Background: DiGeorge syndrome (also known as velo-cardio-facial syndrome) is a rare multisystem genetic disorder occurring in approximately 1 in 4000 to 1 in 6000 live births [1]. Although advances in genetic screenin...Background: DiGeorge syndrome (also known as velo-cardio-facial syndrome) is a rare multisystem genetic disorder occurring in approximately 1 in 4000 to 1 in 6000 live births [1]. Although advances in genetic screening have improved diagnosis in developed countries, the condition remains underdiagnosed in developing nations such as the Republic of Moldova, where access to genetic testing and family planning services is limited. Routine prenatal screening usually includes regular ultrasounds, monitoring of blood pressure, complete blood counts, coagulation studies, glucose, urine protein, and urine culture. Current ultrasound techniques have limitations in detecting this syndrome due to variability in interpretation, and genetic testing is often performed based on clinical discretion. The ultrasound could potentially point towards a genetic problem, as in DiGeorge, if multiple cardiac malformations are spotted in utero, but most cases such as this one are diagnosed after birth while being described as totally normal on prenatal ultrasound. Purpose: This study aims to highlight the diagnostic challenges and the need for comprehensive evaluation in identifying DiGeorge syndrome, emphasizing the importance of considering the syndrome as a whole rather than focusing on isolated organ system issues. Method: We present a case report of a 6-month-old girl who, after an uneventful pregnancy and normal prenatal ultrasound, presented with cardiac insufficiency. Following extensive investigations and multiple surgical interventions, DiGeorge syndrome was diagnosed at 9 months of age. Results: The patient’s diagnosis was delayed due to the lack of prenatal markers and the reliance on separate investigations of affected organ systems. Despite several interventions aimed at managing her symptoms, the final diagnosis was made after observing the association of multiple clinical features and conducting comprehensive genetic testing. Conclusions: This case underscores the importance of a holistic approach to diagnosis, which inv展开更多
We report a 32 year-old Chinese lady with history of tetralogy of Fallot, presented to us with chest pain due to hypocalcemia secondary to hypoparathyroidism. With her dysmerphic facial features and intellectual disab...We report a 32 year-old Chinese lady with history of tetralogy of Fallot, presented to us with chest pain due to hypocalcemia secondary to hypoparathyroidism. With her dysmerphic facial features and intellectual disability 22q11.2 deletion was suspected and confirmed by genetic study. Clinicians should consider the diagnosis of DiGeorge syndrome in adult patient with past medical history of congenital heart disease, facial dysmorphism, intellectual disability and primary hypoparathyroidism.展开更多
Approximately 31%of patients with 22q11.2 deletion syndrome(22q11.2DS)have genitourinary system disorders and 6%of them have undescended testes.Haploinsufficiency of genes on chromosome 22q11.2 might contribute to the...Approximately 31%of patients with 22q11.2 deletion syndrome(22q11.2DS)have genitourinary system disorders and 6%of them have undescended testes.Haploinsufficiency of genes on chromosome 22q11.2 might contribute to the risk of 22q11.2DS.In this study,we used mice with single-allele deletion in mitochondrial ribosomal protein L4o(Mrpl40-)as models to investigate the function of Mrpl40 in testes and spermatozoa development.The penetrance of cryptorchidism in Mrpl40+-mice was found to be higher than that in wild-type(WT)counterparts.Although the weight of testes was not significantly different between the WT and Mrpl40+-mice,the structure of seminiferous tubules and mitochondrial morphology was altered in the Mrpl40+-mice.Moreover,the concentration and motility of spermatozoa were significantly decreased in the Mrpl4O+-mice.In addition,data-independent acquisition mass spectrometry indicated that the expression of genes associated with male infertility was altered in Mrpl40+-testes.Our study demonstrated the important role of Mrpl40 in testicular structure and spermatozoa motility and count.These findings suggest that Mrpl4o is potentially a novel therapeutic target for cryptorchidism and decreased motility and count of spermatozoa.展开更多
The TBX1 gene is considered to be the most important gene in the aetiology of DiGeorge syndrome （DGS）.DGS is a human disorder characterised by a number of phenotypic features involving abnormal development of pharyn...The TBX1 gene is considered to be the most important gene in the aetiology of DiGeorge syndrome （DGS）.DGS is a human disorder characterised by a number of phenotypic features involving abnormal development of pharyngeal arches, facial dysmorphogenesis and cardiac outflow tract anomalies. Retinoic acid （RA） deficiency also produces DGS-like phenotypes. The affectd tissues in DGS are derivatives of neural crest cells （NCCs）, which originate from the border between the neural plate and non-neural ectoderm, migrate to specific destinations in the body, and generate a variety of derivatives. In our study, we have explored the hypothesis that tbxl affects NCC development in zebrafish by regulating RA signaling.展开更多
Background: Individuals with 22q11.2DS, a genetic subtype of Schizophrenia, respond as well to clozapine as those with other forms of Schizophrenia. It has been reported that serious and rare adverse events like seizu...Background: Individuals with 22q11.2DS, a genetic subtype of Schizophrenia, respond as well to clozapine as those with other forms of Schizophrenia. It has been reported that serious and rare adverse events like seizures, and myocarditis have been associated with clozapine treatment in this population. To the best of our knowledge, the incidence of neuroleptic malignant syndrome (NMS) as an adverse effect of antipsychotic use in patients with this disorder has not yet been reported. Aim: In this article, we discuss a case of clozapine-induced NMS and subsequent re-challenge in a patient with 22q11.2DS-associated schizophrenia. The aim of this study is to accumulate scientific data about rare presentations, and serve as a major educational tool, and highlight the unique challenges faced when using clozapine in a patient with DiGeorge Syndrome. Methods: This is a descriptive case report of a patient encountered in the inpatient unit which includes retrospective review of the patient’s electronic medical record and a literature review of antipsychotic medications-induced NMS. Conclusion: This study demonstrates a successful re-challenge with clozapine after the patient developed NMS and seizures during the initial treatment and also highlights how, in addition to drug level monitoring, considering pharmacogenetic testing early in treatment might help minimize adverse drug reactions in individuals with known genetic disorders such as 22q11.2DS.展开更多
Background Di George syndrome（DGS） is the most common microdeletion syndrome in humans and a disorder caused by a defect in chromosome 22. Almost 80% of DGS patients manifest congenital heart defects（CHD）, which a...Background Di George syndrome（DGS） is the most common microdeletion syndrome in humans and a disorder caused by a defect in chromosome 22. Almost 80% of DGS patients manifest congenital heart defects（CHD）, which are highly variable and severe. However, the genetics of CHD in DGS remain elusive. This review concludes that the TBX1 gene plays a critical role in cardiovascular defects, involving many additional genes, such as Six1, Eya1, Fgf8, Fox, and Shh. Concerning the variable manifestations of CHD in DGS,additional modifiers have been shown of involvement, such as Wnt, MOZ, micro RNAs, VEGF, and CRK.Knowledge of the genetics underlying CHD in DGS has the potential to early detection and treatment of this disease.展开更多
We present the case history of a 3-year-old girl who was examined because of severe dystrophy.In the background,cow’s milk allergy was found,but her body weight was unchanged after eliminating milk from her diet.Othe...We present the case history of a 3-year-old girl who was examined because of severe dystrophy.In the background,cow’s milk allergy was found,but her body weight was unchanged after eliminating milk from her diet.Other types of malabsorption were excluded.Based on nasal regurgitation and facial dysmorphisms,the possibility of DiGeorge syndrome was suspected and was confirmed by fluorescence in situ hybridization.The authors suggest a new feature associated with DiGeorge syndrome.展开更多
We report the development and spontaneous resolution of annular erythematous skin lesions consistent with sarcoid dermatitis in a child with DiGeorge syndrome (DGS) carrying the 22q11.2 microdeletion. The skin lesion ...We report the development and spontaneous resolution of annular erythematous skin lesions consistent with sarcoid dermatitis in a child with DiGeorge syndrome (DGS) carrying the 22q11.2 microdeletion. The skin lesion developed after she was treated with isoniazid (INH) following exposure to active tuberculosis (TB). After resolution of the skin lesions, this child developed sterile hyperplastic osteomyelitis consistent with SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) osteomyelitis in her right mandible triggered by an odontogenic infection. This child had congenital heart disease, dysmorphic facies, recurrent sinopulmonary infection, gastroesophgeal re- flux disease, scoliosis, reactive periostitis, and developmental delay. She had a low CD4 and CD8 T cell count with a normal 4/8 ratio, but normal cell proliferation and T cell cytokine production in response to mitogens. When she was presented with sterile osteomyelitis of right mandible, she revealed polyclonal hypergammaglobulinemia with elevated erythrocyte sedimentation rate (ESR)/ angiotensin converting enzyme (ACE) levels, but negative CRP. Autoimmune and sarcoidosis workup was negative. Inflammatory parameters gradually normalized following resolution of odontogenic infection and with the use of non- steroidal anti- inflammatory drugs (NSAIDs). The broad clinical spectrum of DGS is further expanded with the development of autoimmune and inflammatory complications later in life. This case suggests that patients with the DGS can present with unusual sterile inflammatory lesions triggered by environmental factors, further broadening the clinical spectrum of this syndrome.展开更多
在发育儿科门诊中,经常会遇到一些伴有特殊面容或特殊行为的发育障碍儿童,临床医生可以像掌握唐氏综合症特殊面容那样,通过识别这些发育障碍儿童的特殊面容或行为疑诊为某种疾病。伴有特殊面容或行为的常见发育障碍疾病包括William综合...在发育儿科门诊中,经常会遇到一些伴有特殊面容或特殊行为的发育障碍儿童,临床医生可以像掌握唐氏综合症特殊面容那样,通过识别这些发育障碍儿童的特殊面容或行为疑诊为某种疾病。伴有特殊面容或行为的常见发育障碍疾病包括William综合征,Cornelia de Lange综合征,脆性X综合征,Rett综合征,DiGeorge综合征及Prader-Willi综合征。对于以多动症为主诉的患儿,应注意William综合征,该病除了有多动的表现之外,还伴有过度活泼,热情,常见的特殊面容有眶周丰满,面颊突出,嘴唇厚,嘴巴宽,人中长,鼻梁扁平。对于语言发育迟缓或构音障碍为主诉的患儿,应注意DiGeorge综合征,DiGeorge综合征除了语言发育迟缓或/和构音障碍以外,还伴有腭咽功能不全,学习障碍,以及小下颌、低耳位和耳廓异常等特殊面容。怀疑William综合征及DiGeorge综合征时需要做MLPA或array-CGH检查,二者分别为7q11.2及22q11.2微缺失。另外,在发育迟缓或矮小的患儿当中,还应注意Cornelia de Lange综合征,该病除了发育迟缓及矮小的表现外,还伴有连眉,弓形眉,睫毛长且弯曲浓密,前额多毛,鼻梁扁平,短鼻、鼻孔前倾,人中长等特殊面容,确诊本病需要做NIPBL基因、SMC1A基因、SMC3基因、RAD21基因及HDAC8基因分析,其中NIPBL基因突变达50%以上。在男性孤独症或智力低下的患儿中,应注意脆性X综合征,该病除了孤独症及智力低下表现,还伴有脸形较长,双耳明显大,前额和下颌突出,嘴大唇厚,高腭弓等特殊面容,确诊需要做FMR-1基因分析。在女性孤独症、发育迟缓或发育倒退的患儿中,应注意Rett综合征,Rett综合征除了有上述表现,还伴有手的刻板动作(绞手、拍手、拍打、咬手、搓手等),确诊需要做MECP2基因分析。在婴幼儿期表现为营养不良、体重不增或发育迟缓以及儿童期表现为肥胖的患儿中,应注意Prader-Willi综合征,Prader-Willi综合征展开更多
目的:利用运输和高尔基体组织蛋白2同系物(transport and Golgi organization protein 2 homolog,TANGO2)敲除小鼠阐明TANGO2在哺乳动物中的生理功能,探究TANGO2是否是导致DiGeorge综合征发生的候选基因。方法:制备TANGO2敲除小鼠模型,...目的:利用运输和高尔基体组织蛋白2同系物(transport and Golgi organization protein 2 homolog,TANGO2)敲除小鼠阐明TANGO2在哺乳动物中的生理功能,探究TANGO2是否是导致DiGeorge综合征发生的候选基因。方法:制备TANGO2敲除小鼠模型,通过实时荧光定量PCR检测该小鼠模型的基因敲除效率。观察并记录野生型、杂合和纯合敲除小鼠的表型和生长繁育情况。通过组织解剖和组织学分析,观察野生型和敲除小鼠的心脏和大脑组织的形态结构。结果:TANGO2 mRNA在野生型小鼠的心脏和大脑中表达,而在敲除小鼠相应组织中的表达水平显著降低。TANGO2敲除小鼠发育正常,能够存活和繁殖,没有明显的表型异常。与野生型同窝仔相比,生存率没有显著差异。组织形态分析显示,新生敲除小鼠和6月龄敲除小鼠的心脏和大脑与野生型之间无明显差异。结论:TANGO2敲除小鼠能够正常发育和繁殖,并且缺乏人类中TANGO2相关疾病或DiGeorge综合征的相关表型。展开更多
文摘Background: DiGeorge syndrome (also known as velo-cardio-facial syndrome) is a rare multisystem genetic disorder occurring in approximately 1 in 4000 to 1 in 6000 live births [1]. Although advances in genetic screening have improved diagnosis in developed countries, the condition remains underdiagnosed in developing nations such as the Republic of Moldova, where access to genetic testing and family planning services is limited. Routine prenatal screening usually includes regular ultrasounds, monitoring of blood pressure, complete blood counts, coagulation studies, glucose, urine protein, and urine culture. Current ultrasound techniques have limitations in detecting this syndrome due to variability in interpretation, and genetic testing is often performed based on clinical discretion. The ultrasound could potentially point towards a genetic problem, as in DiGeorge, if multiple cardiac malformations are spotted in utero, but most cases such as this one are diagnosed after birth while being described as totally normal on prenatal ultrasound. Purpose: This study aims to highlight the diagnostic challenges and the need for comprehensive evaluation in identifying DiGeorge syndrome, emphasizing the importance of considering the syndrome as a whole rather than focusing on isolated organ system issues. Method: We present a case report of a 6-month-old girl who, after an uneventful pregnancy and normal prenatal ultrasound, presented with cardiac insufficiency. Following extensive investigations and multiple surgical interventions, DiGeorge syndrome was diagnosed at 9 months of age. Results: The patient’s diagnosis was delayed due to the lack of prenatal markers and the reliance on separate investigations of affected organ systems. Despite several interventions aimed at managing her symptoms, the final diagnosis was made after observing the association of multiple clinical features and conducting comprehensive genetic testing. Conclusions: This case underscores the importance of a holistic approach to diagnosis, which inv
文摘We report a 32 year-old Chinese lady with history of tetralogy of Fallot, presented to us with chest pain due to hypocalcemia secondary to hypoparathyroidism. With her dysmerphic facial features and intellectual disability 22q11.2 deletion was suspected and confirmed by genetic study. Clinicians should consider the diagnosis of DiGeorge syndrome in adult patient with past medical history of congenital heart disease, facial dysmorphism, intellectual disability and primary hypoparathyroidism.
基金supported by grants from the National Natural Science Foundation of China(No.81803116 and No.32001072)Open Project Fund from NHC Key Laboratory of Male Reproductive Health/National Research Institute for Family Planning(2022GJP0102)+1 种基金Non-profit Central Research Institute Fund of National Research Institute For Family Planing(2022GJM02)Start-up Fund(Q410800320)from Soochow University.
文摘Approximately 31%of patients with 22q11.2 deletion syndrome(22q11.2DS)have genitourinary system disorders and 6%of them have undescended testes.Haploinsufficiency of genes on chromosome 22q11.2 might contribute to the risk of 22q11.2DS.In this study,we used mice with single-allele deletion in mitochondrial ribosomal protein L4o(Mrpl40-)as models to investigate the function of Mrpl40 in testes and spermatozoa development.The penetrance of cryptorchidism in Mrpl40+-mice was found to be higher than that in wild-type(WT)counterparts.Although the weight of testes was not significantly different between the WT and Mrpl40+-mice,the structure of seminiferous tubules and mitochondrial morphology was altered in the Mrpl40+-mice.Moreover,the concentration and motility of spermatozoa were significantly decreased in the Mrpl4O+-mice.In addition,data-independent acquisition mass spectrometry indicated that the expression of genes associated with male infertility was altered in Mrpl40+-testes.Our study demonstrated the important role of Mrpl40 in testicular structure and spermatozoa motility and count.These findings suggest that Mrpl4o is potentially a novel therapeutic target for cryptorchidism and decreased motility and count of spermatozoa.
基金This work was supported by the grants from the National Natural Science Foundation of China （No. 30772352 and No. 30972959）.
文摘The TBX1 gene is considered to be the most important gene in the aetiology of DiGeorge syndrome （DGS）.DGS is a human disorder characterised by a number of phenotypic features involving abnormal development of pharyngeal arches, facial dysmorphogenesis and cardiac outflow tract anomalies. Retinoic acid （RA） deficiency also produces DGS-like phenotypes. The affectd tissues in DGS are derivatives of neural crest cells （NCCs）, which originate from the border between the neural plate and non-neural ectoderm, migrate to specific destinations in the body, and generate a variety of derivatives. In our study, we have explored the hypothesis that tbxl affects NCC development in zebrafish by regulating RA signaling.
文摘Background: Individuals with 22q11.2DS, a genetic subtype of Schizophrenia, respond as well to clozapine as those with other forms of Schizophrenia. It has been reported that serious and rare adverse events like seizures, and myocarditis have been associated with clozapine treatment in this population. To the best of our knowledge, the incidence of neuroleptic malignant syndrome (NMS) as an adverse effect of antipsychotic use in patients with this disorder has not yet been reported. Aim: In this article, we discuss a case of clozapine-induced NMS and subsequent re-challenge in a patient with 22q11.2DS-associated schizophrenia. The aim of this study is to accumulate scientific data about rare presentations, and serve as a major educational tool, and highlight the unique challenges faced when using clozapine in a patient with DiGeorge Syndrome. Methods: This is a descriptive case report of a patient encountered in the inpatient unit which includes retrospective review of the patient’s electronic medical record and a literature review of antipsychotic medications-induced NMS. Conclusion: This study demonstrates a successful re-challenge with clozapine after the patient developed NMS and seizures during the initial treatment and also highlights how, in addition to drug level monitoring, considering pharmacogenetic testing early in treatment might help minimize adverse drug reactions in individuals with known genetic disorders such as 22q11.2DS.
基金supported by the Major International(Regional)Joint Research Project of Ministry of Science and Technology of China(No.2010DFA32260/No.2008DFA31140)National Natural Science Foundation of China(No.81370230)+2 种基金Technology Foundation for Selected Overseas Chinese Scholar of Ministry of Human Resources and Social Security of China(Ping Zhu)Key Technologies Research and Development Program of China(No.2011BAI11B22)Guangdong Province Natural Science Fund(No.S2013010014009)
文摘Background Di George syndrome（DGS） is the most common microdeletion syndrome in humans and a disorder caused by a defect in chromosome 22. Almost 80% of DGS patients manifest congenital heart defects（CHD）, which are highly variable and severe. However, the genetics of CHD in DGS remain elusive. This review concludes that the TBX1 gene plays a critical role in cardiovascular defects, involving many additional genes, such as Six1, Eya1, Fgf8, Fox, and Shh. Concerning the variable manifestations of CHD in DGS,additional modifiers have been shown of involvement, such as Wnt, MOZ, micro RNAs, VEGF, and CRK.Knowledge of the genetics underlying CHD in DGS has the potential to early detection and treatment of this disease.
文摘We present the case history of a 3-year-old girl who was examined because of severe dystrophy.In the background,cow’s milk allergy was found,but her body weight was unchanged after eliminating milk from her diet.Other types of malabsorption were excluded.Based on nasal regurgitation and facial dysmorphisms,the possibility of DiGeorge syndrome was suspected and was confirmed by fluorescence in situ hybridization.The authors suggest a new feature associated with DiGeorge syndrome.
文摘We report the development and spontaneous resolution of annular erythematous skin lesions consistent with sarcoid dermatitis in a child with DiGeorge syndrome (DGS) carrying the 22q11.2 microdeletion. The skin lesion developed after she was treated with isoniazid (INH) following exposure to active tuberculosis (TB). After resolution of the skin lesions, this child developed sterile hyperplastic osteomyelitis consistent with SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) osteomyelitis in her right mandible triggered by an odontogenic infection. This child had congenital heart disease, dysmorphic facies, recurrent sinopulmonary infection, gastroesophgeal re- flux disease, scoliosis, reactive periostitis, and developmental delay. She had a low CD4 and CD8 T cell count with a normal 4/8 ratio, but normal cell proliferation and T cell cytokine production in response to mitogens. When she was presented with sterile osteomyelitis of right mandible, she revealed polyclonal hypergammaglobulinemia with elevated erythrocyte sedimentation rate (ESR)/ angiotensin converting enzyme (ACE) levels, but negative CRP. Autoimmune and sarcoidosis workup was negative. Inflammatory parameters gradually normalized following resolution of odontogenic infection and with the use of non- steroidal anti- inflammatory drugs (NSAIDs). The broad clinical spectrum of DGS is further expanded with the development of autoimmune and inflammatory complications later in life. This case suggests that patients with the DGS can present with unusual sterile inflammatory lesions triggered by environmental factors, further broadening the clinical spectrum of this syndrome.
文摘在发育儿科门诊中,经常会遇到一些伴有特殊面容或特殊行为的发育障碍儿童,临床医生可以像掌握唐氏综合症特殊面容那样,通过识别这些发育障碍儿童的特殊面容或行为疑诊为某种疾病。伴有特殊面容或行为的常见发育障碍疾病包括William综合征,Cornelia de Lange综合征,脆性X综合征,Rett综合征,DiGeorge综合征及Prader-Willi综合征。对于以多动症为主诉的患儿,应注意William综合征,该病除了有多动的表现之外,还伴有过度活泼,热情,常见的特殊面容有眶周丰满,面颊突出,嘴唇厚,嘴巴宽,人中长,鼻梁扁平。对于语言发育迟缓或构音障碍为主诉的患儿,应注意DiGeorge综合征,DiGeorge综合征除了语言发育迟缓或/和构音障碍以外,还伴有腭咽功能不全,学习障碍,以及小下颌、低耳位和耳廓异常等特殊面容。怀疑William综合征及DiGeorge综合征时需要做MLPA或array-CGH检查,二者分别为7q11.2及22q11.2微缺失。另外,在发育迟缓或矮小的患儿当中,还应注意Cornelia de Lange综合征,该病除了发育迟缓及矮小的表现外,还伴有连眉,弓形眉,睫毛长且弯曲浓密,前额多毛,鼻梁扁平,短鼻、鼻孔前倾,人中长等特殊面容,确诊本病需要做NIPBL基因、SMC1A基因、SMC3基因、RAD21基因及HDAC8基因分析,其中NIPBL基因突变达50%以上。在男性孤独症或智力低下的患儿中,应注意脆性X综合征,该病除了孤独症及智力低下表现,还伴有脸形较长,双耳明显大,前额和下颌突出,嘴大唇厚,高腭弓等特殊面容,确诊需要做FMR-1基因分析。在女性孤独症、发育迟缓或发育倒退的患儿中,应注意Rett综合征,Rett综合征除了有上述表现,还伴有手的刻板动作(绞手、拍手、拍打、咬手、搓手等),确诊需要做MECP2基因分析。在婴幼儿期表现为营养不良、体重不增或发育迟缓以及儿童期表现为肥胖的患儿中,应注意Prader-Willi综合征,Prader-Willi综合征
文摘目的:利用运输和高尔基体组织蛋白2同系物(transport and Golgi organization protein 2 homolog,TANGO2)敲除小鼠阐明TANGO2在哺乳动物中的生理功能,探究TANGO2是否是导致DiGeorge综合征发生的候选基因。方法:制备TANGO2敲除小鼠模型,通过实时荧光定量PCR检测该小鼠模型的基因敲除效率。观察并记录野生型、杂合和纯合敲除小鼠的表型和生长繁育情况。通过组织解剖和组织学分析,观察野生型和敲除小鼠的心脏和大脑组织的形态结构。结果:TANGO2 mRNA在野生型小鼠的心脏和大脑中表达,而在敲除小鼠相应组织中的表达水平显著降低。TANGO2敲除小鼠发育正常,能够存活和繁殖,没有明显的表型异常。与野生型同窝仔相比,生存率没有显著差异。组织形态分析显示,新生敲除小鼠和6月龄敲除小鼠的心脏和大脑与野生型之间无明显差异。结论:TANGO2敲除小鼠能够正常发育和繁殖,并且缺乏人类中TANGO2相关疾病或DiGeorge综合征的相关表型。
