Sindrome del grido di gatto

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Sindrome del grido di gatto
Caratteristiche facciali di un paziente con sindrome del grido di gatto a differenti età: 8 mesi (A), 2 anni (B), 4 anni (C), 9 anni (D)
Malattia rara
Cod. esenz. SSNRN0670
Specialitàgenetica clinica
Classificazione e risorse esterne (EN)
OMIM123450
MeSHD003410
MedlinePlus001593
eMedicine942897

La sindrome del grido di gatto (o sindrome del chat pleure) è una malattia genetica rara causata dalla delezione di parte del cromosoma 5 ("delezione 5p-"). Individuata dal medico francese Jérôme Lejeune nel 1963, ha l'incidenza di un caso ogni 50.000 nati vivi.

La sindrome prende nome dal pianto lamentoso, simile al miagolio del gatto, caratteristico dei soggetti affetti. La perdita di materiale genetico si associa a ritardo dello sviluppo psicomotorio e a grave ritardo mentale, ma l'assenza di malformazioni gravi in una notevole percentuale di casi può garantire una lunga sopravvivenza.

Quadro clinico

I segni distintivi sono rappresentati, oltre che dal tipico pianto, causato dall'ipoplasia delle cartilagini della laringe (che però scompare con il passare dei mesi), da ritardo mentale grave (con tendenza all'automutilazione), microcefalia, ritardo nella crescita e un aspetto caratteristico del volto che appare rotondeggiante, con ipertelorismo marcato, epicanto accentuato, sella nasale slargata, micrognazia e orecchie a basso impianto. Nel 15% dei casi è presente una cardiopatia congenita.

Causa genetica

La causa della sindrome fu individuata nel 1963 dal medico e genetista Jérôme Lejeune: essa risiede nella delezione parziale del cromosoma 5. Nella maggior parte dei casi tale delezione è un evento de novo; solo il 5% dei casi invece è ereditato da genitori in cui sono avvenute traslocazioni cromosomiche bilanciate. Il 90% delle delezioni de novo si genera sul cromosoma di derivazione paterna. I sintomi e i fenotipi che ne derivano dipendono dal frammento cromosomico deleto, in particolare il "pianto del gatto" mappa nella regione 5p15.3, mentre le caratteristiche facciali mappano in una regione più prossimale, 5p15.2. La regione 5p15.2 è considerata la regione critica della sindrome.

Bibliografia

  • Giovanni Neri, Maurizio Genuardi, Genetica umana e medica, Elsevier, 2010, ISBN 88-214-3172-X.
  • Lejeune J., Lafourcade J., Berger R., Vialatte J., Boeswillwald M., Seringe P., Turpin R. Trois cas de délétion partielle du bras court d'un chromosome 5. C R Acad Sci 257:3098–3102,1963.
  • Overhauser J., Huang X., Gersh M., Wilson W., McMahon J., Bengtsson U., Rojas K., Meyer M., Wasmuth JJ. Molecular and phenotypic mapping of the short arm of chromosome 5: sublocalization of the critical region for the cri-du-chat syndrome. Hum Mol Genet 3:247–252,1994.
  • Schinzel A. Catalogue of unbalanced chromosome aberrations in man. Walter de Gruyter ed., Berlin, 1984.
  • Niebuhr E. Cytologic observations in 35 individuals with a 5p- karyotype. Hum Genet 42:143–146,1978.
  • Overhauser J., McMahon J., Oberlender S., Carlin ME., Niebuhr E., Wasmuth JJ., Lee-Chen J. Parental origin of chromosome 5 deletions in the cri du chat syndrome. Am J Med Genet 37:83-86,1990.
  • Medina M., Marinescu RC, Overhauser J., Kosik SK. Hemizigosity of δ-catenin (CTNND2) is associated with severe mental retardation in cri-du-chat syndrome. Genomics 63:157–164,2000.
  • Yuan Y., Singh D., Arikkath J. Mef2 promotes spine elimination in absence of d-catenin. Neurosci Lett 536:10-13,2013.
  • Cerruti Mainardi P, Perfumo C, Pastore G, Calì A, Guala A, Biroli E, Liverani ME, Egidi I, Zara F, Zerega G, Overhauser J, Pierluigi M, Dagna Bricarelli F. Cri du chat syndrome. Ital J Pediatr 27: 840-850,2001.
  • Cerruti Mainardi P. La sindrome del cri du chat in età adulta, in: G. Andria, F. Dagna Bricarelli, G. del Porto, M. De Marchi, A. Federico (Eds.). Patologia genetica ad esordio tardivo, Monduzzi, Bologna, 1987, pp. 113–128.
  • Cerruti Mainardi P., Perfumo C., Calì A., Coucourde G., Pastore G., Cavani S., Zara F., Overhauser J., Pierluigi M., Dagna Bricarelli F. Clinical and molecular characterization of 80 patients with 5p deletion: genotype–phenotype correlation, J Med Genet 38:151–158,2001.
  • Guala A., Spunton M., Cerruti Mainardi P., Emmig U., Acucella G., Danesino C. Anaesthesia in Cri du Chat syndrome: an investigation on 51 Italian patients. Am J Med Genet, in press 2014.
  • Cerruti Mainardi P., Pastore G., Castronovo C., Godi M., Guala A., Tamiazzo S., Provera S., Pierluigi M., Dagna Bricarelli F. The natural history of Cri du Chat Syndrome. A report from the Italian Register. Eur J Med Genet 2006, 49: 363-83.
  • Liverani M.E., Spunton M., Cerruti Mainardi P., Dagna Bricarelli F., Danesino C., Guala A. Cri du Chat syndrome: recommendations for the care in children and adults. 7th European Conference on Rare Diseases, 8-10 maggio 2014, Berlino.
  • Kjaer I, Niebuhr E. Studies of cranial base in 23 patients with cri-du-chat syndrome suggest a cranial developmental field involved in the condition. Am J Med Genet 82:6-14,1999.
  • Church DM., Yang J., Bocian M., Shiang R., Wasmuth JJ. A high-resolution physical and transcript map of the cri du chat region of human chromosome 5p. Genome Res. 7:787–801,1997.
  • Zhang X., Snijders A., Segraves R., Zhang X., Albertson D., Yang H., Gray J., Niebuhr E., Bolund L., Pinkel D. High-resolution mapping of genotype-phenotype relationships in cri du chat syndrome using array comparative genomic hybridization, Am J Hum Genet 76:312–326,2005.
  • Cerruti Mainardi P., Calì A., Guala A., Perfumo C., Liverani ME, Pastore G., Overhauser J., Zara F., Pierluigi M., Dagna Bricarelli F. Phenotype-genotype correlation in 7 patients with 5p/autosome translocations. Risk for carriers of translocations involving 5p. Am J Hum Genet 753:145,2000.
  • Cerruti Mainardi P., Guala A., Pastore G., Pozzo G., Dagna Bricarelli F., Pierluigi M. Psychomotor development in cri du chat sindrome. Clin Genet 57:459–461,2000.
  • Cerruti Mainardi P., Spunton M., Arcuri V., Pastore G., Pedrinazzi M., Nardi S., Castronovo C., Alessi D., Guala A. The Cri du Chat syndrone: a study on the quality of care. Min Ped 64:395-400,2012.
  • Nardi S. La sindrome del cri du chat. Aspetti caratteristici e linee guida applicative. WWW.criduchat.it/riabilitazione.htm

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