title: Unexpected detection of dystrophin gene deletions by array comparative genomic hybridization.
abstract: Array comparative genomic hybridization has increasingly become the standard of care to evaluate patients for genomic imbalance. As the patient population evaluated by microarray expands, there is certain to be an increase in the detection of unexpected, yet common diseases. When array results predict a late-onset disorder or cancer predisposition, it becomes a challenge for physicians and counselors to adequately address with patients. Included in this study were three patients described with nonspecific phenotypic findings who underwent microarray testing to better define their disease etiology. An unexpected deletion within the dystrophin gene was observed in each case, despite that no patient was suspected of a dystrophinopathy at the time of testing. The patients included an 8-day-old male with a dystrophin deletion predictive of Becker muscular dystrophy, an 18-month old female found to be the carrier of deletion, and a 4-year-8-month-old male with a deletion predictive of Duchenne muscular dystrophy. In this circumstance it becomes difficult to counsel the family, as well as to predict disease course when underlying medical conditions may exist. However, early detection may enable the patient to receive proactive treatment, and allows for screening of at-risk family members. Ultimately, it is up to the clinician to promote informed decision-making within the family prior to testing, and ensure that adequate counseling is provided during follow-up.
authors.affiliation: Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH 43205, USA.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Cottrell
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Prior
authors.forename: Robert
authors.initials: R
authors.lastname: Pyatt
authors.forename: Caroline
authors.initials: C
authors.lastname: Astbury
authors.forename: Shalini
authors.initials: S
authors.lastname: Reshmi
authors.forename: Dennis
authors.initials: D
authors.lastname: Bartholomew
authors.forename: Joan
authors.initials: J
authors.lastname: Atkin
authors.forename: Kandamurugu
authors.initials: K
authors.lastname: Manickam
authors.forename: Devon Lamb
authors.initials: DL
authors.lastname: Thrush
authors.forename: Matthew
authors.initials: M
authors.lastname: Pastore
authors.forename: Jerry
authors.initials: J
authors.lastname: Mendell
authors.forename: Chang-Yong
authors.initials: CY
authors.lastname: Tsao
authors.forename: Roula
authors.initials: R
authors.lastname: Al-Dahhak
authors.forename: Amy
authors.initials: A
authors.lastname: Newmeyer
authors.forename: Julie M
authors.initials: JM
authors.lastname: Gastier-Foster
mesh_terms: D017668:Age of Onset; D002675:Child, Preschool; D055028:Comparative Genomic Hybridization / Q000379:methods*; D016189:Dystrophin / Q000235:genetics*; D005190:Family; D005260:Female; D017353:Gene Deletion; D005817:Genetic Counseling; D005820:Genetic Testing / Q000379:methods; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000175:diagnosis
chemical_list: D016189:Dystrophin