012189:Retrospective Studies; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications / Q000175:diagnosis / Q000235:genetics*; D013577:Syndrome; D055815:Young Adult
chemical_list: D008550:Melatonin