Abstract
OBJECTIVE—Early research into Wolf-Hirschhorn syndrome (WHS) described a high mortality and no relationship between deletion size and phenotype. This may need to be revised in the light of improved cytogenetic resolution and medical care. We have collected epidemiological data to allow the calculation of birth incidence and mortality figures. In addition, we have investigated the possibility of a relationship between deletion size and mortality. METHOD—Information relating to past and present cases diagnosed in the UK was collected by multiple ascertainment. RESULTS—A total of 159 cases were collected. The status (alive or dead) was determined for 146, of whom 96 are alive, 37 had died, and 13 were detected on prenatal diagnostic tests. A minimum birth incidence of 1 in 95 896 was calculated. The crude infant mortality rate was 17% (23/132) and in the first two years of life the mortality rate was 21% (28/132). Cases with large de novo deletions (proximal to and including p15.2) were more likely to have died than those with smaller deletions (odds ratio=5.7, 95% CI=1.7-19.9) after adjusting for age. A comparison of survival curves for de novo deletions and translocations did not show a statistically significant difference (p=0.11). The median survival time for de novo deletions was 34+ years while for translocation cases it was 18+ years. CONCLUSIONS—The mortality rate is lower than previously reported. There is a statistically significant relationship between deletion size and overall risk of death in de novo deletion cases. The difference in survival curves between de novo deletions and translocations is not statistically significant. Keywords: Wolf-Hirschhorn syndrome; chromosome 4; mortality
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- Estabrooks L. L., Breg W. R., Hayden M. R., Ledbetter D. H., Myers R. M., Wyandt H. E., Yang-Feng T. L., Hirschhorn K. Summary of the 1993 ASHG ancillary meeting "recent research on chromosome 4p syndromes and genes". Am J Med Genet. 1995 Feb 13;55(4):453–458. doi: 10.1002/ajmg.1320550412. [DOI] [PubMed] [Google Scholar]
- Estabrooks L. L., Lamb A. N., Aylsworth A. S., Callanan N. P., Rao K. W. Molecular characterisation of chromosome 4p deletions resulting in Wolf-Hirschhorn syndrome. J Med Genet. 1994 Feb;31(2):103–107. doi: 10.1136/jmg.31.2.103. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Johnson V. P., Mulder R. D., Hosen R. The Wolf-Hirschhorn (4p-) syndrome. Clin Genet. 1976 Aug;10(2NA-NA-760903-760909):104–112. doi: 10.1111/j.1399-0004.1976.tb00021.x. [DOI] [PubMed] [Google Scholar]
- Lurie I. W., Lazjuk G. I., Ussova Y. I., Presman E. B., Gurevich D. B. The Wolf-Hirschhorn syndrome. I. Genetics. Clin Genet. 1980 Jun;17(6):375–384. doi: 10.1111/j.1399-0004.1980.tb00167.x. [DOI] [PubMed] [Google Scholar]
- Morris J. A., Gardner M. J. Calculating confidence intervals for relative risks (odds ratios) and standardised ratios and rates. Br Med J (Clin Res Ed) 1988 May 7;296(6632):1313–1316. doi: 10.1136/bmj.296.6632.1313. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Partington M. W., Fagan K., Soubjaki V., Turner G. Translocations involving 4p16.3 in three families: deletion causing the Pitt-Rogers-Danks syndrome and duplication resulting in a new overgrowth syndrome. J Med Genet. 1997 Sep;34(9):719–728. doi: 10.1136/jmg.34.9.719. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Passarge E., Altrogge H. C., Rüdiger R. A. Human chromosomal deficiency: the 4p--syndrome. Humangenetik. 1970 Aug 17;10(1):51–57. doi: 10.1007/BF00297640. [DOI] [PubMed] [Google Scholar]
- Preus M., Aymé S., Kaplan P., Vekemans M. A taxonomic approach to the del(4p) phenotype. Am J Med Genet. 1985 Jun;21(2):337–345. doi: 10.1002/ajmg.1320210216. [DOI] [PubMed] [Google Scholar]
- Rigby A. S. Statistical methods in epidemiology. III. The odds ratio as an approximation to the relative risk. Disabil Rehabil. 1999 Apr;21(4):145–151. doi: 10.1080/096382899297756. [DOI] [PubMed] [Google Scholar]
- Stec I., Wright T. J., van Ommen G. J., de Boer P. A., van Haeringen A., Moorman A. F., Altherr M. R., den Dunnen J. T. WHSC1, a 90 kb SET domain-containing gene, expressed in early development and homologous to a Drosophila dysmorphy gene maps in the Wolf-Hirschhorn syndrome critical region and is fused to IgH in t(4;14) multiple myeloma. Hum Mol Genet. 1998 Jul;7(7):1071–1082. doi: 10.1093/hmg/7.7.1071. [DOI] [PubMed] [Google Scholar]
- Wieczorek D., Krause M., Majewski F., Albrecht B., Horn D., Riess O., Gillessen-Kaesbach G. Effect of the size of the deletion and clinical manifestation in Wolf-Hirschhorn syndrome: analysis of 13 patients with a de novo deletion. Eur J Hum Genet. 2000 Jul;8(7):519–526. doi: 10.1038/sj.ejhg.5200498. [DOI] [PubMed] [Google Scholar]
- Wilson M. G., Towner J. W., Coffin G. S., Ebbin A. J., Siris E., Brager P. Genetic and clinical studies in 13 patients with the Wolf-Hirschhorn syndrome [del(4p)]. Hum Genet. 1981;59(4):297–307. doi: 10.1007/BF00295461. [DOI] [PubMed] [Google Scholar]
- Wilson M. G., Towner J. W., Negus L. D. Wolf-Hirschhorn syndrome associated with an unusual abnormality of chromosome no. 4. J Med Genet. 1970 Jun;7(2):164–170. doi: 10.1136/jmg.7.2.164. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wolf U., Reinwein H., Porsch R., Schröter R., Baitsch H. Defizienz an den kuzen Armen eins Chromosoms Nr. 4. Humangenetik. 1965;1(5):397–413. [PubMed] [Google Scholar]
- Wright T. J., Clemens M., Quarrell O., Altherr M. R. Wolf-Hirschhorn and Pitt-Rogers-Danks syndromes caused by overlapping 4p deletions. Am J Med Genet. 1998 Feb 3;75(4):345–350. doi: 10.1002/(sici)1096-8628(19980203)75:4<345::aid-ajmg2>3.0.co;2-p. [DOI] [PubMed] [Google Scholar]
- Wright T. J., Ricke D. O., Denison K., Abmayr S., Cotter P. D., Hirschhorn K., Keinänen M., McDonald-McGinn D., Somer M., Spinner N. A transcript map of the newly defined 165 kb Wolf-Hirschhorn syndrome critical region. Hum Mol Genet. 1997 Feb;6(2):317–324. doi: 10.1093/hmg/6.2.317. [DOI] [PubMed] [Google Scholar]
- Zollino M., Di Stefano C., Zampino G., Mastroiacovo P., Wright T. J., Sorge G., Selicorni A., Tenconi R., Zappalà A., Battaglia A. Genotype-phenotype correlations and clinical diagnostic criteria in Wolf-Hirschhorn syndrome. Am J Med Genet. 2000 Sep 18;94(3):254–261. doi: 10.1002/1096-8628(20000918)94:3<254::aid-ajmg13>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]