title: Angelman syndrome in Denmark. birth incidence, genetic findings, and age at diagnosis.
abstract: Angelman syndrome (AS) is a neurogenetic disorder caused by loss of expression of the maternal imprinted gene UBE3A on chromosome 15q11.2-q13. Clinical features of AS include severe intellectual disability, a happy disposition, ataxia, mandibular prognatism, and epilepsy. Our objectives were to examine the birth incidence of AS in Denmark and to characterize the size of the 15q11.2-q13 deletions with 1,000K array CGH. In addition, we analyzed genotype differences in regard to age at diagnosis and investigated the occurrence of deletions/duplications outside the 15q11.2-q13 regions. We identified 51 patients with genetically verified AS, which corresponded to a birth incidence of 1:24,580 (95%CI: 1:23,727-1:25,433). Thirty-six patients showed a deletion; 13 had a Class I deletion and 20 had a Class II deletion. There was bimodal distribution of the BP3 breakpoint. Three patients had larger and atypical deletions, with distal breakpoints telomeric to BP3. Five patients had paternal uniparental disomy (pUPD) of chromosome 15, and four had a verified UBE3A mutation. Additional deletions/duplications outside the 15q11.2-q13 areas were demonstrated in half the participants. Six harbored more than one CNV. Mean age at diagnosis was 21 months (95%CI: 17-23 months) for children with a deletion and 46 months (95%CI: 36-55 months) for children with pUPD or a UBE3A mutation (P < 0.01). The presence of a CNV outside 15q11.2-q13 did not have an impact on age at diagnosis.
authors.affiliation: Department of Pediatrics, Center for Rare Diseases, Aarhus University Hospital, Aarhus, Denmark. linebiemertz@dadlnet.dk
authors.forename: Line Granild Bie
authors.initials: LG
authors.lastname: Mertz
authors.forename: Rikke
authors.initials: R
authors.lastname: Christensen
authors.forename: Ida
authors.initials: I
authors.lastname: Vogel
authors.forename: Jens Michael
authors.initials: JM
authors.lastname: Hertz
authors.forename: Karen Brøndum
authors.initials: KB
authors.lastname: Nielsen
authors.forename: Karen
authors.initials: K
authors.lastname: Grønskov
authors.forename: John R
authors.initials: JR
authors.lastname: Østergaard
mesh_terms: D000293:Adolescent; D017204:Angelman Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D002872:Chromosome Deletion; D058674:Chromosome Duplication; D002884:Chromosomes, Human, Pair 15; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male
keywords: 15q11.2-q13; Angelman syndrome; array CGH; birth incidence; breakpoints; copy number variation; deletion