Rett syndrome: review of the literature and first cases reported in Colombia with clinical characterization and molecular diagnosis
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Keywords

Rett syndrome
intellectual disability
MECP2
rett prevalence
Colombia (MeSH)

Abstract

INTRODUCTION:

Rett Syndrome is a severe neurological condition and the second genetic cause of profound mental retardation in women. It is generated by mutations in the MECP2 gene and it is characterized by a loss of psychomotor gains, with an estimated overall prevalence of 1:10,000 girls, according to the extrapolation of some European studies. Objectives. To make a review of Rett Syndrome and to present a series of cases diagnosed in Colombia by clinical criteria and molecular tests.

METHODOLOGY:

We made a bibliographic research in 21 international databases, more than 14 health journals and two general search engines between 2014 and 2016. The cases presented were selected from the Medical Genetics consultation carried out by the authors.

FINDINGS:

No Colombian case of Rett Syndrome was found nor confirmed with molecular testing in Latin America. We report the first cases in Colombia and the largest in Latin America, consisting of seven patients with classic type and three with atypical type, all with molecular diagnosis.

CONCLUSIONS:

In spite of having a characterized clinical evolution, its low prevalence and broad clinical spectrum, make Rett Syndrome a diagnostic and therapeutic challenge. We report for the first time the mutation c.749_750insT, the c.473C> G for second time in the literature and the c.763C> T is presented in two patients with totally different phenotypes, confirming the non-correlation genotype-phenotype of the disease.

https://doi.org/10.22379/24224022174

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References

Neul JL, Kaufmann WE, Glaze DG, Clarke AJ, Leonard H, Bailey MES, et al. Rett Syndrome: Revised Diagnostic Criteria and Nomenclature. Ann Neurol. 2011;68(6):944-50. https://doi.org/10.1002/ana.22124.

Christodoulou J, Williamson S. Rett syndrome [Internet]. Vol. 158, Orphanet database. 2007. Recuperado a partir de: http://orpha.net/.

Weng SM, Bailey MES, Cobb SR. Rett syndrome: From bed to bench. Pediatr Neonatol. Elsevier Taiwan LLC; 2011;52(6):309-16.

Jefferson A, Leonard H, Siafarikas A, Woodhead H, Fyfe S, Ward LM, et al. Clinical guidelines for management of bone health in Rett syndrome based on expert consensus and available evidence. PLoS One. 2016;11(2):1-18. https://doi.org/10.1371/journal.pone.0146824.

Hoffbuhr K, Devaney JM, LaFleur B, Sirianni N, Scacheri C, Giron J, et al. MECP2 mutations in children with and without the phenotype of Rett syndrome. Neurology. 2001;56(11):1486-95.

Han Z-A, Jeon HR, Kim SW, Park JY, Chung HJ. Clinical characteristics of children with rett syndrome. Ann Rehabil Med. 2012;36(3):334-9. https://doi.org/10.5535/arm.2012.36.3.334.

Pérez-Moreno JC, Nájera-Losada DC, Domínguez-Pérez F. Manejo anestésico de un paciente con síndrome de Rett y fractura distal de húmero: reporte de un caso y revisión de la literatura. Rev Colomb Anestesiol. 2014;42:57-9. https://doi.org/10.1016/j.rca.2013.09.011.

Blanco NM, Manresa VS, Mesch GJ, Melgarejo MJ. Síndrome de Rett: criterios diagnósticos. Rev Posgrado VIa Cátedra Med. 2006;153:228-.

Jian L, Nagarajan L, Klerk N de, Ravine D, Christodoulou J, Leonard H. Seizures in Rett syndrome: an overview from a one-year calendar study. Eur J Paediatr Neurol. 3.a ed. Bogotá D.C.; 2007;11(5):310-7.

Buckley AW, Holmes GL. Epilepsy and Autism. Cold Spring Harb Perspect Med. 2016 Apr 1;6(4):a022749. https://doi.org/10.1101/cshperspect.a022749.

Flores T de, Ronquillo JM, Toro J, Treserra J, Udina C. DSM-IV-TR. Manual diagnóstico y estadístico de los trastornos mentales. Texto revisado. IV-TR. Barcelona: MASSON; 2002;(819):1-346.

Smeets EEJ, Pelc K, Dan B. Rett Syndrome. Mol Syndr. 2011;2(3-5):113-27. https://doi.org/000337637.

Campos-castello J, Fernandez-mayoralas DM, Muñoz-jareño N, Antonio-arce VSAN. Síndrome de Rett: 50 años de historia de un trastorno aun no bien conocido. Medicina (B Aires). 2007;67(6):531-42.

Coury DL. DSM-5 and autism spectrum disorders: implications for families and clinicians. J Dev Behav Pediatr. 2013;34(7):494-6. https://doi.org/10.1097/DBP.0b013e31829cac3e.

Carpenter L. DSM-5 Autism Spectrum Disorder. Medical University of South Carolina; 2013.

Spence SJ, Tasker RC, Pomeroy SL. Recent advances in autism spectrum disorders. Neurology. 2011;23(6):607-8.

Castro J, Mellios N, Sur M. Mechanisms and therapeutic challenges in autism spectrum disorders: insights from Rett syndrome. Curr Opin Neurol. 2013;26(2):154-9. https://doi.org/10.1097/WCO.0b013e32835f19a7.

Tchaconas A, Adesman A. Autism spectrum disorders: a pediatric overview and update. Curr Opin Pediatr. 2013;25(1):130-44. https://doi.org/10.1097/MOP.0b013e32835c2b70.

Williamson SL, Christodoulou J. Rett syndrome: new clinical and molecular insights. Eur J Hum Genet. 2006;14(8):896-903. https://doi.org/10.1038/sj.ejhg.5201580.

Armstrong J, Pineda M, Roche A, Gerotina E. Diagnóstico genético del síndrome de Rett : Primer paso para una terapia farmacológica . Estudio en los genes implicados y correlación fenotipo-genotipo. Barcelona: Fundació Sant Joan de Déu; 2009;1-27.

Padrón J, Pérez R, Padrón L, Padrón L. Síndrome de Rett. Presentación de un caso. Medisur. 2012;10(1):69-71.

Navarro FJ, Gracia MA, León RC, Centro P, La DS. Síndrome de Rett: ¿qué debemos saber los pediatras de Atención Primaria? A propósito de un caso. Rev Pediatr Aten Primaria. 2007;97(455):455-64.

Asociación Internacional Síndrome de Rett. Intervención educativa y terapéutica en el Síndrome de Rett. AVSR. 1995;(96):1-100.

Bruck I, Antoniuk SA, Paola D de, Araki TY, Flenik LT. Síndrome de rett: relato de 7 casos. Arq Neuro-Psiquiat. 1990;48(4):489-92. http://dx.doi.org/10.1590/S0004-282X1990000400014.

Coronel C. Síndrome de rett: un nuevo reto para los pediatras. Rev Cuba Pediatr. 2002;74(2):1-6.

Orphanet. Le syndrome de Rett. Encyclopédie Orphanet Grand Public. Association Française du Syndrome de Rett et Association Française des Conseillers en Génétique. Mayo 2016. www.orpha.net/data/patho/Pub/fr/Rett-FRfrPub91v01.pdf.

Percy AK, Lane JB, Childers J, Skinner S, Annese F, Barrish J, et al. Rett syndrome: North American database. J Child Neurol. 2007;22(12):1338-41. http://dx.doi.org/10.1177/0883073807308715.

Huppke P, Held M, Laccone F, Hanefeld F. The spectrum of phenotypes in females with Rett Syndrome. Brain Dev. 2003;25(5):346-51.

Bishry Z. Why autism spectrum disorder is increasing. Middle East Curr Psychiatry. 2013;20(3):105.

Musselman KE, Stoyanov CT, Marasigan R, Jenkins ME, Konczak J, Morton SM, et al. Prevalence of ataxia in children: A systematic review. Neurology. 2014;82(1):80-9. http://dx.doi.org/10.1212/01.wnl.0000438224.25600.6c.

Giarelli E. Nursing care of people with autism spectrum disorder: Call for Evidence-based research and practice. New York City: Springer Publishing Company; 2013;2-3.

Whiteley P, Todd L, Carr K, Shattock P. Gender Ratios in Autism, Asperger Syndrome and Autism Spectrum Disorder. Autism Insights. 2010;2:17-24.

Dekkers LMS, Groot NA, Díaz Mosquera EN, Andrade Zúñiga IP, Delfos MF. Prevalence of Autism Spectrum Disorders in Ecuador: A Pilot Study in Quito. J Autism Dev Disord. 2015;45(12):4165-73. http://dx.doi.org/10.1007/s10803-015-2559-6.

Asociación Sueca del Síndrome de Rett. Mano a mano con el Sindrome de Rett. Congr Mund sobre el Síndrome Rett. Gotemburgo (Suecia): A.V.S.R.; 1996;1-94.

Ravn K, Roende G, Duno M, Fuglsang K, Eiklid KL, Tümer Z, et al. Two new Rett syndrome families and review of the literature: expanding the knowledge of MECP2 frameshift mutations. Orphanet J Rare Dis. 2011;6:58. http://dx.doi.org/10.1186/1750-1172-6-58.

De Felice C, Leoncini S, Signorini C, Cortelazzo A, Rovero P, Durand T, et al. Rett syndrome: An autoimmune disease?. Autoimmun Rev. 2016;15(4):411-6. http://dx.doi.org/10.1016/j.autrev.2016.01.011.

Gretta P, Tamara J. Bases moleculares del síndrome de Rett, una mirada actual. Rev Chil Pediatr. 2015;86(3):142-51. http://dx.doi.org/10.1016/j.rchipe.2015.07.001.

Hagberg B. Rett syndrome: Swedish approach to analysis of prevalence and cause. Brain Dev. 1985;3(7):276-80.

Boltshauser E, Kunzle C. Prevalence of Rett syndrome in Switzerland. Helv Paediatr Acta. 1987;42(5-6):407-11.

Suzuki H, Hirayama Y, Arima M. Prevalence of Rett Syndrome in Tokyo. Brain Dev. 1989;21(5):430-3.

Burd L, Vesley B, Martsolf JT, Kerbeshian J. Prevalence study of Rett syndrome in North Dakota children. Am H Med Genet. 1991;38(4):565-8.

Leonard H, Bower C ED. The prevalence and incidence of Rett syndrome in Australia. Eur Child Adolesc Psychiatry. 1997;6(1):8-10.

Skjeldal OH, von Tetzchner S, Aspelund F, Herder GA, Lofterld B. Rett syndrome: geographic variation in prevalence in Norway. Brain Dev. 1997;19(4):258-61.

Wong VCN, Li SYH. Rett syndrome: prevalence among Chinese and a comparison of MECP2 mutations of classic Rett syndrome with other neurodevelopmental disorders. J Child Neurol. 2007;22(12):1397-400. http://dx.doi.org/10.1177/0883073807307091.

Sarajlija A, Kisic-Tepavcevic D, Nikolic Z, Savic Pavicevic D, Obradovic S, Djuric M, et al. Epidemiology of rett syndrome in Serbia: Prevalence, incidence and survival. Neuroepidemiology. 2015;44(1):1-5. http://dx.doi.org/10.1159/000369494.

Orphanet. Informes Periodicos de Orphanet Prevalencia de las enfermedades raras: Datos bibliográficos [Internet]. 2013. Recuperado a partir de: http://www.orpha.net/orphacom/cahiers/docs/ES/Prevalencia_de_las_enfermedades_raras_por_prevalencia_decreciente_o_casos.pdf.

Jorge D, Aviña A, Alejandro D, Aviña H. Síndrome de Rett: microcefalia con retardo mental y autismo. Reporte de un caso. Arch Pediatr Urug. 2007;78(3):228-30.

Gratchev V V., Bashina VM, Klushnik TP, Ulas VU, Gorbachevskaya NL, Vorsanova SG. Clinical, neurophysiological and immunological correlations in classical Rett syndrome. Brain Dev. 2001;23(Suppl. 1):108-12.

Maski KP, Jeste SS, Spence SJ. Common neurological comorbidities in autism spectrum disorders. Curr Opin Pediatr. 2011;23(6):609-15. http://dx.doi.org/10.1097/MOP.0b013e32834c9282.

Paz M, Lozano F, Ferreras AP, José M, Gomariz B, Bogda-novitch AP, et al. Rasgos conductuales y cognitivos de los sindromes de Rett, Cri-du-chat, X frágil y Williams. Liberabit. 2010;16(1):39-50.

Campos-Castelló J, Briceño-Cuadros S. Trastornos de la comunicación: diagnostico diferencial. Rev Neurol. 2002;35(1):36-44.

Augenstein K, Lane JB, Horton A, Schanen C, Percy AK. Variable phenotypic expression of a MECP2 mutation in a family. J Neurodev Disord. 2009;1(4):313-7. http://dx.doi.org/10.1007/s11689-009-9034-7.

Motil KJ, Barrish JO, Lane J, Geerts SP, Annese F, McNair L, et al. Vitamin D deficiency is prevalent in girls and women with Rett syndrome. J Pediatr Gastroenterol Nutr. 2011;53(5):569-74. http://dx.doi.org/10.1097/MPG.0b013e3182267a66.

Som A, Baidya DK, Arora MK, Maitra S, Gupta S. Rett Syndrome: a concern for the anesthesiologists. J Clin Anesth. 2016;31:247-8.

Pidcock FS, Salorio C, Bibat G, Swain J, Scheller J, Shore W, et al. Functional outcomes in Rett syndrome. Brain Dev. 2016;38(1):76-81. http://dx.doi.org/10.1016/j.braindev.2015.06.005.

Nan X, Bird A. The biological functions of the methyl-CpG-binding protein MECP2 and its implications in Rett syndrome. Brain Dev. 2001;23(Suppl.):S32-7.

Rose SA, Djukic A, Jankowski JJ, Feldman JF, Rimler M. Aspects of attention in Rett syndrome. Pediatr Neurol.2016;57:22-8. http://dx.doi.org/10.1016/j.pediatrneurol.2016.01.015.

Tantra M, Hammer C, Kastner A, Dahm L, Begemann M, Bodda C, et al. Mild expression differences of MECP2 influencing aggressive social behavior. EMBO Mol Med. 2014;6(5):662-84. http://dx.doi.org/10.1002/emmm.201303744.

Haggarty SJ, Silva MC, Cross A, Brandon NJ, Perlis RH. Advancing drug discovery for neuropsychiatric disorders using patient-specific stem cell models. Mol Cell Neurosci. 2016;73:104-15. http://dx.doi.org/10.1016/j.mcn.2016.01.011.

Philippe C1, Villard L, De Roux N, Raynaud M, Bonnefond JP, Pasquier L, Lesca G, Mancini J, Jonveaux P, Moncla A, Chelly J BT. Spectrum and distribution of MECP2 mutations in 424 Rett syndrome patients: a molecular update. Eur J Med Genet. 2006;49(1):9-18. http://dx.doi.org/10.1016/j.ejmg.2005.04.003.

Zvereff V, Carpenter L, Patton D, Cabral H, Rita D, Wilson A, et al. Molecular diagnostic dilemmas in Rett syndrome. Brain Dev. 2012;34(9):750-5. http://dx.doi.org/10.1016/j.braindev.2011.12.012.

Zoghbi HY. Rett syndrome : what do we know for sure ? Nat Neurosci. 2009;12(3):239-40. http://dx.doi.org/10.1038/nn0309-239.

Huppke P, Kohler K, Brockmann K, Stettner GM, Gartner J. Treatment of epilepsy in Rett syndrome. Eur J Paediatr Neurol. 2007;11(1):10-6. http://dx.doi.org/10.1016/j.ejpn.2006.09.003.

Walsh RM, Hochedlinger K. Modeling Rett Syndrome with Stem Cells. Cell. 2010;143(4):499-500. http://dx.doi.org/10.1016/j.cell.2010.10.037.

Robinson L, Guy J, McKay L, Brockett E, Spike RC, Selfridge J, et al. Morphological and functional reversal of phenotypes in a mouse model of Rett syndrome. Brain. 2012;135(Pt 9) :2699- 710. http://dx.doi.org/10.1093/brain/aws096.

Killian JT, Lane JB, Lee HS, Pelham JH, Skinner SA, Kaufmann WE, et al. Caretaker Quality of Life in Rett Syndrome: Disorder Features and Psychological Predictors. Pediatr Neurol. 2016.58:67-74. http://dx.doi.org/10.1016/j.pediatrneurol.2015.12.021.

Kaufman KM, Zhao J, Kelly JA, Hughes T, Adler A, Sanchez E, et al. Fine Mapping of Xq28: Botch MECP2 and IRAK1 Contribute to Risk for Systemic Lupus Erythematosus in Multiple Ancestral Groups. Ann Rheum Dis. 2013;72(3):437-44. http://dx.doi.org/10.1136/annrheumdis-2012-201851.

Steffenburg U, Hagberg G, Hagberg B. Epilepsy in a representative series of Rett syndrome. Acta paediatr. 2001;90(1):34-9.

Oriel KN, George CL, Peckus R, Semon A. The effects of aerobic exercise on academic engagement in young children with autism spectrum disorder. Pediatr Phys Ther. 2011;23(2):187-93. http://dx.doi.org/10.1097/PEP.0b013e318218f149.

GAS V. La méthode Tomatis. Rett Info. 61.a ed. Paris: Association Française du Syndrome de Rett; 2007;22-5.

Cardoza B, Clarke A, Wilcox J, Gibbon F, Smith PEM, Archer H, et al. Epilepsy in Rett syndrome: Association between phe-notype and genotype, and implications for practice. Seizure. 2011;20(8):646-9. http://dx.doi.org/10.1016/j.seizure.2011.06.010.

Isaias IU, Dipaola M, Michi M, Marzegan A, Volkmann J, Roidi MLR, et al. Gait initiation in children with rett syndrome. PLoS One. 2014;9(4):1-7. https://doi.org/10.1371/journal.pone.0092736.

Segawa M1 MT. Rett syndrome: correlation of clinical symptoms and the mutations in the gene of methyl CPG binding protein 2 (MECP2): introductory remarks. No To Hattatsu. 2002;34(3):197-9.

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