Updated clinical practice recommendations for managing adults with 22q11.2 deletion syndrome

Erik Boot; Sólveig Óskarsdóttir; Joanne C Y Loo; Terrence Blaine Crowley; Ani Orchanian-Cheff; Danielle M Andrade; Jill M Arganbright; René M Castelein; Christine Cserti-Gazdewich; Steven de Reuver; Ania M Fiksinski; Gunilla Klingberg; Anthony E Lang; Maria R Mascarenhas; Edward M Moss; Beata Anna Nowakowska; Erwin Oechslin; Lisa Palmer; Gabriela M Repetto; Nikolai Gil D Reyes; Maude Schneider; Candice Silversides; Kathleen E Sullivan; Ann Swillen; Therese A M J van Amelsvoort; Jason P Van Batavia; Claudia Vingerhoets; Donna M McDonald-McGinn; Anne S Bassett

doi:10.1016/j.gim.2022.11.012

Updated clinical practice recommendations for managing adults with 22q11.2 deletion syndrome

Genet Med. 2023 Mar;25(3):100344. doi: 10.1016/j.gim.2022.11.012. Epub 2023 Feb 2.

Authors

Erik Boot¹, Sólveig Óskarsdóttir², Joanne C Y Loo³, Terrence Blaine Crowley⁴, Ani Orchanian-Cheff⁵, Danielle M Andrade⁶, Jill M Arganbright⁷, René M Castelein⁸, Christine Cserti-Gazdewich⁹, Steven de Reuver⁸, Ania M Fiksinski¹⁰, Gunilla Klingberg¹¹, Anthony E Lang¹², Maria R Mascarenhas¹³, Edward M Moss¹⁴, Beata Anna Nowakowska¹⁵, Erwin Oechslin¹⁶, Lisa Palmer³, Gabriela M Repetto¹⁷, Nikolai Gil D Reyes¹², Maude Schneider¹⁸, Candice Silversides¹⁹, Kathleen E Sullivan²⁰, Ann Swillen²¹, Therese A M J van Amelsvoort²², Jason P Van Batavia²³, Claudia Vingerhoets²⁴, Donna M McDonald-McGinn²⁵, Anne S Bassett²⁶

Affiliations

¹ Advisium, 's Heeren Loo Zorggroep, Amersfoort, The Netherlands; The Dalglish Family 22q Clinic, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada; Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands. Electronic address: [email protected].
² Department of Pediatric Rheumatology and Immunology, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Electronic address: [email protected].
³ The Dalglish Family 22q Clinic, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
⁴ 22q and You Center, Clinical Genetics Center, and Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA.
⁵ Library and Information Services, and The Institute of Education Research (TIER), University Health Network, Toronto, Ontario, Canada.
⁶ Adult Genetic Epilepsy Program, Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada.
⁷ Division of Otolaryngology, Children's Mercy Hospital and University of Missouri Kansas City School of Medicine, Kansas City, MO.
⁸ Department of Orthopedic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
⁹ Hematology and Transfusion Medicine, University Health Network, Toronto, Ontario, Canada.
¹⁰ Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands; Department of Pediatric Psychology, University Medical Centre, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
¹¹ Faculty of Odontology, Malmö University, Malmö, Sweden.
¹² The Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
¹³ Division of Gastroenterology and 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA.
¹⁴ Bryn Mawr, PA.
¹⁵ Department of Medical Genetics, Institute of Mother and Child, Warsaw, Poland.
¹⁶ Toronto Adult Congenital Heart Disease Program, Peter Munk Cardiac Centre, University Health Network and University of Toronto, Toronto, Ontario, Canada.
¹⁷ Rare Diseases Program, Institute for Sciences and Innovation in Medicine, Facultad de Medicina Clinica Alemana Universidad del Desarrollo, Santiago, Chile.
¹⁸ Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.
¹⁹ Toronto ACHD Program, Mount Sinai and Toronto General Hospitals, University of Toronto, Toronto, Ontario, Canada.
²⁰ Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA; Division of Allergy and Immunology and 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA.
²¹ Center for Human Genetics, University Hospital UZ Leuven, Department of Human Genetics, KU Leuven, Leuven, Belgium.
²² Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands.
²³ Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA; Division of Urology and 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA.
²⁴ Advisium, 's Heeren Loo Zorggroep, Amersfoort, The Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands.
²⁵ 22q and You Center, Clinical Genetics Center, and Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA; Department of Human Biology and Medical Genetics, Sapienza University, Rome, Italy. Electronic address: [email protected].
²⁶ The Dalglish Family 22q Clinic, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Clinical Genetics Research Program and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Mental Health and Division of Cardiology, Department of Medicine, and Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada. Electronic address: [email protected].

PMID: 36729052
DOI: 10.1016/j.gim.2022.11.012

Abstract

This review aimed to update the clinical practice guidelines for managing adults with 22q11.2 deletion syndrome (22q11.2DS). The 22q11.2 Society recruited expert clinicians worldwide to revise the original clinical practice guidelines for adults in a stepwise process according to best practices: (1) a systematic literature search (1992-2021), (2) study selection and synthesis by clinical experts from 8 countries, covering 24 subspecialties, and (3) formulation of consensus recommendations based on the literature and further shaped by patient advocate survey results. Of 2441 22q11.2DS-relevant publications initially identified, 2344 received full-text review, with 2318 meeting inclusion criteria (clinical care relevance to 22q11.2DS) including 894 with potential relevance to adults. The evidence base remains limited. Thus multidisciplinary recommendations represent statements of current best practice for this evolving field, informed by the available literature. These recommendations provide guidance for the recognition, evaluation, surveillance, and management of the many emerging and chronic 22q11.2DS-associated multisystem morbidities relevant to adults. The recommendations also address key genetic counseling and psychosocial considerations for the increasing numbers of adults with this complex condition.

Keywords: Adults; Aging; Clinical practice guidelines; DiGeorge syndrome; Treatment.

Publication types

Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Clinical Relevance
Consensus
DiGeorge Syndrome* / genetics
DiGeorge Syndrome* / therapy
Genetic Counseling
Humans
Surveys and Questionnaires