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一名具有特纳综合征表型且有自发青春期发育的患者存在47,XXX/45,X/46,XX嵌合体。

47,XXX/45,X/46,XX mosaicism in a patient with Turner phenotype and spontaneous puberal development.

作者信息

Brambila-Tapia Aniel Jessica Leticia, Rivera Horacio, García-Castillo Herbert, Domínguez-Quezada Maria Guadalupe, Dávalos-Rodríguez Ingrid Patricia

机构信息

División de Genética, Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social, and Doctorado en Genética Humana, Instituto de Genética Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México.

出版信息

Fertil Steril. 2009 Nov;92(5):1747.e5-7. doi: 10.1016/j.fertnstert.2009.07.1008. Epub 2009 Sep 3.

Abstract

OBJECTIVE

To describe a patient with infertility and phenotypic combination of Turner and triple-X syndrome related to mos 47,XXX/45X/46,XX karyotype.

DESIGN

Case report.

SETTING

División de Genética, Centro de Investigación Biomédica de Occidente and Hospital de Ginecología y Obstetricia, CMNO, Instituto Mexicano del Seguro Social.

PATIENT(S): The 24-year-old patient presented a phenotypic combination of Turner syndrome and X polysomy. She showed wide and short neck, low posterior hairline, cubitus valgus, bilateral shortening of the fourth and fifth metacarpals, multiple nevi, and müllerian anomalies but had spontaneous pubarche, thelarche, and menarche.

INTERVENTION(S): Laboratory evaluations, imaging studies, ovarian biopsy, G-banding karyotype, and in situ fluorescence hybridization.

MAIN OUTCOME MEASURE(S): Clinical and laboratory findings.

RESULT(S): A karyotype: mos 47,XXX/45X/46,XX was found in the cytogenetic studies, a bicornuate uterus in the ultrasonographic scan, and a normal ovarian profile in the laboratory tests.

CONCLUSION(S): The infertility in the present case can be related to either bicornuate uterus or subclinical abortions due to aneuploid ova. Cytogenetic assessment provides important information regarding infertile patients with uterine factors and short stature.

摘要

目的

描述一名患有不孕症且具有特纳综合征和XXX综合征表型组合的患者,其核型为47,XXX/45X/46,XX嵌合体。

设计

病例报告。

地点

墨西哥社会保障局西部生物医学研究中心遗传学部门以及CMNO妇产科医院。

患者

该24岁患者呈现出特纳综合征和X多体性的表型组合。她表现出宽而短的颈部、低后发际线、肘外翻、双侧第四和第五掌骨缩短、多发痣以及苗勒管异常,但有自发的阴毛生长、乳房发育和月经初潮。

干预措施

实验室评估、影像学检查、卵巢活检、G显带核型分析和原位荧光杂交。

主要观察指标

临床和实验室检查结果。

结果

细胞遗传学研究发现核型为47,XXX/45X/46,XX嵌合体,超声扫描显示双角子宫,实验室检查显示卵巢情况正常。

结论

本病例中的不孕症可能与双角子宫或非整倍体卵子导致的亚临床流产有关。细胞遗传学评估为患有子宫因素和身材矮小的不孕患者提供了重要信息。

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