The Turkish Journal of Pediatrics
2014 , Vol 56 , Num 2
The Significance of Molecular Studies in the Long-Term Follow-Up of Children with Beckwith- Wiedemann Syndrome
Departments of 1Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology, 4Pediatrics, Hematology
and Oncology, 5Pediatric Surgery and Oncology, 6Pediatrics, Nephrology with Dializotherapy and Management of Acute
Poisoning, Pomeranian Medical University, Szczecin, Poland; 2Division of Human Genetics, University of Southampton,
Southampton, United Kingdom; 3Wessex Regional Genetics Laboratory, Salisbury District Hospital, Salisbury, United
Kingdom. E-mail: maria.gizewska@gmail.com
Beckwith–Wiedemann syndrome (BWS) is a congenital disorder of imprinting
caused by epimutations and mutations affecting two imprinted loci on
chromosome 11p15. Its clinical features are heterogeneous, including
macrosomia, macroglossia, hemihyperplasia, abdominal wall defects, neonatal
hypoglycemia, and increased risk of embryonal tumors such as Wilms tumor,
adrenocortical carcinoma, hepatoblastoma, and neuroblastoma. The molecular
and clinical heterogeneity of BWS makes the diagnosis challenging, but essential,
since different etiologies of BWS have different clinical prognoses - most
crucially, patients with gain of maternal methylation at imprinting control
region type 1 (ICR1) are at significant risk of Wilms tumor or hepatoblastoma.
We present three cases of BWS with different symptomatology and two different molecular diagnoses. The authors emphasize the importance of molecular studies in the long-term follow-up of children with BWS, including refinement of phenotype-genotype correlation and its connection with optimal management and tumor surveillance.
Keywords : Beckwith–Wiedemann syndrome (BWS), methylation, imprinting disorder, chromosome 11p15.