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Clinical diagnostic criteria

R1
Welke kenmerken zouden deel moeten uitmaken van een 'severity score', dwz een score die aangeeft hoeveel last het iemand geeft (en diens familie) als men PTHS heeft?

R2
A set of criteria to indicate the severity of PTHS should be developed in collaboration with families.  A++

Molecular Diagnostic Criteria

R3 TCF4 variants can cause PTHS but can also cause other intellectual disability associated phenotypes which should not be labeled PTHS.
A+++


R4 Empirically, after the birth of an individual with molecularly confirmed PTHS, a recurrence risk of 2% should be given.
A++


R5 Interpretation of variants in TCF4 require consideration of the phenotype of the tested individual, pattern of inheritance of the phenotype and the variant, earlier experience with the variant, and nature and localization of the variant, using ACMG criteria.
A+++

Prenatal Diagnosis

R6 Prenatal testing should be offered to families in which the diagnosis of PTHS in the index patient is molecularly confirmed.
A+++


R7 Prenatal testing for PTHS outside of a known familial genetic alteration remains challenging due to the current difficulty in interpreting reliably all variants that will be obtained. Use of this type of testing as a screening method is not recommended at the present time.
A+++

General health

R8
The commonly occurring marked and chronic constipation in indi-viduals with PTHS should be monitored and evaluated through a diary ordedicated questionnaires. A+++






This list will be completed soon
  General health

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