Duane syndrome (MIM126800) is an autosomal dominant disease responsible for 1% of all strabismus cases and has been related to a 8q12-13 contiguous gene syndrome. We report on an insertion of chromosome region 8q13-q21.2 on to band 6q25 in a patient presenting with Duane syndrome, mental retardation, and other dysmorphisms. FISH analysis using chromosome 8 radiation hybrid LIA2L indicated a concurrent deletion within the 8q rearranged region. These results were corroborated by STR-PCR analysis and FISH using YAC contig WC8.8 disclosed a deletion in 8q13. Comparison of the two known patients with Duane syndrome associated with deletion of 8q identifies a small region of overlap (SRO) of < 3 cM extending from D8S533 and D8S1767 in which a Duane syndrome locus is assigned. In addition YAC analysis in our patient showed that 8q rearrangement was rather complex since 8q deletion and insertion occurred in two distinct segments separated by a region which maintained its location on 8q.Keywords: chromosome 8; deletion; Duane syndrome; mapping; complex rearrangement
IntroductionDuane syndrome is a primary form of strabismus consisting of an ocular motility defect with absent or severely limited abduction and variable limitation of adduction, associated with bilateral globe retraction and narrowing palpebral fissure. 1 This autosomal dominant (MIM 126800) disorder is responsible for approximately 1% of all strabismus cases. Duane syndrome has been clinically subclassified by Huber in three forms which cause deficiency of binocular sight due to altered ocular motility, eventually associated with nistagmus and other ocular anomalies. The pathogenesis of this syndrome is unknown but, in some patients at least, a muscular/neuronal origin has been proved. 187-193 © 1998 Stockton Press All rights reserved 1018-4813/98 $12.00 http://www.stockton-press.co.uk/ejhg Although Duane syndrome is considered a clinically distinct condition, genetic heterogeneity has been suspected. In fact a few atypical cases of Duane syndrome have been described in association with deafness, renal defects, muscular, and skeletal anomalies 4-7 and chromosome imbalances. [7][8][9][10] In particular a contiguous gene syndrome consisting of Duane syndrome, branchio-oto-renal syndrome (BOR), hydrocephalus and trapeze aplasia was found in a patient with 8q12.2-q21.2 deletion. 7 We report on an insertion deletion of chromosome 8q13-q21.2 in a patient presenting with Duane syndrome type I, severe mental retardation, and minor limbs abnormalities. Molecular studies were carried out in order to analyse and map this Duane syndrome containing region.
Materials and Methods
PatientA 7-year-old girl, the first child of unrelated parents, was referred for cytogenetic analysis on the basis of severe mental retardation and dysmorphisms. Family history was unremarkable. At birth her length was 48 cm and weight 3250 g. At 7 years of age, she was 119 cm in height (5th centile) and weighted 25 kg (65th centile). On clinical evaluation she presented with microcephaly, bil...