Cytogenetics and Cancer Research

Angelman syndrome (AS) was first described by Dr. Harry Angelman, who is an English physician. He noticed that there are 3 children under his care with similar developmental problems. They looked very happy and tend to flap their hands when excited. Therefore, Dr. Harry Angelman described these children in his paper called “Puppet Children” as these children’s characteristics just like the puppet.
 
Angelman Syndrome is now a familiar genetic disorder to most clinical geneticists and child neurologists in Cytogenetics. It is a recognizable syndrome which related to mental retardation and infantile seizures. Unlike Prader-Willi syndrome that I described last week, individual with Angelman syndrome is because the loss of maternally inherited region 15q11 – q13 of chromosome 15. Simple to say, the AS individual does not inherit the region 15q11 – q13 of chromosome 15 from his/her mother but only from father.

 
The Angelman syndrome clinical diagnosis is heavily dependent on the combination of some common behaviour like excessive laughter, apparent happiness with tremulous movements and gait ataxia (lack of coordination of muscle movement). Usually, the normal prenatal and birth history do not provides any clues in diagnosis of AS in Cytogenetics. CT scans, laboratory tests of blood and urine are usually normal including metabolic screening. Consequently, it is difficult for the clinical experts to encounter the AS especially when the child is less than 12 months of age. It is because the tremulous movements, ataxia and severe lack of speech may not be apparent during that time.
 
There are many common features of Angelman syndrome.

i. Severe speech deficit (usually absent speech)
 
ii. Mental retardation
 
iii. Microcephaly (small head)
 
iv. Seizures (convulsions in which AS patient’s body shakes rapidly and uncontrollably)
 
v. Developmental delay
 
vi. Feeding problems
 
vii. Hypopigmentation (the loss of skin color)
 
viii. Frequently drooling
 
ix. Tend to put objects in mouth
 
The facial features general physical appearances are generally normal for the individual of Angelman syndrome. As the child with AS growing up, the correct diagnosis may become evident when speech is essentially absent and the attempts at walking are compromised because of sever ataxia. In addition, the seizures will occur more frequently after 1 year of age.
 
In conclusion, the individual of Angelman syndrome may be hyperexcitable with excessive laughing, grabbing and pulling to engage others. They are just like the ‘Angels’ who always bring happiness to people. Usually, the parents may be the first to suggest the possibility of Angelman syndrome. Thus, earlier detection of this genetic disorder may help the children to overcome the learning problem through the assessment from the clinical experts.
 

My ultimate hope is this Cytogenetics and Cancer Research blog can really help in increasing the awareness of people about the genetic disorders and cancer.

Prader-Willi syndrome or PWS syndrome is thought to be one of the most common genetic disorders. Prader-Willi syndrome and Angelman syndrome were the first examples in humans of genomic imprinting in Cytogenetics. Angelman syndrome has an entirely different clinical condition with PWS syndrome. I will explain about the Angelman syndrome in my future post.
 
What is genomic imprinting? Imprinting is a type of marking process that has a memory. Genomic imprinting is where a segment of DNA is marked or imprinted during gametogenesis. This mark will be retained and recognized throughout the life of the individual. Maternal and paternal inherited alleles will be marked differently and are expressed differently in the offsprings. Therefore, the offspring with the same genetic material will have different appearances. The individual with Prader-Willi syndrome is because the loss of paternally inherited region 15q11 – q13 of chromosome 15. Simple to say, the PWS individual does not inherit the region 15q11 – q13 of chromosome 15 from his/her father but only from mother.

Prader-Willi syndrome is the most common genetic cause of marked obesity in humans according to Cytogenetics. It is a complex disorder with cardinal features of
 
i)    Infantile hypotonia (low muscle tone)
 
ii)   Mild growth retardation
 
iii)  Frequent occurrence of breech presentation (baby enters the birth canal with the buttocks or feet first)
 
iv)  Small hands and feet with gracile and tapering fingers
 
v)   Microcephaly (smaller head)
 
vi)  Almond-shaped eyes
 
vii) Mental deficiency (average IQ of 65)
 
viii) Short stature and so on.
 
From the age of about one and half years onward, hyperphagia becomes a serious problem, leading to gross obesity. Due to hyperphagia and gross obesity, diabetes often sets in during adolescence or later. Epilepsy is found in a minority of cases. Mental development is characterised by moderate to severe retardation with tendency to behaviour disorders, especially reactive to food deprivation. Patients with this syndrome may need specialists for assessment and treatment of their behavioural and learning problems, at the beginning of childhood. Prader-Willi syndrome is present in all races and ethnic groups and most cases are sporadic.
 
In conclusion, Prader-willi syndrome is a genetic disorder that needs treatment and assessment to overcome the learning problem and obesity problem of the patients. I will write a series of Prader-Willi syndrome in this Cytogenetics and Cancer Research blog in order to give people a clear mind about this syndrome. Stay tuned!