Mosaicism

镶嵌主义
  • 文章类型: Case Reports
    FOXP1基因(OMIM#605515)中的杂合突变是一种特征明确的神经发育综合征,称为“具有或不具有自闭症特征的语言障碍的智力发育障碍”(OMIM#613670)或简称FOXP1综合征。这种情况的主要特征是全球发育迟缓/智力残疾;所有个体的语言障碍,无论他们的认知能力水平如何;行为异常;先天性异常,包括微妙的畸形特征;和斜视,大脑,心脏,和泌尿生殖器异常。这里,我们提出了两个具有从头杂合FOXP1变体的兄弟姐妹,即,一个四岁的男孩和14个月大的女孩.两个孩子都明显延迟了早期精神运动发育,低张力,非常相似,轻微畸形的面部特征。缺乏表达性言语是四岁男孩的主要症状。我们对男性患者进行了全外显子组测序,鉴定出致病性杂合c.1541G>A(p。Arg514His)FOXP1突变。他姐姐的靶向突变分析也显示了相同的杂合FOXP1变体。分离分析揭示了突变的从头起源,表明父母性腺镶嵌的存在。据我们所知,这是医学文献中关于FOXP1相关神经发育障碍中性腺镶嵌性的首次报道.
    Heterozygous mutations in the FOXP1 gene (OMIM#605515) are responsible for a well-characterized neurodevelopmental syndrome known as \"intellectual developmental disorder with language impairment with or without autistic features\" (OMIM#613670) or FOXP1 syndrome for short. The main features of the condition are global developmental delay/intellectual disability; speech impairment in all individuals, regardless of their level of cognitive abilities; behavioral abnormalities; congenital anomalies, including subtle dysmorphic features; and strabismus, brain, cardiac, and urogenital abnormalities. Here, we present two siblings with a de novo heterozygous FOXP1 variant, namely, a four-year-old boy and 14-month-old girl. Both children have significantly delayed early psychomotor development, hypotonia, and very similar, slightly dysmorphic facial features. A lack of expressive speech was the leading symptom in the case of the four-year-old boy. We performed whole-exome sequencing on the male patient, which identified a pathogenic heterozygous c.1541G>A (p.Arg514His) FOXP1 mutation. His sister\'s targeted mutation analysis also showed the same heterozygous FOXP1 variant. Segregation analysis revealed the de novo origin of the mutation, suggesting the presence of parental gonadal mosaicism. To the best of our knowledge, this is the first report of gonadal mosaicism in FOXP1-related neurodevelopmental disorders in the medical literature.
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  • 文章类型: Case Reports
    目的:这里,我们介绍了一例羊膜穿刺术检测到的镶嵌三体6。
    方法:在妊娠17周时进行羊膜穿刺术(G带);结果为47,XY,+6[3]/46,XY[12]。胎儿筛查超声检查显示无形态学异常,父母希望继续怀孕。婴儿在妊娠39周时经阴道分娩。男婴出生时重3002g,无形态异常。对婴儿外周血进行的G显带核型分析显示46,XY[20]。FISH分析揭示了来自胎盘的100个细胞中的1-4个中的6号染色体上的三体性信号。脐带血的单核苷酸多态性微阵列未显示异常。脐带血的甲基化分析显示PLAGL1没有异常。在一岁时没有观察到疾病。
    结论:当羊膜穿刺术显示染色体镶嵌时,提供全面的胎儿超声检查和仔细的遗传咨询以支持夫妇的决策是至关重要的。
    OBJECTIVE: Herein, we present a case of mosaic trisomy 6 detected by amniocentesis.
    METHODS: Amniocentesis (G-banding) was performed at 17 weeks of gestation; the results were 47,XY,+6[3]/46,XY[12]. Fetal screening ultrasonography showed no morphological abnormalities, and the parents desired to continue the pregnancy. The infant was delivered vaginally at 39 weeks\' gestation. The male infant weighed 3002 g at birth with no morphological abnormalities. G-banding karyotype analysis performed on the infant\'s peripheral blood revealed 46,XY[20]. FISH analysis revealed trisomy signals on chromosome 6 in 1-4 out of 100 cells from the placenta. The single nucleotide polymorphism microarray of the umbilical cord blood revealed no abnormalities. Methylation analysis of umbilical cord blood revealed no abnormalities in PLAGL1. No disorders were observed at one year of age.
    CONCLUSIONS: When amniocentesis reveals chromosomal mosaicism, it is essential to provide a thorough fetal ultrasound examination and careful genetic counseling to support the couples\' decision-making.
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  • 文章类型: Journal Article
    Klinefelter综合征(KS),男性的特征是额外的X染色体,表现为广泛的神经内分泌和精神症状。患有KS的人经常面临荷尔蒙功能障碍的风险增加,导致抑郁和焦虑,尽管在儿科和青少年年龄的扩展研究仍然有限。这个关键阶段,对KS儿童来说是决定性的,受遗传因素的影响,环境和家庭因素,影响大脑可塑性。在这份报告中,我们回顾了,以叙事的形式,儿童中至关重要的KS精神病理学标志。为了更好地描述KS患儿的神经内分泌和神经精神结局,我们介绍了一个11岁的患有马赛克KS的青春期前儿童的案例,由于他的学习成绩下降,他被转诊到我们的发育精神病理学中心。在过去的几个月中,白天过度疲劳和分心增加。家族史显示一级和二级亲属患有精神疾病,包括最近离婚的父母和一个15岁的妹妹。诊断为早发性持续性抑郁症和焦虑特征。及时识别易感儿童,彻底检查家族精神病史,环境影响和神经认知特征,除了有针对性的干预措施,可能会减轻儿童和青少年KS病例中与精神病理学相关的终身残疾,包括那些马赛克KS。
    Klinefelter syndrome (KS), characterized by an additional X-chromosome in males, manifests in a wide range of neuroendocrine and psychiatric symptoms. Individuals with KS often face increased risks of hormonal dysfunction, leading to depression and anxiety, although extended research during pediatric and adolescent age is still limited. This critical phase, decisive for KS children, is influenced by a combination of genetic, environmental and familial factors, which impact brain plasticity. In this report, we reviewed, in a narrative form, the crucial KS psychopathological hallmarks in children. To better describe neuroendocrine and neuropsychiatric outcomes in children with KS, we presented the case of an 11-year-old prepubertal child with mosaic KS who was referred to our Center of Developmental Psychopathology due to a decline in his academic performance, excessive daytime fatigue and increased distractibility over the past few months. Family history revealed psychiatric conditions among first- and second-degree relatives, including recently divorced parents and a 15-year-old sister. Early-onset persistent depressive disorder and anxious traits were diagnosed. Timely identification of susceptible children, with thorough examination of familial psychiatric history, environmental influences and neurocognitive profile, alongside targeted interventions, could potentially mitigate lifelong psychopathology-related disabilities in pediatric and adolescent KS cases, including those with mosaic KS.
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  • 文章类型: Journal Article
    背景:我们的目的是讨论由X和Y染色体材料镶嵌单体引起的罕见的性发育障碍的表型特征的起源和差异以及管理护理。
    方法:我们报告了我们在2005年至2022年期间通过血细胞核型诊断并在我们部门护理的具有镶嵌X和Y染色体材料的患者的经验。
    结果:我们在研究中纳入了5名婴儿。目前的平均年龄为8岁。在四个案例中,诊断仍然是出生后,在一个病例中,它是在15岁。体格检查显示了不同程度的男性化,从单侧异位性腺的正常男性阴茎到生殖器结节和双侧无法触及的性腺的模棱两可,有4例患者和5例患者的正常女性外生殖器。核型发现45,X/46,XY镶嵌在患者1和2和45,X/46,X,患者3、4和5的der(Y)镶嵌性。3例分配给男性,2例分配给女性。放射学和组织学探查后,对4例患者进行了腹腔镜检查,其中2例进行了性腺切除术,另1例进行了Mullerian衍生切除术.在2例后尿道下裂中进行了尿道成形术。仅在3例中,性别认同与出生时的分配性别一致。
    结论:由于这种性功能障碍的表型异质性及其管理护理的变异性,那么这个决定应该依靠多学科的团队方法。
    BACKGROUND: we aim to discuss the origin and the differences of the phenotypic features and the management care of rare form of disorder of sex development due to Mosaic monosomy X and Y chromosome materiel.
    METHODS: We report our experience with patients harboring mosaic monosomy X and Y chromosome material diagnosed by blood cells karyotypes and cared for in our department from 2005 to 2022.
    RESULTS: We have included five infants in our study. The current average age was 8 years. In four cases, the diagnosis was still after born and it was at the age of 15 years in one case. Physical examination revealed a variable degree of virilization, ranging from a normal male phallus with unilateral ectopic gonad to ambiguous with a genital tubercle and bilateral not palpable gonads in four cases and normal female external genitalia in patient 5. Karyotype found 45, X/46, XY mosaicism in patient 1 and 2 and 45, X/46, X, der (Y) mosaicism in patient 3, 4 and 5. Three cases were assigned to male gender and two cases were assigned to female. After radiologic and histologic exploration, four patients had been explored by laparoscopy to perform gonadectomy in two cases and Mullerian derivative resection in the other. Urethroplasty was done in two cases of posterior hypospadias. Gender identity was concordant with the sex of assignment at birth in only 3 cases.
    CONCLUSIONS: Because of the phenotypic heterogeneity of this sexual disorders and the variability of its management care, then the decision should rely on a multidisciplinary team approach.
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  • 文章类型: Journal Article
    目的:本研究旨在对通过非侵入性产前检测(NIPT)鉴定的7三体高危胎儿进行产前基因诊断,并评估不同基因检测技术在产前诊断三体镶嵌性方面的有效性。
    方法:对于NIPT建议的7三体高风险孕妇的产前诊断,对羊水样本进行核型分析和染色体微阵列分析(CMA)。低深度全基因组拷贝数变异测序(CNV-seq)和荧光原位杂交(FISH)用于进一步阐明结果。此外,进行甲基化特异性多重连接依赖性探针扩增(MS-MLPA)以分析单亲二体性(UPD)的可能性。
    结果:羊水核型分析显示46,XX结果。根据CMA结果检测到大约20%的镶嵌三体7。CNV-seq和FISH检测到约16%和4%的镶嵌性,分别。MS-MLPA未显示甲基化异常。除了在妊娠39周时看到的轻度宫内发育迟缓外,胎儿超声检查未显示任何可检测到的异常。在接受遗传咨询后,准妈妈决定继续怀孕,分娩后三个月内随访正常。
    结论:在高风险NIPT诊断中,细胞遗传学和分子遗传学技术的结合证明了检测低水平镶嵌性的卓有成效。此外,当NIPT显示7三体的产前诊断为阳性时,排除7号染色体上的UPD仍然至关重要。
    OBJECTIVE: This study aims to perform a prenatal genetic diagnosis of a high-risk fetus with trisomy 7 identified by noninvasive prenatal testing (NIPT) and to evaluate the efficacy of different genetic testing techniques for prenatal diagnosis of trisomy mosaicism.
    METHODS: For prenatal diagnosis of a pregnant woman with a high risk of trisomy 7 suggested by NIPT, karyotyping and chromosomal microarray analysis (CMA) were performed on an amniotic fluid sample. Low-depth whole-genome copy number variation sequencing (CNV-seq) and fluorescence in situ hybridization (FISH) were used to clarify the results further. In addition, methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) was performed to analyze the possibility of uniparental disomy(UPD).
    RESULTS: Amniotic fluid karyotype analysis revealed a 46, XX result. Approximately 20% mosaic trisomy 7 was detected according to the CMA result. About 16% and 4% of mosaicism was detected by CNV-seq and FISH, respectively. MS-MLPA showed no methylation abnormalities. The fetal ultrasound did not show any detectable abnormalities except for mild intrauterine growth retardation seen at 39 weeks of gestation. After receiving genetic counseling, the expectant mother decided to continue the pregnancy, and follow-up within three months of delivery was normal.
    CONCLUSIONS: In high-risk NIPT diagnosis, a combination of cytogenetic and molecular genetic techniques proves fruitful in detecting low-level mosaicism. Furthermore, the exclusion of UPD on chromosome 7 remains crucial when NIPT indicates a positive prenatal diagnosis of trisomy 7.
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  • 文章类型: Journal Article
    除了两千多个正常的Polyommatusicarus标本(Rottemburg,1775)通过饲养实验产生的,首先,有一个完全双侧的二色性个体被认为是妇科。在分析生殖器性状的基础上,机翼表面覆盖尺度微观形态,以及由覆盖尺度产生的蓝色的光谱特征,标本的性别已被确定为女性。与匈牙利自然历史博物馆藏品中的妇科标本进行了比较,研究了该样本,这些标本表现出不同程度的蓝色和棕色混合。焦点堆叠显微镜用于详细的尺度形态和紫外-可见反射光谱用于光学性质的表征。检查文献参考资料和博物馆的Lycaenidae收藏,在密切相关的多叶素lycaenid物种Lysandrabellargus(Rottemburg,1775年)和LysandraCoridon(Poda,1761)这表明多聚ommatine女性二色性可以通过双边性和镶嵌性的方式显示,迄今为止仅与gynandromorphy有关的现象。
    Beside the more than two thousand normal specimens of Polyommatus icarus (Rottemburg, 1775) yielded by rearing experiments, there was one perfectly bilateral dichromatic individual first considered to be gynandrous. On the basis of analysing genitalia traits, wing surface covering scale micromorphology, and the spectral characteristics of the blue colour generated by the cover scales, the gender of the specimen has been identified as female. This exemplar was investigated in comparison with gynandrous specimens from the collections of the Hungarian Natural History Museum exhibiting various degrees of intermixing of blue and brown coloration. Focus stacking microscopy for detailed scale morphology and UV-visible reflectance spectroscopy was used for the characterization of the optical properties. Inspecting literature references and the Lycaenidae collection of the museum, further examples have been found for female bilateral dichromatism in the closely related polyommatine lycaenid species Lysandra bellargus (Rottemburg, 1775) and Lysandra coridon (Poda, 1761) what suggests that polyommatine female dichromaticity may be displayed by the manner of bilaterality and mosaicism, phenomena hitherto solely connected to gynandromorphy.
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  • 文章类型: Journal Article
    背景:在新诊断的B型血友病病例中,散发性病例的比例通常为重症病例的50%和中度/轻度病例的25%。然而,由于家族史而推测为零星的病例可能并不总是零星的。关于血友病B的镶嵌性的病例报道很少。
    目的:本研究旨在通过单倍型标记在明确的散发性血友病B病例队列中追踪致病变异的起源。它还旨在确定假定的非携带者母亲的镶嵌频率。
    方法:研究组为40个家庭,每个人都有一个散发性的B型血友病病例,通过Sanger测序分析了两到三代,单体分型和使用敏感的液滴数字聚合酶链反应(ddPCR)技术。
    结果:在31/40(78%)的家庭中,这位母亲携带着和她儿子相同的致病变种,而Sanger测序显示,9/40(22%)的母亲没有携带这种变异。在这些变体中,使用ddPCR技术显示2/9(22%)是马赛克。16/21携带者母亲,有三代的样本,有一个从头致病变异,其中14个来自健康的外祖父。
    结论:散发性乙型血友病病例中致病变异的起源最常见于X染色体上,很少,来自外婆。似乎发现花叶病雌性的频率与A型血友病相同,但致病变异的百分比较低。
    BACKGROUND: Of newly diagnosed cases of haemophilia B, the proportion of sporadic cases is usually 50% of severe cases and 25% of moderate/mild cases. However, cases presumed to be sporadic due to family history may not always be sporadic. Few case reports have been published on mosaicism in haemophilia B.
    OBJECTIVE: The present study aimed to trace the origin of the pathogenic variant in a well-defined cohort of sporadic cases of haemophilia B by haplotyping markers. It also aimed to determine the frequency of mosaicism in presumed non-carrier mothers.
    METHODS: The study group was 40 families, each with a sporadic case of haemophilia B analysed in two-to-three generations by Sanger sequencing, haplotyping and using the sensitive droplet digital polymerase chain reaction (ddPCR) technique.
    RESULTS: In 31/40 (78%) of the families, the mother carried the same pathogenic variant as her son, while Sanger sequencing showed that 9/40 (22%) of the mothers did not carry this variant. Of these variants, 2/9 (22%) were shown to be mosaics by using the ddPCR technique. 16/21 carrier mothers, with samples from three generations available, had a de novo pathogenic variant of which 14 derived from the healthy maternal grandfather.
    CONCLUSIONS: The origin of the pathogenic variant in sporadic cases of haemophilia B is most often found in the X-chromosome derived from the maternal grandfather or, less often, from the maternal grandmother. Mosaic females seem to be found at the same frequency as in haemophilia A but at a lower percentage of the pathogenic variant.
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  • 文章类型: Case Reports
    TreacherCollins综合征(TCS)是一种罕见的先天性颅面疾病,通常作为常染色体显性遗传。这里,我们报道了一个可能存在TCS生殖系镶嵌的家族。先证者根据典型的临床特征和致病性变异体TCOF1诊断为TCS(c.4369_4373delAAGAA,p.K1457Efs*12)。在他父母的外周血DNA样本中没有检测到这种突变,提示先证者发生了从头突变。然而,一年后,先证者的母亲怀孕了,羊水穿刺显示胎儿携带与先证者相同的突变。产前超声还显示颌面部发育不良伴单侧小耳畸形。这位母亲随后透露了以前的出生史,其中一名婴儿在出生后不久死于呼吸窘迫,显示TCS样表型。大约在同一时间,先证者的父亲被诊断为轻度双侧传导性听力损失。基于阵列数据,我们得出的结论是,父亲可能对TCOF1突变有种系镶嵌。我们的发现强调了在提供遗传咨询时,在零星的从头TCOF1突变中考虑种系镶嵌的重要性。当先证者的父母再次怀孕时,产前诊断很重要。
    Treacher Collins syndrome (TCS) is a rare congenital craniofacial disorder, typically inherited as an autosomal dominant condition. Here, we report on a family in which germline mosaicism for TCS was likely present. The proband was diagnosed with TCS based on the typical clinical features and a pathogenic variant TCOF1 (c.4369_4373delAAGAA, p.K1457Efs*12). The mutation was not detected in his parents\' peripheral blood DNA samples, suggesting a de novo mutation had occurred in the proband. However, a year later, the proband\'s mother became pregnant, and the amniotic fluid puncture revealed that the fetus carried the same mutation as the proband. Prenatal ultrasound also indicated a maxillofacial dysplasia with unilateral microtia. The mother then disclosed a previous birth history in which a baby had died of respiratory distress shortly after birth, displaying a TCS-like phenotype. Around the same time, the proband\'s father was diagnosed with mild bilateral conductive hearing loss. Based on array data, we concluded that the father may have had germline mosaicism for TCOF1 mutation. Our findings highlight the importance of considering germline mosaicism in sporadic de novo TCOF1 mutations when providing genetic consulting, and prenatal diagnosis is important when the proband\'s parents become pregnant again.
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  • 文章类型: Systematic Review
    背景:在与生命相容的非整倍体中,三体22镶嵌是非常罕见的,到目前为止,文献中只描述了大约25例产后病例和18例产前病例。这种情况的主要特征是面部和身体不对称,心脏缺陷,面部畸形,生长失败,青春期延迟,和不同程度的神经发育迟缓。
    目的:关于病情的分散信息以及关于其自然史和发育结果的数据的缺乏限制了遗传咨询,特别是在产前设置。此外,及时诊断经常被血液中三体细胞的阴性选择所延迟,镶嵌性百分比在组织之间不同,这通常需要进一步的测试。目的/主题:我们工作的目的是通过系统地描述当前的病情知识,为产前和产后遗传咨询提供帮助。这需要定义产前和产后的条件的特点,并提出新的数据,从三个案例,无论是出生前还是出生后。此外,我们报告了两名新患者的发育结局.
    Among aneuploidies compatible with life, trisomy 22 mosaicism is extremely rare, and only about 25 postnatal and 18 prenatal cases have been described in the literature so far. The condition is mainly characterized by facial and body asymmetry, cardiac heart defects, facial dysmorphisms, growth failure, delayed puberty, and variable degrees of neurodevelopmental delay.
    The scattered information regarding the condition and the dearth of data on its natural history and developmental outcomes restrict genetic counseling, particularly in prenatal settings. Moreover, a prompt diagnosis is frequently delayed by the negative selection of trisomic cells in blood, with mosaicism percentage varying among tissues, which often entails the need for further testing. Purpose/topic: The aim of our work is to provide assistance in prenatal and postnatal genetic counseling by systematically delineating the current knowledge of the condition. This entails defining the prenatal and postnatal characteristics of the condition and presenting novel data from three cases, both prenatally and postnatally. Additionally, we report the developmental outcomes observed in two new patients.
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  • 文章类型: Journal Article
    目的:区分散发性和种系/马赛克NF2相关神经鞘瘤病对于确保患者获得适当的长期护理很重要。有了这份报告,我们描述了一例4例同侧神经鞘瘤患者的独特病例,并确定了可以准确诊断镶嵌型NF2相关神经鞘瘤病的测序方式组合.
    方法:我们介绍了一位32岁的女性,她的父亲有前庭神经鞘瘤家族史,右侧神经鞘瘤累及耳蜗的顶端和基底转向,外侧半规管,和内耳道(IAC)。使用下一代测序(NGS)对2种肿瘤(abyrinethine和IAC肿瘤)的血液和冷冻组织进行遗传分析,多重连接依赖性探针扩增(MLPA),和光学基因组作图(OGM)。
    结果:NF2、LZTR1和SMARCB1的胚系检测结果为阴性。肿瘤基因检测揭示了两种肿瘤之间共有的NF2致病变异(“第一次击中”),但明显的“第二次击中”NF2变异,包括仅使用OGM观察到的IAC肿瘤中22号染色体的马赛克丢失,与马赛克NF2相关的神经鞘瘤病一致。
    结论:多模态测序,包括NGS,MLPA,和OGM,需要确保该患者的马赛克NF2相关神经鞘瘤病的适当诊断。类似的方法可用于患有多个同侧肿瘤和可疑肿瘤倾向的其他患者。
    OBJECTIVE: Distinguishing between sporadic and germline/mosaic NF2-related schwannomatosis is important to ensure that patients have appropriate long-term care. With this report, we describe a unique case of a patient with 4 ipsilateral schwannomas and identify a combination of sequencing modalities that can accurately diagnose mosaic NF2-related schwannomatosis.
    METHODS: We present a 32-year-old woman with a familial history of vestibular schwannoma in her father and right-sided schwannomas involving the apical and basal turns of cochlea, lateral semicircular canal, and internal auditory canal (IAC). Genetic analysis of blood and frozen tissue from 2 tumors (intralabyrinthine and IAC tumors) was performed using next-generation sequencing (NGS), multiplex ligation-dependent probe amplification (MLPA), and optical genome mapping (OGM).
    RESULTS: Germline testing for NF2, LZTR1, and SMARCB1 was negative. Tumor genetic testing revealed a shared NF2 pathogenic variant between the 2 tumors (\"first hit\") but distinct \"second hit\" NF2 variants, including mosaic loss of chromosome 22 in the IAC tumor seen only with OGM, consistent with mosaic NF2-related schwannomatosis.
    CONCLUSIONS: Multimodality sequencing, including NGS, MLPA, and OGM, was required to ensure appropriate diagnosis of mosaic NF2-related schwannomatosis in this patient. A similar approach can be used for other patients with multiple ipsilateral tumors and suspected tumor predisposition.
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