Wolf–Hirschhorn syndrome

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Wolf-Hirschhorn syndrome
Mia - whs.jpg
Young girl with Wolf-Hirschhorn syndrome
Classification and external resources
Specialty medical genetics
ICD-10 Q93.3
ICD-9-CM 758.3
OMIM 194190
DiseasesDB 32279
eMedicine ped/2446
Patient UK Wolf–Hirschhorn syndrome
MeSH D054877
Orphanet 280

Wolf–Hirschhorn syndrome (WHS), also known as chromosome deletion Dillan 4p syndrome, Pitt–Rogers–Danks syndrome (PRDS) or Pitt syndrome,[1][2] was first described in 1961 by Americans Herbert L. Cooper and Kurt Hirschhorn[3] and, thereafter, gained worldwide attention by publications by the German Ulrich Wolf, and Hirschhorn and their co-workers, specifically their articles in the German scientific magazine Humangenetik.[4][5] It is a characteristic phenotype resulting from a partial deletion of chromosomal material of the short arm of chromosome 4 (del(4p16.3)).[6]

Signs and symptoms[edit]

The most common characteristics include a distinct craniofacial phenotype (microcephaly, micrognathia, short philtrum, prominent glabella, ocular hypertelorism, dysplastic ears and periauricular tags), growth restriction, intellectual disability, muscle hypotonia, seizures, and congenital heart defects. Less common characteristics include hypospadias, colobomata of the iris, renal anomalies, and deafness.[7] Antibody deficiencies are also common, including common variable immunodeficiency and IgA deficiency. T-cell immunity is normal.[8]


Deletion of short arm of the chromosome 4 in a patient with Wolf–Hirschhorn syndrome

Wolf–Hirschhorn syndrome is a microdeletion syndrome caused by a deletion within HSA band 4p16.3 of the short arm of chromosome 4, particularly in the region of WHSC1 and WHSC2.[9] About 87% of cases represent a de novo deletion, while about 13% are inherited from a parent with a chromosome translocation. In the cases of familial translocation, there is a 2 to 1 excess of maternal transmission. Of the de novo cases, 80% are paternally derived. Severity of symptoms and expressed phenotype differ based on the amount of genetic material deleted. The critical region for determining the phenotype is at 4p16.3 and can often be detected through genetic testing and fluorescence in situ hybridization (FISH). Genetic testing and genetic counseling is offered to affected families.


The minimum birth incidence has been calculated as 1 in 95,896.[10]

See also[edit]


  1. ^ Online Mendelian Inheritance in Man (OMIM) Wolf-Hirschhorn syndrome -194190
  2. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. pp. 892, 894. ISBN 1-4160-2999-0. 
  3. ^ Cooper H, Hirschhorn K (1961). "Apparent deletion of short arms of one chromosome (4 or 5) in a child with defects of midline fusion". Mammalian Chrom Nwsl. (4): 14. 
  4. ^ Hirschhorn K, Cooper HL, Firschein IL (1965). "Deletion of short arms of chromosome 4-5 in a child with defects of midline fusion". Humangenetik. 1 (5): 479–82. PMID 5895684. doi:10.1007/bf00279124. 
  5. ^ Wolf U, Reinwein H, Porsch R, Schröter R, Baitsch H (1965). "Deficiency on the short arms of a chromosome No. 4". Humangenetik (in German). 1 (5): 397–413. PMID 5868696. 
  6. ^ Dufke, A; Seidel, J; Schöning, M; Döbler-Neumann, M; Kelbova, C; Liehr, T; Beensen, V; Backsch, C; Klein-Vogler, U; Enders, H (2000). "Microdeletion 4p16.3 in three unrelated patients with Wolf-Hirschhorn syndrome.". Cytogenetics and cell genetics. 91 (1-4): 81–4. PMID 11173835. doi:10.1159/000056823. 
  7. ^ Wieczorek D. Wolf-Hirschhorn syndrome. Orphanet encyclopedia. September 2003: http://www.orpha.net/data/patho/GB/uk-WHS.pdf
  8. ^ Hanley-Lopez J, Estabrooks LL, Stiehm R (July 1998). "Antibody deficiency in Wolf-Hirschhorn syndrome". J. Pediatr. 133 (1): 141–3. PMID 9672528. doi:10.1016/S0022-3476(98)70194-5. 
  9. ^ Rauch, A; Schellmoser, S; Kraus, C; Dörr, HG; Trautmann, U; Altherr, MR; Pfeiffer, RA; Reis, A (1 April 2001). "First known microdeletion within the Wolf-Hirschhorn syndrome critical region refines genotype-phenotype correlation.". American Journal of Medical Genetics. 99 (4): 338–42. PMID 11252005. doi:10.1002/ajmg.1203. 
  10. ^ http://jmg.bmj.com/content/38/10/674.full#ref-20

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