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13号染色体部分单体/单体镶嵌现象一例的产前诊断:因颈项透明层增厚怀疑为46,XX,r(13)(p11q33)/45,XX,-13

Prenatal diagnosis of a case of partial monosomy/monosomy 13 mosaicism: 46,XX,r(13)(p11q33)/45,XX,-13 suspected by nuchal fold translucency increasing.

作者信息

Kataoka Akio, Hirakawa Shouko, Iwamoto Manami, Sakumura Yumi, Yoshinaga Ryouta, Ohba Takashi

机构信息

Clinic of Obstetrics and Gynecology, Kataoka Ladies Clinic, Yatsushiro, Japan.

出版信息

Kurume Med J. 2011;58(4):127-30. doi: 10.2739/kurumemedj.58.127.

Abstract

Large numbers of patients with deletions of the long arm of chromosome 13 have been described. However, only a few instances have been reported of monosomy 13/r(13) mosaicism. A 31-year-old Japanese woman underwent an ultrasound tomographic screening, which detected a fetus with a nuchal translucency (NT) of >5.8mm, indicating an increased risk of fetal chromosomal abnormality. An amniocentesis (AC) was performed, and the karyotype was 46,XX,r(13)(p11q33)[18] / 45XX[12]. Ultrasound showed echogenic skin edema. Phenotype of the fetus after delivery revealed some anomalies, including hyponasal bridge, hypertelorism, ambiguous genitalia with huge clitoris, low-set ear, neck edema and webbing.Deletion of the long arm of chromosome 13 is associated with a wide spectrum of abnormalities, including retinoblastoma, mental and growth retardation, brain malformations, heart defects, distal limb deformities, and digestive, urogenital, and other abnormalities. The present case, however, had anomalies which were too faint to be detected by ultrasound tomography. Prenatal diagnosis of deletion 13q syndrome is rare. A number of reports have documented an association between increased NT and chromosomal defects. Ultrasound did not identify any major anomaly in this case, however amniocentesis was able to detect this rare abnormality.

摘要

已有大量关于13号染色体长臂缺失患者的描述。然而,仅有少数13号染色体单体/环状13号染色体(r(13))嵌合体的病例报道。一名31岁的日本女性接受了超声断层扫描筛查,检测到一名胎儿颈部透明带(NT)>5.8mm,提示胎儿染色体异常风险增加。进行了羊膜腔穿刺术(AC),核型为46,XX,r(13)(p11q33)[18] / 45,XX[12]。超声显示皮肤回声增强性水肿。分娩后胎儿的表型显示出一些异常,包括鼻根部低平、眼距增宽、生殖器模糊伴巨大阴蒂、低位耳、颈部水肿和蹼状畸形。13号染色体长臂缺失与多种异常相关,包括视网膜母细胞瘤、智力和生长发育迟缓、脑畸形、心脏缺陷、肢体远端畸形以及消化、泌尿生殖系统和其他异常。然而,本病例中的异常非常轻微,超声断层扫描无法检测到。13q缺失综合征的产前诊断很少见。许多报告记录了NT增加与染色体缺陷之间的关联。本病例中超声未发现任何主要异常,但羊膜腔穿刺术能够检测到这种罕见的异常。

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