Perfil clínico e genotípico de pacientes com Síndrome de Prader-Willi atendidos em um Hospital Universitário no município de Belo Horizonte

Detalhes bibliográficos
Autor(a) principal: Jackeline Alves Galdino
Data de Publicação: 2017
Tipo de documento: Trabalho de conclusão de curso
Idioma: por
Título da fonte: Repositório Institucional da UFMG
Texto Completo: http://hdl.handle.net/1843/BUOS-AP2PAY
Resumo: Prader-Willi syndrome (PWS) is a disorder caused by lack of expression of genes on the paternally inherited chromosome 15q11-q13 or morerarely, region maternal uniparental disomy or imprinting defect. The estimated prevalence of PWS is 1:10.000 - 1:30.000, affecting both sexesequally. Objective: Develop a review of the literature on the genotypic andphenotypic characteristics of PWS and investigated the most commonlypresented patients treated at the Pediatric Endocrinology outpatient clinic of Hospital das Clínicas of UFMG from 2000 to 2016. Methodology:Were analyzed 14 medical records of children and adolescents (mean age 11.8 ± 5.96 years) with clinical and cytogenetic-molecular diagnosis of the syndrome. The following variables were obtained: age, sex, age at diagnosis, genetic-clinical diagnosis, referral source, BMI, presence of hypotonia, weak suction, delayed neuropsychomotor development, low birth weight, cryptorchidism, hypogonadism, diabetes mellitus, systemic arterial hypertension, deficiency and use of GH. Results: Of the medical records analyzed, 64.28% (n = 9) were male. The mean age at diagnosis was 4 years (± 4.55), the most frequent genetic result being the deletion of chromosome 15 q11-13 (53.84%). The maternal uniparental disomy was present in 30.77% of the patients and the imprinting deletion was7.69%. Obesity and overweight were observed in 50% of the cases, low birth weight in 78.57% and hypotonia / weak suction in 85.71% of the children. Of the obese individuals, 60% had systemic arterial hypertension and 80% had diabetes Mellitus type 2. All patients presented delayed neuropsychomotor development and one used GH with good response. The patients stature was low in 57.14%of the cases. The mean final height of the boys was 147 ± 4 cm (n = 2) and 143.3 ± 5.24 cm in the girls (n = 3). Two patients presented hypogonadism with low levels of gonadotrophins. Conclusion: Clinical signs as hypotonia and sucking deficit in children, especially those that develop with later overweight, short stature and delayed neuropsychomotor development, should be valued for thehigh probability of diagnosis of SPW. In such cases, genetic confirmation should preferably be performed by DNA methylation analysis.
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spelling Perfil clínico e genotípico de pacientes com Síndrome de Prader-Willi atendidos em um Hospital Universitário no município de Belo HorizonteSíndrome de Prader WilliObesidadeHipotoniaSistema endócrinoPrader-Willi syndrome (PWS) is a disorder caused by lack of expression of genes on the paternally inherited chromosome 15q11-q13 or morerarely, region maternal uniparental disomy or imprinting defect. The estimated prevalence of PWS is 1:10.000 - 1:30.000, affecting both sexesequally. Objective: Develop a review of the literature on the genotypic andphenotypic characteristics of PWS and investigated the most commonlypresented patients treated at the Pediatric Endocrinology outpatient clinic of Hospital das Clínicas of UFMG from 2000 to 2016. Methodology:Were analyzed 14 medical records of children and adolescents (mean age 11.8 ± 5.96 years) with clinical and cytogenetic-molecular diagnosis of the syndrome. The following variables were obtained: age, sex, age at diagnosis, genetic-clinical diagnosis, referral source, BMI, presence of hypotonia, weak suction, delayed neuropsychomotor development, low birth weight, cryptorchidism, hypogonadism, diabetes mellitus, systemic arterial hypertension, deficiency and use of GH. Results: Of the medical records analyzed, 64.28% (n = 9) were male. The mean age at diagnosis was 4 years (± 4.55), the most frequent genetic result being the deletion of chromosome 15 q11-13 (53.84%). The maternal uniparental disomy was present in 30.77% of the patients and the imprinting deletion was7.69%. Obesity and overweight were observed in 50% of the cases, low birth weight in 78.57% and hypotonia / weak suction in 85.71% of the children. Of the obese individuals, 60% had systemic arterial hypertension and 80% had diabetes Mellitus type 2. All patients presented delayed neuropsychomotor development and one used GH with good response. The patients stature was low in 57.14%of the cases. The mean final height of the boys was 147 ± 4 cm (n = 2) and 143.3 ± 5.24 cm in the girls (n = 3). Two patients presented hypogonadism with low levels of gonadotrophins. Conclusion: Clinical signs as hypotonia and sucking deficit in children, especially those that develop with later overweight, short stature and delayed neuropsychomotor development, should be valued for thehigh probability of diagnosis of SPW. In such cases, genetic confirmation should preferably be performed by DNA methylation analysis.A Síndrome de Prader-Willi (SPW) ocorre devido à deleção docromossomo 15q11-q13 ou, de forma mais rara, pela dissomia uniparental materna ou defeitos do imprinting. A prevalência estimada da SPW é de 1:10.000 1:30.000, acometendo igualmente ambos os sexos. Objetivo: Realizar uma revisão de literatura sobre as características genotípicas e fenotípicas da SPW e investigar as mais comumente apresentadas pelos pacientes atendidos no ambulatório de Endocrinologia Pediátrica do Hospital das Clínicas da UFMG do ano 2000 a 2016. Metodologia: Foram analisados 14 prontuários de crianças e adolescentes (idade média de 11,8 ± 5,96 anos) com diagnóstico clínico e citogenético-molecular da síndrome, sendo obtidas as variáveis: idade, sexo, idade ao diagnóstico, diagnóstico genético-clínico, fonte de encaminhamento, IMC, presença de hipotonia, sucção débil, atraso do desenvolvimento neuropsicomotor, baixo peso ao nascer, criptorquidia, hipogonadismo, diabetes mellitus, hipertensão arterial sistêmica, deficiência e uso de GH. Resultados: Dos prontuários analisados, 64,28% (n = 9) eram do sexo masculino. A médiada idade ao diagnóstico foi de 4 anos (± 4,55), sendo o resultado genético mais frequente a deleção do cromossomo 15 q11-13 (53,84%). A dissomia uniparental materna esteve presente em 30,77% dos pacientes e a deleção de imprinting em 7,69%. Obesidade e sobrepeso foram observados em 50% dos casos, baixo peso ao nascer em 78,57% e hipotonia/sucção débil em 85,71% das crianças. Dos indivíduos obesos, 60% apresentaram hipertensão arterial sistêmica e 80% diabetes mellitus tipo 2. Todos os pacientes apresentaram atraso do desenvolvimento neuropsicomotor e um fazia uso de GH com boa resposta. A estatura dos pacientes foi baixa em 57,14% dos casos. A altura final média dos meninos foi de 147 ± 4 cm (n = 2) e de 143,3 ± 5,24 cm nas meninas (n = 3). Dois pacientes apresentaram hipogonadismo com níveis baixos de gonadotrofinas. Conclusão: Sinais clínicos como hipotonia e déficit de sucção em crianças, especialmente naquelas que evoluem com posterior sobrepeso, baixa estatura e atraso do desenvolvimento neuropsicomotor devem ser valorizados pela alta probabilidade de diagnóstico da SPW. Nesses casos, deve-se realizar preferencialmente a confirmação genética pela análise de metilação do DNAUniversidade Federal de Minas GeraisUFMGRafael Machado MantovaniVera Maria Alves DiasCristina Botelho BarraJackeline Alves Galdino2019-08-13T23:35:58Z2019-08-13T23:35:58Z2017-02-21info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/bachelorThesisapplication/pdfhttp://hdl.handle.net/1843/BUOS-AP2PAYinfo:eu-repo/semantics/openAccessporreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMG2019-11-14T18:06:42Zoai:repositorio.ufmg.br:1843/BUOS-AP2PAYRepositório InstitucionalPUBhttps://repositorio.ufmg.br/oairepositorio@ufmg.bropendoar:2019-11-14T18:06:42Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false
dc.title.none.fl_str_mv Perfil clínico e genotípico de pacientes com Síndrome de Prader-Willi atendidos em um Hospital Universitário no município de Belo Horizonte
title Perfil clínico e genotípico de pacientes com Síndrome de Prader-Willi atendidos em um Hospital Universitário no município de Belo Horizonte
spellingShingle Perfil clínico e genotípico de pacientes com Síndrome de Prader-Willi atendidos em um Hospital Universitário no município de Belo Horizonte
Jackeline Alves Galdino
Síndrome de Prader Willi
Obesidade
Hipotonia
Sistema endócrino
title_short Perfil clínico e genotípico de pacientes com Síndrome de Prader-Willi atendidos em um Hospital Universitário no município de Belo Horizonte
title_full Perfil clínico e genotípico de pacientes com Síndrome de Prader-Willi atendidos em um Hospital Universitário no município de Belo Horizonte
title_fullStr Perfil clínico e genotípico de pacientes com Síndrome de Prader-Willi atendidos em um Hospital Universitário no município de Belo Horizonte
title_full_unstemmed Perfil clínico e genotípico de pacientes com Síndrome de Prader-Willi atendidos em um Hospital Universitário no município de Belo Horizonte
title_sort Perfil clínico e genotípico de pacientes com Síndrome de Prader-Willi atendidos em um Hospital Universitário no município de Belo Horizonte
author Jackeline Alves Galdino
author_facet Jackeline Alves Galdino
author_role author
dc.contributor.none.fl_str_mv Rafael Machado Mantovani
Vera Maria Alves Dias
Cristina Botelho Barra
dc.contributor.author.fl_str_mv Jackeline Alves Galdino
dc.subject.por.fl_str_mv Síndrome de Prader Willi
Obesidade
Hipotonia
Sistema endócrino
topic Síndrome de Prader Willi
Obesidade
Hipotonia
Sistema endócrino
description Prader-Willi syndrome (PWS) is a disorder caused by lack of expression of genes on the paternally inherited chromosome 15q11-q13 or morerarely, region maternal uniparental disomy or imprinting defect. The estimated prevalence of PWS is 1:10.000 - 1:30.000, affecting both sexesequally. Objective: Develop a review of the literature on the genotypic andphenotypic characteristics of PWS and investigated the most commonlypresented patients treated at the Pediatric Endocrinology outpatient clinic of Hospital das Clínicas of UFMG from 2000 to 2016. Methodology:Were analyzed 14 medical records of children and adolescents (mean age 11.8 ± 5.96 years) with clinical and cytogenetic-molecular diagnosis of the syndrome. The following variables were obtained: age, sex, age at diagnosis, genetic-clinical diagnosis, referral source, BMI, presence of hypotonia, weak suction, delayed neuropsychomotor development, low birth weight, cryptorchidism, hypogonadism, diabetes mellitus, systemic arterial hypertension, deficiency and use of GH. Results: Of the medical records analyzed, 64.28% (n = 9) were male. The mean age at diagnosis was 4 years (± 4.55), the most frequent genetic result being the deletion of chromosome 15 q11-13 (53.84%). The maternal uniparental disomy was present in 30.77% of the patients and the imprinting deletion was7.69%. Obesity and overweight were observed in 50% of the cases, low birth weight in 78.57% and hypotonia / weak suction in 85.71% of the children. Of the obese individuals, 60% had systemic arterial hypertension and 80% had diabetes Mellitus type 2. All patients presented delayed neuropsychomotor development and one used GH with good response. The patients stature was low in 57.14%of the cases. The mean final height of the boys was 147 ± 4 cm (n = 2) and 143.3 ± 5.24 cm in the girls (n = 3). Two patients presented hypogonadism with low levels of gonadotrophins. Conclusion: Clinical signs as hypotonia and sucking deficit in children, especially those that develop with later overweight, short stature and delayed neuropsychomotor development, should be valued for thehigh probability of diagnosis of SPW. In such cases, genetic confirmation should preferably be performed by DNA methylation analysis.
publishDate 2017
dc.date.none.fl_str_mv 2017-02-21
2019-08-13T23:35:58Z
2019-08-13T23:35:58Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/bachelorThesis
format bachelorThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/1843/BUOS-AP2PAY
url http://hdl.handle.net/1843/BUOS-AP2PAY
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade Federal de Minas Gerais
UFMG
publisher.none.fl_str_mv Universidade Federal de Minas Gerais
UFMG
dc.source.none.fl_str_mv reponame:Repositório Institucional da UFMG
instname:Universidade Federal de Minas Gerais (UFMG)
instacron:UFMG
instname_str Universidade Federal de Minas Gerais (UFMG)
instacron_str UFMG
institution UFMG
reponame_str Repositório Institucional da UFMG
collection Repositório Institucional da UFMG
repository.name.fl_str_mv Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)
repository.mail.fl_str_mv repositorio@ufmg.br
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