Sun Meiling, Yue Fagui, Yu Yang, Li Leilei, Jiang Yuting, Zhang Hongguo, Liu Ruizhi
Center for Reproductive Medicine and Center for Prenatal Diagnosis, First Hospital.
Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin University, Changchun, Jilin, PR China.
Medicine (Baltimore). 2020 Oct 2;99(40):e22496. doi: 10.1097/MD.0000000000022496.
15q11.2 microdeletion syndrome is a relatively rare chromosomal abnormality with incomplete penetrance and phenotypic variability. The reports on prenatal ultrasound abnormalities of fetus with 15q11.2 microdeletion are rare.
A 30-year-old woman was referred for genetic counseling and prenatal diagnosis at 19 weeks of gestation because of increased nuchal translucency in prenatal ultrasound findings and a history of spontaneous abortion.
The cytogenetic analysis showed the karyotype of the fetus was 46,XY, inv(4)(p15q31) and chromosomal microarray analysis detected a 0.512 Mb deletion in 15q11.2 region. We recalled the parents to determine the origination of these chromosomal abnormalities.
The pregnant woman chose to continue the pregnancies and finally delivered a healthy male infant at 39 weeks.
The fetus inherited the inv(4)(p15q31) from his mother while the deletion in 15q11.2 was identified as de novo. Given the normal phenotype of the mother, it was reasonable to assume that the maternal inherited inv(4) in the fetus would not increase the risk of his abnormal phenotype. However, the pathogenicity of the microdeletion in 15q11.2 for the infant is unknown and long-term follow-up of progeny should be paid more attention.
The combined application of traditional banding technique and molecular cytogenetic techniques can not only detect chromosomal structural abnormalities, but also identify the subchromosomal imbalances, which is beneficial to genetic counselling and would offer more guidance to prenatal diagnosis.
15q11.2微缺失综合征是一种相对罕见的染色体异常疾病,具有不完全外显率和表型变异性。关于15q11.2微缺失胎儿产前超声异常的报道很少。
一名30岁女性因产前超声检查发现颈部透明带增厚及有自然流产史,于妊娠19周时前来接受遗传咨询和产前诊断。
细胞遗传学分析显示胎儿核型为46,XY,inv(4)(p15q31),染色体微阵列分析检测到15q11.2区域存在0.512 Mb的缺失。我们召回父母以确定这些染色体异常的来源。
孕妇选择继续妊娠,最终于39周时分娩出一名健康男婴。
胎儿从母亲那里遗传了inv(4)(p15q31),而15q11.2的缺失被确定为新发突变。鉴于母亲表型正常,可以合理推测胎儿中母亲遗传的inv(4)不会增加其出现异常表型的风险。然而,15q11.2微缺失对婴儿的致病性尚不清楚,应更加关注对后代的长期随访。
传统显带技术与分子细胞遗传学技术的联合应用不仅可以检测染色体结构异常,还能识别亚染色体不平衡,这有利于遗传咨询,并为产前诊断提供更多指导。