Reittinger Andrew M, Helm Benjamin M, Boles Debra J, Gadi Inder K, Schrier Vergano Samantha A
Department of Pediatrics, Eastern Virginia Medical School, Norfolk, Virginia.
Department of Medical & Molecular Genetics, Indiana University School of Medicine and Riley Hospital for Children at IU Health, Indianapolis, Indiana.
Am J Med Genet A. 2017 Sep;173(9):2528-2533. doi: 10.1002/ajmg.a.38344. Epub 2017 Jun 27.
Mosaic trisomy 5 is a very rare condition in liveborns, with few cases reported in the last four decades. There are some reports of prenatally diagnosed mosaic trisomy 5 resulting in phenotypically normal offspring, suggesting a low level of mosaicism, but there are also reports associated with multiple congenital anomalies, cardiovascular malformations, and intrauterine growth restriction. We report an infant male diagnosed with mosaic trisomy 5 (5/15 cells) via amniocentesis. The patient was subsequently found to have uniparental disomy 5 (UPD5) by postnatal chromosome microarray, but high-resolution chromosome analysis on peripheral blood did not identify trisomy 5. Dysmorphic features included a tall forehead with low anterior hairline, hypertelorism, low-set ears, and a prominent nose and midface. Other anomalies included bilateral bifid thumbs, hypospadias, a perineal fistula, unilateral multicystic kidney, and decreased subcutaneous fat with loose skin. He had complex congenital heart disease consisting of ventricular and atrial septal defects and polyvalvular defects. The patient died at age one after a prolonged admission. We add this case to the literature with the added benefit of data from a postnatal microarray, which was not available in other cases, to broaden the phenotype of mosaic trisomy 5 and UPD5.With the current available technology, we stress the importance of postnatal genetic testing to confirm prenatal cytogenetic findings in order to further define such phenotypes. This will provide the most accurate information and counseling to affected families.
5号染色体嵌合三体在活产儿中是一种非常罕见的病症,在过去四十年中仅有少数病例报道。有一些关于产前诊断出5号染色体嵌合三体但后代表型正常的报道,这表明嵌合率较低,但也有与多种先天性异常、心血管畸形和宫内生长受限相关的报道。我们报告了一名通过羊膜穿刺术诊断为5号染色体嵌合三体(5/15个细胞)的男婴。该患者随后通过产后染色体微阵列检测发现存在单亲二体5(UPD5),但外周血的高分辨率染色体分析未发现5号染色体三体。畸形特征包括前额高且前发际低、眼距增宽、耳朵低位、鼻子和中面部突出。其他异常包括双侧拇指分叉、尿道下裂、会阴瘘、单侧多囊肾以及皮下脂肪减少和皮肤松弛。他患有复杂的先天性心脏病,包括室间隔和房间隔缺损以及多瓣膜缺损。该患者在长期住院后于一岁时死亡。我们将此病例补充到文献中,由于有产后微阵列的数据,而其他病例中没有这些数据,从而拓宽了5号染色体嵌合三体和UPD5的表型。利用当前可用技术,我们强调产后基因检测对于确认产前细胞遗传学结果的重要性,以便进一步明确此类表型。这将为受影响的家庭提供最准确的信息和咨询。