title: Microdeletion 9q22.3 syndrome includes metopic craniosynostosis, hydrocephalus, macrosomia, and developmental delay.
abstract: Basal cell nevus syndrome (BCNS), also known as Gorlin syndrome (OMIM #109400) is a well-described rare autosomal dominant condition due to haploinsufficiency of PTCH1. With the availability of comparative genomic hybridization arrays, increasing numbers of individuals with microdeletions involving this locus are being identified. We present 10 previously unreported individuals with 9q22.3 deletions that include PTCH1. While 7 of the 10 patients (7 females, 3 males) did not meet strict clinical criteria for BCNS at the time of molecular diagnosis, almost all of the patients were too young to exhibit many of the diagnostic features. A number of the patients exhibited metopic craniosynostosis, severe obstructive hydrocephalus, and macrosomia, which are not typically observed in BCNS. All individuals older than a few months of age also had developmental delays and/or intellectual disability. Only facial features typical of BCNS, except in those with prominent midforeheads secondary to metopic craniosynostosis, were shared among the 10 patients. The deletions in these individuals ranged from 352  kb to 20.5  Mb in size, the largest spanning 9q21.33 through 9q31.2. There was significant overlap of the deleted segments among most of the patients. The smallest common regions shared among the deletions were identified in order to localize putative candidate genes that are potentially responsible for each of the non-BCNS features. These were a 929  kb region for metopic craniosynostosis, a 1.08  Mb region for obstructive hydrocephalus, and a 1.84  Mb region for macrosomia. Additional studies are needed to further characterize the candidate genes within these regions.
authors.affiliation: Stanford University, Stanford, California 94305, USA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Muller
authors.forename: Swaroop
authors.initials: S
authors.lastname: Aradhya
authors.forename: Joan F
authors.initials: JF
authors.lastname: Atkin
authors.forename: Erin P
authors.initials: EP
authors.lastname: Carmany
authors.forename: Alison M
authors.initials: AM
authors.lastname: Elliott
authors.forename: Albert E
authors.initials: AE
authors.lastname: Chudley
authors.forename: Robin D
authors.initials: RD
authors.lastname: Clark
authors.forename: David B
authors.initials: DB
authors.lastname: Everman
authors.forename: Shannon
authors.initials: S
authors.lastname: Garner
authors.forename: Bryan D
authors.initials: BD
authors.lastname: Hall
authors.forename: Gail E
authors.initials: GE
authors.lastname: Herman
authors.forename: Emma
authors.initials: E
authors.lastname: Kivuva
authors.forename: Subhadra
authors.initials: S
authors.lastname: Ramanathan
authors.forename: David A
authors.initials: DA
authors.lastname: Stevenson
authors.forename: David W
authors.initials: DW
authors.lastname: Stockton
authors.forename: Louanne
authors.initials: L
authors.lastname: Hudgins
mesh_terms: D001478:Basal Cell Nevus Syndrome / Q000175:diagnosis* / Q000235:genetics* / Q000473:pathology*; D002280:Basal Cell Carcinoma / Q000175:diagnosis / Q000235:genetics / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D002872:Chromosome Deletion; D002899:Chromosomes, Human, Pair 9 / Q000235:genetics*; D055028:Comparative Genomic Hybridization; D003398:Craniosynostoses / Q000175:diagnosis / Q000235:genetics; D002658:Developmental Disabilities / Q000175:diagnosis / Q000235:genetics; D005260:Female; D005320:Fetal Macrosomia / Q000235:genetics; D056726:Genetic Association Studies; D057895:Haploinsufficiency / Q000235:genetics; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000235:genetics; D007223:Infant; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000175:diagnosis / Q000473:pathology; D008297:Male; D000072079:Patched Receptors; D000072081:Patched-1 Receptor; D057089:Pathology, Molecular; D011956:Receptors, Cell Surface / Q000235:genetics*
chemical_list: C000606236:PTCH1 protein, human; D000072079:Patched Receptors; D000072081:Patched-1 Receptor; D011956:Receptors, Cell Surface