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Liu S, Zheng J, Liu X, Lai Y, Zhang X, He T, Yang Y, Wang H, Zhang X. Comprehensive analysis of three female patients with different types of X/Y translocations and literature review. Mol Cytogenet 2023; 16:7. [PMID: 37202823 DOI: 10.1186/s13039-023-00639-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/07/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND X/Y translocations are highly heterogeneity in terms of clinical genetic effects, and most patients lack complete pedigree analysis for clinical and genetic characterization. RESULTS This study comprehensively analyzed the clinical and genetic characteristics of three new patients with X/Y translocations. Furthermore, cases with X/Y translocations reported in the literature and studies exploring the clinical genetic effects in patients with X/Y translocations were reviewed. All three female patients were carriers of X/Y translocations with different phenotypes. The karyotype for patient 1 was 46,X,der(X)t(X;Y)(p22.33;q12)mat, patient 2 was 46,X,der(X)t(X;Y)(q21.2;q11.2)dn, and patient 3 was 46,X,der(X)t(X;Y)(q28;q11.223)t(Y;Y)(q12;q11.223)mat. C-banding analysis of all three patients revealed a large heterochromatin region in the terminal region of the X chromosome. All patients underwent chromosomal microarray analysis, which revealed the precise copy number loss or gain. Data on 128 patients with X/Y translocations were retrieved from 81 studies; the phenotype of these patients was related to the breakpoint of the chromosome, size of the deleted region, and their sex. We reclassified the X/Y translocations into new types based on the breakpoints of the X and Y chromosomes. CONCLUSION X/Y translocations have substantial phenotypic diversity, and the genetic classification standards are not unified. With the development of molecular cytogenetics, it is necessary to combine multiple genetic methods to obtain an accurate and reasonable classification. Thus, clarifying their genetic causes and effects promptly will help in genetic counseling, prenatal diagnosis, preimplantation genetic testing, and improvement in clinical treatment strategies.
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Affiliation(s)
- Shanquan Liu
- Department of Medical Genetics & Prenatal Diagnosis Center, West China Second University Hospital, Sichuan University, No.20, South Section 3, Renmin Road, Chengdu, 610041, Sichuan, China
- Department of Obstetrics & Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University), Ministry of Education, Chengdu, China
| | - Jiemei Zheng
- Department of Medical Genetics & Prenatal Diagnosis Center, West China Second University Hospital, Sichuan University, No.20, South Section 3, Renmin Road, Chengdu, 610041, Sichuan, China
- Department of Obstetrics & Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University), Ministry of Education, Chengdu, China
| | - Xijing Liu
- Department of Medical Genetics & Prenatal Diagnosis Center, West China Second University Hospital, Sichuan University, No.20, South Section 3, Renmin Road, Chengdu, 610041, Sichuan, China
- Department of Obstetrics & Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University), Ministry of Education, Chengdu, China
| | - Yi Lai
- Department of Medical Genetics & Prenatal Diagnosis Center, West China Second University Hospital, Sichuan University, No.20, South Section 3, Renmin Road, Chengdu, 610041, Sichuan, China
- Department of Obstetrics & Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University), Ministry of Education, Chengdu, China
| | - Xuan Zhang
- Department of Medical Genetics & Prenatal Diagnosis Center, West China Second University Hospital, Sichuan University, No.20, South Section 3, Renmin Road, Chengdu, 610041, Sichuan, China
- Department of Obstetrics & Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University), Ministry of Education, Chengdu, China
| | - Tiantian He
- Department of Medical Genetics & Prenatal Diagnosis Center, West China Second University Hospital, Sichuan University, No.20, South Section 3, Renmin Road, Chengdu, 610041, Sichuan, China
- Department of Obstetrics & Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University), Ministry of Education, Chengdu, China
| | - Yan Yang
- Department of Medical Genetics & Prenatal Diagnosis Center, West China Second University Hospital, Sichuan University, No.20, South Section 3, Renmin Road, Chengdu, 610041, Sichuan, China
- Department of Obstetrics & Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University), Ministry of Education, Chengdu, China
| | - He Wang
- Department of Medical Genetics & Prenatal Diagnosis Center, West China Second University Hospital, Sichuan University, No.20, South Section 3, Renmin Road, Chengdu, 610041, Sichuan, China
- Department of Obstetrics & Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University), Ministry of Education, Chengdu, China
| | - Xuemei Zhang
- Department of Medical Genetics & Prenatal Diagnosis Center, West China Second University Hospital, Sichuan University, No.20, South Section 3, Renmin Road, Chengdu, 610041, Sichuan, China.
- Department of Obstetrics & Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
- Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University), Ministry of Education, Chengdu, China.
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Hemesath TP, de Paula LCP, Carvalho CG, Leite JCL, Guaragna-Filho G, Costa EC. Controversies on Timing of Sex Assignment and Surgery in Individuals With Disorders of Sex Development: A Perspective. Front Pediatr 2019; 6:419. [PMID: 30687685 PMCID: PMC6335325 DOI: 10.3389/fped.2018.00419] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 12/18/2018] [Indexed: 12/23/2022] Open
Abstract
Appropriate management of disorders of sex development (DSD) has been a matter of discussion since the first guidelines were published in the 1950s. In the last decade, with the advent of the 2006 consensus, the classical methods, especially regarding timing of surgery and sex of rearing, are being questioned. In our culture, parents of DSD newborns usually want their children to undergo genital surgery as soon as possible after sexual assignment, as surgery helps them to confirm the assigned sex. Developmental psychology theories back this hypothesis. They state that anatomic differences between sexes initiate the very important process of identification with the parent of the same sex. Sex-related endocrinological issues also demand early care. For example, using dihydrotestosterone cream to increase penile length or growth hormone treatment to improve final height require intervention at young ages to obtain better results. Although the timing of surgery remains controversial, recent evidence suggests that male reconstruction should be performed between 6 and 18 months of age. Feminizing surgery is still somewhat controversial. Most guidelines agree that severe virilization requires surgical intervention, while no consensus exists regarding mild cases. Our perspective is that precocious binary sex assignment and early surgery is a better management method. There is no strong evidence for delays and the consequences can be catastrophic in adulthood.
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Affiliation(s)
- Tatiana Prade Hemesath
- PADS DSD Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Psycology Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Leila Cristina Pedroso de Paula
- PADS DSD Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Endocrinology Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Clarissa Gutierrez Carvalho
- PADS DSD Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Pediatrics Department, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Julio Cesar Loguercio Leite
- PADS DSD Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Medical Genetics Service, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Guilherme Guaragna-Filho
- PADS DSD Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Pediatrics Department, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Eduardo Corrêa Costa
- PADS DSD Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Pediatric Surgery Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
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