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因无创产前检测出现假阳性结果而发现的一例中国家族性18号染色体短臂缺失综合征

Discovery of a Chinese familial deletion 18p syndrome due to a false positive result on noninvasive prenatal testing.

作者信息

Ju Duan, Zuo Zhigang, Li Xiaozhou, Shi Yunfang, Zhang Ying, Xue Fengxia

机构信息

Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, China.

Department of Orthodontics, Stomatological Hospital of Tianjin Medical University, Tianjin, China.

出版信息

J Obstet Gynaecol Res. 2021 Feb;47(2):827-832. doi: 10.1111/jog.14565. Epub 2020 Nov 16.

Abstract

Clinical manifestations of deletion 18p syndrome vary a lot, which makes it easily overlooked in the clinical practice. Familial transmission of deletion 18p syndrome is rare. We report a Chinese familial deletion 18p syndrome, which was diagnosed by anatomizing the underlying reason for the discrepancy between noninvasive prenatal testing (NIPT) and prenatal diagnosis. A 35-year-old pregnant woman was recruited to our center owing to the abnormal NIPT result with a high risk of chromosome 18 monosomy. However, the karyotype of the fetus was normal after amniocentesis. Further analysis indicated that the pregnant woman herself had an abnormal karyotype of 46,XX,del(18)(p11.2), (arr18p11.32p11.21[136,227-15,099,116]×1) and her first 12-year-old son had got the same deletion of 18p as her. A distinct phenotype variability was noted although they share identical deletion. We consider that adequate clinical genetic counseling is vital for women with adverse pregnancy history before getting pregnant. Maternal CNVs may be one of the main causes of the false-positive result on NIPT. NIPT, especially extended NIPT may provide extra valuable evidence when used as routine prenatal screening method.

摘要

18号染色体短臂缺失综合征的临床表现差异很大,这使得其在临床实践中容易被忽视。18号染色体短臂缺失综合征的家族性传递较为罕见。我们报告了一例中国家族性18号染色体短臂缺失综合征,通过剖析无创产前检测(NIPT)与产前诊断结果不符的潜在原因得以确诊。一名35岁的孕妇因NIPT结果异常提示18号染色体单体风险高而被收入我们中心。然而,羊水穿刺后胎儿的核型正常。进一步分析表明,该孕妇自身核型异常,为46,XX,del(18)(p11.2),(染色体微阵列分析:arr18p11.32p11.21[136,227-15,099,116]×1),她12岁的大儿子与她有相同的18号染色体短臂缺失。尽管他们的缺失相同,但仍观察到明显的表型差异。我们认为,对于有不良孕史的女性,孕前进行充分的临床遗传咨询至关重要。母体拷贝数变异可能是NIPT假阳性结果的主要原因之一。当NIPT,尤其是扩展NIPT用作常规产前筛查方法时,可能会提供额外有价值的证据。

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