Skip to main content Accessibility help
×
Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-27T12:46:10.727Z Has data issue: false hasContentIssue false

6 - Immunodeficiency in velo-cardio-facial syndrome

Published online by Cambridge University Press:  11 August 2009

Kathleen E. Sullivan
Affiliation:
The Children's Hospital of Philadelphia, PA, USA
Kieran C. Murphy
Affiliation:
Education and Research Centre, Royal College of Surgeons of Ireland
Peter J. Scambler
Affiliation:
Institute of Child Health, University College London
Get access

Summary

Overview

Velo-cardio-facial syndrome (VCFS) is one of a number of syndromes which are associated with monosomic deletions of chromosome 22q11.2 (Kelley et al., 1982, Kelley et al., 1993, Driscoll et al., 1992). It is estimated that 80–100% of patients with the clinical features of VCFS have a chromosome 22q11.2 deletion and 90% of those with the deletion carry an identical 2.5–3 megabase deletion (Motzkin et al., 1993). DiGeorge syndrome, conotruncal anomaly face syndrome, and occasional patients with Opitz GBBB, CHARGE association, and Noonan's syndrome are also associated with chromosome 22q11.2 deletions. Although the immunodeficiency was generally believed to be associated with DiGeorge syndrome, most patients with the deletion will have compromise of T-cell production regardless of their other phenotypic features. The clinical findings are generally not related to the specific genes encompassed by the breakpoints and family studies confirm that twins and siblings with the same deletion may have very discordant clinical features (Kasprzak et al., 1998; Yamagishi et al., 1998; Vincent et al., 1999). The deletion is mediated by homologous recombination between low copy number repeats (Edelmann et al., 1999) and includes several genes implicated in development. Some patients with VCFS have been identified as having monosomic deletions of chromosome 10 p (Schuffenhauer et al., 1998; Daw et al., 1996). The more proximal region appears to mediate immunodeficiency while the distal region mediates hypocalcemia.

Type
Chapter
Information
Velo-Cardio-Facial Syndrome
A Model for Understanding Microdeletion Disorders
, pp. 123 - 134
Publisher: Cambridge University Press
Print publication year: 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Berend, S. A., Spikes, A. S., Kashak, C. D.et al. (2000) Dual-probe fluorescence in situ hybridization assay for detecting deletions associated with VCFS/DiGeorge syndrome I and DiGeorge syndrome II loci. Am. J. Med. Genet.., 91, 313–17.Google Scholar
Collard, H. R., Boeck, A., McLaughlin, T. M.et al. (1999) Possible extrathymic development of nonfunctional T cells in a patient with complete DiGeorge syndrome. Clin. Immunol., 91, 156–62.Google Scholar
Conley, M. E., Beckwith, J. B., Mancer, J. F. & Tenckhoff, (1979) The spectrum of the DiGeorge syndrome. J. Pediatr., 94, 883–90.Google Scholar
Davies, K., Stiehm, E. R., Woo, P. & Murray, K. J. (2001) Juvenile idiopathic polyarticular arthritis and IgA deficiency in the 22q11 deletion syndrome. J. Rheumatol., 28, 2326–34.Google Scholar
Daw, S. C. M., Tayior, C., Kraman, M.et al. (1996) A common region of 10 p deleted in DiGeorge and velocardiofacial syndromes. Nat. Genet., 13, 458–60.Google Scholar
DiPiero, A. D., Lourie, E. M., Berman, B. W., Robin, N. H., Zinn, A. B. & Hostoffer, R. W. (1997) Recurrent immune cytopenias in two patients with DiGeorge/velocardiofacial syndrome. J. Pediatr., 131, 484–6.Google Scholar
Driscoll, D. A., Budarf, M. L. & Emanuel, B. S. (1992) A genetic etiology for DiGeorge syndrome: consistent deletions and microdeletions of 22q11. Am. J. Hum Genet., 50, 924–33.Google Scholar
Duke, S. G., McGuirt, W. F. Jr. Jewett, T. & Fasano, M. B. (2000) Velocardiofacial syndrome: incidence of immune cytopenias. Arch. Otolaryn. Head Neck Surg., 126, 1141–5.Google Scholar
Edelmann, L., Pandita, R. K. & Morrow, B. E. (1999) Low-copy repeats mediate the common 3-Mb deletion in patients with velo-cardio-facial syndrome. Am. J. Hum. Genet., 64, 1076–86.Google Scholar
Eicher, P. S., McDonald-McGinn, D. M., Fox, C. A., Driscoll, D. A., Emanuel, B. S. & Zackai, E. H.et al. (2000) Dysphagia in children with a 22q11.2 deletion: unusual pattern found on modified barium swallow. J. Pediatr., 137, 158–64.CrossRefGoogle Scholar
Gennery, A. R., Barge, D., O'Sullivan, J. J., Flood, T. J., Abinun, M. & Cant, A. J.et al. (2002) Antibody deficiency and autoimmunity in 22q11.2 deletion syndrome. Arch. Dis. Child., 86, 422–5.Google Scholar
Goldmuntz, E., Clark, B. J., Mitchell, L. E.et al. (1998) Frequency of 22q11 deletions in patients with conotruncal defects. J. Am. Coll. Cardiol., 32, 492–8.Google Scholar
Ham Pong, A. J., Cavallo, A., Holman, G. H., & Goldman, A. S. (1985) DiGeorge syndrome: long term survival complicated by Graves disease. J. Pediatr., 106, 619–20.Google Scholar
Hopkin, R. J., Schorry, E. K., Bofinger, M. & Saal, H. M. (2000) Increased need for medical interventions in infants with velocardiofacial (deletion 22q11) syndrome. J. Pediatr., 137, 247–9.Google Scholar
Jawad, A. F., McDonald-McGinn, D. M., Zackai, E. & Sullivan, K. E. (2001) Immunologic features of chromosome 22q11.2 deletion syndrome (DiGeorge syndrome/velocardiofacial syndrome). J. Pediatr., 139, 715–23.Google Scholar
Junker, A. K. & Driscoll, D. A. (1995) Humoral immunity in DiGeorge syndrome. J. Pediatr., 127, 231–7.Google Scholar
Kasprzak, L., Kabustian, V. M., Elliott, A. M., Shevell, M., Lejtenyi, C. & Eydoux, P., (1998) Deletion of 22q11 in two brothers with different phenotype. Am. J. Med. Genet., 75, 288–91.Google Scholar
Kelley, D., Goldberg, R., Wilson, D.et al. (1993) Confirmation that the velo-cardiofacial syndrome is associated with haplo-insufficiency of genes at chromosome 22. Am. J. Med. Genet., 45, 308–12.Google Scholar
Kelley, R. I., Zackai, E. H., Emanuel, B. S., Kistenmacher, M., Greenberg, F. & Punnett, H. H. (1982) The association of the DiGeorge anomalad with partial monosomy of chromosome 22. J. Pediatr., 101, 197–200.Google Scholar
Lin, A. E., Gavver, K. L., Diggans, G.et al. (1988) Interstitial and terminal deletions of the long arm of chromosome 4: further delineation of phenotypes. Am. J. Med. Genet., 31, 533–48.Google Scholar
Lischner, H. W. & Huff, D. S. (1975) T-cell deficiency in DiGeorge syndrome. Birth Defects: Orig. Art. Ser., 11, 16–21.Google Scholar
Markert, M. L., Kostyu, D. D., Ward, F. E.et al. (1997) Successful formation of a chimeric human thymus allograft following transplantation of cultured postnatal human thymus. J. Immunol., 158, 998–1005.Google Scholar
Markert, M. L., Hummell, D. S., Rosenblatt, H. M.et al. (1998) Complete DiGeorge syndrome: persistence of profound immunodeficiency. J. Pediatr., 132, 15–21.Google Scholar
Markert, M. L., Boeck, A., Hale, L. P.et al. (1999) Transplantation of thymus tissue in complete DiGeorge syndrome. N. Engl. J. Med., 341, 1180–9.Google Scholar
McDonald-McGinn, D. M., Kirschner, R., Goldmuntz, E.et al. (1999) The Philadelphia story: the 22q11.2 deletion: report on 250 patients. Genet. Counsel., 10, 11–24.Google Scholar
Moran, A. M., Colan, S. D., Mayer, J. E. Jr. & Velde, M. E. (1999) Echocardiographic identification of thymic hypoplasia in tetralogy of fallot/tetralogy pulmonary atresia. Am. J. Card., 84, 1268–71.Google Scholar
Motzkin, B., Marion, R., Goldberg, R., Shprintzen, R. & Saenger, P. (1993) Variable phenotypes in velocardiofacial syndrome with chromosomal deletion. J. Pediatr., 123, 406–10.Google Scholar
Muller, W., Peter, H. H., Wilken, M.et al. (1988) The DiGeorge syndrome. I. Clinical evaluation and course of partial and complete forms of the syndrome. Eur. J. Pediatr., 147, 496–502.Google Scholar
Muller, W., Peter, H. H., Kallfelz, H. C., Franz, A. & Rieger, C. H. (1989) The DiGeorge sequence. II. Immunologic findings in partial and complete forms of the disorder. Eur. J. Pediatr., 149, 96–103.Google Scholar
Pierdominici, M., Marziali, M., Giovannetti, A.et al. (2000) T cell receptor repertoire and function in patients with DiGeorge syndrome and velocardiofacial syndrome. Clin. Exp. Immunol., 121, 127–32.Google Scholar
Pinchas-Hamiel, O., Engelberg, S., Mandel, M. & Passwell, J. H. (1994) Immune hemolytic anemia, thrombocytopenia and liver disease in a patient with DiGeorge syndrome. Israel J. Med. Sci., 30, 530–2.Google Scholar
Ryan, A. K., Goodship, J. A., Wilson, D. I., et al. (1997) Spectrum of clinical features associated with interstitial chromosome 22q11 deletions: a European collaborative study. J. Med. Genet., 34, 798–804.Google Scholar
Schubert, M. S. & Moss, R. B. (1992) Selective polysaccharide antibody deficiency in familial DiGeorge syndrome. Ann. All., 69, 231–8.Google Scholar
Schuffenhauer, S., Lichtner, P., Peykar-Derakhshandeh, P.et al. (1998) Deletion mapping on chromosome 10 p and definition of a critical region for the second DiGeorge syndrome locus (DGS2). Eur. J. Hum. Gen., 6, 213–25.Google Scholar
Smith, C. A., Driscoll, D. A., Emanuel, B. S., McDonald-McGinn, D. M., Zackai, E. H. & Sullivan, K. E. (1998) Increased prevalence of immunoglobulin A deficiency in patients with the chromosome 22q11.2 deletion syndrome (DiGeorge syndrome/velocardiofacial syndrome). Clin. Labor Diag. Immunol., 5, 415–17.Google Scholar
Sullivan, K., McDonald-McGinn, D., Driscoll, D.et al. (1997) Juvenile rheumatoid arthritis-like polyarthritis in chromosome 22q11.2 deletion syndrome (DiGeorge anomalad/velocardiofacial syndrome/conotruncal anomaly face syndrome). Arthritis Rheum, 40, 430–6.CrossRefGoogle Scholar
Sullivan, K. E., Jawad, A. F., Randall, P.et al. (1998) Lack of correlation between impaired T-cell production, immunodeficiency and other phenotypic features in chromosome 22q11.2 deletion syndrome (DiGeorge syndrome/velocardiofacial syndrome). Clin. Immunol. Immunopathol., 84, 141–6.Google Scholar
Sullivan, K. E., McDonald-McGinn, D., Driscoll, D., Emanuel, B. S., Zackai, E. H. & Jawad, A. F. (1999) Longitudinal analysis of lymphocyte function and numbers in the first year of life in chromosome 22q11.2 deletion syndrome (DiGeorge syndrome/velocardiofacial syndrome). Clin. Labor Diag. Immunol., 6, 906–11.Google Scholar
Tuvia, J., Weisselberg, B., Shif, I. & Keren, G. (1988) Aplastic anaemia complicating adenovirus infection in DiGeorge syndrome. Eur. J. Pediatr., 147, 643–4.Google Scholar
Esch, H., Groenen, P., Nesbitt, M. A.et al. (2000) GATA3 haplo-insufficiency causes human HDR syndrome. Nature, 406, 419–22.Google Scholar
Vincent, M. C., Heitz, F., Tricoire, J., et al. (1999) 22q11 deletion in DGS/VCFS monozygotic twins with discordant phenotypes. Genet. Counsel., 10, 43–9.Google Scholar
Yamagishi, H., Ishii, C., Maeda, J.et al. (1998) Phenotypic discordance in monozygotic twins with 22q11.2 deletion. Am. J. Med. Genet., 78, 319–21.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×