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If nonsyndromic deafness is suspected AND the patient is a simplex case: CMV testing should be performed.
It is important to emphasize that a genetic cause is not excluded by such an evaluation because patients with recessive NSHI can present without a family history of hearing loss (i.e., as a simplex case).
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Simplex case: also known as sporadic cases; those in which only a single individual has a clinical diagnosis and no relatives are affected.
An important goal of genetic evaluation is to attempt to distinguish these isolated or simplex cases in which there may be a 25% chance of deafness in subsequent offspring from sporadic cases caused by environmental factors with a low chance of recurrence in families with no history of hearing loss.
Sporadic or simplex cases account for about 30% [ 3].
In contrast, for simplex cases (Category C) the diagnostic success rate was 4/15 (27%).
All children had sporadic autism (simplex cases), and all tested negative for the Fragile × syndrome.
The mutation occurred de novo in the three simplex cases for whom parental DNA was available.
Compound heterozygous variants were found in four of 7 simplex cases.
Possible causal genes responsible for simplex cases had primarily autosomal recessive inheritance (5 out of 7 cases, 71%%) as suggested previously [ 1, 2].
Finally, causal variants were detected from 10 of 18 familial cases (55.5%%) and 7 of 16 simplex cases (43.7 %) in total.
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