Abstract
CHARGE syndrome (OMIM 214800) is a rare autosomal-dominant congenital malformation syndrome that results from haploinsufficiency of the chromodomain helicase DNA-binding protein 7 (CHD7). We performed a phenotypic characterization and genetic analysis of CHD7 in 18 Korean patients with CHARGE syndrome. Eighteen unrelated Korean patients (10 females and 8 males; age range 0.0–19.6 years) with CHARGE syndrome were enrolled. Clinical data were collected by retrospective review of medical records. A serial analysis via sequencing and multiple ligation-dependent probe amplification of CHD7 was performed to determine the molecular genetic spectrum of the patients. The prevalence of cardinal symptoms was as follows: coloboma (13/18, 72.2%), heart defects (13/18, 72.2%), choanal atresia/stenosis (4/18, 22.2%), retarded growth (10/18, 55.6%), genital anomalies (15/18, 83.3%) and ear abnormalities (18/18, 100%). Five patients had cerebellar vermis hypoplasia (5/17, 29.4%) with no clinical symptoms or signs of cerebellar dysfunction. Furthermore, we identified genetic alterations in all 18 patients, including 10 novel mutations. Considering its frequency among patients with CHD7 mutations, cerebellar vermis hypoplasia may be a clinical diagnostic clue of CHARGE syndrome, although it is not included in the diagnostic critieria. And, the identification of CHD7 mutations may help the confirmative diagnosis.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Blake, K. D. & Prasad, C. CHARGE syndrome. Orphanet J. Rare Dis. 1, 34 (2006).
Pagon, R. A., Graham, J. M. Jr ., Zonana, J. & Yong, S. L. Coloboma, congenital heart disease, and choanal atresia with multiple anomalies: CHARGE association. J. Pediatr. 99, 223–227 (1981).
Blake, K. D., Davenport, S. L., Hall, B. D., Hefner, M. A., Pagon, R. A., Williams, M. S. et al. CHARGE association: an update and review for the primary pediatrician. Clin. Pediatr. 37, 159–173 (1998).
Verloes, A. Updated diagnostic criteria for CHARGE syndrome: a proposal. Am. J. Med. Genet. Part A 133A, 306–308 (2005).
Issekutz, K. A., Graham, J. M. Jr ., Prasad, C., Smith, I. M. & Blake, K. D. An epidemiological analysis of CHARGE syndrome: preliminary results from a Canadian study. Am. J. Med. Genet. Part A 133A, 309–317 (2005).
Vissers, L. E., van Ravenswaaij, C. M., Admiraal, R., Hurst, J. A., de Vries, B. B., Janssen, I. M. et al. Mutations in a new member of the chromodomain gene family cause CHARGE syndrome. Nat. Genet. 36, 955–957 (2004).
Husu, E., Hove, H. D., Farholt, S., Bille, M., Tranebjaerg, L., Vogel, I. et al. Phenotype in 18 Danish subjects with genetically verified CHARGE syndrome. Clin. Genet. 83, 125–134 (2013).
Bajpai, R., Chen, D. A., Rada-Iglesias, A., Zhang, J., Xiong, Y., Helms, J. et al. CHD7 cooperates with PBAF to control multipotent neural crest formation. Nature 463, 958–962 (2010).
Layman, W. S., Hurd, E. A. & Martin, D. M. Chromodomain proteins in development: lessons from CHARGE syndrome. Clin. Genet. 78, 11–20 (2010).
Schnetz, M. P., Handoko, L., Akhtar-Zaidi, B., Bartels, C. F., Pereira, C. F., Fisher, A. G. et al. CHD7 targets active gene enhancer elements to modulate ES cell-specific gene expression. PLoS Genet. 6, e1001023 (2010).
Zentner, G. E., Layman, W. S., Martin, D. M. & Scacheri, P. C. Molecular and phenotypic aspects of CHD7 mutation in CHARGE syndrome. Am. J. Med. Genet. Part A 152A, 674–686 (2010).
Jongmans, M. C., Admiraal, R. J., van der Donk, K. P., Vissers, L. E., Baas, A. F., Kapusta, L. et al. CHARGE syndrome: the phenotypic spectrum of mutations in the CHD7 gene. J. Med. Genet. 43, 306–314 (2006).
Lalani, S. R., Safiullah, A. M., Fernbach, S. D., Harutyunyan, K. G., Thaller, C., Peterson, L. E. et al. Spectrum of CHD7 mutations in 110 individuals with CHARGE syndrome and genotype-phenotype correlation. Am. J. Hum. Genet. 78, 303–314 (2006).
Bergman, J. E., Janssen, N., Hoefsloot, L. H., Jongmans, M. C., Hofstra, R. M. & van Ravenswaaij-Arts, C. M. CHD7 mutations and CHARGE syndrome: the clinical implications of an expanding phenotype. J. Med. Genet. 48, 334–342 (2011).
Cho, H. J., Song, M. H., Choi, S. Y., Kim, J., Lee, J., Kim, U. K. et al. Genetic analysis of the CHD7 gene in Korean patients with CHARGE syndrome. Gene 517, 164–168 (2013).
Lee, Y. W., Kim, S. C., Shin, Y. L., Kim, J. W., Hong, H. S., Lee, Y. K. et al. Clinical and genetic analysis of the CHD7 gene in Korean patients with CHARGE syndrome. Clin. Genet. 75, 290–293 (2009).
Song, M. H., Cho, H. J., Lee, H. K., Kwon, T. J., Lee, W. S., Oh, S. et al. CHD7 mutational analysis and clinical considerations for auditory rehabilitation in deaf patients with CHARGE syndrome. PLoS ONE 6, e24511 (2011).
Kim, Y., Lee, H. S., Yu, J. S., Ahn, K., Ki, C. S. & Kim, J. Identification of a novel mutation in the CHD7 gene in a patient with CHARGE syndrome. Korean J. Pediatr. 57, 46–49 (2014).
Lee, S. J., Chae, J. H., Lee, J. A., Cho, S. I., Seo, S. H., Park, H. et al. Non-homologous end joining repair mechanism-mediated deletion of CHD7 gene in a patient with typical CHARGE syndrome. Ann. Lab. Med. 35, 141–145 (2015).
Moon, J. S., Lee, S. Y., Nam, C. M., Choi, J. M., Choe, B. K., Seo, J. W. et al. 2007 Korean National Growth Charts: review of developmental process and an outlook. Korean. J. Pediatr. (Korean) 51, 1–25 (2008).
McMain, K., Blake, K., Smith, I., Johnson, J., Wood, E., Tremblay, F. et al. Ocular features of CHARGE syndrome. J. AAPOS 12, 460–465 (2008).
Yu, T., Meiners, L. C., Danielsen, K., Wong, M. T., Bowler, T., Reinberg, D. et al. Deregulated FGF and homeotic gene expression underlies cerebellar vermis hypoplasia in CHARGE syndrome. eLife 2, e01305 (2013).
Bergman, J. E., de Wijs, I., Jongmans, M. C., Admiraal, R. J., Hoefsloot, L. H. & van Ravenswaaij-Arts, C. M. Exon copy number alterations of the CHD7 gene are not a major cause of CHARGE and CHARGE-like syndrome. Eur. J. Med. Genet. 51, 417–425 (2008).
Acknowledgements
We thank the patients and their families for participating in this study. This study was supported by a grant from the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (A120030).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Sohn, Y., Ko, J., Shin, C. et al. Cerebellar vermis hypoplasia in CHARGE syndrome: clinical and molecular characterization of 18 unrelated Korean patients. J Hum Genet 61, 235–239 (2016). https://doi.org/10.1038/jhg.2015.135
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/jhg.2015.135
This article is cited by
-
ALS and CHARGE syndrome: a clinical and genetic study
Acta Neurologica Belgica (2018)