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一名严重身材矮小的女孩,核型为 47,XX, + 14/46,XX,upd(14)mat,镶嵌型。

A severely short-statured girl with 47,XX, + 14/46,XX,upd(14)mat, mosaicism.

机构信息

Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan.

Department of Pediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan.

出版信息

J Hum Genet. 2018 Mar;63(3):377-381. doi: 10.1038/s10038-017-0381-z. Epub 2018 Jan 9.

Abstract

The predominant symptoms of trisomy 14 mosaicism are prenatal and postnatal growth failure, ear abnormalities, congenital heart disease, developmental delay, and genitourinary abnormalities. Maternal uniparental disomy of chromosome 14 (upd(14)mat) presents discernible clinical features such as prenatal and postnatal growth failure, hypotonia, precocious puberty, and obesity. Given the small number of previously reported patients with a combination of trisomy 14 mosaicism and upd(14)mat, the detailed clinical features of these patients remain to be elucidated. Here we report a severely short-statured girl with feeding difficulties and failure to thrive, ear abnormalities, deafness, small hands, and developmental delay. Karyotyping, FISH analysis, methylation analysis, and microsatellite marker analysis using her leukocytes and buccal cells showed that she had a combination of trisomy 14 mosaicism and upd(14)mat. Furthermore, a comparison of the clinical features of this patient with those of previously reported patients with genetic anomalies including the combination of trisomy 14 mosaicism and upd(14)mat or upd(14)mat suggested that the severe short stature observed in patients with a combination of trisomy 14 mosaicism and upd(14)mat stemmed from the synergic effect of these two events. In severely short-statured patients with trisomy 14 mosaicism, we should be aware of the possible coexistence of upd(14)mat.

摘要

三体 14 嵌合体的主要症状是产前和产后生长发育迟缓、耳部异常、先天性心脏病、发育迟缓以及泌尿生殖系统异常。14 号染色体单亲二体(upd(14)mat)的母体单亲二体性表现出明显的临床特征,如产前和产后生长发育迟缓、肌张力低下、性早熟和肥胖。鉴于先前报道的三体 14 嵌合体和 upd(14)mat 合并患者数量较少,这些患者的详细临床特征仍有待阐明。我们在此报告一例严重矮小的女孩,存在喂养困难和生长发育不良、耳部异常、耳聋、小手和发育迟缓。对其白细胞和口腔细胞进行核型分析、FISH 分析、甲基化分析和微卫星标记分析显示,她患有三体 14 嵌合体和 upd(14)mat。此外,将该患者的临床特征与先前报道的包括三体 14 嵌合体和 upd(14)mat 或 upd(14)mat 合并的遗传异常患者的临床特征进行比较表明,三体 14 嵌合体和 upd(14)mat 合并患者的严重矮小源于这两个事件的协同作用。在三体 14 嵌合体严重矮小的患者中,我们应该意识到 upd(14)mat 可能同时存在。

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