About Phelan-McDermid Syndrome
Phelan-McDermid Syndrome results from deletion of chromosome 22q13 (the smallest deletion is 100 kb involving only SHANK3, while larger deletions involve multiple adjacent genes). The SHANK3 gene encodes a scaffold protein crucial for dendritic spine formation and stabilization, synaptic transmission, and neurodevelopment. SHANK3 is highly expressed in the brain and is critical for proper synaptic function and plasticity. Loss of SHANK3 leads to abnormal dendritic spine development, impaired glutamatergic synaptic transmission, and disrupted neural circuit development.
Clinical features of Phelan-McDermid Syndrome include significant intellectual disability (usually moderate to severe), autism spectrum features (present in 50-80% of individuals), and severe speech and language delay. Hypotonia is common in infancy, improving somewhat with development but often resulting in motor delays and coordination problems. Seizures occur in 25-40% of individuals and may be difficult to manage. Behavioral challenges including autism features, anxiety, self-injurious behaviors, and attention problems are common. Some individuals have distinctive facial features and other minor dysmorphisms. Growth may be affected with some children showing failure to thrive or short stature. Cardiac defects and renal anomalies occur in some cases.
Common Symptoms of Phelan-McDermid Syndrome
Recognizing the signs of Phelan-McDermid 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.
- Developmental delay affecting motor, cognitive, and language skills
- Autism spectrum disorder features including social communication difficulties
- Severe speech and language impairment or absence of speech
- Hypotonia and motor coordination problems
- Seizures in 25-40% of affected individuals
- Behavioral problems including self-injurious behaviors
Who Phelan-McDermid Syndrome Affects
Symptoms present from early infancy with developmental delay becoming apparent by 6-12 months. Affects males and females equally. Can result from de novo deletion, paternal deletion with inheritance, or SHANK3 mutation without deletion. Familial forms show autosomal dominant inheritance. Occurs in all populations.
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