Title:A 3-Year-Old Boy with an Xp21 Deletion Syndrome: A Case Report
Volume: 22
Issue: 8
Author(s): Shaghayegh Sadeghmousavi, Sepideh Shahkarami, Elham Rayzan, Souran Ahmed, Farzaneh Hosseini Gharalari, Meino Rohlfs, Christoph Klein and Nima Rezaei*
Affiliation:
- Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical
Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific
Education and Research Network (USERN), Tehran, Iran
Keywords:
Contiguous deletion syndromes, chromosome xp21 deletion syndrome, complex glycerol kinase deficiency, adrenal insufficiency, hypoaldosteronism, next generation sequencing.
Abstract:
Background: Chromosome Xp21 deletion syndrome is a rare X-linked recessive defect
that occurs as a result of multiple gene deletions, including Glycerol kinase (GK) and its
neighboring genes, dystrophin, which causes Duchenne muscular dystrophy (DMD), and NR0B1,
which causes congenital adrenal hypoplasia (CAHhttps://www.omim.org/entry/300200). Patients
usually present with glycerol kinase deficiency, congenital adrenal hypoplasia, Duchenne muscular
dystrophy, hyperglycerolemia, and glyceroluria, associated with DMD and/or CAH, growth failure,
myopathy, osteoporosis, mental retardation, and psychomotor retardation.
Case Presentation: Herein, we report a 3-year- old boy from Iraq who had bloody diarrhea, food
intolerance and abdominal cramp, adrenal insufficiency, recurrent fevers, tuberculosis (TB)
infection, cervical abscess, oral thrush, cervical and mediastinal lymphadenopathies, developmental
delay, and undescended testis. His parents are non-consanguine and had no family history of
diseases. Next generation sequencing demonstrated a hemizygote deletion in chromosome X.
Conclusion: Loss of a large part of the X-chromosome most likely can explain the clinical findings
of this patient. Contiguous gene deletion syndrome in Xp21 should be considered after diagnosing
adrenal insufficiency to treat metabolic complications efficiently.