About 22q11.2 Deletion Syndrome
22q11.2 deletion syndrome (also called DiGeorge syndrome or velocardiofacial syndrome) results from a 1.5-3 Mb microdeletion on chromosome 22q11.2, affecting approximately 50 genes. This is the most common recurrent microdeletion in humans, occurring in approximately 1 in 2,000-4,500 people. The deletion results from non-allelic homologous recombination between low copy repeats (LCRs) flanking the 22q11.2 region.
Clinical manifestations are highly variable due to variable breakpoints and gene dosage effects, even among family members. The 'CATCH-22' mnemonic describes cardinal features: Cardiac defects (occurring in ~75-80%, especially conotruncal abnormalities including tetralogy of Fallot, truncus arteriosus, and interrupted aortic arch), Abnormal facies (dysmorphic features), Cleft palate or velopharyngeal insufficiency (occurring in ~30-40%), Thymic hypoplasia (causing variable immunodeficiency in ~75%), Hypocalcemia (from parathyroid hypoplasia in ~50%), and 22q11 deletion. Additional features include learning disability and developmental delay (occurring in ~70%), speech delays, hearing loss, renal anomalies, and increased psychiatric manifestations particularly schizophrenia.
Common Symptoms of 22q11.2 Deletion Syndrome
Recognizing the signs of 22q11.2 Deletion Syndrome early can lead to faster diagnosis and better outcomes. Symptoms may vary in severity from person to person. If you or a loved one are experiencing any of the following, consider speaking with a specialist.
- Cardiac defects (conotruncal abnormalities, especially Tetralogy of Fallot)
- Cleft palate and velopharyngeal insufficiency
- Immune deficiency from thymic hypoplasia
- Hypocalcemia and hypoparathyroidism
- Intellectual and developmental disability
- Learning problems and speech delays
Who 22q11.2 Deletion Syndrome Affects
22q11.2 deletion syndrome shows autosomal dominant inheritance; approximately 90% of cases represent de novo (new) mutations, while approximately 10% are inherited from an affected parent with variable expressivity.
The condition affects males and females equally. The deletion occurs across all ethnic groups and geographic populations without significant population predisposition or founder effects. Prognosis varies significantly based on the specific genes involved and the presence or severity of cardiac abnormalities, immunodeficiency, and psychiatric manifestations.
Early diagnosis (through prenatal diagnosis, newborn screening, or clinical recognition in infancy) enables preventive measures and early intervention. Recurrence risk for unaffected parents is <1%; for an affected parent, the recurrence risk is 50% per pregnancy (though expressivity is variable). Germline mosaicism has been reported rarely in phenotypically normal parents.
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Trusted 22q11.2 Deletion Syndrome Resources
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