Figure 1 Flow chart for investigation and diagnosis of SRS

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Presentation transcript:

Figure 1 Flow chart for investigation and diagnosis of SRS Figure 1 | Flow chart for investigation and diagnosis of SRS. Diagnostic questions are in blue boxes; recommended molecular tests are in beige boxes. Pink boxes: diagnosis not confirmed; green boxes: diagnosis of SRS confirmed. *Studies have excluded 11p15 LOM and upd(7)mat in patients with intrauterine growth retardation and postnatal growth retardation alone; some patients, particularly those with upd(7)mat or children under 2 years, score 3/6 (see text for details). ‡Arrange CNV analysis before other investigations if patient has notable unexplained global developmental delay and/or intellectual disability and/or relative microcephaly. §Insufficient evidence at present to determine relationship to SRS, with the exception of tissue mosaicism for 11p15 LOM. ||Unless evidence of catch-up growth by 2 years. ¶Previously known as idiopathic SRS. CNV, copy number variant; LOM, loss of methylation; NH-CSS, Netchine-Harbison clinical scoring system; SRS, Silver–Russell syndrome. Wakeling, E. L. et al. (2016) Diagnosis and management of Silver–Russell syndrome: first international consensus statement Nat. Rev. Endocrinol. doi:10.1038/nrendo.2016.138