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Table 6 Medial comorbidities in individuals with nested deletion or duplication of 22q11.2

From: Critical region within 22q11.2 linked to higher rate of autism spectrum disorder

 

A to B deletion (n = 11)

A to C deletion (n = 4)

B to D deletion (n = 14)

B to D duplication (n = 8)

C to D deletion (n = 4)

C to D duplication (n = 2)

Audiologic

 Audiogram

11

4

14

8

4

2

 Abnormal

6

1

2

2

0

1

 Abnormal Ratea

55%

25%

14%

25%

0%

50%

 Abnormalities

CHL

CHL

SNHL

CHL, CSNHL

n/a

CHL

Cardiac

 Echocardiogram

9

4

11

5

2

1

 Abnormal

7

3

7

1

1

0

 Abnormal Ratea

64% (78%)

75%

50% (64%)

12% (20%)

25% (50%)

0%

 Abnormalities

Enlarged PA, VR, PS, TOF with PS, IAA with ARSCA, TR, PDA

TA, RAA with ALSCA, dilated aortic root, VR, ASD/VSD

Aortic root dilation, aneurism of TV, ASD, PDA, PFO, TA, VSD

PFO

TOF with pulmonary valve stenosis

n/a

Endocrine

 Bloodwork

11

4

14

4

4

1

 Abnormal

6

2

6

2

0

0

 Abnormal Ratea

55%

50%

43%

25% (50%)

0%

0%

 Abnormalities

Hypocalcemia hypothyroidism low vitamin D (each category n = 2)

Hypocalcemia

Hypocalcemia (n = 2), diabetes mellitus, borderline HbA1C, low growth factors, low vitamin D, hypothyroidism

Borderline abnormal thyroid function tests, neonatal hypoglycemia

n/a

n/a

GI

 Symptom screen

11

3

13

6

3

2

 Abnormal

7

2

12

5

1

2

 Abnormal ratea

64%

50% (67%)

86% (92%)

63% (83%)

25% (33%)

100%

 Abnormalities

GERD (n = 7), constipation (n = 4), anal atresia (n = 1), feeding tube (n = 2)

Constipation (n = 2), GERD

GERD (n = 11), constipation (n = 9), feeding tube (n = 4)

GERD (n = 4), eosinophilic esophagitis, feeding tube

GERD, chronic constipation

GERD (n = 2), constipation, feeding tube

Hematologic

 CBC completed

11

4

14

8

4

2

 Cytopenias

3

3

2

0

0

0

 Abnormal Ratea

27%

75%

14%

0%

0%

0%

Immune

 Bloodwork

9

4

11

4

4

2

 Abnormal

2

2

4

1

2

0

 Abnormal Ratea

18% (22%)

50%

29% (36%)

13% (26%)

50%

0%

 Abnormalities

Low Ig

Low Ig, T cell lymphopenia, inadequate vaccine titers

Low Ig (n = 2), absent thymus, inadequate vaccine response

Low Ig

Low Ig, recurrent MRSA infections, inadequate vaccine response

n/a

Neurologic

 Seizures

3

0

2

0

0

0

 % reported

27%

0%

14%

0%

0%

0%

 MRI

8

2

10

4

0

0

 Abnormal MRI

3

1

3

2

n/a

n/a

 Abnormal Ratea

27% (38%)

25% (50%)

21% (30%)

25% (50%)

0%

0%

 MRI findings

Chiari 1, white matter lesions, pachygyria

Minimal bilateral congenital optic nerve hypoplasia

Chiari 1, hypoplastic corpus callosum, polymicrogyria

Prominent ventricles, subarachnoid spaces, choroid plexus cysts

n/a

n/a

Ophthalmologic

 Ophtho exam

9

4

11

3

4

1

 Abnormal

3

2

5

1

0

0

 Abnormal ratea

27% (33%)

50%

45%

13% (33%)

n/a

n/a

 Abnormalities

Astigmatism, exophoria, nystagmus

Strabismus, minimal ONH

Anisocoria, iris coloboma, ONH nystagmus (n = 2), retinal detachment, strabismus (n = 3)

Amblyopia

n/a

n/a

Palate

 Clinical eval.

9

4

12

6

2

2

 Abnormal

8

3

4

1

0

1

 Abnormal ratea

89% (73%)

75% (27%)

33% (29%)

17% (13%)

0%

50%

 Abnormalities

SMCP (n = 3) VPI (n = 8)

SMCP (n = 1), VPI (n = 3)

SMCP (n = 2), VPI (n = 4)

High arched palate with small uvula

n/a

VPI

Renal

 Ultrasound

9

2

9

6

2

1

 Abnormal

3

0

1

4

1

0

 Abnormal ratea

27% (33%)

0%

7% (11%)

50% (67%)

25% (50%)

0%

 Abnormalities

Bilateral pelviectasis, nephrocalcinosis hydronephrosis

n/a

Medullary nephrocalcinosis

Duplicated collecting system, small kidneys (n = 3)

Solitary, low-lying kidney

n/a

Spine

 Screening x-rays

6

4

4

2

1

1

 Abnormal

6

3

2

1

1

0

 Abnormal Ratea

55% (100%)

38% (75%)

14% (50%)

13% (50%)

25% (100%)

0%

 Abnormalities

Hypoplastic vertebra (n = 2), vertebral fusion (n = 4), extra lumbar vertebra

Fusion of C2-C3, kyphoscoliosis, thickened spinous process of C2

Scoliosis, C2-C3 fusion and dysmorphic dens, upswept C2

Hemivertebra at T9, absent rib

6 thoracic ribs and 6 lumbar vertebrae

n/a

  1. The total number of patients in each group is designated in column headings. Each screened organ system is listed along with the number of patients who received the screening recommended for patients with classic 22q11.2 deletions and duplications. aWe present the rate of patients with abnormal findings as a percentage of total patients. Many patients did not receive all recommended screening; when not all patients were screened, we use parentheses to note the percentage of patients with abnormal findings ofthose who received screening
  2. Abbreviations: ARSCA aberrant right subclavian artery, ALSCA aberrant left subclavian artery, ASD atrial septal defect (in cardiac row only, in remainder of manuscript ASD refers to autism spectrum disorder), CHL conductive hearing loss, C/SNHL mixed conductive and sensorineural hearing loss, GERD gastroesophageal reflux disease, HbA1C hemoglobin A1C, IAA interrupted aortic arch, Ig immunoglobulins, MRI magnetic resonance imaging, MRSA methicillin-resistant Staphylococcus aureus, ONH optic nerve hypoplasia, PA pulmonary artery, PDA patent ductus arteriosus, PFO patent foramen ovale, PS pulmonic stenosis, SMCP submucous cleft palate, SNHL sensorineural hearing loss, TA truncus arteriosus, TR tricuspid regurgitation, TOF Tetralogy of Fallot, TV tricuspid valve, VPI velopharyngeal insufficiency, VR vascular ring, VSD ventricular septal defect, n/a not applicable