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      Caracterización: fenotípica de varones adultos con diagnóstico de síndrome X frágil Translated title: Phenotypic characterization of adult men diagnosed with fragile X syndrome

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          Abstract

          El síndrome X frágil (SXF), constituye la primera causa de discapacidad intelectual hereditaria. Es una de las alteraciones más frecuentes aunque no siempre bien conocida por los profesionales de la salud, los educadores y la sociedad. El desconocimiento provoca que un porcentaje importante de afectados esté sin diagnosticar. Hay importantes diferencias entre comunidades autónomas, en algunas, el síndrome esta infradiagnosticado, no llevándose a cabo la detección, el consejo genético ni la adecuada intervención educativa. Tras revisar las características generales del SXF, presentamos el estudio realizado en la provincia de Burgos, recogiéndose datos de 273 varones con discapacidad intelectual, 57 fueron estudiados genéticamente resultando 13 nuevos afectados. Al menos, el 9,5% de varones atendidos en los centros de discapacidad intelectual en la provincia de Burgos, no diagnosticados por síndromes o discapacidades excluyentes, están afectados de SXF. La hoja de recogida de datos (HRD-1), seleccionó los participantes a estudiar genéticamente y con las modificaciones se ha obtenido la HRD-2, que consideramos sirve como protocolo facilitador para la preselección de posibles varones adultos afectados.

          Translated abstract

          Fragile X syndrome (FXS) is the first known cause of hereditary intellectual disability. Although one of the most common alterations, it is not always well known by health professionals, educators and society in general. This lack of knowledge means that a significant percentage of those affected are not diagnosed. Major differences among autonomous communities exist; in some of them, the syndrome is under diagnosed, due to non-detection, lack of genetic counselling or adequate educational intervention. After reviewing the general characteristics of FXS, we hereby present the study conducted in the province of Burgos, where data was gathered from 273 males with intellectual disability. 57 of them were genetically studied, resulting in the detection of 13 new cases of FXS. The data collection sheet (HRD-1) was the basis for selecting the participants to be studied; this, after undergoing the necessary modifications, resulted in HRD-2. We believe that this sheet can be used as a protocol to facilitate the pre-selection of possible affected adult males. At least 9.5% of males treated at the centres for the intellectually disabled in the province of Burgos, who have not been diagnosed with syndromes or exclusive disabilities, suffer from FXS.

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          Most cited references40

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          Intention tremor, parkinsonism, and generalized brain atrophy in male carriers of fragile X.

          The authors report five elderly men with the fragile X premutation who had a progressive action tremor associated with executive function deficits and generalized brain atrophy. These individuals had elevated fragile X mental retardation 1 gene (FMR1) messenger RNA and normal or borderline levels of FMR1 protein. The authors propose that elevations of FMR1 messenger RNA may be causative for a neurodegenerative syndrome in a subgroup of elderly men with the FMR1 premutation.
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            Association of FMR1 repeat size with ovarian dysfunction.

            Women who carry the FMR1 premutation allele have a significantly increased risk for ovarian dysfunction. We hypothesize that molecular characteristics of the FMR1 gene may explain this increased risk. Thus, we examined the effect of FMR1 CGG repeat size and related factors on measures of ovarian dysfunction using data from 507 women with a wide range of repeat sizes. We found a significant positive association of repeat size with ovarian dysfunction, but have preliminary evidence that this relationship is non-linear. We suggest that FMR1 repeat size in the lower range ( or =100 repeats).
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              FMR1 repeat sizes in the gray zone and high end of the normal range are associated with premature ovarian failure.

              Premature ovarian failure (POF) is the occurrence of menopause before the age of 40 and affects 1% of the female population. Whereas the etiology of POF is largely unexplained, FMR1 premutation carriers are known to be at increased risk of POF compared with the general population. The FMR1 premutation alleles have 55-200 copies of a CGG repeat in the 5' untranslated region of the FMR1 gene. However, functional effects on gene expression may occur even for repeat sizes in what has been considered the "normal" range. To evaluate the role of the FMR1 repeat in POF, repeat sizes were examined in 53 women with idiopathic POF, 161 control women from the general population, and 21 women with proven fertility at an advanced maternal age. A significant increase in the number of FMR1 alleles between and including 35 and 54 CGG repeats was found in the POF patient population; 15 of 106 (14.2%) POF alleles were between and including 35 and 54 repeats, whereas only 21 of 322 (6.5%) alleles in the general population (P=0.02) and 2 of 42 (4.8%) alleles from women with proven late fertility (P=0.09) were of this size (P=0.01 versus combined controls). The effect was also significant for comparisons of genotype repeat size (repeat size weighted by the relative activity of the two FMR1 alleles) and biallelic mean (average size of the two alleles). These results are clinically relevant and suggest that the FMR1 gene plays a more significant role in the incidence of POF than has previously been thought.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                inter
                Psychosocial Intervention
                Psychosocial Intervention
                Colegio Oficial de Psicólogos de Madrid (Madrid, Madrid, Spain )
                1132-0559
                2173-4712
                2008
                : 17
                : 2
                : 201-214
                Affiliations
                [01] Burgos orgnameUniversidad de Burgos orgdiv1Facultad de Humanidades y Educación igarcia@ 123456ubu.es
                Article
                S1132-05592008000200008
                10.4321/s1132-05592008000200008
                7c1ba9b9-83ca-4bd2-8cc3-3fd226ffb24a

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

                History
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 36, Pages: 14
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                SciELO Spain


                Fragile X syndrome,Phenotypic characteristics,Discapacidad intelectual,Síndrome x frágil,Características fenotípicas,Intellectual disabilities

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