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由一条标记染色体导致的5号染色体短臂12区至长臂11.2区部分三体:一例合并注意缺陷多动障碍的新病例报告

PARTIAL TRISOMY 5p12-q 11.2 RESULTING FROM A MARKER CHROMOSOME: A NEW CASE REPORT WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER.

作者信息

Erdem H B, Sahin I, Tasdemir S, Tatar A

出版信息

Genet Couns. 2016;27(3):295-303.

Abstract

Partial trisomy of chromosome 5 was first described by Lejeune et al. in 1964 on the short arm (12). The vast majority of the partial trisomy 5 cases include 5p duplications; however we reported a small supernumerary marker chromosome. General symptoms include developmental delay, mental retardation, seizures, respiratory difficulties, congenital heart defects, abdominal muscle hypoplasia and dysmorphic features such as macrocephaly, enlarged anterior fontanelle, dolichocephaly, upslanting palpebral fissures, epicanthal folds, hypertelorism, abnormal ears, midface hypoplasia, short nose, broad nasal bridge and microretrognathia. Arachnodactyly and club foot may be seen as cytoskeletal abnormalities and, hypotonia may be determined in neurological exam. Here we reported a case with developmental delay, attention deficit hyperactivity disorder, mild mental retardation and dysmorphic features, caused by a new small supernumerary marker chromosome, generating partial trisomy 5pI 2-q 11.2. To our knowledge, this small supernumerary marker chromosome has not been reported before. Severe type of partial trisomy 5 includes seizures, congenital heart defects, hypotonia and failure to thrive. Previously reported partial trisomy 5 cases, who showed severe phenotype, had usually duplicated 5p13 region. Therefore, patients, who do not have duplicated 5p13, showed mild phenotype. Also, duplication of the long arm of chromosome 5, may contribute to the milder phenotype and the longer survival in partial trisomy 5 patients. Attention deficit hyperactivity disorder, which we described in the present case, may be a result of partial trisomy 5, because it includes ADHD4 gene. This case may help better understanding the karyotype/phenotype correlation related to partial trisomy 5.

摘要

5号染色体部分三体综合征最早由勒热纳等人于1964年在短臂上发现(12)。绝大多数5号染色体部分三体病例包括5p重复;然而,我们报告了一例小的额外标记染色体。一般症状包括发育迟缓、智力低下、癫痫发作、呼吸困难、先天性心脏缺陷、腹部肌肉发育不全以及畸形特征,如巨头畸形、前囟增大、长头畸形、睑裂向上倾斜、内眦赘皮、眼距过宽、耳部异常、面中部发育不全、短鼻、鼻梁宽和小颌后缩。蜘蛛指(趾)和马蹄内翻足可能被视为细胞骨架异常,并且在神经学检查中可能发现肌张力减退。在此,我们报告了一例由一条新的小额外标记染色体导致5p12 - q11.2部分三体,表现为发育迟缓、注意力缺陷多动障碍、轻度智力低下和畸形特征的病例。据我们所知,这条小额外标记染色体此前尚未见报道。严重类型的5号染色体部分三体包括癫痫发作、先天性心脏缺陷、肌张力减退和生长发育不良。先前报道的表现为严重表型的5号染色体部分三体病例通常有5p13区域重复。因此,没有5p13重复的患者表现为轻度表型。此外,5号染色体长臂的重复可能导致5号染色体部分三体患者的表型较轻且生存期较长。我们在本病例中描述的注意力缺陷多动障碍可能是5号染色体部分三体的结果,因为它包含ADHD4基因。该病例可能有助于更好地理解与5号染色体部分三体相关的核型/表型相关性。

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