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7q11.23 微缺失的产前诊断:两例病例报告及文献复习。

Prenatal diagnosis of 7q11.23 microdeletion: Two cases report and literature review.

机构信息

Prenatal Diagnosis Center and Reproductive Medicine Center, The First Hospital of Jilin University, Changchun, China.

出版信息

Medicine (Baltimore). 2023 Oct 27;102(43):e34852. doi: 10.1097/MD.0000000000034852.

Abstract

RATIONALE

Chromosome microdeletions within 7q11.23 can result in Williams-Beuren syndrome which is a rare autosomal dominant disorder. Williams-Beuren syndrome is usually associated with developmental delay, cardiovascular anomalies, mental retardation, and characteristic facial appearance.

PATIENT CONCERNS

Two pregnant women underwent amniocentesis for cytogenetic analysis and chromosomal microarray analysis (CMA) because of abnormal ultrasound findings. Case 1 presented subependymal cyst and case 2 presented intrauterine growth restriction, persistent left superior vena cava and pericardial effusion in clinical ultrasound examination.

DIAGNOSES

Cytogenetic examination showed that the 2 fetuses presented normal karyotypic results. CMA detected 1.536 Mb (case 1) and 1.409 Mb (case 2) microdeletions in the region of 7q11.23 separately.

INTERVENTIONS

Both couples opted for the termination of pregnancies based upon genetic counseling.

OUTCOMES

The deleted region in both fetuses overlapped with Williams-Beuren syndrome. To our knowledge, case 1 was the first reported fetus of Williams-Beuren syndrome with subependymal cyst.

LESSONS

The genotype-phenotype of Williams-Beuren syndrome is complicated due to the phenotypic diversity. For prenatal cases, clinicians should consider the combination of ultrasonography, traditional cytogenetic, and molecular diagnosis technology when genetic counseling.

摘要

背景

7q11.23 号染色体微缺失可导致威廉姆斯-贝伦综合征,这是一种罕见的常染色体显性遗传疾病。威廉姆斯-贝伦综合征通常伴有发育迟缓、心血管异常、智力障碍和特征性面部外观。

患者关注

两名孕妇因超声异常接受羊膜穿刺术进行细胞遗传学分析和染色体微阵列分析(CMA)。病例 1 表现为室管膜下囊肿,病例 2 表现为宫内生长受限、永存左上腔静脉和心包积液。

诊断

细胞遗传学检查显示 2 例胎儿均具有正常核型结果。CMA 分别检测到 7q11.23 区域的 1.536Mb(病例 1)和 1.409Mb(病例 2)微缺失。

干预

根据遗传咨询,两对夫妇均选择终止妊娠。

结果

两个胎儿缺失的区域均与威廉姆斯-贝伦综合征重叠。据我们所知,病例 1 是首例伴有室管膜下囊肿的威廉姆斯-贝伦综合征胎儿。

教训

由于表型多样性,威廉姆斯-贝伦综合征的基因型-表型非常复杂。对于产前病例,临床医生在遗传咨询时应考虑将超声、传统细胞遗传学和分子诊断技术相结合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbba/10615468/1cfe9f2855a1/medi-102-e34852-g001.jpg

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