22q11.2 deletion syndrome

I told myself I wasn't going to look up anything related to chromosome 22 deletion, but I did. I am now pretty sure Malhotra is talking about 22q11.2 deletion syndrome. This is what I got off of a NIH website. The sections in bold were bolded by me.

What is 22q11.2 deletion syndrome?

22q11.2 deletion syndrome is a disorder caused by the deletion of a small piece of chromosome 22. The deletion occurs near the middle of the chromosome at a location designated q11.2.

The features of this syndrome vary widely, even among affected members of the same family, and involve many parts of the body. Characteristic signs and symptoms include heart defects that are often present from birth, an opening in the roof of the mouth (a cleft palate) or other palate defects, and mild differences in facial features. People with 22q11.2 deletion syndrome often experience recurrent infections caused by problems with the immune system, and some develop autoimmune disorders such as rheumatoid arthritis and Graves' disease. Affected individuals may also have kidney abnormalities, low levels of calcium in the blood (which can result in seizures), a decrease in blood platelets (thrombocytopenia), significant feeding difficulties, and hearing loss. Skeletal differences are possible, including mild short stature and, less frequently, abnormalities of the spinal bones.

Many children with 22q11.2 deletion syndrome have developmental delays and learning disabilities. Later in life, they are at an increased risk of developing mental illnesses such as schizophrenia, depression, anxiety, and bipolar disorder. Additionally, affected children are more likely than children without 22q11.2 deletion syndrome to have attention deficit hyperactivity disorder (ADHD) and developmental disorders such as autism that affect communication and social interaction.

Because the signs and symptoms of 22q11.2 deletion syndrome are so varied, different groupings of features were once described as separate conditions. Doctors named these conditions DiGeorge syndrome, velocardiofacial syndrome (also called Shprintzen syndrome), and conotruncal anomaly face syndrome. In addition, some children with the 22q11.2 deletion were diagnosed with the autosomal dominant form of Opitz G/BBB syndrome and Cayler cardiofacial syndrome. Once the genetic basis for these disorders was identified, doctors determined that they were all part of a single syndrome with many possible signs and symptoms. To avoid confusion, this condition is usually called 22q11.2 deletion syndrome, a description based on its underlying genetic cause.

How common is 22q11.2 deletion syndrome?

22q11.2 deletion syndrome affects an estimated 1 in 4,000 people. The condition may actually be more common than this estimate, however, because some people with a 22q11.2 deletion have few signs and symptoms and are not diagnosed with the disorder.

What are the genetic changes related to 22q11.2 deletion syndrome?

22q11.2 deletion syndrome is related to chromosome 22.

The COMT and TBX1 genes are associated with 22q11.2 deletion syndrome.

Most people with 22q11.2 deletion syndrome are missing a sequence of about 3 million DNA building blocks (base pairs) on one copy of chromosome 22 in each cell. This region contains 30 to 40 genes, many of which have not been well characterized. A small percentage of affected individuals have shorter deletions in the same region. This condition is often described as a contiguous gene deletion syndrome because it results from the loss of many genes that are close together.

Researchers are working to identify all of the genes that contribute to the features of 22q11.2 deletion syndrome. They have determined that the loss of a particular gene on chromosome 22, TBX1, is probably responsible for many of the syndrome's characteristic signs (such as heart defects, a cleft palate, distinctive facial features, hearing loss, and low calcium levels). Some studies suggest that a deletion of this gene may contribute to behavioral problems as well. The loss of another gene, COMT, in the same region of chromosome 22 may also help explain the increased risk of behavioral problems and mental illness. Additional genes in the deleted region likely contribute to the varied features of 22q11.2 deletion syndrome.

Can 22q11.2 deletion syndrome be inherited?

The inheritance of 22q11.2 deletion syndrome is considered autosomal dominant because a deletion in one copy of chromosome 22 in each cell is sufficient to cause the condition. Most cases of 22q11.2 deletion syndrome are not inherited, however. The deletion occurs most often as a random event during the formation of reproductive cells (eggs or sperm) or in early fetal development. Affected people typically have no history of the disorder in their family, though they can pass the condition to their children. In about 10 percent of cases, a person with this condition inherits the deletion in chromosome 22 from a parent. In inherited cases, other family members may be affected as well.

What other names do people use for 22q11.2 deletion syndrome?

* Autosomal dominant Opitz G/BBB syndrome
* CATCH22
* Cayler cardiofacial syndrome
* Conotruncal anomaly face syndrome (CTAF)
* Deletion 22q11.2 syndrome
* DiGeorge Syndrome
* Sedlackova syndrome
* Shprintzen syndrome
* VCFS
* Velocardiofacial syndrome
* Velo-cardio-facial syndrome

I have to admit the information on mental illnesses disturbed me quite a bit and autism. I am not sure what I am going to do with this information. I might call Catherine Klump, our genetic counselor from the CVS, and hear what she has to say. I am encouraged by the part that says that many people have a mild form of the disease and probably not everyone with it is diagnosed. I just feel like I need a better understanding of the mental illness component of the syndrome. I can't believe the things I have had to deal with in having Wyatt. I never would have imagined parenting would be like this. I am not sure what I would have done had Wyatt really been born with issues. So far, while he hasn't had the typical course one expects when they have children, we have still had it relatively easy. And I am thankful for that.

In other news, we didn't remove Wyatt's urine collection bag soon enough and it came off on it's own. No urine collected. We will try again when we see his pediatrician on Monday.