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Prevalence of Fragile X Syndrome among children receiving special education and carrier states in first degree relatives.

Authors:

B Chandrasekara ,

Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Colombo, LK
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S Wijesundera,

Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Colombo, LK
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S S Chong,

Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, SG
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H N Perera

Department of Laboratory Medicine, National University Hospital, Singapore, SG
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Abstract

Introduction Fragile X syndrome (FXS) is a genetically determined developmental disorder. Underlying genotype is cytosine-guanine-guanine (CGG) repeat expansions with over 200 repeats in the fragile X mental retardation 1 (FMR1) gene. Children with FXS are most accessible in special education institutions in Sri Lanka, with a total of approximately 6000 registered attendees.   

 

Objectives The aim of the current study was to estimate the prevalence of FXS among special school attendees and to screen first degree relatives of affected children.   

 

Methods A nationally representative sample of 850 children (5-18 years) was selected using multi-level stratified sampling.  Screening was performed by 3’ direct triplet primed PCR, followed by melting curve analysis. Expanded repeat status of the screened positives were confirmed using capillary electrophoresis, methylation specific PCR and Southern hybridization. Screening of available first degree relatives (n=12) were carried out using the same method of screening and diagnosis. 

 

Results Eleven had FXS. Prevalence of FXS was 1.3% (95% CI 0.9-1.6).  Among the 11 with FXS 9 had more than 350 CGG repeats, while the rest had around 300. Twelve first degree relatives consisting of nine mothers, two female siblings and a male sibling were tested. All mothers and female siblings had either full mutation or premutation while the male sibling had CGG repeats in the normal range. 

 

Conclusions Among the special school attendees, prevalence of FXS was 1.3% which has a high risk for autism and attention deficit hyperactivity disorder. Identification of carriers in first degree relatives is important in view of the clinical implications of carrier status.   

How to Cite: Chandrasekara, B. et al., (2017). Prevalence of Fragile X Syndrome among children receiving special education and carrier states in first degree relatives.. Ceylon Medical Journal. 62(2), pp.92–96. DOI: http://doi.org/10.4038/cmj.v62i2.8473
Published on 30 Jun 2017.
Peer Reviewed

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