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胎儿不平衡易位 46,XY,der(10)t(6;10)(p22;q26.1)伴多发畸形的围产诊断:病例报告及文献复习。

Perinatal diagnosis of a fetus with an unbalanced translocation 46,XY,der(10)t(6;10)(p22;q26.1) with multiple malformations:a case report and literature review.

机构信息

Iwase General Hospital, Department of Obstetrics and Gynecology, Iwase General Hospital.

Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine.

出版信息

Fukushima J Med Sci. 2021 Aug 27;67(2):83-88. doi: 10.5387/fms.2020-28. Epub 2021 May 15.

Abstract

The phenotype of an unbalanced translocation is characterized by the dosage effects of the affected genes in the translocated chromosome. We present the case of a fetus with a paternally derived unbalanced 46,XY,der(10)t(6;10)(p22;q26.1) translocation, detected following growth retardation and cardiac malformation. In trisomy 6p and 10q26 monosomy, external surface malformations, including characteristic facial abnormalities, and neurological or higher effects have been reported. Developmental delay and hypotonia are reported in ≤ 80% of cases of 10q monosomy. Herein, low birth weight, cephalic abnormalities including microcephaly, low-set ears and a high arched palate, ambiguous genitalia including scrotal hypoplasia and cryptorchidism, and congenital heart defects, including ventricular septal defect and pulmonary atresia, were observed. Neurological impact was not evaluated due to neonatal death. The mortality rate and frequency of low birth weight in such translocations has been seldom reported. In this case, severe cardiac malformation and low birth weight may have caused early neonatal death. Whilst Trisomy 6 is associated with low birth weight and perinatal death, few studies have reported these outcomes in 10q26 deletion syndrome. Our findings therefore contribute to the evidence base regarding unbalanced translocations and may improve the clinical management of such patients.

摘要

不平衡易位的表型特征是易位染色体中受影响基因的剂量效应。我们报告了一例胎儿的父亲源性不平衡 46,XY,der(10)t(6;10)(p22;q26.1)易位,该易位是在生长迟缓伴心脏畸形后检测到的。在 6p 三体和 10q26 单体中,已经报道了外部表面畸形,包括特征性面部异常,以及神经或更高的影响。10q 单体中报告了≤80%的发育迟缓伴张力减退。在此,观察到低出生体重、包括小头畸形、低位耳和高拱形腭在内的头颅异常、包括阴囊发育不全和隐睾在内的生殖器模糊、以及先天性心脏缺陷,包括室间隔缺损和肺动脉闭锁。由于新生儿死亡,未评估神经影响。在这种易位中,死亡率和低出生体重的发生率很少被报道。在这种情况下,严重的心脏畸形和低出生体重可能导致新生儿早期死亡。虽然 6 三体与低出生体重和围产期死亡相关,但很少有研究在 10q26 缺失综合征中报告这些结果。因此,我们的发现为不平衡易位提供了证据基础,并可能改善此类患者的临床管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/239e/8460283/4577ef6a6802/2185-4610-67-083-g001.jpg

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