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Phung V, Singh KE, Danon S, Tan CA, Dabagh S. Non-mosaic trisomy 22 and congenital heart surgery using the shared decision making model: a case report. BMC Pediatr 2023; 23:122. [PMID: 36932325 PMCID: PMC10024442 DOI: 10.1186/s12887-023-03949-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 06/17/2022] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Liveborn infants with non-mosaic trisomy 22 are rarely described in the medical literature. Reported lifespan of these patients ranges from minutes to 3 years, with the absence of cardiac anomalies associated with longer-term survival. The landscape for offering cardiac surgery to patients with rare autosomal trisomies is currently evolving, as has been demonstrated recently in trisomies 13 and 18. However, limited available data on patients with rare autosomal trisomies provides a significant challenge in perinatal counseling, especially when there are options for surgical intervention. CASE PRESENTATION In this case report, we describe an infant born at term with prenatally diagnosed apparently non-mosaic trisomy 22 and multiple cardiac anomalies, including a double outlet right ventricle, hypoplastic aortic valve and severe aortic arch hypoplasia, who underwent cardiac surgery. The decisions made by her family lending to her progress and survival to this day were made with a focus on the shared decision making model and support in the prenatal and perinatal period. We also review the published data on survival and quality of life after cardiac surgery in infants with rare trisomies. CONCLUSIONS This patient is the only known case of apparently non-mosaic trisomy 22 in the literature who has undergone cardiac surgery with significant survival benefit. This case highlights the impact of using a shared decision making model when there is prognostic uncertainty.
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Affiliation(s)
- Vivien Phung
- Department of Pediatrics, University of California, Irvine, USA.
| | - Kathryn E Singh
- Department of Pediatrics, University of California, Irvine, USA
- Department of Medical Genetics, Miller Women and Children's Hospital, Long Beach, CA, USA
| | - Saar Danon
- Department of Pediatric Cardiology, Miller Women and Children's Hospital, Long Beach, CA, USA
- Department of Pediatrics, University of California, Los Angeles, USA
| | - Christopher A Tan
- Department of Pediatrics, University of California, Irvine, USA
- Department of Pediatric Cardiology, Miller Women and Children's Hospital, Long Beach, CA, USA
| | - Sarah Dabagh
- Department of Palliative Care, Miller Women and Children's Hospital, Long Beach, CA, USA
- Department of Medicine, University of California, Irvine, USA
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2
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Abstract
Trisomy 22 (47, XX, +22), a rare chromosomal defect, was detected antenatally by chromosome analysis of the amniotic fluid after an obstetric ultrasound examination revealed multiple anomalies. The ultrasound findings included intrauterine growth retardation, holoprosencephaly, cleft lip, cardiac anomalies, decreased amniotic fluid level, and an abnormally thickened nuchal fold. Postnatal examination and autopsy confirmed the ultrasound findings.
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3
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Heinrich T, Nanda I, Rehn M, Zollner U, Frieauff E, Wirbelauer J, Grimm T, Schmid M. Live-born trisomy 22: patient report and review. Mol Syndromol 2013; 3:262-9. [PMID: 23599696 DOI: 10.1159/000346189] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2012] [Indexed: 11/19/2022] Open
Abstract
Trisomy 22 is a common trisomy in spontaneous abortions. In contrast, live-born trisomy 22 is rarely seen due to severe organ malformations associated with this condition. Here, we report on a male infant with complete, non-mosaic trisomy 22 born at 35 + 5 weeks via caesarean section. Peripheral blood lymphocytes and fibroblasts showed an additional chromosome 22 in all metaphases analyzed (47,XY,+22). In addition, array CGH confirmed complete trisomy 22. The patient's clinical features included dolichocephalus, hypertelorism, flattened nasal bridge, dysplastic ears with preauricular sinuses and tags, medial cleft palate, anal atresia, and coronary hypospadias with scrotum bipartitum. Essential treatment was implemented in close coordination with the parents. The child died 29 days after birth due to respiratory insufficiency and deterioration of renal function. Our patient's history complements other reports illustrating that children with complete trisomy 22 may survive until birth and beyond.
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Affiliation(s)
- T Heinrich
- Department of Human Genetics, University of Würzburg, Würzburg, Germany
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4
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Kovaleva NV. Nonmosaic balanced homologous translocations of major clinical significance: some may be mosaic. Am J Med Genet A 2007; 143A:2843-50. [PMID: 17975800 DOI: 10.1002/ajmg.a.31745] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The main mechanism proposed for formation of homologous translocations/isochromosomes is mitotic and if this occurs in a chromosomally normal conceptus, mosaicism would be expected to be seen. The lack of mosaicism in published cases of rearrangement (REA) of mitotic origin might be explained by under-detection due to the low level mosaicism for a normal line. Recently it was reported that sex-specific centromere instability in early embryogenesis leads to a female prevalence among individuals with mosaicism for pericentromeric rearrangements. To determine whether carriers of apparent non-mosaic homologous REA could be mosaics for a normal cell line, the sex ratio (male to female ratio) among carriers of balanced and unbalanced homologous translocations/isochromosomes was studied. This ratio was determined to establish if there is a female predominance similar to that seen in carriers of REA with mosaicism. In reviewing the literature, a female prevalence among fetuses with balanced homologous REA and among carriers of unbalanced homologous REA detected prenatally, postnatally and in miscarriages was found. Overall, there were 48 males and 72 females in the collected sample, and this ratio differed significantly from the expected sex ratio of 1.06 (P = 0.0075). There is not a male prevalence among miscarried fetuses, there is no evidence of selection against males in the collected material of this study. The analysis of sex ratios in different variants of trisomy 13 with respect to ascertainment (prenatal diagnosis, miscarriages, liveborn) also does not support an intrauterine selection against males as a cause of a female prevalence among carriers of homologous REA. Thus the data presented in this paper suggests that a proportion of the carriers of balanced homologous REA may have mosaicism for a normal line. Since low level mosaicism for a normal line in a translocation carrier would alter his/her reproductive options, it can be recommended that molecular polymorphic analysis be applied to these cases. This would allow those resulting from meiotic formation to be distinguished from those resulting from postzygotic formation. This latter mechanism may indicate the presence of a mosaicism for a normal line, making further intensive karyotypic analysis advisable. However, additional studies of healthy carriers of homologous REA of chromosome 14 or 15 should not be done. (c) 2007 Wiley-Liss, Inc.
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Affiliation(s)
- Natalia V Kovaleva
- St. Petersburg Center for Medical Genetics, St. Petersburg, Russian Federation.
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5
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Mokate T, Leask K, Mehta S, Sharif S, Smith A, Saxena A, Mahmood T. Non-mosaic trisomy 22: a report of 2 cases. Prenat Diagn 2007; 26:962-5. [PMID: 16906599 DOI: 10.1002/pd.1537] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Non-mosaic trisomy 22 is a common cause of first trimester miscarriage and has a livebirth incidence of 1 in 30,000-50,000. Consequently there is a paucity of information for counselling parents. Detection in the second trimester is rare. It is commonly associated with severe growth retardation and multiple structural abnormalities. Oligohydramnios is frequently seen and can make detection of other abnormalities difficult. The outlook is uniformly poor and survival beyond the first trimester may present management dilemmas. A thorough fetal assessment including high-resolution cytogenetics with or without FISH is required for counselling. Careful plans for intrapartum and neonatal management may be necessary. The recurrence risk is thought to be low but information is very limited as there have been no reported cases of recurrence. We present two case of non-mosaic trisomy 22 including the first to be diagnosed subsequent to investigation for a high serum screening Down's risk.
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Affiliation(s)
- T Mokate
- Department of Obstetrics and Gynaecology, Tameside General Hospital, Ashton-Under-Lyne, United Kingdom.
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6
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Tinkle BT, Walker ME, Blough-Pfau RI, Saal HM, Hopkin RJ. Unexpected survival in a case of prenatally diagnosed non-mosaic trisomy 22: Clinical report and review of the natural history. Am J Med Genet A 2003; 118A:90-5. [PMID: 12605450 DOI: 10.1002/ajmg.a.10216] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Over 30 cases of complete non-mosaic trisomy 22 have been reported in the literature in the last 20 years [Crowe et al., 1997: Am J Med Genet 71:406-413]. Twenty-two infants were liveborn with an average life expectancy of four days. Of these, nine survived beyond the first two weeks of life. The life span ranged from minutes to 3 years of age. We report a case of an infant diagnosed prenatally with complete non-mosaic trisomy 22. Options such as aggressive medical/surgical intervention or limiting interventions to symptomatic care including home hospice were discussed openly. Given this information, the family elected to provide minimal supportive measures with pediatric hospice. The infant lived for 2 months with her family before her death. Numerous medical and surgical complications are associated with this disorder. Both the family and the medical team must be prepared for in utero fetal demise, stillbirth, or for limited life expectancy. Proper management, therefore, depends upon an understanding of the diagnosis.
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Affiliation(s)
- Brad T Tinkle
- Cincinnati Children's Hospital Medical Center, Division of Human Genetics, Cincinnati, Ohio 45229, USA.
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7
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Kamnasaran D, Gerritsen JA, McLeod DR, Cox DW. Features within the holoprosencephaly spectrum in sibs with a Robertsonian (14q;22q) translocation chromosome. Clin Genet 2001; 60:237-9. [PMID: 11595027 DOI: 10.1034/j.1399-0004.2001.600311.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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8
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Manasse BF, Pfaffenzeller WM, Gurtunca N, de Ravel TJ. Possible isochromosome 22 leading to trisomy 22. AMERICAN JOURNAL OF MEDICAL GENETICS 2000; 95:411-4. [PMID: 11146458 DOI: 10.1002/1096-8628(20001218)95:5<411::aid-ajmg1>3.0.co;2-q] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We describe the first case of trisomy 22 resulting from a monocentric, possible isochromosome 22. The female infant had multiple anomalies including an abnormal face, ambiguous genitalia, and both ventricular and atrial septal defects. Survival was short.
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Affiliation(s)
- B F Manasse
- Department of Human Genetics, The South African Institute for Medical Research and The University of the Witwatersrand, Johannesburg, South Africa
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9
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Abstract
Trisomy 22 was detected in a 32-week-old fetus born to an overweight mother with hypertension. Severe intrauterine growth retardation was associated with phenotypic manifestations of Fryns syndrome: diaphragmatic hernia, facial defects, and nail hypoplasia with short distal fifth phalanges. This is the second report of congenital diaphragmatic hernia in trisomy 22. This case demonstrates the importance of karyotyping malformed fetuses or newborns, even if a nonchromosome syndrome seems identifiable on clinical grounds. To date, at least 10 cases of Fryns syndrome have been reported without chromosome analysis.
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Affiliation(s)
- J M Ladonne
- Department of Gynecology and Obstetrics, INSERM U314, Reims, France
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10
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Bacino CA, Schreck R, Fischel-Ghodsian N, Pepkowitz S, Prezant TR, Graham JM. Clinical and molecular studies in full trisomy 22: further delineation of the phenotype and review of the literature. AMERICAN JOURNAL OF MEDICAL GENETICS 1995; 56:359-65. [PMID: 7604844 DOI: 10.1002/ajmg.1320560404] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Trisomy 22 is commonly found among spontaneous abortions, second in frequency of occurrence only to trisomy 16. Most earlier reports of surviving trisomy 22 cases in the literature are thought to represent the product of unbalanced 11;22 translocations or the result of undetected mosaicism, since this condition is thought to manifest early embryonic or fetal lethality. We present two strikingly similar cases of non-mosaic trisomy 22 surviving to late gestation. In this paper we emphasize the unique phenotype of this trisomy which included intrauterine growth retardation, microcephaly, broad flat nasal bridge with epicanthal folds and ocular hypertelorism, microtia, variable cleft palate, webbed neck, congenital heart defects involving anomalous great vessels, anorectal and renal anomalies, and hypoplastic distal digits with thumb anomalies. We also explore why some cases survive to late gestation. Confined placental mosaicism, a frequent finding in other lethal trisomies, has been ruled out in one of the cases. Molecular studies done to assess the parental origin of the extra chromosome in the other case showed that the non-disjunction originated during maternal meiosis II. Parental origin of the extra chromosome does not seem to play a role in late survival for trisomy 22.
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Affiliation(s)
- C A Bacino
- Medical Genetics Birth Defects Center, Cedars-Sinai Medical Center, UCLA School of Medicine, USA
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11
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Prasher VP, Roberts E, Norman A, Butler AC, Krishnan VH, McMullan DJ. Partial trisomy 22 (q11.2-q13.1) as a result of duplication and pericentric inversion. J Med Genet 1995; 32:306-8. [PMID: 7643363 PMCID: PMC1050382 DOI: 10.1136/jmg.32.4.306] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A case of a 27 year old male with a duplication of part of the long arm of chromosome 22 (22q11.2-q13.1) together with a pericentric inversion of the same chromosome is reported. Particular phenotypic features of note include absence of speech, persistent self-injury, lack of daily living skills, colobomata, and very poor vision. Similarities between this case and other case reports of duplications of the long arm of chromosome 22 are discussed.
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Affiliation(s)
- V P Prasher
- Department of Psychiatry, University of Birmingham, Queen Elizabeth Psychiatric Hospital, Edgbaston, UK
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12
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Abstract
We present an infant with true trisomy 22. Mosaicism is ruled out by the finding of a 47,XX, +22 karyotype in all cells analysed originating from two embryonic germ layers. The physical findings are consistent with the previously noted features including developmental delay, ear abnormalities, micrognathia, clefting, and congenital heart disease. The patient is the first described with macrocephaly and hydrocephalus and the second with holoprosencephaly.
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Affiliation(s)
- F Fahmi
- Department of Pediatrics, St Joseph's Hospital and Medical Center, Paterson, New Jersey 07503
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13
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Kim EH, Cohen RS, Ramachandran P, Mineta AK, Babu VR. Trisomy 22 with congenital diaphragmatic hernia and absence of corpus callosum in a liveborn premature infant. AMERICAN JOURNAL OF MEDICAL GENETICS 1992; 44:437-8. [PMID: 1442883 DOI: 10.1002/ajmg.1320440410] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We report on a liveborn premature male with trisomy 22 who had multiple congenital anomalies, including congenital diaphragmatic hernia and absence of corpus callosum. He died of pulmonary hypoplasia associated with diaphragmatic hernia within 12 hours of age. Chromosome analysis by multiple banding techniques based on lymphocyte culture confirmed that he had trisomy 22. This may be the first report of congenital diaphragmatic hernia and isolated absence of corpus callosum associated with trisomy 22.
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MESH Headings
- Abnormalities, Multiple/genetics
- Agenesis of Corpus Callosum
- Chromosomes, Human, Pair 22
- Hernia, Diaphragmatic/diagnostic imaging
- Hernia, Diaphragmatic/genetics
- Hernias, Diaphragmatic, Congenital
- Humans
- Infant, Newborn
- Infant, Premature, Diseases/genetics
- Male
- Radiography
- Trisomy
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Affiliation(s)
- E H Kim
- Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, CA 95128
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14
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Hsu LY, Kaffe S, Jenkins EC, Alonso L, Benn PA, David K, Hirschhorn K, Lieber E, Shanske A, Shapiro LR. Proposed guidelines for diagnosis of chromosome mosaicism in amniocytes based on data derived from chromosome mosaicism and pseudomosaicism studies. Prenat Diagn 1992; 12:555-73. [PMID: 1508847 DOI: 10.1002/pd.1970120702] [Citation(s) in RCA: 85] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Currently, accepted protocol which has been developed at the Prenatal Diagnosis Laboratory of New York City (PDL) requires that when a chromosome abnormality is found in one or more cells in one flask, another 20-40 cells must be examined from one or two additional flasks. Chromosome mosaicism is diagnosed only when an identical abnormality is detected in cells from two or more flasks. In a recent PDL series of 12,000 cases studied according to this protocol, we diagnosed 801 cases (6.68 per cent) of single-cell pseudomosaicism (SCPM), 126 cases (1.05 per cent) of multiple-cell pseudomosaicism (MCPM), and 24 cases (0.2 per cent) of true mosaicism. Pseudomosaicism (PM) involving a structural abnormality was a frequent finding (2/3 of SCPM and 3/5 of MCPM), with an unbalanced structural abnormality in 55 per cent of SCPM and 24 per cent of MCPM. We also reviewed all true mosaic cases (a total of 50) diagnosed in the first 22,000 PDL cases. Of these 50 cases, 23 were sex chromosome mosaics and 27 had autosomal mosaicism; 48 cases had numerical abnormalities and two had structural abnormalities. Twenty-five cases of mosaicism were diagnosed in the first 20 cells from two flasks, i.e., without additional work-up, whereas the other 25 cases required extensive work-up to establish a diagnosis (12 needed additional cell counts from the initial two culture flasks; 13 required harvesting a third flask for cell analysis). Our data plus review of other available data led us to conclude that rigorous efforts to diagnose true mosaicism have little impact in many instances, and therefore are not cost-effective. On the basis of all available data, a work-up for potential mosaicism involving a sex chromosome aneuploidy or structural abnormality should have less priority than a work-up for a common viable autosomal trisomy. We recommend revised guidelines for dealing with (1) a numerical versus a structural abnormality and (2) an autosomal versus a sex chromosome numerical aneuploidy. Emphasis should be placed on autosomes known to be associated with phenotypic abnormalities. These new guidelines, which cover both flask and in situ methods, should result in more effective prenatal cytogenetic diagnosis and reduced patient anxiety.
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Affiliation(s)
- L Y Hsu
- Prenatal Diagnosis Laboratory of New York City (PDL), Medical and Health Research Association of New York City, Inc., NY 10016
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15
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Spinner NB, Gibas Z, Kline R, Berger B, Jackson L. Placental mosaicism in a case of 46,XY,-22,+t(22;22)(p11;q11) or i(22q) diagnosed at amniocentesis. Prenat Diagn 1992; 12:47-51. [PMID: 1557310 DOI: 10.1002/pd.1970120107] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
46,XY,-22,+t(22;22)(p11;q11) or i(22q) was diagnosed in 15/15 cells from two cultures from the amniotic fluid culture of a 31-year-old patient whose fetus demonstrated cystic hygroma on ultrasound. Cytogenetic studies performed on fetal skin from the abortus revealed the same karyotype as that seen on amniocentesis, but the placenta demonstrated a 46,XY/46,XY,-22,+t(22;22) or i(22q) mosaicism, with 65 per cent of the cells being 46,XY. This case provides an example of placental mosaicism for a normal male karyotype, while the fetus demonstrated non-mosaic trisomy 22.
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Affiliation(s)
- N B Spinner
- Department of Pediatrics, Albert Einstein Medical Center, Philadelphia, PA 19141
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16
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Antle CM, Pantzar JT, White VA. The ocular pathology of trisomy 22: report of two cases and review. J Pediatr Ophthalmol Strabismus 1990; 27:310-4. [PMID: 2086748 DOI: 10.3928/0191-3913-19901101-09] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Two cases of full trisomy 22 with the associated gross and microscopic pathology are reported. These cases demonstrate the typical craniofacial and organ system anomalies previously reported in trisomy 22 but also exhibit uveal colobomas that, within the spectrum of chromosome 22 anomalies, are usually restricted to the so-called "cat eye" syndrome. The attendant microscopic ocular findings represent, the best of our knowledge, the first such report in the literature.
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Affiliation(s)
- C M Antle
- Department of Pathology, Vancouver General Hospital, B.C., Canada
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17
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McPherson E, Stetka DG. Trisomy 22 in a liveborn infant with multiple congenital anomalies. AMERICAN JOURNAL OF MEDICAL GENETICS 1990; 36:11-4. [PMID: 2333899 DOI: 10.1002/ajmg.1320360104] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We report on the third confirmed case of trisomy 22 in a liveborn infant. High-resolution banding studies ruled out translocations such as the relatively common t(11;22). The infant shared many manifestations with other reported cases of trisomy 22 (e.g., growth deficiency, microcephaly, micrognathia, ear malformations, cleft palate, and congenital heart defect) and some manifestations in common with dup 22. Trisomy 22 appears to cause a severe malformation syndrome, and survival to term is rare.
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Affiliation(s)
- E McPherson
- Capital Area Permanente Medical Group, Springfield, Virginia
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18
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Phillipson J, Benirschke K, Bogart M. Two live-born infants with trisomy 22. PEDIATRIC PATHOLOGY 1990; 10:1001-5. [PMID: 2082329 DOI: 10.3109/15513819009064734] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The autopsy findings and karyotypes of two live-born fetuses with full trisomy 22 are discussed. Confined placental mosaicism was documented in one of the two cases. Confined placental mosaicism may play a role in the intrauterine survival of some trisomy 22 conceptions.
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Affiliation(s)
- J Phillipson
- Department of Pathology, University of California San Diego Medical Center 92103
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19
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Kukolich MK, Kulharya A, Jalal SM, Drummond-Borg M. Trisomy 22: no longer an enigma. AMERICAN JOURNAL OF MEDICAL GENETICS 1989; 34:541-4. [PMID: 2624265 DOI: 10.1002/ajmg.1320340417] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We describe a live-born male with 47,XY,+22. He had multiple congenital anomalies, severe growth retardation and psychomotor delay. Physical manifestations included broad nasal bridge, epicanthic folds, micrognathia, long philtrum, cleft palate, microcephaly with prominent occiput, apparently low-set malformed ears, heart murmur, genital anomaly, clinodactyly of the fifth fingers, and a low total finger ridge count. He died just before his 3rd birthday. Chromosome analysis by multiple banding techniques based on lymphocyte and fibroblast cultures confirm that the boy had complete trisomy 22.
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Affiliation(s)
- M K Kukolich
- Cytogenetics Laboratory, Texas Genetic Screening and Counseling Services, Denton 76201-2467
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20
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Cohen MM. Perspectives on holoprosencephaly: Part I. Epidemiology, genetics, and syndromology. TERATOLOGY 1989; 40:211-35. [PMID: 2688166 DOI: 10.1002/tera.1420400304] [Citation(s) in RCA: 207] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This paper provides an updated, comprehensive, critical review of the epidemiology, genetics, and syndromic aspects of holoprosencephaly and is divided into four parts. In the first part, epidemiologic aspects are discussed under the following headings: prevalence, temporal trends, socioeconomic status, exposure to environmental teratogens, maternal and paternal ages, pregnancy histories, and birth weights. The second part analyzes the facial phenotypes because the genetic and syndromic aspects of holoprosencephaly cannot be understood without knowledge of facial variability and its meaning. Topics discussed include cyclopia, ethmocephaly, cebocephaly, median cleft lip, and less severe facial dysmorphism. The third section, on genetics, analyzes associated anomalies, chromosomal and non-chromosomal holoprosencephaly, family studies, twin studies, genetics of nonsyndromic holoprosencephaly, and recurrence risks. The final section on syndromology summarizes 48 conditions in which some degree of holoprosencephaly may be a feature.
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Affiliation(s)
- M M Cohen
- Department of Oral Biology, Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada
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21
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Münke M, Emanuel BS, Zackai EH. Holoprosencephaly: association with interstitial deletion of 2p and review of the cytogenetic literature. AMERICAN JOURNAL OF MEDICAL GENETICS 1988; 30:929-38. [PMID: 3055987 DOI: 10.1002/ajmg.1320300409] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Chromosome analysis with high-resolution banding showed a small de novo interstitial deletion of chromosome 2(p21----p22.2) in an infant with holoprosencephaly. This is the first such observation. There is a well-known association with abnormalities of chromosome 13 (most commonly trisomy 13, but also dup(13q) and del(13q) and chromosome 18 (most often del(18p), but also trisomy 18). Review of the literature also showed duplications of 3p and deletions of 7q to be causes of the holoprosencephaly defect.
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Affiliation(s)
- M Münke
- Division of Clinical Genetics, Children's Hospital of Philadelphia, Pennsylvania
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