Skip to main content
Top
Published in: Orphanet Journal of Rare Diseases 1/2016

Open Access 01-12-2016 | Research

Phenotype and natural history in 101 individuals with Pitt-Hopkins syndrome through an internet questionnaire system

Authors: Channa F. de Winter, Melanie Baas, Emilia K. Bijlsma, John van Heukelingen, Sue Routledge, Raoul C. M. Hennekam

Published in: Orphanet Journal of Rare Diseases | Issue 1/2016

Login to get access

Abstract

Background

Pitt-Hopkins syndrome (PTHS; MIM# 610954) is a genetically determined entity mainly caused by mutations in TransCription Factor 4 (TCF4). We have developed a new way to collect information on (ultra-)rare disorders through a web-based database which we call ‘waihonapedia’ (waihona [meaning treasure in Hawaiian] encyclopaedia).

Methods

We have built a waihonapedia system in a collaboration between physicians, social scientists, and parent support groups. The system consists of an initial extensive questionnaire for background cross-sectional data, and subsequent follow-up using small questionnaires, with a particular focus on behavioural aspects. The system was built to be used through the internet, ensuring a secure environment, respecting privacy for participants, and acting automated to allow for low costs and limiting human mistakes in data handling. Recruitment of participants is through the patient support groups. In addition, as a sub-study, we used the data from the waihonapedia system to compare the two proposed diagnostic classification systems for PTHS.

Results

We present here the results of the initial, cross-sectional questionnaire in which early development, physical health, cognition and behaviour are interrogated, and to which modules specific for PTHS were added on epilepsy and breathing patterns. We describe 101 individuals with a molecularly confirmed diagnosis of PTHS.
Comparison of the two classification systems aimed at helping the clinical diagnosis was performed in 47 of the present PTHS individuals, with disappointing results for both. Internationally accepted clinical diagnostic criteria are needed.

Conclusion

The present cross-sectional data on the natural history of PTHS have yielded useful information which will further increase when follow-up data will be added. No doubt this will improve both care and research.
Literature
1.
go back to reference Pitt D, Hopkins I. A syndrome of mental retardation, wide mouth and intermittent overbreathing. Aust Paediatr J. 1978;14(3):182–4.PubMed Pitt D, Hopkins I. A syndrome of mental retardation, wide mouth and intermittent overbreathing. Aust Paediatr J. 1978;14(3):182–4.PubMed
2.
go back to reference Peippo MM et al. Pitt-Hopkins syndrome in two patients and further definition of the phenotype. Clin Dysmorphol. 2006;15(2):47–54.CrossRefPubMed Peippo MM et al. Pitt-Hopkins syndrome in two patients and further definition of the phenotype. Clin Dysmorphol. 2006;15(2):47–54.CrossRefPubMed
3.
go back to reference Whalen S et al. Novel comprehensive diagnostic strategy in Pitt-Hopkins syndrome: clinical score and further delineation of the TCF4 mutational spectrum. Hum Mutat. 2012;33(1):64–72.CrossRefPubMed Whalen S et al. Novel comprehensive diagnostic strategy in Pitt-Hopkins syndrome: clinical score and further delineation of the TCF4 mutational spectrum. Hum Mutat. 2012;33(1):64–72.CrossRefPubMed
4.
go back to reference Marangi G et al. The Pitt-Hopkins syndrome: report of 16 new patients and clinical diagnostic criteria. Am J Med Genet A. 2011;155A(7):1536–45.CrossRefPubMed Marangi G et al. The Pitt-Hopkins syndrome: report of 16 new patients and clinical diagnostic criteria. Am J Med Genet A. 2011;155A(7):1536–45.CrossRefPubMed
5.
go back to reference Rosenfeld JA et al. Genotype-phenotype analysis of TCF4 mutations causing Pitt-Hopkins syndrome shows increased seizure activity with missense mutations. Genet Med. 2009;11(11):797–805.CrossRefPubMed Rosenfeld JA et al. Genotype-phenotype analysis of TCF4 mutations causing Pitt-Hopkins syndrome shows increased seizure activity with missense mutations. Genet Med. 2009;11(11):797–805.CrossRefPubMed
6.
go back to reference Ardinger HH, Welsh HI, Saunders CJ. Pitt-Hopkins Syndrome. 1993. Ardinger HH, Welsh HI, Saunders CJ. Pitt-Hopkins Syndrome. 1993.
7.
go back to reference Zweier C et al. Haploinsufficiency of TCF4 causes syndromal mental retardation with intermittent hyperventilation (Pitt-Hopkins syndrome). Am J Hum Genet. 2007;80(5):994–1001.CrossRefPubMedPubMedCentral Zweier C et al. Haploinsufficiency of TCF4 causes syndromal mental retardation with intermittent hyperventilation (Pitt-Hopkins syndrome). Am J Hum Genet. 2007;80(5):994–1001.CrossRefPubMedPubMedCentral
8.
go back to reference Amiel J et al. Mutations in TCF4, encoding a class I basic helix-loop-helix transcription factor, are responsible for Pitt-Hopkins syndrome, a severe epileptic encephalopathy associated with autonomic dysfunction. Am J Hum Genet. 2007;80(5):988–93.CrossRefPubMedPubMedCentral Amiel J et al. Mutations in TCF4, encoding a class I basic helix-loop-helix transcription factor, are responsible for Pitt-Hopkins syndrome, a severe epileptic encephalopathy associated with autonomic dysfunction. Am J Hum Genet. 2007;80(5):988–93.CrossRefPubMedPubMedCentral
9.
go back to reference Brockschmidt A et al. Severe mental retardation with breathing abnormalities (Pitt-Hopkins syndrome) is caused by haploinsufficiency of the neuronal bHLH transcription factor TCF4. Hum Mol Genet. 2007;16(12):1488–94.CrossRefPubMed Brockschmidt A et al. Severe mental retardation with breathing abnormalities (Pitt-Hopkins syndrome) is caused by haploinsufficiency of the neuronal bHLH transcription factor TCF4. Hum Mol Genet. 2007;16(12):1488–94.CrossRefPubMed
10.
go back to reference de Pontual L et al. Mutational, functional, and expression studies of the TCF4 gene in Pitt-Hopkins syndrome. Hum Mutat. 2009;30(4):669–76.CrossRefPubMed de Pontual L et al. Mutational, functional, and expression studies of the TCF4 gene in Pitt-Hopkins syndrome. Hum Mutat. 2009;30(4):669–76.CrossRefPubMed
11.
go back to reference Zweier C et al. Further delineation of Pitt-Hopkins syndrome: phenotypic and genotypic description of 16 novel patients. J Med Genet. 2008;45(11):738–44.CrossRefPubMed Zweier C et al. Further delineation of Pitt-Hopkins syndrome: phenotypic and genotypic description of 16 novel patients. J Med Genet. 2008;45(11):738–44.CrossRefPubMed
12.
go back to reference Inati A et al. A case of Pitt-Hopkins syndrome with absence of hyperventilation. J Child Neurol. 2013;28(12):1698–701.CrossRefPubMed Inati A et al. A case of Pitt-Hopkins syndrome with absence of hyperventilation. J Child Neurol. 2013;28(12):1698–701.CrossRefPubMed
13.
go back to reference Marangi G et al. Proposal of a clinical score for the molecular test for Pitt-Hopkins syndrome. Am J Med Genet A. 2012;158A(7):1604–11.CrossRefPubMed Marangi G et al. Proposal of a clinical score for the molecular test for Pitt-Hopkins syndrome. Am J Med Genet A. 2012;158A(7):1604–11.CrossRefPubMed
14.
16.
Metadata
Title
Phenotype and natural history in 101 individuals with Pitt-Hopkins syndrome through an internet questionnaire system
Authors
Channa F. de Winter
Melanie Baas
Emilia K. Bijlsma
John van Heukelingen
Sue Routledge
Raoul C. M. Hennekam
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Orphanet Journal of Rare Diseases / Issue 1/2016
Electronic ISSN: 1750-1172
DOI
https://doi.org/10.1186/s13023-016-0422-2

Other articles of this Issue 1/2016

Orphanet Journal of Rare Diseases 1/2016 Go to the issue