Phenotype and genotype analysis of a French cohort of 119 patients with CHARGE syndrome

Am J Med Genet C Semin Med Genet. 2017 Dec;175(4):417-430. doi: 10.1002/ajmg.c.31591. Epub 2017 Nov 27.

Abstract

CHARGE syndrome (CS) is a genetic disorder whose first description included Coloboma, Heart disease, Atresia of choanae, Retarded growth and development, Genital hypoplasia, and Ear anomalies and deafness, most often caused by a genetic mutation in the CHD7 gene. Two features were then added: semicircular canal anomalies and arhinencephaly/olfactory bulb agenesis, with classification of typical, partial, or atypical forms on the basis of major and minor clinical criteria. The detection rate of a pathogenic variant in the CHD7 gene varies from 67% to 90%. To try to have an overview of this heterogenous clinical condition and specify a genotype-phenotype relation, we conducted a national study of phenotype and genotype in 119 patients with CS. Selected clinical diagnostic criteria were from Verloes (2005), updated by Blake & Prasad (). Besides obtaining a detailed clinical description, when possible, patients underwent a full ophthalmologic examination, audiometry, temporal bone CT scan, gonadotropin analysis, and olfactory-bulb MRI. All patients underwent CHD7 sequencing and MLPA analysis. We found a pathogenic CHD7 variant in 83% of typical CS cases and 58% of atypical cases. Pathogenic variants in the CHD7 gene were classified by the expected impact on the protein. In all, 90% of patients had a typical form of CS and 10% an atypical form. The most frequent features were deafness/semicircular canal hypoplasia (94%), pituitary defect/hypogonadism (89%), external ear anomalies (87%), square-shaped face (81%), and arhinencephaly/anosmia (80%). Coloboma (73%), heart defects (65%), and choanal atresia (43%) were less frequent.

Keywords: CHARGE syndrome; CHD7 gene; genotype; phenotype.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abnormalities, Multiple / diagnosis
  • Abnormalities, Multiple / genetics
  • Adolescent
  • Adult
  • Alleles
  • Amino Acid Substitution
  • CHARGE Syndrome / diagnosis*
  • CHARGE Syndrome / genetics*
  • Central Nervous System / abnormalities
  • Child
  • Child, Preschool
  • Cohort Studies
  • Cranial Nerves / abnormalities
  • DNA Helicases / genetics
  • DNA-Binding Proteins / genetics
  • Female
  • France
  • Genetic Association Studies*
  • Genetic Testing
  • Genotype*
  • Humans
  • Infant
  • Male
  • Molecular Diagnostic Techniques
  • Phenotype*
  • Young Adult

Substances

  • DNA-Binding Proteins
  • DNA Helicases
  • CHD7 protein, human