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        "resumen" => "<span class="elsevierStyleSectionTitle">Antecedentes</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El s&#237;ndrome X fr&#225;gil &#40;SXF&#41; es la causa hereditaria m&#225;s frecuente de retraso mental&#46; Puede diagnosticarse con t&#233;cnicas de gen&#233;tica molecular&#44; pero su variada expresi&#243;n dificulta la sospecha cl&#237;nica</p> <span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se valora la utilidad de un test de seis criterios cl&#237;nicos como m&#233;todo de preselecci&#243;n a los ni&#241;os candidatos para estudio gen&#233;tico del s&#237;ndrome</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 70 pacientes varones entre 2 y 10 a&#241;os&#44; con retraso mental de causa desconocida&#44; aplic&#225;ndoseles un test con seis criterios cl&#237;nicos &#40;retraso mental&#44; historia familiar de retraso mental&#44; facies alargada&#44; orejas grandes&#44; conducta aut&#237;stica y d&#233;ficit de atenci&#243;n&#41; que se valoraron de 0 a 2 puntos&#46; En todos se realiz&#243; estudio molecular del gen SXF usando reacci&#243;n en cadena de la polimerasa y Southern-blot</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El estudio molecular confirm&#243; la mutaci&#243;n complete &#40;&#62; 200 repeticiones CGG&#41; en 14&#47;70 &#40;20 &#37;&#41; ni&#241;os&#46; La suma de 6 puntos en el test fue el l&#237;mite m&#225;s discriminativo y fue alcanzado por los 14 enfermos con mutaci&#243;n &#40;100 &#37;&#41;&#44; pero s&#243;lo por 2 de 56 casos &#40;3&#44;5 &#37;&#41; sin mutaci&#243;n&#46; El mejor modelo diagn&#243;stico fue la asociaci&#243;n del retraso mental&#44; deficiencia de atenci&#243;n e hiperactividad&#44; historia familiar de retraso mental y orejas grandes seguido de la facies alargada y la conducta autista</p> <span class="elsevierStyleSectionTitle">Conclusi&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Un test cl&#237;nico de 6 par&#225;metros facilita la preselecci&#243;n de ni&#241;os con sospecha de SXF para ser confirmados luego con t&#233;cnicas de gen&#233;tica molecular</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Fragile X syndrome &#40;FXS&#41; is the most frequent hereditary cause of mental retardation&#46; It can be diagnosed by molecular genetic techniques&#44; but clinical suspicion is made less likely by it variable expression</p> <span class="elsevierStyleSectionTitle">Objective</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To assess the effectiveness of a six-item checklist in the preselection of children who are candidates for FXS genetic study</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">W e studied 70 male patients aged between 2 and 10 years with mental retardation of unknown cause&#46; In all patients a checklist with six clinical criteria &#40;mental retardation&#44; history of familial mental retardation&#44; long face&#44; large ears&#44; autistic-like behaviour&#44; and attention deficit disorder with hyperactivity&#41; measured from 0-2 points was applied and molecular genetic studies using polymerase chain reaction and Southern-blot were performed</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">In 14 of the 70 children &#40;20 &#37;&#41; molecular study confirmed full mutation &#40;&#62; 200 CGG repeats&#41;&#46; A score of six points in the test had the greatest discriminatory power and was reached by 14 patients &#40;100 &#37;&#41; with mutation&#44; but only by 2 of 56 patients &#40;3&#46;5 &#37;&#41; without mutation&#46; The most accurate diagnostic model was the association of mental retardation&#44; attention deficit disorder with hyperactivity&#44; large ears and a history of familial mental retardation followed by long face and autistic-like behaviour</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">The six-item checklist improved the preselection of children with suspicion of FXS&#44; which was later confirmed by molecular genetic techniques</p>"
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Vol. 54. Núm. 4.
Páginas 326-330 (abril 2001)
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Vol. 54. Núm. 4.
Páginas 326-330 (abril 2001)
Acceso a texto completo
Eficacia de un test clínico como preselección de niños con sospecha de síndrome X frágil
Effectiveness of a clinical checklist in the preselection of children with suspicion of fragile X syndrome
Visitas
6932
I. Fernández Carvajala, A. Blanco Quirósa,
Autor para correspondencia
ablanco@ped.uva.es

Correspondencia: Área de Pediatría. Facultad de Medicina. Ramón y Cajal, 5. 47005 Valladolid
, J. Fernández Toralb, J.J. Tellería Orriolsa, M.J. Alonso Ramosa, A. Sanz Cantalapiedraa, J.F. Martín Rodríguezc, R. Palencia Luancesd
a Instituto de Biología Molecular y Genética (IBGM)
b Unidad de Genética. Hospital Central de Oviedo
c Área de Estadística. Universidad de Valladolid
d Servicio de Pediatría. Hospital Clínico de Valladolid
Este artículo ha recibido
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Resumen
Bibliografía
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Estadísticas
Antecedentes

El síndrome X frágil (SXF) es la causa hereditaria más frecuente de retraso mental. Puede diagnosticarse con técnicas de genética molecular, pero su variada expresión dificulta la sospecha clínica

Objetivo

Se valora la utilidad de un test de seis criterios clínicos como método de preselección a los niños candidatos para estudio genético del síndrome

Pacientes y métodos

Se estudiaron 70 pacientes varones entre 2 y 10 años, con retraso mental de causa desconocida, aplicándoseles un test con seis criterios clínicos (retraso mental, historia familiar de retraso mental, facies alargada, orejas grandes, conducta autística y déficit de atención) que se valoraron de 0 a 2 puntos. En todos se realizó estudio molecular del gen SXF usando reacción en cadena de la polimerasa y Southern-blot

Resultados

El estudio molecular confirmó la mutación complete (> 200 repeticiones CGG) en 14/70 (20 %) niños. La suma de 6 puntos en el test fue el límite más discriminativo y fue alcanzado por los 14 enfermos con mutación (100 %), pero sólo por 2 de 56 casos (3,5 %) sin mutación. El mejor modelo diagnóstico fue la asociación del retraso mental, deficiencia de atención e hiperactividad, historia familiar de retraso mental y orejas grandes seguido de la facies alargada y la conducta autista

Conclusión

Un test clínico de 6 parámetros facilita la preselección de niños con sospecha de SXF para ser confirmados luego con técnicas de genética molecular

Palabras clave:
Síndrome X frágil
Retraso mental
Alteraciones de la conducta
Mutaciones dinámicas
Genética molecular
Cromosoma X
Background

Fragile X syndrome (FXS) is the most frequent hereditary cause of mental retardation. It can be diagnosed by molecular genetic techniques, but clinical suspicion is made less likely by it variable expression

Objective

To assess the effectiveness of a six-item checklist in the preselection of children who are candidates for FXS genetic study

Material and methods

W e studied 70 male patients aged between 2 and 10 years with mental retardation of unknown cause. In all patients a checklist with six clinical criteria (mental retardation, history of familial mental retardation, long face, large ears, autistic-like behaviour, and attention deficit disorder with hyperactivity) measured from 0-2 points was applied and molecular genetic studies using polymerase chain reaction and Southern-blot were performed

Results

In 14 of the 70 children (20 %) molecular study confirmed full mutation (> 200 CGG repeats). A score of six points in the test had the greatest discriminatory power and was reached by 14 patients (100 %) with mutation, but only by 2 of 56 patients (3.5 %) without mutation. The most accurate diagnostic model was the association of mental retardation, attention deficit disorder with hyperactivity, large ears and a history of familial mental retardation followed by long face and autistic-like behaviour

Conclusion

The six-item checklist improved the preselection of children with suspicion of FXS, which was later confirmed by molecular genetic techniques

Key words:
Fragile X syndrome
Mental retardation
Behaviour problems
Dynamic mutations
Molecular genetics
X chro m osome
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Trabajo realizado parcialmente con una ayuda a la investigación de la Junta de Castilla y León (ref. VA 04/95)

Copyright © 2001. Asociación Española de Pediatría
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