TY - CHAP M1 - Book, Section TI - Down Syndrome A1 - Harris, David J. A1 - Alkuraya, Fowzan S. A2 - Murray, Michael F. A2 - Babyatsky, Mark W. A2 - Giovanni, Monica A. A2 - Alkuraya, Fowzan S. A2 - Stewart, Douglas R. Y1 - 2014 N1 - T2 - Clinical Genomics: Practical Applications in Adult Patient Care AB - Disease summary:Down syndrome (DS) is a chromosomal aneuploidy of chromosome 21 and represents the most frequently identified cause of intellectual disability, with a wide range of severity.In addition to typical facial features, the phenotype includes skeletal, neurologic, gastrointestinal, endocrine, and hematologic components or risks. Anticipatory guidance is the key to the prevention and treatment of these complications.DS is associated with increased mortality in childhood (usually due to congenital heart disease) and in adulthood (due to Alzheimer disease and premature aging, among other factors).Prenatal screening for DS is widely practiced and has evolved from ultrasound-based approach to combined ultrasound and biochemical marker-based approach to DNA-based approach.Hereditary basis:DS is usually caused by the sporadic de novo occurrence of a meiotic error involving chromosome 21 in the parent (usually the mother especially in the older age group), which is associated with a low recurrence risk.A much higher recurrence risk is observed when the meiotic error is the result of a constitutional parental translocation (<5% of DS cases) or parental mosaicism (frequency unknown).Differential diagnosis:Single palmar (Simian) crease, sandal gap, upslanting palpebral fissures, epicanthic folds, protruding tongue, and hypotonia are seen in the majority of DS but can also be seen in normal individuals and this explains why clinical diagnosis is only accurate in two-thirds of the cases in the neonatal period. Hypothyroidism may present with similar features. Other rare disorders, such as peroxisomal disorders and Menkes syndrome are possible alternatives in infants. Short stature and mental retardation occur in a number of disorders. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - accessmedicine.mhmedical.com/content.aspx?aid=1102706929 ER -