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We report on three individuals with deletions and two individuals with duplications at 5q31, ranging from 3.6\u2009Mb to 8.1\u2009Mb and 830\u2009kb to 3.4\u2009Mb in size, respectively. All five copy number changes are apparently de novo and involve several genes that are important in developmental pathways, including <jats:italic>PITX1, SMAD5<\/jats:italic>, and <jats:italic>WNT8A<\/jats:italic>. The individuals with deletions have characteristic features including DD, short stature, club feet, cleft or high palate, dysmorphic features, and skeletal anomalies. Haploinsufficiency of <jats:italic>PITX1<\/jats:italic>, a transcription factor important for limb development, is likely the cause for the club feet, skeletal anomalies, and cleft\/high palate, while additional genes, including <jats:italic>SMAD5<\/jats:italic> and <jats:italic>WNT8A<\/jats:italic>, may also contribute to additional phenotypic features. Two patients with deletions also presented with corneal anomalies. To identify a causative gene for the corneal anomalies, we sequenced candidate genes in a family with apparent autosomal dominant keratoconus with suggestive linkage to 5q31, but no mutations in candidate genes were found. The duplications are smaller than the deletions, and the patients with duplications have nonspecific features. Although development is likely affected by increased dosage of the genes in the region, the developmental disruption appears less severe than that seen with deletion. \u00a9 2011 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ajmg.a.34100","type":"journal-article","created":{"date-parts":[[2011,7,8]],"date-time":"2011-07-08T23:47:08Z","timestamp":1310168828000},"page":"1906-1916","source":"Crossref","is-referenced-by-count":32,"title":["Deletions and duplications of developmental pathway genes in 5q31 contribute to abnormal phenotypes"],"prefix":"10.1002","volume":"155","author":[{"given":"Jill A.","family":"Rosenfeld","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne Milisa","family":"Drautz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol 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