Plaiasu Vasilica, Ochiana Diana, Motei Gabriela, Georgescu Adrian
Genetics Department, IOMC "Alfred Rusescu", Bucharest, Romania.
Maedica (Bucur). 2011 Apr;6(2):132-6.
Tetrasomy 18p is a very rare chromosomal disorder and is the result of a spontaneous mutation early in embryonic development in most of the cases. This condition is characterised by the presence of a supernumerary 18p isochromosome (i(18p)) in all or some cells of the affected individual. It has a prevalence of 1/180000 live births and affects both genders equally.
In this paper we report a de novo tetrasomy 18p in a 3 months old female dysmorphic child. The clinical features were distinctive with a particular facies, strabismus, microcephaly, growth delay, neonatal hypertonia and talipes varus. An additional small metacentric marker chromosome has been identified after standard cytogenetic analysis, without recognized parental origin of the supplementary genetic material. The child's parents were also tested and their karyotype results were normal. The characterization of the marker chromosome was performed in our genetics laboratory using conventional cytogenetic methods and Fluorescence in Situ Hybridization (FISH) analysis. Also, our patient was compared with other published cases with the same diagnosis.
Cytogenetic investigation is an essential step towards the accurate diagnosis of individuals with clinical suspicion of a genetic anomaly. Also, this type of investigation could offer critical information to the practitioner for prognosis of patient and the correct appreciation of the recurrence risk of a certain genetic condition.With current advances in preventive and interventional procedures, patients with rare chromosomal disorders can live longer. Therefore, proper medical and behavioural management of each case is important for the enhancement of the quality of life for the patients and their families.
18号染色体短臂四体是一种非常罕见的染色体疾病,在大多数情况下是胚胎发育早期自发突变的结果。这种疾病的特征是在受影响个体的所有或一些细胞中存在一条额外的18号染色体短臂等臂染色体(i(18p))。其在活产婴儿中的患病率为1/180000,且男女发病率相等。
在本文中,我们报告了一名3个月大的畸形女童新发18号染色体短臂四体病例。临床特征独特,有特殊面容、斜视、小头畸形、生长发育迟缓、新生儿肌张力亢进和内翻足。经过标准细胞遗传学分析后,发现了一条额外的小中着丝粒标记染色体,补充的遗传物质来源不明。对患儿父母也进行了检测,其核型结果正常。在我们的遗传学实验室使用传统细胞遗传学方法和荧光原位杂交(FISH)分析对标记染色体进行了特征鉴定。此外,还将我们的患者与其他已发表的相同诊断病例进行了比较。
细胞遗传学检查是准确诊断临床怀疑有基因异常个体的关键步骤。此外,这类检查可为医生提供有关患者预后及正确评估某种遗传疾病复发风险的关键信息。随着目前预防和干预措施的进展,患有罕见染色体疾病的患者可以活得更长。因此,对每个病例进行适当的医疗和行为管理对于提高患者及其家庭的生活质量非常重要。