Department of Medical Genetics, Molecular and Clinical Pharmacology, Division of Clinical Genetics, Innsbruck Medical University, Innsbruck, Austria.
Am J Med Genet A. 2009 Nov;149A(11):2522-6. doi: 10.1002/ajmg.a.33058.
Partial duplication 3q is a well defined clinical entity characterized by growth retardation, cryptorchism, microcephaly, and characteristic dysmorphisms. Most patients present with large duplications or are associated with a second chromosomal imbalance, which makes the definition of the phenotype difficult. Here, we report on a 4-year and 8-month-old girl with pre- and postnatal measurements in the high normal range, developmental delay, minor dysmorphic features, and a de novo unbalanced 3/4 translocation with trisomy 3q27 --> qter and monosomy of the subtelomeric region of 4p. Conventional karyotyping, FISH with probes from the Wolf-Hirschhorn syndrome critical region and chromosome 4p locus-specific probes, microsatellite marker-based haplotyping, and SNP microarray copy number analysis revealed a terminal 4p deletion of less than 500 kb with a breakpoint distal to the Wolf-Hirschhorn syndrome critical region, a chromosome 3q duplication of around 15.3 Mb, with origin of the rearrangement in paternal meiosis. Thus, our case clearly characterizes the phenotype of pure partial duplication 3q more exactly, and moreover, indicates that small chromosome rearrangements might lead to growth in the upper normal range or even cause overgrowth.
3q 部分重复是一种明确的临床实体,其特征为生长迟缓、隐睾、小头畸形和特征性的发育异常。大多数患者具有较大的重复或与第二个染色体不平衡有关,这使得表型的定义变得困难。在这里,我们报告了一个 4 岁 8 个月大的女孩,其出生前和出生后的测量值均处于高正常范围,发育迟缓,存在轻微的发育异常特征,以及新发的不平衡 3/4 易位,伴有 3q27-->qter 的三体和 4p 端粒区域的单体。常规核型分析、用 Wolf-Hirschhorn 综合征关键区域和染色体 4p 位特异性探针进行的 FISH、微卫星标记基于单体型分析和 SNP 微阵列拷贝数分析显示,存在小于 500kb 的 4p 端缺失,断裂点位于 Wolf-Hirschhorn 综合征关键区域远端,3q 染色体重复约 15.3Mb,重排的起源发生在父减数分裂中。因此,我们的病例更准确地描述了纯 3q 部分重复的表型,此外,还表明小的染色体重排可能导致生长在正常范围的上限,甚至导致过度生长。