Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialities "G. D'Alessandro", University of Palermo, Palermo, Italy.
Ital J Pediatr. 2019 Aug 14;45(1):100. doi: 10.1186/s13052-019-0694-y.
Children with chromosome translocations, concerning X chromosome, have a genetic pattern different from Turner syndrome; however, when a translocation involves the of part of X chromosome including short stature homeobox-containing Sex-determining Region Y gene, growth may be severely compromised.We describe the clinical case of a 2.2-year-old-female, arrived at our paediatric unit for a decrease of height velocity. The karyotype was 46,XX,add(X)(p36.3). Array comparative genomic hybridization showed a fragment of Y chromosome, extended from 8.803.981 (Yp11.2) to 28.767.604 (Yq11.23). The final karyotype was 46,XX,add(X)(p36),t(X;Y)(p36.3;p11.2). Fluorescence in situ Hybridization analysis using Sex-determining Region Y probe revealed no signal on the derivative Y chromosome.At the admittance, height was 84.5 cm (- 1.24 SDS); SPAN was 79 cm; sitting height: 72.4 cm; weight was 17.5 kg. Bone age was 1.2 years. Multiplex Ligation Probe Amplification showed a heterozygous deletion of the Short Stature Homeobox-containing gene and of the pseudoautosomal region-1. This result correlated with Leri-Weill Syndrome. She started Growth Hormone treatment, with a good response.The case described shows a rare translocation, involving the X chromosome and including SHOX gene and the pseudoautosomal region-1. At our knowledge, this is the first case of a patient with a karyotype 46,XX,add(X)(p36),t(X;Y)(p36.3;p11.2) and Short Stature Homeobox-containing gene haploinsufficiency, successfully treated with Growth Hormone.
患有 X 染色体易位的儿童具有不同于特纳综合征的遗传模式;然而,当易位涉及 X 染色体的部分包括短臂同源盒基因和性决定区 Y 基因时,生长可能会受到严重影响。我们描述了一名 2.2 岁女性的临床病例,她因身高生长速度下降而来到我们的儿科病房。该患者的核型为 46,XX,add(X)(p36.3)。比较基因组杂交阵列显示,一条来自 Y 染色体的片段,从 8.803.981(Yp11.2)延伸至 28.767.604(Yq11.23)。最终的核型为 46,XX,add(X)(p36),t(X;Y)(p36.3;p11.2)。使用性决定区 Y 探针的荧光原位杂交分析显示,衍生 Y 染色体上没有信号。入院时,身高为 84.5cm(-1.24SDS);SPAN 为 79cm;坐高为 72.4cm;体重为 17.5kg。骨龄为 1.2 岁。多重连接探针扩增显示,短臂同源盒基因和假常染色体区域 1 存在杂合性缺失。这一结果与 Leri-Weill 综合征相关。她开始接受生长激素治疗,反应良好。所描述的病例显示了一种罕见的易位,涉及 X 染色体,包括 SHOX 基因和假常染色体区域 1。据我们所知,这是首例 X 染色体 46,XX,add(X)(p36),t(X;Y)(p36.3;p11.2)和短臂同源盒基因单倍不足的患者,成功接受了生长激素治疗。