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一例罕见的产后嵌合型 12 三体综合征合并严重先天性心脏病及文献复习

A rare case of postnatal mosaic trisomy 12 with severe congenital heart disease and literature review.

机构信息

Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.

出版信息

Am J Med Genet A. 2021 Jun;185(6):1864-1869. doi: 10.1002/ajmg.a.62166. Epub 2021 Mar 24.

Abstract

Trisomy 12 is a rare autosomal aneuploidy. All postnatally diagnosed individuals with trisomy 12 have been mosaic for this chromosome abnormality. We herein report an infant girl presented at 2 weeks of age with severe congenital heart defect, tracheobronchomalacia, and dysmorphic features. All of the dysmorphic features of this patient fit into the known phenotype spectrum of mosaic trisomy 12, although this patient uniquely presented with macrocephaly. Tracheo-bronchomalacia has been described once previously but had a significant impact on this patient's clinical course. The patient passed away at 2-month-old due to cardiac and respiratory complications. Chromosomal single nucleotide polymorphism (SNP) microarray analysis on a peripheral blood sample from the patient revealed trisomy 12 in approximately 50% of cells. Concurrent fluorescence in situ hybridization analysis of uncultured blood cells detected a comparable level of trisomy 12 mosaicism. Compared to conventional cytogenetics, SNP microarray examines all nucleated cells without sampling bias, has an increased power to estimate mosaicism level, and can provide a quick assessment of the underlying mechanism. Here we demonstrate the utilization of SNP microarray in the clinical diagnosis of those once considered rare disorders but might have been missed by conventional cytogenetic techniques.

摘要

三体 12 是一种罕见的常染色体非整倍体。所有在出生后被诊断为三体 12 的个体均为这种染色体异常的嵌合体。本文报道了一例 2 周龄女婴,患有严重的先天性心脏缺陷、气管支气管软化和畸形特征。该患者的所有畸形特征均符合已知的三体 12 嵌合体表型谱,尽管该患者独特地表现为大头畸形。气管支气管软化已被描述过一次,但对该患者的临床病程有重大影响。由于心脏和呼吸并发症,该患者在 2 个月大时死亡。对来自患者外周血样本的染色体单核苷酸多态性 (SNP) 微阵列分析显示,约 50%的细胞中存在三体 12。未培养血细胞的荧光原位杂交分析检测到类似水平的三体 12 嵌合体。与传统细胞遗传学相比,SNP 微阵列检查所有有核细胞,没有采样偏差,具有更高的估计嵌合体水平的能力,并且可以快速评估潜在的机制。在这里,我们展示了 SNP 微阵列在临床诊断中对那些曾经被认为是罕见疾病的应用,但可能被传统细胞遗传学技术所忽略。

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