IllnessIntellectual deficit + small stature, differential diagnosis
Summary
Comprehensive differential diagnostic panel for Intellectual deficit + small stature comprising 18 and altogether 68 curated genes according to the clinical signs
61,9 kb (Extended panel: incl. additional genes)
- EDTA-anticoagulated blood (3-5 ml)
NGS +
[Sanger]
Gene panel
Selected genes
Name | Exon Length (bp) | OMIM-G | Referenz-Seq. | Heredity |
---|---|---|---|---|
BLM | 4254 | NM_000057.4 | AR | |
BRAF | 2301 | NM_004333.6 | AD | |
CBL | 2721 | NM_005188.4 | AD | |
HRAS | 570 | NM_005343.4 | AD | |
IGF1 | 462 | NM_000618.5 | AR | |
IGF1R | 4104 | NM_000875.5 | AR | |
KRAS | 567 | NM_004985.5 | AD | |
LZTR1 | 2523 | NM_006767.4 | AD, AR | |
MAP2K1 | 1182 | NM_002755.4 | AD | |
MAP2K2 | 1203 | NM_030662.4 | AD | |
NRAS | 570 | NM_002524.5 | AD | |
PTPN11 | 1782 | NM_002834.5 | AD | |
RAF1 | 1947 | NM_002880.4 | AD | |
SHOC2 | 1749 | NM_007373.4 | AD | |
SLX4 | 5505 | NM_032444.4 | AR | |
SOS1 | 4002 | NM_005633.4 | AD | |
SOS2 | 3999 | NM_006939.4 | AD | |
SRCAP | 9693 | NM_006662.3 | AD | |
DHCR7 | 1428 | NM_001360.3 | AR | |
MECP2 | 1461 | NM_004992.4 | XL | |
NF1 | 8457 | NM_001042492.3 | AD | |
PPP1CB | 350 | NM_002709.3 | AD | |
RIT1 | 660 | NM_006912.6 | AD | |
RRAS2 | 384 | NM_012250.6 | AD |
Informations about the disease
Most children with short stature have average test scores for intelligence and behavior. Yet of >1100 genetic syndromes with short stature, two-thirds are associated with mental retardation. Genetic causes may account for an increased risk for children with short stature to have intellectual deficits. Prominent examples include Noonan syndrome, LEOPARD syndrome (Noonan syndrome with multiple lentigines) and craniofaciocutaneous syndrome as well as numerous even partly much rarer conditions. Most of the defined syndromes with symptoms of short stature and intellectual deficits are inherited autosomal dominantly, less frequently autosomal recessively. While the DNA diagnostic yield for Noonan syndrome is over 80%, it is lower for the other syndromes with the same combination of cardinal symptoms or virtually unknown for most true orphan diseases.
References: https://www.ncbi.nlm.nih.gov/books/NBK1124/
https://www.ncbi.nlm.nih.gov/books/NBK1383/
https://www.ncbi.nlm.nih.gov/books/NBK1186/
- Alias: Intellectual deficit + small stature
- Alias: Intellectual disability + short stature
- Alias: Psycho-motor retardation + short stature
- Allelic: Adenocarcinoma of lung, somatic (BRAF)
- Allelic: Arteriovenous malformation of the brain, somatic (KRAS)
- Allelic: Autism susceptibility, XL 3 (MECP2)
- Allelic: Bladder cancer, somatic (HRAS)
- Allelic: Bladder cancer, somatic (KRAS)
- Allelic: Breast cancer, somatic (KRAS)
- Allelic: Breast cancer, susceptibility to (RAD51)
- Allelic: Cardiomyopathy, dilated, 1NN (RAF1)
- Allelic: Colorectal cancer, somatic (BRAF)
- Allelic: Colorectal cancer, somatic (NRAS)
- Allelic: Congenital myopathy with excess of muscle spindles (HRAS)
- Allelic: Epidermal nevus, somatic (NRAS)
- Allelic: Fibromatosis, gingival, 1 (SOS1)
- Allelic: Gastric cancer, somatic (KRAS)
- Allelic: Hyperphenylalaninemia, non-PKU mild (PAH)
- Allelic: Infantile liver failure syndrome 2 (NBAS)
- Allelic: Intellectual developmental disorder, XL 19 (RPS6KA3)
- Allelic: Juvenile myelomonocytic leukemia (CBL)
- Allelic: Leukemia, acute myeloid, somatic (KRAS)
- Allelic: Leukemia, juvenile myelomonocytic (NF1)
- Allelic: Leukemia, juvenile myelomonocytic, somatic (PTPN11)
- Allelic: Lung cancer, somatic (KRAS)
- Allelic: Melanocytic nevus syndrome, congenital, somatic (NRAS)
- Allelic: Melanoma, malignant, somatic (BRAF)
- Allelic: Melorheostosis, isolated, somatic mosaic (MAP2K1)
- Allelic: Metachondromatosis (PTPN11)
- Allelic: Mirror movements 2 (RAD51)
- Allelic: Neurocutaneous melanosis, somatic (NRAS)
- Allelic: Neurofibromatosis, familial spinal (NF1)
- Allelic: Neurofibromatosis, type 1 (NF1)
- Allelic: Nevus sebaceous or woolly hair nevus, somatic (HRAS)
- Allelic: Nonsmall cell lung cancer, somatic (BRAF)
- Allelic: Pancreatic carcinoma, somatic (KRAS)
- Allelic: Pigmentary disorder, reticulate, with systemic manifestations, XL (POLA1)
- Allelic: RAS-associated autoimmune leukoproliferative disorder (KRAS)
- Allelic: RAS-associated autoimmune lymphoproliferative syndrome type IV, somatic (NRAS)
- Allelic: Schwannomatosis-2, susceptibility to (LZTR1)
- Allelic: Spitz nevus or nevus spilus, somatic (HRAS)
- Allelic: Thyroid carcinoma, follicular, somatic (HRAS, NRAS)
- Alzahrani-Kuwahara syndrome (SMG8)
- Bloom syndrome (BLM)
- Cardiofaciocutaneous syndrome (BRAF)
- Cardiofaciocutaneous syndrome 2 (KRAS)
- Cardiofaciocutaneous syndrome 3 (MAP2K1)
- Cardiofaciocutaneous syndrome 4 (MAP2K2)
- Coffin-Lowry syndrome (RPS6KA3)
- Congenital disorder of glycosylation, type IIj (COG4)
- Costello syndrome (HRAS)
- Developmental delay, short stature, dysmorphic facial features + sparse hair (DPH1)
- Diamond-Blackfan anemia 21 (HEATR3)
- Diets-Jongmans syndrome (KDM3B)
- Encephalopathy, neonatal severe (MECP2)
- Failure to thrive and developmental delay (CCDC186)
- Fanconi anemia, complementation group P (SLX4)
- Fanconi anemia, complementation group R (RAD51)
- Floating-Harbor syndrome (SCAP)
- Growth retardation with deafness and mental retardation due to IGF1 deficiency (IGF1)
- Hypogonadotropic hypogonadism 14 with/-out anosmia (WDR11)
- ID, autistism, seizures, microcephaly, short stature, abnormal skeletal system [panelapp] (UBAP2L)
- Immunodeficiency 23: ID, skeletal dysplasia, short stature, brachydactyly, facial features... (PGM3)
- Insulin-like growth factor I, resistance to (IGF1R)
- Intellectual developmental disorder, AD 23 (SETD5)
- Intellectual developmental disorder, X-linked syndromic, Lubs type (MECP2)
- Intellectual developmental disorder, XL, isolated growth hormone deficiency (SOX3)
- Intellectual developmental disorder, XL, syndromic 13 (MECP2)
- Intellectual developmental disorder, abnormal behavior, microcephaly + short stature (PUS7)
- Intellectual developmental disorder, short stature + behavioral abnormalities (IQSEC1)
- Intellectual developmental disorder, short stature, facial anomalies + speech defects (FBXL3)
- Intellectual developmental disorder, short stature, variable skeletal anomalies (WIPI2)
- KBG syndrome (ANKRD11)
- Koolen-De Vries syndrome (KANSL1)
- LEOPARD syndrome 1 (PTPN11)
- LEOPARD syndrome 2 (RAF1)
- LEOPARD syndrome 3 (BRAF)
- Leukodystrophy, hypomyelinating, 26, with chondrodysplasia (SLC35B)
- Menke-Hennekam syndrome 1 (CREBBP)
- Microcephaly and chorioretinopathy, AR, 2 (PLK4)
- Microcephaly, short stature + impaired glucose metabolism 1 (TRMT10A)
- Microcephaly, short stature + impaired glucose metabolism 2 (PPP1R15B)
- Microcephaly, short stature + limb abnormalities (DONSON)
- Microcephaly, short stature, polymicrogyria + seizures (RTTN)
- Microcephaly-micromelia syndrome (DONSON)
- Mosaic variegated aneuploidy syndrome 2 (CEP57)
- Neurodevelopmental disorder with cataracts, poor growth, dysmorphic facies (INTS1)
- Neurodevelopmental disorder with microcephaly, movement abnormalities, seizures (CHKA)
- Neurodevelopmental disorder with microcephaly, seizures, neonatal cholestasis (VPS50)
- Neurodevelopmental disorder with microcephaly, short stature, speech delay (TRAPPC10)
- Neurodevelopmental disorder with poor growth, large ears, dysmorphic facies (ZNF668)
- Neurodevelopmental disorder with severe motor impairment + absent language (DHX30)
- Neurodevelopmental disorder, dysmorphic facies, sleep disturbance + brain abnormalities (KAT5)
- Neurodevelopmental disorder, multiple congenital abnormalities [panelapp] (FOXP4)
- Neurofibromatosis-Noonan syndrome (NF1)
- Noonan syndrome 1 (PTPN11)
- Noonan syndrome 10 (LZTR1)
- Noonan syndrome 11 (MRAS)
- Noonan syndrome 12 (RRAS2)
- Noonan syndrome 14 (SPRED2)
- Noonan syndrome 2 (LZTR1)
- Noonan syndrome 3 (KRAS)
- Noonan syndrome 4 (SOS1)
- Noonan syndrome 5 (RAF1)
- Noonan syndrome 6 (NRAS)
- Noonan syndrome 7 (BRAF)
- Noonan syndrome 8 (RIT1)
- Noonan syndrome 9 (SOS2)
- Noonan syndrome-like disorder with loose anagen hair 2 (PPP1CB)
- Noonan syndrome-like disorder with/-out juvenile myelomonocytic leukemia (CBL)
- Noonan syndrome-like with loose anagen hair 1 (SHOC2)
- Oculoectodermal syndrome, somatic (KRAS)
- Panhypopituitarism, XL (SOX3)
- Phenylketonuria (PAH)
- Rett syndrome (MECP2)
- Rett syndrome, atypical (MECP2)
- Rett syndrome, preserved speech variant (MECP2)
- Rubinstein-Taybi syndrome 1 (CREBBP)
- Saul-Wilson syndrome (COG4)
- Schimmelpenning-Feuerstein-Mims syndrome, somatic mosaic (HRAS, KRAS, NRAS)
- Short stature, brachydactyly, intellectual developmental disability + seizures (PRMT7)
- Short stature, developmental delay + congenital heart defects (TKT)
- Short stature, macrocephaly, ID + autism spectrum disorder [panelapp] (RHEB)
- Short stature, optic nerve atrophy + Pelger-Huet anomaly (NBAS)
- Short stature, rhizomelic, with microcephaly, micrognathia + developmental delay (ARCN1)
- Smith-Lemli-Opitz syndrome (DHCR7)
- Syndromic intellectual disability, short stature [panelapp] (RAP1B)
- Van Esch-O'Driscoll syndrome (POLA1)
- Watson syndrome (NF1)
- AD
- AR
- XL
- Multiple OMIM-Ps
Bioinformatics and clinical interpretation
Test-Stärken
- DAkkS-akkreditiertes Labor
- EU-Richtlinie für IVD in Umsetzung
- Qualitäts-kontrolliert arbeitendes Personal
- Leistungsstarke Sequenzierungstechnologien, fortschrittliche Target-Anreicherungsmethoden und Präzisions-Bioinformatik-Pipelines sorgen für überragende analytische Leistung
- Sorgfältige Kuratierung klinisch relevanter und wissenschaftlich begründeter Gen-Panels
- eine Vielzahl nicht Protein-kodierender Varianten, die in unseren klinischen NGS-Tests mit erfasst werden
- unser strenges Variantenklassifizierungsschema nach ACMG-Kriterien
- unser systematischer klinischer Interpretations-Workflow mit proprietärer Software ermöglicht die genaue und nachvollziehbare Verarbeitung von NGS-Daten
- unsere umfassenden klinischen Aussagen
Testeinschränkungen
- Gene mit eingeschränkter Abdeckung werden gekennzeichnet
- Gene mit kompletten oder partiellen Duplikationen werden gekennzeichnet
- es wird angenommen, dass ein Gen suboptimal abgedeckt ist, wenn >90% der Nukleotide des Gens bei einem Mapping-Qualitätsfaktor von >20 (MQ>20) nicht abgedeckt sind
- die Sensitivität der Diagnostik zur Erkennung von Varianten mit genannten Testeinschränkungen ist möglicherweise begrenzt bei:
- Gen-Konversionen
- komplexe Inversionen
- Balancierte Translokationen
- Mitochondriale Varianten
- Repeat-Expansionen, sofern nicht anders dokumentiert
- nicht kodierende Varianten, die Krankheiten verursachen, die von diesem Panel nicht mit abgedeckt werden
- niedriger Mosaik-Status
- Repeat-Blöcke von Mononukleotiden
- Indels >50bp (Insertionen-Deletionen)
- Deletionen oder Duplikationen einzelner Exons
- Varianten innerhalb von Pseudogenen
- die analytische Sensitivität kann geringer ausfallen werden, wenn die DNA nicht von amedes genetics extrahiert wurde
Laboratory requirement
Die in grün gezeigten Gene sind kuratiert und werden als Gen-Panel untersucht. Eine Erweiterung des Panels (blau gezeigte Gene, jeweils ebenfalls kuratiert) kann auf Anfrage erfolgen. Sofern unter "Erweitertes Panel" ein Minuszeichen angezeigt wird, sind nur Core-/Basis-Gene verfügbar.
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