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Background: The Alpha Thalassemia mental Retardation syndrome, X-linked (ATR-X syndrome, MIM: 301040) is a rare genetic disorder characterized by alpha thalassemia, intellectual disability, peculier facial characteristics and genital abnormalities. Detailed information regarding the clinical phenotype is lacking.
Aims: Detailed descriptions of the clinical phenotype are rare. The aim of this study was to describe the clinical phenotype of ATR-X syndrome.
Methods: Data was collected through questionnaires, interviews, physical examination and the study of medical records.
Results: Twenty-two individuals, aged 2-68 years old, were included. Three individuals were deceased at the time of the study. The individuals had a variable degree of intellectual disability. Alpha thalassemia was found in 30 % and genital anomalies in 70 % of the individuals. First clinical signs of the syndrome were most frequently feeding problems, started in the neonatal period in the majority. Other main reported health problems were reflux (59 %), constipation (72 %), periods of anorexia and adipsia (45 %), heart defects (28 %), epilepsy (33 %), scoliosis/kyphosis (48 %), visual impairment (61 %) and hearing loss (38 %). Behavioral problems (86 %) and sleeping problems (64 %) also occurred frequently.
Conclusion: We report on the largest cohort of clinically studied individuals with ATR-X syndrome, including the eldest individuals, reported to date. Clinical knowledge is essential to improve care and to evaluate future therapies for this group.
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http://dx.doi.org/10.1016/j.ejmg.2025.105026 | DOI Listing |
Cureus
July 2025
Pediatric Department, Royal Medical Services, Queen Rania Children's Hospital, Amman, JOR.
Alpha-thalassemia X-linked intellectual disability syndrome (ATR-X syndrome) is a rare genetic disorder caused by mutations in the gene, typically affecting males and presenting with neurodevelopmental and systemic manifestations. We report, to the best of our knowledge, the first genetically confirmed case of ATR-X syndrome in Jordan, involving a two-and-a-half-year-old male patient who presented with global developmental delay, dysmorphic facies, hypotonia, and bilateral cystic kidneys. Despite persistent microcytic anemia, hemoglobin electrophoresis and PCR for alpha-globin gene deletions were negative.
View Article and Find Full Text PDFNat Commun
July 2025
Department of Physiology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Mutations in the ATRX genes cause alpha-thalassemia X-linked intellectual disability (ATR-X) syndrome. Here, we show that ATRX influences the fate of human neural progenitor cells (hNPCs) by forming condensates through liquid-liquid phase separation (LLPS). The intrinsically disordered region (IDR) of ATRX is essential for LLPS and enables ATRX to form dynamic condensates that recruit co-activators.
View Article and Find Full Text PDFIndian J Psychiatry
June 2025
Department of Psychiatry, Jorhat Medical College, Jorhat, Assam, India.
Eur J Med Genet
August 2025
Intellectual Disability Medicine, Department of General Practice, Erasmus MC Rotterdam, the Netherlands; ASVZ, Medical Department, Care and Service Centre for People with Intellectual Disabilities, P.O. Box 121, AC Sliedrecht, 3360, the Netherlands. Electronic address:
Background: The Alpha Thalassemia mental Retardation syndrome, X-linked (ATR-X syndrome, MIM: 301040) is a rare genetic disorder characterized by alpha thalassemia, intellectual disability, peculier facial characteristics and genital abnormalities. Detailed information regarding the clinical phenotype is lacking.
Aims: Detailed descriptions of the clinical phenotype are rare.
Acta Biochim Biophys Sin (Shanghai)
May 2025
Key Laboratory of Epigenetic Regulation and Intervention, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences; University of Chinese Academy of Sciences, Shanghai 200031, China.
Alpha Thalassemia/Mental developmental retardation, X-linked (ATRX) is an important heterochromatin regulator, frequent mutated in ATR-X syndrome and various cancers. ATRX binds a histone variant macroH2A, forming a functional axis crucial for transcription regulation and genome stability. However, the molecular mechanism underlying the ATRX-macroH2A interaction remains obscure.
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