RESUMEN
BACKGROUND: Kleefstra syndrome is a rare genetic disorder, with core phenotypic features encompassing developmental delay/intellectual disability, characteristic facial features - brachy(micro)cephaly, unusual shaped eyebrows, flat face with hypertelorism, short nose with anteverted nostrils, thickened lower lip, carpmouth with macroglossia - and childhood hypotonia. Some additional symptoms are observed in different percentage of the patients. Epilepsy is common symptom as well. The underlying cause of the syndrome is a submicroscopic deletion in the chromosomal region 9q34.3 or disruption of the euchromatin histone methyl transferase 1. CASE PRESENTATION: We describe two Hungarian Kleefstra syndrome patients, one with the classic phenotype of the syndrome, the diagnosis was confirmed by subtelomeric FISH. Meanwhile in our second patient beside the classic phenotype a new symptom - abnormal antiepileptic drug metabolic response - could be observed. Subtelomere FISH confirmed the 9q34.3 terminal deletion. Because of the abnormal drug metabolism in our second patient, we performed array CGH analysis as well searching for other rearrangements. Array CGH analysis indicated a large - 1.211 Mb -, deletion only in the 9q subtelomeric region with breakpoints ch9:139,641,471-140,852,911. CONCLUSIONS: This is the first report on Kleefstra syndrome in patients describing a classical and a complex phenotype involving altered drug metabolism.
RESUMEN
Recently, associations were found between autoimmune diseases and variants of interleukin-23 receptor (IL23R) gene; here, we analyzed the association of nine IL23R polymorphisms with psoriasis and with immunoglobulin A nephropathy (IgAN). Groups of patients with psoriasis, IgAN, and controls were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods. We observed a significant increase in the carriage of the minor allele of rs11805303 in psoriasis patients compared to controls. Similarly, for rs2201841 prevalence of the CC genotype and for rs10889677, the AA genotype showed a more than two- and threefold increase, respectively in patients compared to controls. There was no difference in the distribution of IL23R variants between controls and IgAN patients. We confirmed the association of IL23R with psoriasis in a Hungarian population and demonstrated the effect of the rs11805303 SNP, which was tested so far only for other autoimmune diseases. We could not detect any association between the IL23R variants and IgAN.
