Información de la revista
Vol. 60. Núm. 6.
Páginas 530-536 (junio 2004)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 60. Núm. 6.
Páginas 530-536 (junio 2004)
Acceso a texto completo
Síndrome de Williams-Beuren: presentación de 82 casos
Williams-beuren syndrome. presentation of 82 cases
Visitas
22318
I. Pascual-Castroviejoa,
Autor para correspondencia
pascas@inves.es

Correspondencia: Orense, 14, 10.° E. 28020 Madrid. España
, S.I. Pascual-Pascuala, F. Moreno Granadob, L. García-Gueretab, R. Gracia-Bouthelierc, M. Navarro Torresd, A. Delicado Navarroe, D. López-Pajarese, R. Palencia Luacesf
a Servicios de Neurología Pediátrica. Hospital Universitario La Paz, Madrid
b Servicios de Cardiología Pediátrica. Hospital Universitario La Paz, Madrid
c Servicios de Endocrinología Pediátrica. Hospital Universitario La Paz, Madrid
d Servicios de Nefrología Pediátrica. Hospital Universitario La Paz, Madrid
e Servicios de Genética. Hospital Universitario La Paz, Madrid
f Unidad de Neurología Pediátrica. Hospital Clínico Universitario. Valladolid. España
Este artículo ha recibido
Información del artículo
Objetivo

Revisión retrospectiva de una serie de 82 casos de síndrome de Williams-Beuren y los trastornos asociados

Material y métodos

Cohorte de 82 pacientes, 47 varones y 35 mujeres, que consultaron en hospital por retraso psicomotor y/o por cardiopatía congénita. Se estudiaron principalmente desde el punto de vista neurológico y cardiológico y, en segundo lugar, endocrinológico y nefrológico. Desde que se describió la alteración cromosómica que provoca el cuadro, se practica el cariotipo a todos los casos sospechosos de síndrome de Williams-Beuren

Resultados

Las alteraciones principales consistieron en: facies peculiar (100 %); retraso psíquico con actitud amistosa (90 %); cardiopatía congénita (85,4 %), siendo las estenosis aórtica supravalvular, aislada (60 %) o asociada a estenosis pulmonar (12 %), la malformación más frecuente (72 %); trastorno por déficit de atención con hiperactividad (SDAHA), que se apreciaba en la mayoría de los casos, varones y mujeres, a partir de los 5–6 años; iniciación de la marcha y del lenguaje tardíos en aproximadamente el 90 %. El peso al nacer estaba por debajo de los 3.000 g en el 65 % de los casos en que este dato era consignado en las historias clínicas. Once de nuestros 13 casos estudiados (84,5 %) mostraron la deleción del síndrome de Williams- Beuren

Conclusión

Los pacientes con este síndrome deben ser estudiados multidisciplinarmente. La mayoría de ellos precisan ayuda en su escolaridad y encauzamiento profesional posterior

Palabras clave:
Síndrome de Williams-Beuren
Cardiopatía congénita
Encefalopatía
Trastorno por déficit de atención con hiperactividad
Objective

We performed a retrospective review of a series of 82 cases of Williams-Beuren syndrome (WBS) and associated diseases

Material and methods

A series of 82 patients (47 males and 35 females) who consulted at the hospital because of mental retardation and/or congenital cardiopathy were included. The patients were studied mainly from a neurological and cardiological point of view, and secondarily because of endocrinological and nephrological problems. Since description of the chromosomal abnormalities provoking the syndrome, we perform karyotyping in all patients with suspected WBS

Results

Alterations mainly consisted of distinctive facial appearance (100 %), mental retardation with friendly behavior (90 %), congenital cardiopathy (85.4 %), mostly consisting of supravalvular aortic stenosis (72 %), with (12%) or without (60 %) pulmonary stenosis, and behavior typical of attention deficit-hyperactivity disorder, which usually manifested at the age of 4 to 5 years in both boys and girls. Approximately 90 % started to walk and speak later than average. Birthweight was below 3000 g in 65 % of the patients in whom this datum was included in the medical record. Eleven of the 13 patients (84.5%) studied showed the typical deletion of WBS

Conclusion

Study of patients with WBS should be multidisciplinary. Most patients require help during schooling and subsequent vocational guidance

Key words:
Williams-Beuren syndrome
Congenital cardiopathy
Encephalopathy
Attention deficit/hyperactivity disorder
El Texto completo está disponible en PDF
Bibliografía
[1.]
J.C.P. Williams, B.G. Barratt-Boyes, J.B. Lowe.
Supravalvular aortic stenosis.
Circulation, 24 (1961), pp. 1311-1318
[2.]
A.J. Beuren, J. Apitz, D. Harmjanz.
Supravalvular aortic stenosis in association with mental retardation and a certain facial appearance.
Circulation, 26 (1962), pp. 1235-1240
[3.]
C.A. Morris, S.A. Demsey, C.O. Leonard, C. Dilts, B.L. Blackburn.
Natural history of Williams syndrome: Physical characteristics.
J Pediatr, 113 (1988), pp. 318-326
[4.]
D. Kotzot, F. Bernasconi, L. Brecevic, W.P. Robinson, P. Kiss, G. Kosztolanyi, et al.
Phenotype of the Williams-Beuren syndrome associated with hemizygosity at the elastin locus.
Eur J Pediatr, 154 (1995), pp. 477-482
[5.]
E. Nickerson, F. Greenberg, M. Keating, C. McCaskill, L. Shaffer.
Deletions of the elastin gene at 7q11.23 occur in ˜ 90 % of patients with Williams syndrome.
Am J Hum Genet, 56 (1995), pp. 1156-1161
[6.]
J.A. Black, R.E. Bonham-Carter.
Association between aortic stenosis and facies of severe infantile hypercalcemia.
Lancet, 2 (1963), pp. 745-748
[7.]
D. Donnai, A. Karmiloff-Smith.
Williams syndrome: From genotype through to the cognitive phenotype.
Am J Med Genet (Sem Med Genet), 97 (2000), pp. 164-171
[8.]
K.A. Hallidie-Smith, S. Karas.
Cardiac anomalies in Williams-Beuren syndrome.
Arch Dis Child, 63 (1988), pp. 809-813
[9.]
R. Pankau, C.J. Partsch, A. Gosch, H.C. Oppermann, A. Wessel.
Statural growth in Williams-Beuren syndrome.
Eur J Pediatr, 151 (1992), pp. 751-755
[10.]
C.J. Partsch, G. Dreyer, A. Gosh, M. Winter, R. Schneppenheim, A. Wessel, et al.
Longitudinal evaluation of growth, puberty and bone maturation in children with Williams syndrome.
J Pediatr, 134 (1999), pp. 82-89
[11.]
K. Ounap, P. Laidre, O. Bartsch, R. Rein, M. Lipping-Sitska.
Familial Williams-Beuren syndrome.
Am J Med Genet, 80 (1998), pp. 491-493
[12.]
R.A. Pagon, F.C. Bennett, B. La Veck, K.B. Stewart, J. Johnson.
Williams syndrome: Features in late childhood and adolescence.
Pediatrics, 80 (1987), pp. 85-91
[13.]
C.A. Morris, C.O. Leonard, C. Dilts, S. Dempsey.
Adults with Williams syndrome.
Am J Med Genet, 35 (1990), pp. 102-107
[14.]
A. Gosch, R. Pankau.
Longitudinal study of the cognitive development in children with Williams syndrome.
[15.]
U. Bellugi, A. Bihrle, T. Jernigan, D. Trauner, S. Doherty.
Neuropsychological, neurological, and neuro-anatomical profile of Williams síndrome.
Am J Med Genet, 35 (1990), pp. 115-125
[16.]
O. Udwin, W. Yule.
An cognitive and behavioural phenotype in Williams syndrome.
J Clin Exp Neuropsychol, 13 (1991), pp. 232-244
[17.]
S.A. Tomc, N.K. Williamson, R.M. Pauli.
Temperament in Williams syndrome.
Am J Med Genet, 36 (1990), pp. 345-352
[18.]
J. Grant, A. Karmiloff-Smith, S.E. Gathercole, S. Paterson, P. Howlin, M. Davis, et al.
Phonological short-term memory and its relationship to language in Williams syndrome.
Cogn Neuropsychiatry, 2 (1997), pp. 81-99
[19.]
J.P. Fryns, M. Borghgraef, P. Volcke, H. Van den Berghe.
Adults with Williams syndrome [carta].
Am J Med Genet, 40 (1991), pp. 253
[20.]
C. Rae, A. Karmiloff-Smith, M.A. Lee, R.M. Dixon, J. Grant, A.M. Blamire, et al.
Brain biochemistry in Williams syndrome: evidence for a role of the cerebellum in cognition?.
Neurology, 51 (1998), pp. 33-40
[21.]
A.J. Beuren, C. Schulze, P. Eberle, D. Harmajanz, J. Apitz.
The syndrome of supravalvular aortic stenosis peripheral pulmonary stenosis, mental retardation and similar facial appearance.
Am J Cardiol, 13 (1964), pp. 471-482
[22.]
A. Wessel, R. Pankau, D. Rececioglu, W. Ruschewski, J.H. Bursch.
Three decades of follow-up of aortic and pulmonary vascular lesions in the Williams-Beuren syndrome.
Am J Med Genet, 52 (1994), pp. 297-301
[23.]
Y.Q. Wu, V.R. Sutton, E. Nikerson, J.R. Lupski, L. Potocki, J.R. Korenberg, et al.
Delineation of the common critical region in Williams syndrome and clinical correlations of growth, heart defects, ethnicity, and parenteral origin.
Am J Med Genet, 78 (1998), pp. 82-89
[24.]
L.M. Bird, G.F. Billman, R.V. Lacro, R.L. Spicer, L.K. Jariwala, H.P. Hoyme, et al.
Sudden death in Williams syndrome: Report of ten cases.
J Pediatr, 129 (1996), pp. 926-931
[25.]
P.E. Terhune, J.J. Buchino, A.H. Rees.
Myocardial infarction associated with supravalvular aortic stenosis.
J Pediatr, 106 (1985), pp. 251-254
[26.]
L.S. Sadler, B.R. Pober, A. Grandinetti, D. Scheiber, G. Fekete, A.N. Sharma, et al.
Differences by sex in cardiovascular disease in Williams syndrome.
J Pediatr, 139 (2001), pp. 849-853
[27.]
M. Eronen, M. Peippo, A. Hippala, M. Raatika, M. Arvio, R. Johansson, et al.
Cardiovascular manifestations in 75 patients with Williams syndrome.
J Med Genet, 39 (2002), pp. 554-558
[28.]
M. Del Campo Casanelles, J.J. Gil-Fernández, L.F. Magano Casero, M. García Bengoechea, R. Serrano, J.M. Fernández Rañada, et al.
Portal hipertensión in Williams syndrome: Report of two patients.
Am J Med Genet, 118A (2003), pp. 372-376
[29.]
J.R. Ingelfinger, J.W. Newburger.
Spectrum of renal anomalies in patients with Williams syndrome.
J Pediatr, 119 (1991), pp. 771-773
[30.]
M.E. Curran, D.L. Atkinson, A.K. Ewart, C.A. Morris, M.F. Leppert, M.T. Keating.
The elastin gene is disrupted by a translocation associated with supravalvular aortic stenosis.
Cell, 73 (1993), pp. 159-168
[31.]
L.A. Pérez-Jurado, R. Peoples, P. Kaplan, B.C.J. Hamel.
Molecular difinition of the chromosome 7 deletion in Williams síndrome and parent-of-origin effects on growth.
Am J Hum Genet, 59 (1996), pp. 781-792
[32.]
R. Peoples, Y. Franke, Y.K. Wang, L. Pérez-Jurado, T. Paperna, M. Cisco, et al.
A physical map, including a BAC/PAC clone conting, of the Williams-Beuren syndrome deletion region at 7q11.23.
Am J Hum Genet, 66 (2000), pp. 47-68
[33.]
G. Merla, C. Ucla, M. Guipponi, A. Reymond.
Identification of additional transcripts in the Williams-Beuren syndrome critical region.
Hum Genet, 110 (2002), pp. 429-438
[34.]
M. Bayés, L.F. Magano, N. Rivera, R. Flores, L.A. Pérez-Jurado.
Mutational mechanisms of Williams-Beuren syndrome deletions.
Am J Hum Genet, 73 (2003), pp. 131-151
[35.]
L.A. Pérez-Jurado, Y.K. Wang, R. Peoples, A. Coloma, J. Cruces, U. Francke.
A duplicated gene in the breakpoint regions of the 7q11.23 Williams-Beuren syndrome deletion-encodes the initiator binding protein TFH-I and BAP-135, a phosphorylation target of BTK.
Hum Mol Genet, 7 (1998), pp. 325-334
[36.]
L.A. Pérez-Jurado.
Williams-Beuren syndrome: A model of recurrent genomic mutation.
Horm Res, 59 (2003), pp. 106-113
[37.]
C. Gagliardi, M.C. Bonagli, A. Selicorni, R. Bogartti, R. Giorda.
Unusual cognitive and behavioural profile in a Williams syndrome patient with atypical 7q11.23 deletion.
J Med Genet, 40 (2003), pp. 26-30
[38.]
M. Tassabehji, K. Metcalfe, A. Karmiloff-Smith, M.J. Carette, J. Grant, N. Dennis, et al.
Williams syndrome: Use of chromosomal microdeletions as a tool to dissect cognitive and physical phenotypes.
Am J Hum Genet, 64 (1999), pp. 118-125
[39.]
M.C. Valero, O. De Luis, J. Cruces, L.A. Pérez Jurado.
Finescale comparative mapping of the human 7q11.23 region and the orthologous region on the mouse chromosome 5G: The lowcopy repeats that flank the Williams-Beuren syndrome deletion arose at breakpoint sites of an evolutionary inversion (S).
Genomics, 69 (2000), pp. 1-13
[40.]
D.Y. Li, B. Brooke, E.C. Davis, R.P. Mecham, L.K. Sorensen, B.B. Boak, et al.
Elastin is an essential determinant of arterial morphogenosis.
Nature, 393 (1998), pp. 276-280
[41.]
D.Y. Li, G. Faury, D.G. Taylor, E.C. Davis, W.A. Boyle, R.P. Mecham, et al.
Novel arterial pathology in mice and human hemizygous for elastin.
J Clin Invest, 102 (1998), pp. 1783-1787
[42.]
Y. Meng, Y. Zhang, V. Tregoubov, C. Janus, L. Cruz, M. Jackson, et al.
Abnormal spine morphology and enhanced LTP in Limk-1 Knockout mice.
Neuron, 35 (2002), pp. 121-133
[43.]
C.C. Hoogenraad, B. Koekkoek, A. Akmanova, H. Krugers, B. Dortland, M. Miedema, et al.
Targeted mutation of Cyln 2 in the Williams syndrome critical region links CL1P-115 haploinsufficiency to neurodevelopmental abnormalities in mice.
Nat Genet, 32 (2002), pp. 117-127
[44.]
M.E. Durkin, C.L. Keck-Waggoner, N.C. Popescu, S.S. Thorgeirsson.
Integration of a c-myc transgene results in disruption of the mouse Gtf2ird1gene, the homologue of the human GTF21RD1 gene hemizygously deleted in Williams-Beuren syndrome.
Genomics, 73 (2001), pp. 20-27
[45.]
A.D. Stock, P.A. Spallone, T.R. Dennis, D. Netski, C.A. Morris, C.B. Mervis, et al.
Heat shock protein 27 gene: chromosomal and molecular location and relationship to Williams syndrome.
Am J Med Genet, 120A (2003), pp. 320-325
Copyright © 2004. Asociación Española de Pediatría
Descargar PDF
Idiomas
Anales de Pediatría
Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?