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  2. Diseases
  3. Fragile XE syndrome
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Fragile XE syndrome


Title


Other Names:
FRAXE syndrome; Fragile site, folic acid type; X-linked mental retardation associated with fragile site FRAXE
Categories:
Congenital and Genetic Diseases; Nervous System Diseases

Summary Summary


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Fragile XE syndrome (FRAXE) is a genetic condition associated with mild to borderline intellectual disabilities with physical features differing from person to person. The characteristic features are learning difficulties, often a consequence of communication problems (speech delay, poor writing skills), hyperactivity, and a shortened attention span. Nearly all cases of FRAXE are caused by a specific type of mutation, called a trinucleotide repeat expansion, in the AFF2 gene, which is located on the X chromosome. A trinucleotide repeat expansion occurs when there is an abnormally large number of repeats of a specific sequence of three nucleotides (building block of DNA) within our DNA. The repeating nucleotides in FRAXE syndrome are CCG. When the number of CCG repeats is over 200, people typically have the signs and symptoms seen in FRAXE. FRAXE is inherited in an X-linked manner.[1][2][3] Although there is no specific treatment for FRAXE, there may be ways to manage the symptoms. A team of doctors or specialists is often needed to figure out the treatment options for each person.
Last updated: 9/9/2016

Symptoms Symptoms


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This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

Showing of 12 |
Medical Terms Other Names
Learn More:
HPO ID
Percent of people who have these symptoms is not available through HPO
Abnormality of metabolism/homeostasis
Laboratory abnormality
Metabolism abnormality
[ more ]
0001939
Aggressive behavior
Aggression
Aggressive behaviour
Aggressiveness
[ more ]
0000718
Agitation 0000713
Delayed speech and language development
Deficiency of speech development
Delayed language development
Delayed speech
Delayed speech acquisition
Delayed speech development
Impaired speech and language development
Impaired speech development
Language delay
Language delayed
Language development deficit
Late-onset speech development
Poor language development
Speech and language delay
Speech and language difficulties
Speech delay
[ more ]
0000750
Epicanthus
Eye folds
Prominent eye folds
[ more ]
0000286
Hyperactivity
More active than typical
0000752
Impulsivity
Impulsive
0100710
Intellectual disability
Mental deficiency
Mental retardation
Mental retardation, nonspecific
Mental-retardation
[ more ]
0001249
Obsessive-compulsive behavior
Obsessive compulsive behavior
0000722
Prominent nasal bridge
Elevated nasal bridge
High nasal bridge
Prominent bridge of nose
Prominent nasal root
Protruding bridge of nose
Protruding nasal bridge
[ more ]
0000426
X-linked inheritance 0001417
X-linked recessive inheritance 0001419
Showing of 12 |
Do you have more information about symptoms of this disease? We want to hear from you.
Last updated: 2/1/2019
Do you have updated information on this disease? We want to hear from you.

Cause Cause


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FRAXE is a genetic disorder caused by mutations in the AFF2 gene. This gene provides instructions for making a protein whose function is not well understood. Nearly all cases of FRAXE are caused by a specific type of mutation, called a trinucleotide repeat. A trinucleotide repeat is an abnormal expansion of three repeats of our DNA building blocks (nucleotides). The repeating nucleotides in FRAXE are CCG. Normally, the involved segment of three nucleotides is repeated approximately 4 to 40 times. However, in people with FRAXE, the CCG segment is repeated more than 200 times, which makes this region of the gene unstable or fragile. As a result, the AFF2 gene is turned off (silenced), and no AFF2 protein is produced. It is unclear how a shortage of this protein leads to intellectual disability in people with FRAXE. Some people with FRAXE have a deletion of genetic material in the AFF2 gene.[4][2][3]

People with 50 to 200 CCG repeats are said to have an AFF2 gene premutation. Current research suggests that people with a premutation do not have associated cognitive problems.[2]

Last updated: 9/9/2016

Diagnosis Diagnosis


Listen
The diagnosis of FRAXE is made based on signs and symptoms and genetic testing to confirm either a trinucleotide repeat expansion or a deletion within the AFF2 gene.[3]
Last updated: 9/9/2016

Testing Resources

  • The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional.

Find a Specialist Find a Specialist


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If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources

  • To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. Online directories are provided by the American College of Medical Genetics and the National Society of Genetic Counselors. If you need additional help, contact a GARD Information Specialist. You can also learn more about genetic consultations from Genetics Home Reference.

Research Research


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Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

  • The National Fragile X Foundation provides a state by state list of clinical trials involving fragile X-associated disorders. Click on National Fragile X Foundation to view the list.

Organizations Organizations


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Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

  • Developmental Delay Resources (DDR)
    5801 Beacon Street
    Pittsburgh, PA 15217
    Toll-free: 800-497-0944
    Fax: 412-422-1374
    E-mail: devdelay@mindspring.com
    Website: http://www.devdelay.org

Organizations Providing General Support

  • American Association on Intellectual and Developmental Disabilities
    501 3rd Street NW
    Suite 200
    Washington, DC 20001
    Toll-free: (800) 424-3688
    Telephone: (202) 387-1968
    Fax: (202) 387-2193
    Website: http://www.aaidd.org
  • The Society for Developmental and Behavioral Pediatrics
    6728 Old McLean Village Drive
    McLean, VA 22101
    Telephone: 703-556-9222
    E-mail: info@sdbp.org
    Website: http://www.sdbp.org/index.cfm
Do you know of an organization? We want to hear from you.

Learn More Learn More


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These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

  • The National Center on Birth Defects and Developmental Disabilities (NCBDDD) at the Center for Disease Control and Prevention (CDC) provides information about developmental disabilities, including intellectual disability.  To view this information, click on the link below.
    Link: http://www.cdc.gov/ncbddd/dd/ddmr.htm
  • Genetics Home Reference (GHR) contains information on Fragile XE syndrome. This website is maintained by the National Library of Medicine.

In-Depth Information

  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine. 
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Fragile XE syndrome. Click on the link to view a sample search on this topic.

News & Events News & Events


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News

  • NIH Hosts Rare Disease Day Event, Twitter Chat
    January 24, 2019

GARD Answers GARD Answers


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Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know. Submit a new question

  • I would like some information on Fragile XE (FRAXE) syndrome. See answer


Have a question? Contact a GARD Information Specialist.

References References


  1. Gecz J. The FMR2 gene, FRAXE and non-specific X-linked mental retardation: clinical and molecular aspects. Ann. Hum. Genet. Mar 2000; 64(Pt 2):95-106. http://www.ncbi.nlm.nih.gov/pubmed/?term=11246464.
  2. fragile XE syndrome. Genetics Home Reference. January 2014; https://ghr.nlm.nih.gov/condition/fragile-xe-syndrome.
  3. Victor A. McKusick. MENTAL RETARDATION, X-LINKED, ASSOCIATED WITH FRAGILE SITE FRAXE. In: Cassandra L. Kniffin. OMIM. 9/22/2011; http://omim.org/entry/309548.
  4. Rimoin DL, Connor JM, Pyeritz RE, Korf BR. Emery and Rimoin's Principles and Practice of Medical Genetics, 5th ed. Philadelphia: Churchill Livingstone Elsevier; 2007;
Do you know of a review article? We want to hear from you.
You can help advance
rare disease research!
You can help advance rare disease research!
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