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绒毛取样中的8号染色体三体嵌合体:病例报告及咨询问题

Trisomy 8 mosaicism in chorionic villus sampling: case report and counselling issues.

作者信息

Klein J, Graham J M, Platt L D, Schreck R

机构信息

Ahmanson Department of Pediatrics, Cedars-Sinai Medical Center, UCLA School of Medicine 90048.

出版信息

Prenat Diagn. 1994 Jun;14(6):451-4. doi: 10.1002/pd.1970140606.

Abstract

We report an unusual case involving chorionic villus sampling (CVS) and trisomy 8 mosaicism. CVS showed a normal direct preparation while the culture showed mosaicism for trisomy 8. Subsequent amniocentesis revealed only normal chromosomes. A peripheral blood culture after birth revealed low-level trisomy 8 mosaicism. The patient appeared phenotypically and developmentally normal at 30 months of age. We conclude that prenatal counselling for similar cases needs to include the rare but real possibility that chromosome mosaicism detected prenatally may be found postnatally with largely unknown consequences. Secondly, low-level chromosomal mosaicism may be more common than previously recognized. Thirdly, very low-level trisomy 8 mosaicism may be compatible with a normal phenotype but long-term follow-up is required. And lastly, the use of fetal blood sampling is questionable in these cases because the phenotype may not be accurately predicted. Further studies of such cases are needed to address these important and unanswered issues, including the potential implication of mosaicism on academic performance and cognitive functioning.

摘要

我们报告了一例涉及绒毛取样(CVS)和8号染色体三体嵌合体的罕见病例。CVS的直接制片显示正常,而培养结果显示存在8号染色体三体嵌合体。随后的羊膜穿刺术显示染色体正常。出生后的外周血培养显示存在低水平的8号染色体三体嵌合体。该患者在30个月大时,表型和发育均正常。我们得出结论,对于类似病例的产前咨询需要纳入这样一种罕见但确实存在的可能性,即产前检测到的染色体嵌合体在出生后可能仍然存在,但其后果很大程度上未知。其次,低水平的染色体嵌合体可能比之前认为的更为常见。第三,极低水平的8号染色体三体嵌合体可能与正常表型相符,但需要长期随访。最后,在这些病例中使用胎儿血样取样存在疑问,因为可能无法准确预测表型。需要对此类病例进行进一步研究,以解决这些重要且尚未得到解答的问题,包括嵌合体对学业成绩和认知功能的潜在影响。

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