The spectrum of Silver-Russell syndrome: a clinical and molecular genetic study and new diagnostic criteria
- aChild Health Directorate, Northampton General Hospital NHS Trust, Cliftonville, Northampton NN1 5BD, UK, bBiochemistry, Endocrinology, and Metabolism Unit, Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK, cThe Kennedy-Galton Centre, North West Thames Regional Genetic Service, Level 8V, Northwick Park Hospital, Watford Road, Harrow HA1 3UJ, UK, dDepartment of Clinical Genetics, Leicester Royal Infirmary, Leicester LE1 5WW, UK
- Dr Price.
- Revised 28 June 1999
- Accepted 5 July 1999
Abstract
The Silver-Russell syndrome (SRS) is characterised by severe intrauterine growth retardation, with a preserved head circumference, leading to a lean body habitus and short stature. Facial dysmorphism and asymmetry are considered typical features of the syndrome, although the range of phenotypic variance is unknown. Fifty seven subjects varying in age from 0.84 to 35.01 years, in whom the diagnosis of SRS had been considered definite or likely, were re-evaluated in a combined clinical and molecular study by a single observer (SMP).
In 50 patients the clinical findings complied with a very broad definition of SRS. Notable additional findings included generalised camptodactyly seen in 11 (22%), many with distal arthrogryposis. Thirteen of the 25 males required genital surgery for conditions including hypospadias and inguinal hernia.
Fourteen (36.8%) subjects above school age have received a statement of special educational needs.
Molecular genetic analysis was performed in 42 subjects and has identified maternal uniparental disomy of chromosome 7 in four. The phenotype was generally milder with birth weights for one patient above and three below −2 SD from the mean. Two children had classical facial dysmorphic features, and two had a milder facial phenotype. Of relevance to the possible molecular mechanism underlying this condition, none of the four disomic patients had significant asymmetry.
