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Samanta D, Schaefer B. Mosaic chromosome 5p tetrasomy: eye closure-induced seizures in a rare neurocutaneous syndrome. Acta Neurol Belg 2020; 120:713-716. [PMID: 31292937 DOI: 10.1007/s13760-019-01183-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 07/02/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Debopam Samanta
- Child Neurology Section, Department of Pediatrics, University of Arkansas for Medical Sciences, 1 Children's Way, Little Rock, AR, 72202, USA.
| | - Bradley Schaefer
- Division of Genetics, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Blakey-Cheung S, Parker P, Schlaff W, Monseur B, Keppler-Noreuil K, Al-Kouatly HB. Diagnosis and clinical delineation of mosaic tetrasomy 5p. Eur J Med Genet 2019; 63:103634. [PMID: 30797979 DOI: 10.1016/j.ejmg.2019.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 02/06/2019] [Accepted: 02/17/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Our objective was to review the phenotypic and genetic characteristics of tetrasomy 5p from the fetal period until adulthood including prenatal diagnostic evaluations. BACKGROUND Tetrasomy 5p is a rare chromosomal abnormality. Of the 14 reports, most document mosaic tetrasomy 5p resulting from a supernumerary marker chromosome or isochromosome. There is a wide range of phenotypic manifestations with severity related to more proximal breakpoints and the degree of mosaicism. DESIGN We conducted a systematic review using Scopus, PubMed Central® and Ovid MEDLINE® from inception through July 1, 2018 for all articles describing tetrasomy 5p. All articles describing the syndrome of tetrasomy 5p were included. RESULTS Of the 15 included cases, 13 exhibited mosaic tetrasomy and two had complete tetrasomy identified by amniocentesis. The most common features include seizures (8/11 live births, 73%), hypotonia (7/11 live births, 64%), developmental delay (7/9 cases that reached childhood, 78%), abnormal external ears (6/11 live births, 55%), short stature (6/11 live births, 55%), ventriculomegaly (5/11 live births, 45.5%) and congenital heart defect (6/15 cases, 40%). The clinical phenotype ranged in severity from mild with no defining characteristics to severe with seizures, developmental delay, and multiple congenital anomalies, resulting in early death. Of these 15 cases, only 6 were diagnosed prenatally by prenatal genetic testing (40%) with prenatal ultrasound identifying abnormalities in 4/6 (67%). Confined placental mosaicism (CPM) was diagnosed in six additional cases due to discordance between CVS and amniocentesis results. Four of the five live births returned for evaluation and each showed normal development. CONCLUSIONS Fourteen out of 15 (93%) cases of tetrasomy 5p were associated with an abnormal phenotype. Once a diagnosis is made prenatally, a detailed anatomy ultrasound and fetal echocardiogram must be performed to further characterize any structural abnormalities of the fetus and potentially estimate the clinical severity. Caution should be exercised when prenatal diagnosis of mosaic tetrasomy 5p is found by chorionic villus sampling. CVS alone is insufficient to diagnose tetrasomy 5p and needs to be confirmed with amniocentesis. Our review seeks to inform clinicians on the current literature regarding tetrasomy 5p so that they may better counsel patients when this syndrome is diagnosed.
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Affiliation(s)
- Sophia Blakey-Cheung
- 1025 Walnut Street #100, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Pamela Parker
- 833 Chestnut Street, Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, Philadelphia, PA, 19107, USA
| | - William Schlaff
- 833 Chestnut Street, Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, Philadelphia, PA, 19107, USA
| | - Brent Monseur
- 833 Chestnut Street, Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, Philadelphia, PA, 19107, USA
| | - Kim Keppler-Noreuil
- 5140 South Drive, Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Huda B Al-Kouatly
- 833 Chestnut Street, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, U19107, USA.
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Tesner P, Drabova J, Stolfa M, Kudr M, Kyncl M, Moslerova V, Novotna D, Kremlikova Pourova R, Kocarek E, Rasplickova T, Sedlacek Z, Vlckova M. A boy with developmental delay and mosaic supernumerary inv dup(5)(p15.33p15.1) leading to distal 5p tetrasomy - case report and review of the literature. Mol Cytogenet 2018; 11:29. [PMID: 29760779 PMCID: PMC5941596 DOI: 10.1186/s13039-018-0377-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 04/20/2018] [Indexed: 01/01/2023] Open
Abstract
Background With only 11 patients reported, 5p tetrasomy belongs to rare postnatal findings. Most cases are due to small supernumerary marker chromosomes (sSMCs) or isochromosomes. The patients share common but unspecific symptoms such as developmental delay, seizures, ventriculomegaly, hypotonia, and fifth finger clinodactyly. Simple interstitial duplications leading to trisomies of parts of 5p are much more frequent and better described. Duplications encompassing 5p13.2 cause a defined syndrome with macrocephaly, distinct facial phenotype, heart defects, talipes equinovarus, feeding difficulties, respiratory distress and anomalies of the central nervous system, developmental delay and hypotonia. Case presentation We present a boy with dysmorphic features, developmental delay, intellectual disability and congenital anomalies, and a mosaic sSMC inv dup(5)(p15.33p15.1). He is the fourth and the oldest reported patient with distal 5p tetrasomy. His level of mosaicism was significantly different in lymphocytes (13.2%) and buccal cells (64.7%). The amplification in our patient is smaller than that in the three previously published patients but the only phenotype difference is the absence of seizures in our patient. Conclusions Our observations indicate that for the assessment of prognosis, especially with respect to intellectual functioning, the level of mosaicism could be more important than the extent of amplification and the number of extra copies. Evaluation of the phenotypical effect of rare chromosomal aberrations is challenging and each additional case is valuable for refinement of the genotype-phenotype correlation. Moreover, our patient demonstrates that if the phenotype is severe and if the level of sSMC mosaicism is low in lymphocytes, other tissues should be tested. Electronic supplementary material The online version of this article (10.1186/s13039-018-0377-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pavel Tesner
- 1Department of Biology and Medical Genetics, Charles University 2nd Faculty of Medicine and University Hospital Motol, V Uvalu 84, 15006 Prague 5, Czech Republic
| | - Jana Drabova
- 1Department of Biology and Medical Genetics, Charles University 2nd Faculty of Medicine and University Hospital Motol, V Uvalu 84, 15006 Prague 5, Czech Republic
| | - Miroslav Stolfa
- 1Department of Biology and Medical Genetics, Charles University 2nd Faculty of Medicine and University Hospital Motol, V Uvalu 84, 15006 Prague 5, Czech Republic
| | - Martin Kudr
- 2Department of Paediatric Neurology, Charles University 2nd Faculty of Medicine and University Hospital Motol, V Uvalu 84, 15006 Prague 5, Czech Republic
| | - Martin Kyncl
- 3Department of Radiology, Charles University 2nd Faculty of Medicine and University Hospital Motol, V Uvalu 84, 15006 Prague 5, Czech Republic
| | - Veronika Moslerova
- 1Department of Biology and Medical Genetics, Charles University 2nd Faculty of Medicine and University Hospital Motol, V Uvalu 84, 15006 Prague 5, Czech Republic
| | - Drahuse Novotna
- 1Department of Biology and Medical Genetics, Charles University 2nd Faculty of Medicine and University Hospital Motol, V Uvalu 84, 15006 Prague 5, Czech Republic
| | - Radka Kremlikova Pourova
- 1Department of Biology and Medical Genetics, Charles University 2nd Faculty of Medicine and University Hospital Motol, V Uvalu 84, 15006 Prague 5, Czech Republic
| | - Eduard Kocarek
- 1Department of Biology and Medical Genetics, Charles University 2nd Faculty of Medicine and University Hospital Motol, V Uvalu 84, 15006 Prague 5, Czech Republic
| | - Tereza Rasplickova
- 1Department of Biology and Medical Genetics, Charles University 2nd Faculty of Medicine and University Hospital Motol, V Uvalu 84, 15006 Prague 5, Czech Republic
| | - Zdenek Sedlacek
- 1Department of Biology and Medical Genetics, Charles University 2nd Faculty of Medicine and University Hospital Motol, V Uvalu 84, 15006 Prague 5, Czech Republic
| | - Marketa Vlckova
- 1Department of Biology and Medical Genetics, Charles University 2nd Faculty of Medicine and University Hospital Motol, V Uvalu 84, 15006 Prague 5, Czech Republic
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Roulet-Coudrier F, Rouibi A, Thuillier C, Bourthoumieu S, Lebbar A, Dupont JM, Yardin C. Unusual isochromosome 5p marker chromosome. Am J Med Genet A 2014; 167A:455-9. [DOI: 10.1002/ajmg.a.36843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 09/11/2014] [Indexed: 11/12/2022]
Affiliation(s)
- Fanny Roulet-Coudrier
- Service d'Histologie; Cytologie; Biologie Cellulaire et Cytogénétique; Hôpital de la Mère et de l'Enfant (HME); CHU (Centre Hospitalier Universitaire) Dupuytren; Limoges France
| | - Amine Rouibi
- Service d'Histologie; Cytologie; Biologie Cellulaire et Cytogénétique; Hôpital de la Mère et de l'Enfant (HME); CHU (Centre Hospitalier Universitaire) Dupuytren; Limoges France
| | - Clotilde Thuillier
- Service de Pédiatrie; Hôpital de la Mère et de l'Enfant (HME); CHU (Centre Hospitalier Universitaire) Dupuytren; Limoges France
| | - Sylvie Bourthoumieu
- Service d'Histologie; Cytologie; Biologie Cellulaire et Cytogénétique; Hôpital de la Mère et de l'Enfant (HME); CHU (Centre Hospitalier Universitaire) Dupuytren; Limoges France
- CHREC (Comité de Recherche Clinique du HME); CHU (Centre Hospitalier Universitaire) Dupuytren; Limoges France
| | - Aziza Lebbar
- Service de Cytogénétique; Groupe Hospitalier Cochin-Saint Vincent de Paul; APHP (Assistance Publique Hôpitaux de Paris); Paris France
| | - Jean-Michel Dupont
- Service de Cytogénétique; Groupe Hospitalier Cochin-Saint Vincent de Paul; APHP (Assistance Publique Hôpitaux de Paris); Paris France
| | - Catherine Yardin
- Service d'Histologie; Cytologie; Biologie Cellulaire et Cytogénétique; Hôpital de la Mère et de l'Enfant (HME); CHU (Centre Hospitalier Universitaire) Dupuytren; Limoges France
- CHREC (Comité de Recherche Clinique du HME); CHU (Centre Hospitalier Universitaire) Dupuytren; Limoges France
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Abstract
Human genetic mosaicism is the presence of two or more cellular populations with distinct genotypes in an individual who developed from a single fertilized ovum. While initially observed across a spectrum of rare genetic disorders, detailed assessment of data from genome-wide association studies now reveal that detectable clonal mosaicism involving large structural alterations (>2 Mb) can also be seen in populations of apparently healthy individuals. The first generation of descriptive studies has generated new interest in understanding the molecular basis of the affected genomic regions, percent of the cellular subpopulation involved, and developmental timing of the underlying mutational event, which could reveal new insights into the initiation, clonal expansion, and phenotypic manifestations of mosaic events. Early evidence indicates detectable clonal mosaicism increases in frequency with age and could preferentially occur in males. The observed pattern of recurrent events affecting specific chromosomal regions indicates some regions are more susceptible to these events, which could reflect inter-individual differences in genomic stability. Moreover, it is also plausible that the presence of large structural events could be associated with cancer risk. The characterization of detectable genetic mosaicism reveals that there could be important dynamic changes in the human genome associated with the aging process, which could be associated with risk for common disorders, such as cancer, cardiovascular disease, diabetes, and neurological disorders.
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Affiliation(s)
- Mitchell J. Machiela
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA. 20892-4605
| | - Stephen J. Chanock
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA. 20892-4605
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Brock JAK, Dyack S, Ludman M, Dumas N, Gaudet M, Morash B. Mosaic tetrasomy 5p resulting from an isochromosome 5p marker chromosome: Case report and review of literature. Am J Med Genet A 2012; 158A:406-11. [DOI: 10.1002/ajmg.a.34272] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Accepted: 07/27/2011] [Indexed: 12/21/2022]
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Complete isochromosome 5p in one fetus of a monochorionic twin pair. Prenat Diagn 2011; 31:605-7. [DOI: 10.1002/pd.2741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Revised: 09/21/2010] [Accepted: 02/08/2011] [Indexed: 11/07/2022]
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8
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Venci A, Bettio D. Tetrasomy 5p mosaicism due to an additional isochromosome 5p in a man with normal phenotype. Am J Med Genet A 2009; 149A:2889-91. [DOI: 10.1002/ajmg.a.33131] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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9
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Schlegel Z, Valent A, Hirsch A. Partial mosaic trisomy 5: A new case report with ocular involvement. J Fr Ophtalmol 2009; 32:533-9. [DOI: 10.1016/j.jfo.2009.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2009] [Accepted: 06/16/2009] [Indexed: 01/31/2023]
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Grosso S, Cioni M, Garibaldi G, Pucci L, Galluzzi P, Canapicchi R, Morgese G, Balestri P. De novo complete trisomy 5p: clinical and neuroradiological findings. AMERICAN JOURNAL OF MEDICAL GENETICS 2002; 112:56-60. [PMID: 12239721 DOI: 10.1002/ajmg.10679] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Partial or complete duplication of 5p is a rare chromosomal abnormality in which genotype-phenotype correlation studies are hampered by other commonly associated chromosomal abnormalities. We report on a new patient in whom a complete de novo trisomy 5p in all metaphases represented the only chromosomal aberration. The present case further contributes to delineate the typical clinical picture of the trisomy 5p syndrome. Long-term clinical follow-up demonstrated low levels of secretory immunoglobulin A (IgA) on several occasions and likely related to the patient's recurrent respiratory infections (RRIs), a main clinical feature of the trisomy 5p syndrome. An extensive neuroradiological study detected a progressive triventricular hydrocephalus during the fist year of life with subsequent stabilization. Neuronal migration disorders were also present and probably account for the drug-resistant epilepsy presented by the patient.
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Wilson SC, Susman M, Bain S, Wohlferd M, Van Dyke DL, Daniel A, White B, Gardner RJM. Isochromosome 5p mosaicism at prenatal diagnosis: observations and outcomes in six cases at chorionic villus sampling and one at amniocentesis. Prenat Diagn 2002; 22:681-5. [PMID: 12210576 DOI: 10.1002/pd.379] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We present six cases of 47,+i(5p)/46 mosaicism diagnosed at chorionic villus sampling (CVS), this being the first prospective series to be reported. The clinical indication in each was advanced maternal age. Further prenatal studies in four (amniocentesis, plus fetal blood sampling in one) did not show the isochromosome. In one case, subsequent amniocentesis showed 1/48 in situ colonies with the isochromosome, but fetal blood was karyotypically normal. These five pregnancies resulted in phenotypically normal livebirths; further normal follow-up reports (from age 4 months through 4 years) are noted in four of these. Analysis of placental tissue in one case confirmed the presence of the i(5p) mosaicism. In the remaining case, in which 100% of CVS cultured cells had the i(5p), the pregnancy was terminated. Fetal skin fibroblasts did not show the i(5p). Thus, in none of these six cases was true fetal mosaicism detected, nor an abnormal phenotype noted. We suggest that a 47,+i(5p)/46 karyotype, detected at CVS, may frequently reflect confined placental mosaicism. In addition, we report a case of the primary diagnosis of 47,+i(5p)/46 mosaicism at amniocentesis. The infant appeared normal at birth, but a brain malformation was subsequently identified.
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Affiliation(s)
- Susan Clement Wilson
- Genetic Health Services Victoria, Royal Children's Hospital, Melbourne, Australia.
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Park JP, Barefoot KH, Ornvold K, Berg SZ, Dossu JR, Mohandas TK. Prenatal diagnosis of mosaic tetrasomy 5p. Prenat Diagn 2001; 21:351-3. [PMID: 11360274 DOI: 10.1002/pd.66] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We report the prenatal diagnosis of a fetus with tetrasomy 5p mosaicism resulting from a supernumerary isochromosome for the short arm of chromosome 5. The pregnancy was terminated and fetal autopsy revealed minor facial abnormalities (long philtrum, up-slanting palpebral fissures and a broad nasal bridge). Cultures were established from fetal skin, kidney, and pancreas for cytogenetic analysis; the i(5p) was observed only in the skin fibroblasts. To our knowledge, this is the fourth report of mosaic tetrasomy 5p and the first report of prenatal diagnosis of this abnormality.
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Affiliation(s)
- J P Park
- Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA.
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