Zaslav A L, Fallet S, Brown S, Ebert R, Fleischer A, Valderama E, Fox J E
Department of Pediatrics, Schneider Children's Hospital, The Long Island Campus for the Albert Einstein College of Medicine, New Hyde Park, NY 11040, USA.
Clin Genet. 1998 Apr;53(4):286-92. doi: 10.1111/j.1399-0004.1998.tb02698.x.
Low level chromosome mosaicism found at amniocentesis is problematic for clinicians and patients. We report prenatal diagnosis of a fetus with a rare karyotype of 47,XX, + 15/46,XX. Second trimester amniocentesis was performed for advanced maternal age. Fetal ultrasound revealed a hypoplastic right ventricle and intrauterine growth retardation (IUGR). The rest of the fetal anatomy was within normal limits. A mosaic karyotype of 47,XX, + 15/46,XX was observed. The couple interrupted the pregnancy at 19 weeks by dilation and suction evacuation. Careful evaluation of multiple pieces of fetal parts and placenta revealed one abnormal finding: a single umbilical artery. Cytogenetic metaphase and fluorescent in situ hybridization (FISH) interphase analyses of cells from fetal lung, heart, placenta, and skin revealed the presence of the trisomic line in all tissues. Molecular analysis demonstrated that the origin of the extra chromosome 15 was maternal, the error most likely occurred in meiosis I and the diploid line was of biparental inheritance. This case report discusses the associated findings in this fetus and reviews the literature describing other cases of mosaic trisomy 15.
羊膜穿刺术发现的低水平染色体嵌合现象对临床医生和患者来说是个难题。我们报告了一例胎儿的产前诊断,其核型罕见,为47,XX, + 15/46,XX。因产妇年龄较大,在孕中期进行了羊膜穿刺术。胎儿超声检查显示右心室发育不全和宫内生长受限(IUGR)。胎儿其他部位的解剖结构在正常范围内。观察到一种47,XX, + 15/46,XX的嵌合核型。这对夫妇在孕19周时通过扩张刮宫术终止了妊娠。对多块胎儿组织和胎盘进行仔细评估后发现一个异常情况:单脐动脉。对胎儿肺、心脏、胎盘和皮肤细胞进行的细胞遗传学中期分析和荧光原位杂交(FISH)间期分析显示,所有组织中均存在三体细胞系。分子分析表明,额外的15号染色体起源于母亲,错误很可能发生在减数分裂I期,二倍体细胞系为双亲遗传。本病例报告讨论了该胎儿的相关发现,并回顾了描述其他15号染色体三体嵌合病例的文献。