FG syndrome | |
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Other names | Opitz–Kaveggia syndrome, FGS1 |
In a 2008 study by medical geneticist John M. Opitz, James Smith and Lucia Santoro, they posit that Kim Peek, the basis for Dustin Hoffman's character in the film Rain Man , had FG syndrome [1] [2] | |
Specialty | Medical genetics |
Usual onset | Birth |
Duration | Lifelong |
Risk factors | Family history (genetics) |
FG syndrome (FGS) is a rare genetic syndrome caused by one or more recessive genes located on the X chromosome and causing physical anomalies and developmental delays. FG syndrome was named after the first letters of the surnames of the first patients noted with the disease. [3] First reported by American geneticists John M. Opitz and Elisabeth G. Kaveggia in 1974, [4] its major clinical features include intellectual disability, hyperactivity, hypotonia (low muscle tone), and a characteristic facial appearance including macrocephaly (an abnormally large head). [5]
FG syndrome's major clinical features include physical disability, usually mild; hyperactive behavior, often with a slow personality; severe constipation, with or without structural anomalies in the anus such as imperforate anus; macrocephaly; severe hypotonia; a characteristic facial appearance due to hypotonia, giving a droopy, "open-mouthed" expression, a thin upper lip, a full or pouting upper lip; and most or complete loss of the corpus callosum. About a third of reported cases of individuals with FG syndrome die in infancy, usually due to respiratory infection; premature death is rare after infancy. [5]
Associated with agenesis (absence) of the corpus callosum, intellectual disabilities are common among individuals with FG syndrome. Motor ability is also impaired as a result of FG syndrome, and it also affects the development of semen. During childhood, problems arise in the gastrointestinal and gastroesophageal systems of the body. The most common gastrointestinal problems include constipation from an imperforate anus and gastroesophageal reflux. Cardiopulmonary defects contribute to roughly 60% of premature deaths in infants with FG syndrome. Septal defects are the most common. After infancy, long-term survival has been recorded beyond the age of 50. [6]
Most mutations that cause FG syndrome can be found in the MED12 gene. However, mutations have also been found in FMR1 , FLNA , UPF3B , CASK , MECP2 and ATRX genes. [6] Mutations on these different genes lead to the different types of FG syndrome, all with similar characteristics. [6] The FGS8 type mutation is the most common of the types, and is found in the MED12 gene. [6]
Known types and affected genes include:
Type | OMIM | Gene | Locus |
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FGS1 | 305450 | MED12 | Xq13 |
FGS2 | 300321 | FLNA | Xq28 |
FGS3 | 300406 | FGS3 | Xp22.3 |
FGS4 | 300422 | CASK | Xp11.4-p11.3 |
FGS5 | 300581 | FGS5 | Xq22.3 |
The MED12 gene codes for the mediator complex subunit 12 protein. [7] The mediator complex is composed of around 25 different proteins that all help with the regulation of gene activity. [7] This mediator complex regulates gene expression by bridging interaction between RNA polymerase II and gene-specific regulating proteins such as transcription factors, repressor proteins, activator proteins, etc. [7] Changes to this complex and the proteins associated can have a severe impact on the production of new proteins. [7] The MED12 gene is also thought to be highly linked to neuron development as well as high usage in the cells signal transduction pathway. [7] This explains the slowed intellectual development individuals with FG syndrome have. [7]
There is no established clinical diagnostic criteria for FG syndrome. [8] A healthcare professional might consider the following clinical features in an individual as indicative for further evaluation: [8]
Treatment for FG Syndrome is individualized to each person. It generally involves a team of specialists to manage the symptoms.[ citation needed ]
The name of the syndrome comes from the initials of the surnames of two sisters, who had five sons with the syndrome. The first study of the syndrome, published in 1974, [4] established that it was linked to inheritance of the X chromosome. [9]
Macrocephaly is a condition in which circumference of the human head is abnormally large. It may be pathological or harmless, and can be a familial genetic characteristic. People diagnosed with macrocephaly will receive further medical tests to determine whether the syndrome is accompanied by particular disorders. Those with benign or familial macrocephaly are considered to have megalencephaly.
Laurence Kim Peek was an American savant. Known as a "megasavant", he had an exceptional memory, but he also experienced social difficulties, possibly resulting from a developmental disability related to congenital brain abnormalities. He was the inspiration for the character Raymond Babbitt in the 1988 movie Rain Man. Although Peek was previously diagnosed with autism, he is now thought to have had FG syndrome. The Utah Film Center's Peek Award honors his legacy.
ICF syndrome is a very rare autosomal recessive immune disorder.
Mowat–Wilson syndrome is a rare genetic disorder that was clinically delineated by David R. Mowat and Meredith J. Wilson in 1998. The condition affects both males and females, has been described in various countries and ethnic groups around the world, and occurs in approximately 1 in 50,000–100,000 births.
Kaufman oculocerebrofacial syndrome, also known as blepharophimosis-ptosis-intellectual disability syndrome, is an extremely rare autosomal recessive congenital disorder characterized by severe mental retardation, brachycephaly, upslanting palpebral fissures, eye abnormalities, and highly arched palate. It was characterized in 1971; eight cases had been identified as of 1995. To date, the amount of cases is disputed, with sources claiming the number ranges from 14 to 31.
Vici syndrome, also called immunodeficiency with cleft lip/palate, cataract, hypopigmentation and absent corpus callosum, is a rare autosomal recessive congenital disorder characterized by albinism, agenesis of the corpus callosum, cataracts, cardiomyopathy, severe psychomotor retardation, seizures, immunodeficiency and recurrent severe infections. To date, about 50 cases have been reported.
Acrocallosal syndrome is an extremely rare autosomal recessive syndrome characterized by corpus callosum agenesis, polydactyly, multiple dysmorphic features, motor and intellectual disabilities, and other symptoms. The syndrome was first described by Albert Schinzel in 1979. Mutations in KIF7 are causative for ACLS, and mutations in GLI3 are associated with a similar syndrome.
Lujan–Fryns syndrome (LFS) is an X-linked genetic disorder that causes mild to moderate intellectual disability and features described as Marfanoid habitus, referring to a group of physical characteristics similar to those found in Marfan syndrome. These features include a tall, thin stature and long, slender limbs. LFS is also associated with psychopathology and behavioral abnormalities, and it exhibits a number of malformations affecting the brain and heart. The disorder is inherited in an X-linked dominant manner, and is attributed to a missense mutation in the MED12 gene. There is currently no treatment or therapy for the underlying MED12 malfunction, and the exact cause of the disorder remains unclear.
Pitt–Hopkins syndrome (PTHS) is a rare genetic disorder characterized by developmental delay, moderate to severe intellectual disability, distinctive facial features, and possible intermittent hyperventilation followed by apnea. Epilepsy often occurs in Pitt-Hopkins. It is part of the clinical spectrum of Rett-like syndromes. Pitt-Hopkins syndrome is clinically similar to Angelman syndrome, Rett-syndrome, Mowat Wilson syndrome, and ATR-X syndrome.
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Goldberg–Shprintzen syndrome is a very rare connective tissue condition associated with mutations in KIAA1279 gene which encodes KIF-binding protein (KBP), a protein that may interact with microtubules and actin filaments. KBP may play a key role in cytoskeleton formation and neurite growth.
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Lateral meningocele syndrome, also known as Lehman syndrome, is a very rare skeletal disorder with facial anomalies, hypotonia, and meningocele-related neurologic dysfunction. These protrusions form from membranes surrounding the spinal cord in gaps in the spine (vertebrae). They most often occur in the lower spine and damage the surrounding nerves that spread throughout the rest of the body. Examples of resulting damages are bladder function, prickling or tingling sensations, stiffness and weakness in the legs, and back pain. People affected with lateral meningocele typically have high arched eyebrows, widely spaced eyes, droopy eyes, and other facial features. There have been only 14 reported individuals with lateral meningocele syndrome with 7 of those who have a molecularly confirmed diagnosis. There is no specific treatment for this syndrome, but only supportive management including lateral spinal meningoceles, psychomotor development, musculoskeletal, and routine management.
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