1
|
Wu X, Xie X, Su L, Lin N, Liang B, Guo N, Chen Q, Xu L, Huang H. Prenatal diagnosis of Pallister-Killian syndrome and literature review. J Cell Mol Med 2021; 25:8929-8935. [PMID: 34405543 PMCID: PMC8435413 DOI: 10.1111/jcmm.16853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 07/31/2021] [Indexed: 01/12/2023] Open
Abstract
Pallister‐Killian syndrome (PKS) is a rare sporadic genetic disorder usually caused by mosaicism of an extra isochromosome of 12p (i(12p)). This retrospective study analysed the prenatal ultrasound manifestations and molecular and cytogenetic results of five PKS foetuses. Samples of amniotic fluid and/or cord blood, skin biopsy and placenta were collected. Conventional karyotyping and single nucleotide polymorphism array (SNP array) were performed on all the amniotic fluid or cord blood samples. Copy number variants sequencing (CNV‐seq) and fluorescence in situ hybridization (FISH) were also used for the validation for one foetus. All the five foetuses were from pregnancies with advanced parental age. Two foetuses involved structural abnormalities and one foetus had only soft markers, all of which included increased nuchal translucency. The rest two foetuses had normal ultrasounds in the second trimester, which has rarely been reported before. The karyotype revealed typical i(12p) in four cases and a small supernumerary marker chromosome consisting of 12p and 20p in the remaining one case. The proportion of cells with i(12p) ranged from 0 to 100% in cultural cells, while SNP array results suggested 2−4 copies of 12p. For one foetus, metaphase FISH showed normal results, but the interphase FISH suggested cell lines with two, three and four copies of 12p in the amniotic fluid. Advanced parental age may be an important risk factor for PKS, and there were no typical ultrasound manifestations related to PKS. A combination of karyotype analysis and molecular diagnosis is an effective method for the diagnosis of PKS.
Collapse
Affiliation(s)
- Xiaoqing Wu
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Department of Laboratory Medicine, Fujian Medical University, Fuzhou, China
| | - Xiaorui Xie
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Linjuan Su
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Na Lin
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Bin Liang
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Nan Guo
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Qingquan Chen
- Department of Laboratory Medicine, Fujian Medical University, Fuzhou, China
| | - Liangpu Xu
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Hailong Huang
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| |
Collapse
|
2
|
Salzano E, Raible SE, Kaur M, Wilkens A, Sperti G, Tilton RK, Bettini LR, Rocca A, Cocchi G, Selicorni A, Conlin LK, McEldrew D, Gupta R, Thakur S, Izumi K, Krantz ID. Prenatal profile of Pallister-Killian syndrome: Retrospective analysis of 114 pregnancies, literature review and approach to prenatal diagnosis. Am J Med Genet A 2018; 176:2575-2586. [PMID: 30289601 DOI: 10.1002/ajmg.a.40499] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 06/23/2018] [Accepted: 07/14/2018] [Indexed: 01/10/2023]
Abstract
Pallister-Killian syndrome (PKS) is a tissue limited mosaic disorder, characterized by variable degrees of neurodevelopmental delay and intellectual disability, typical craniofacial findings, skin pigmentation anomalies and multiple congenital malformations. The wide phenotypic spectrum of PKS in conjunction with the mosaic distribution of the i(12p) makes PKS an underdiagnosed disorder. Recognition of prenatal findings that should raise a suspicion of PKS is complicated by the fragmentation of data currently available in the literature and challenges in diagnosing a mosaic diagnosis on prenatal testing. Ultrasound anomalies, especially congenital diaphragmatic hernia, congenital heart defects, and rhizomelic limb shortening, have been related to PKS, but they are singularly not specific and are not present in all affected fetuses. We have combined prenatal data from 86 previously published reports and from our cohort of 114 PKS probands (retrospectively reviewed). Summarizing this data we have defined a prenatal growth profile and identified markers of perinatal outcome which collectively provide guidelines for early recognition of the distinctive prenatal profile and consideration of a diagnosis of PKS as well as for management and genetic counseling.
Collapse
Affiliation(s)
- E Salzano
- Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - S E Raible
- Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - M Kaur
- Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - A Wilkens
- Division of Genomic Diagnostics, Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - G Sperti
- Neonatology Unit, St. Orsola-Malpighi Polyclinic, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - R K Tilton
- Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - L R Bettini
- Dipartimento di Scienze Della Salute, San Paolo Hospital Medical School, Università degli Studi di Milano, Milan, Italy
| | - A Rocca
- Neonatology Unit, St. Orsola-Malpighi Polyclinic, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - G Cocchi
- Neonatology Unit, St. Orsola-Malpighi Polyclinic, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | | | - L K Conlin
- Division of Genomic Diagnostics, Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pathology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - D McEldrew
- Division of Genomic Diagnostics, Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - R Gupta
- Department of Fetal Medicine, Maharaja Agrasen Hospital, Delhi & Sonepat Genetic and Fetal Medicine Centre, Sonepat, Haryana
| | - S Thakur
- Department of Genetic & Fetal Medicine, Fortis Hospital, Delhi-NCR & Apollo Hospital, Delhi, India
| | - K Izumi
- Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Division of Genomic Diagnostics, Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - I D Krantz
- Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
3
|
Li L, Huang L, Huang X, Lin S, He Z, Fang Q. Prenatal diagnosis of Pallister-Killian syndrome in one twin. Clin Case Rep 2018; 6:1470-1473. [PMID: 30147884 PMCID: PMC6099054 DOI: 10.1002/ccr3.1624] [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: 04/08/2018] [Revised: 04/29/2018] [Accepted: 05/08/2018] [Indexed: 11/11/2022] Open
Abstract
Pallister-Killian syndrome (PKS) is often incidentally diagnosed prenatally due to ultrasound abnormalities or advanced maternal age. Severely shortened limbs could be the most outstanding abnormal observation in a fetus with PKS. PKS can be detected with the highest mosaic ratio by chromosomal microarray analysis (CMA) on uncultured amniocytes prenatally.
Collapse
Affiliation(s)
- Lin Li
- Fetal Medicine CenterDepartment of Obstetrics and GynecologyThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| | - Linhuan Huang
- Fetal Medicine CenterDepartment of Obstetrics and GynecologyThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| | - Xuan Huang
- Fetal Medicine CenterDepartment of Obstetrics and GynecologyThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| | - Shaobin Lin
- Fetal Medicine CenterDepartment of Obstetrics and GynecologyThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| | - Zhiming He
- Fetal Medicine CenterDepartment of Obstetrics and GynecologyThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| | - Qun Fang
- Fetal Medicine CenterDepartment of Obstetrics and GynecologyThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| |
Collapse
|
4
|
Thakur S, Gupta R, Tiwari B, Singh N, Saxena KK. Pallister-Killian syndrome: Review of fetal phenotype. Clin Genet 2018; 95:79-84. [PMID: 29790157 DOI: 10.1111/cge.13381] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/08/2018] [Accepted: 05/10/2018] [Indexed: 11/30/2022]
Abstract
Pallister-Killian syndrome is a multi-system sporadic disorder with developmental delay. It is a rare chromosomal abnormality involving supernumerary isochormosome 12p. The disorder exhibits tissue specific mosaicism. The first prenatal diagnosis of PKS was reported in 1985 after ultrasound detection of fetal anomalies. Since this observation, there have been about 62 reports of fetuses with PKS. In this review, we cover the prenatal aspects of PKS.
Collapse
Affiliation(s)
- S Thakur
- Department of Genetic Med, Fortis lafemme, New Delhi, India.,Apollo Hospital, Sarita Vihar, New Delhi, India
| | - R Gupta
- Department of Fetal Med, Maharaja Agrasen Hospital, New Delhi, India
| | - B Tiwari
- Department of Radiology, Fortis lafemme, New Delhi, India
| | - N Singh
- Department of Obstetrics, Fortis lafemme, New Delhi, India
| | - K K Saxena
- Department of Radiology, Sir Ganga Ram Hospital, New Delhi, India
| |
Collapse
|
5
|
Libotte F, Bizzoco D, Gabrielli I, Mesoraca A, Cignini P, Vitale SG, Marilli I, Gulino FA, Rapisarda AMC, Giorlandino C. Pallister-Killian syndrome: Cytogenetics and molecular investigations of mosaic tetrasomy 12p in prenatal chorionic villus and in amniocytes. Strategy of prenatal diagnosis. Taiwan J Obstet Gynecol 2017; 55:863-866. [PMID: 28040135 DOI: 10.1016/j.tjog.2016.07.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Pallister-Killian syndrome (PKS) is a rare, sporadic genetic disorder caused by mosaic tetrasomy of the short arm of chromosome 12 (12p). Clinically, PKS is characterized by several systemic abnormalities, such as intellectual impairment, hearing loss, epilepsy, hypotonia, craniofacial dysmorphism, pigmentary skin anomalies, epilepsy, and a variety of congenital malformations. Prenatally, PKS can be suspected in the presence of ultrasound anomalies: diaphragmatic hernia, rhizomelic micromelia, hydrops fetalis, fetal overweight, ventriculomegaly in the central nervous system, congenital heart defects, or absent visualization of the stomach. In all these cases, a detailed genetic study is required. PKS is diagnosed by prenatal genetic analysis through chorionic villus sampling, genetic amniocentesis, and cordocentesis. CASE REPORT We report two cases of PKS with prenatal diagnosis of isochromosome 12p made by cytogenetic studies. The first case is of a 36-year-old pregnant woman who underwent genetic chorionic villus sampling at 13th weeks of gestation after 1st trimester prenatal ultrasound revealed clinical features of PKS: flat nasal bridge and fetal hydrops. The second case is of a 32-year-old pregnant woman with genetic amniocentesis at 17th weeks of gestation that showed mos46,XX[21]/47,XX,+i(12p) associated to PKS. CONCLUSION New molecular cytogenetic techniques array comparative genomic hybridization and fluorescence in-situ hybridization in association with conventional karyotype are pivotal innovative tools to search for chromosomic anomalies and for a complete prenatal diagnosis, especially in cases such as PKS where array comparative genomic hybridization analysis alone could not show mosaicism of i(12p).
Collapse
Affiliation(s)
- Francesco Libotte
- Department of Genetics, Altamedica Fetal Maternal Medical Centre, Rome, Italy
| | - Domenico Bizzoco
- Department of Genetics, Altamedica Fetal Maternal Medical Centre, Rome, Italy
| | - Ivan Gabrielli
- Department of Genetics, Altamedica Fetal Maternal Medical Centre, Rome, Italy
| | - Alvaro Mesoraca
- Department of Genetics, Altamedica Fetal Maternal Medical Centre, Rome, Italy
| | - Pietro Cignini
- Department of Prenatal Diagnosis, Altamedica Fetal Maternal Medical Centre, Rome, Italy
| | - Salvatore Giovanni Vitale
- Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy.
| | - Ilaria Marilli
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Ferdinando Antonio Gulino
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | | | - Claudio Giorlandino
- Department of Prenatal Diagnosis, Altamedica Fetal Maternal Medical Centre, Rome, Italy
| |
Collapse
|
6
|
Santamaria A, Laganà AS, Barresi V, Triolo O, Fondacaro NS, Corrado F. Prenatally identified Pallister-Killian syndrome: Ultrasound pattern and diagnostic considerations. J OBSTET GYNAECOL 2015; 36:406-7. [PMID: 26471928 DOI: 10.3109/01443615.2015.1086984] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- A Santamaria
- a Department of Pediatric , Gynecological, Microbiological and Biomedical Sciences, University of Messina , Messina , Italy
| | - A S Laganà
- a Department of Pediatric , Gynecological, Microbiological and Biomedical Sciences, University of Messina , Messina , Italy
| | - V Barresi
- b Department of Human Pathology , University of Messina , Messina , Italy
| | - O Triolo
- a Department of Pediatric , Gynecological, Microbiological and Biomedical Sciences, University of Messina , Messina , Italy
| | - N S Fondacaro
- a Department of Pediatric , Gynecological, Microbiological and Biomedical Sciences, University of Messina , Messina , Italy
| | - F Corrado
- a Department of Pediatric , Gynecological, Microbiological and Biomedical Sciences, University of Messina , Messina , Italy
| |
Collapse
|
7
|
Izumi K, Krantz ID. Pallister-Killian syndrome. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2014; 166C:406-13. [PMID: 25425112 DOI: 10.1002/ajmg.c.31423] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Pallister-Killian syndrome (PKS) is characterized by craniofacial dysmorphism, pigmentary skin anomalies, congenital heart defects, congenital diaphragmatic hernia, hypotonia, intellectual disability, and epilepsy. PKS is caused by extra copies of chromosome 12p, most characteristically a marker isochromosome 12p that demonstrates tissue-limited mosaicism. The cytogenetic diagnosis of PKS is often cumbersome due to the absence of the isochromosome in lymphocytes requiring sampling of other tissues. The mechanism by which the isochromosome 12p results in the constellation of multiple congenital anomalies remains largely unknown. In this review, we summarize the background of, and recent advances in, the clinical and molecular understanding of PKS.
Collapse
|
8
|
Özlü T, Ocak Z, Ozyurt O. Prenatal diagnosis of Pallister Killian Syndrome in a fetus with congenital diaphragmatic hernia, short limbs, and increased nuchal translucency. Taiwan J Obstet Gynecol 2014; 53:404-5. [DOI: 10.1016/j.tjog.2013.06.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2013] [Indexed: 11/16/2022] Open
|
9
|
Srinivasan A, Wright D. Pallister-Killian syndrome. AMERICAN JOURNAL OF CASE REPORTS 2014; 15:194-8. [PMID: 24826207 PMCID: PMC4018245 DOI: 10.12659/ajcr.890614] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 04/01/2014] [Indexed: 12/18/2022]
Abstract
PATIENT Male, 0 FINAL DIAGNOSIS: Pallister-Killian syndrome Symptoms: Decidious tooth • flattened nasal bridge • frontal bossing • grooved palate • low-set ears • mid-facial hypoplasia • nuchal fold thickening • right inquinal testis • shortened upper extremities • undescended left intraabdominal testis • widely spaced nipples MEDICATION - Clinical Procedure: - Specialty: Pediatrics and Neonatology. OBJECTIVE Congenital defects/diseases. BACKGROUND Pallister-Killian syndrome (PKS) is a rare, sporadic, polydysmorphic condition that often has highly distinctive features. The clinical features are highly variable, ranging from mild to severe intellectual disability and birth defects. We here report the first case of PKS diagnosed at our institution in a patient in the second trimester of pregnancy. CASE REPORT A pregnant 43-year-old woman presented for genetic counseling secondary to advanced maternal age and an increased risk for Down syndrome. Ultrasound showed increased fetal nuchal fold thickness, short limbs, polyhydramnios, and a small stomach. The ultrasound evaluation was compromised due to the patient's body habitus. The patient subsequently underwent amniocentesis and the karyotype revealed the presence of an isochromosome in the short arm of chromosome 12 consistent with the diagnosis of Pallister-Killian syndrome. Postnatally, the infant showed frontal bossing, a flattened nasal bridge, mid-facial hypoplasia, low-set ears, a right upper deciduous tooth, grooved palate, nuchal fold thickening, widely spaced nipples, left ulnar polydactyly, simian creases, flexion contractures of the right middle finger, shortened upper extremities, undescended left intraabdominal testis, and right inguinal testis. CONCLUSIONS The occurrence of PKS is sporadic in nature, but prenatal diagnosis is possible.
Collapse
|
10
|
Tilton RK, Wilkens A, Krantz ID, Izumi K. Cardiac manifestations of Pallister-Killian syndrome. Am J Med Genet A 2014; 164A:1130-5. [PMID: 24504854 DOI: 10.1002/ajmg.a.36413] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 12/07/2013] [Indexed: 11/10/2022]
Abstract
Pallister-Killian syndrome (PKS) is a sporadic multisystem genetic diagnosis characterized by facial dysmorphia, variable developmental delay and intellectual impairment, hypotonia, hearing loss, seizures, differences in skin pigmentation, temporal alopecia, diaphragmatic hernia, congenital heart defects, and other systemic abnormalities. Although congenital heart defects have been described in association with PKS, the full spectrum of heart disease is still not entirely known. Here, we describe the pattern of cardiac findings of 81 probands with PKS who have had at least one cardiac evaluation, demonstrating structural heart difference in 37% of our cohort (n = 30). Septal defects such as atrial or ventricular septal defects (n = 12) were the most commonly seen congenital heart differences. Additional findings included the occasional occurrence of bicuspid aortic valve, aortic dilatation, and cardiac hypertrophy/cardiomyopathy. We suggest cardiac evaluation for all individuals with PKS at the time of diagnosis as well as subsequent longitudinal follow-up to monitor for the development of cardiomyopathy and aortic dilatation.
Collapse
Affiliation(s)
- Richard K Tilton
- Division of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Temple University School of Medicine, Philadelphia, Pennsylvania
| | | | | | | |
Collapse
|
11
|
Rao KP, Belogolovkin V. Marker chromosomes. Fetal Pediatr Pathol 2013; 32:97-112. [PMID: 22587446 DOI: 10.3109/15513815.2012.681425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Marker chromosomes are a morphologically heterogeneous group of structurally abnormal chromosomes that pose a significant challenge in prenatal diagnosis. Phenotypes associated with marker chromosomes are highly variable and range from normal to severely abnormal. Clinical outcomes are very difficult to predict when marker chromosomes are detected prenatally. In this review, we outline the classification, etiology, cytogenetic characterization, and clinical consequences of marker chromosomes, as well as practical approaches to prenatal diagnosis and genetic counseling.
Collapse
Affiliation(s)
- Kiran Prabhaker Rao
- Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, FL 33606, USA
| | | |
Collapse
|
12
|
Sananes N, Guigue V, Vayssiere C, Kohler M, Girard-Lemaire F, Flori E, Carelle-Calmels N, Boehm N, Samama B, Doray B, Favre R. Contribution of 3D ultrasound and fetal face studies to the prenatal diagnosis of Pallister-Killian syndrome. J Matern Fetal Neonatal Med 2010; 23:558-62. [DOI: 10.3109/14767050903214558] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
13
|
|
14
|
Park IY, Shin JC, Kwon JY, Koo BK, Kim M, Lim J, Kim Y, Han K. Prenatal diagnosis of Pallister-Killian syndrome associated with pulmonary stenosis and right ventricular dilatation. Korean J Lab Med 2009; 29:366-70. [PMID: 19726901 DOI: 10.3343/kjlm.2009.29.4.366] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Pallister-Killian syndrome (PKS) is a rare disorder characterized cytogenetically by tetrasomy 12p for isochromosome of the short arm of chromosome 12. PKS is diagnosed by prenatal genetic analysis through chorionic villous sampling, genetic amniocentesis, and cordocentesis, or by chromosomal analysis of skin fibroblasts, but is not usually detected by chromosomal analysis of peripheral blood cells. Herein, we report a case of a gravida at 23 weeks gestation with pulmonary stenosis and right ventricular dilation of the heart which were detected by sonography. Fluorescence in situ hybridization and a multicolor banding technique were performed to verify the diagnosis as 47,XX, +mar.ish i(12)(p10)(TEL++)[16]/46,XX[4], and an autopsy confirmed the cardiac anomalies detected on antenatal sonography.
Collapse
Affiliation(s)
- In Yang Park
- Department of Obstetrics and Gynecology, The Catholic University of Korea, Seoul, Korea
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Vogel I, Lyngbye T, Nielsen A, Pedersen S, Hertz JM. Pallister-Killian syndrome in a girl with mild developmental delay and mosaicism for hexasomy 12p. Am J Med Genet A 2009; 149A:510-4. [PMID: 19215056 DOI: 10.1002/ajmg.a.32681] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We report on a 5-year-old girl with Pallister-Killian syndrome (OMIM #601803) due to mosaicism of two supernumerary isochromosomes (hexasomy 12p). Hexasomy 12p was found in 20% of the cells by chromosome analysis of cultured skin fibroblasts and confirmed by FISH- and arrayCGH analysis. The girl has woolly and sparse hair, absence of lateral eyebrows, dry skin, brittle nails, hypopigmented patches, frontal bossing, hearing loss, hypertrophic dilated cardiomyopathy, polydactyly, and mild developmental delay. This is the second live case of mosaicism for hexasomy 12p to be reported. A gene-dosage hypothesis has previously suggested that cases with hexasomy 12p would have a worse phenotype than cases with tetrasomy 12p. The relatively mild symptoms found in the current girl with hexasomy 12p may to contradict this hypothesis.
Collapse
Affiliation(s)
- Ida Vogel
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus C, Denmark.
| | | | | | | | | |
Collapse
|
16
|
Tetrasomy 12p (Pallister-Killian syndrome): difficulties in prenatal diagnosis. Arch Gynecol Obstet 2009; 280:1049-53. [PMID: 19340439 DOI: 10.1007/s00404-009-1059-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2009] [Accepted: 03/16/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE We report a rare case of Pallister-Killian syndrome diagnosed prenatally with increased nuchal translucency during screening for trisomy 21. MATERIALS AND METHODS Echografic and postmortem examination of the fetus, G-banded chromosome and FISH analysis on short- and long-term chorion villous sampling (CVS) culture. RESULTS AND DISCUSSION Cytogenetic analysis revealed a supernumerary isochromosome 12p after long-term culture whereas a normal cell line was detected in short-term culture only. Sonografic examination in 17-weeks' gestation showed further increase of the NT and the additional presence of brachymelia, diaphragmatic hernia and a marked dextroposition of the heart. Termination of the pregnancy was performed. The cases of PKS karyotypically confirmed on CVS are reviewed, and cytogenetic and sonographic aspects of the prenatal diagnosis of PKS are discussed.
Collapse
|
17
|
|
18
|
Kim MH, Park SY, Kim MY, Lee BY, Lee MH, Ryu HM. Prenatal diagnosis of Pallister–Killian syndrome in two fetuses with increased nuchal translucency. Prenat Diagn 2008; 28:454-6. [DOI: 10.1002/pd.1974] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
19
|
Liberati M, Melchiorre K, D’Emilio I, Guanciali-Franchi PE, Iezzi I, Rotmensch S, Celentano C. Fetal Facial Profile in Pallister-Killian Syndrome. Fetal Diagn Ther 2007; 23:15-7. [DOI: 10.1159/000109220] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2006] [Accepted: 10/03/2006] [Indexed: 11/19/2022]
|
20
|
Abad DE, Gabarre JA, Izquierdo AM, López-Sánchez C, García-Martínez V, Izquierdo AG. Pallister-Killian syndrome presenting with a complex congenital heart defect and increased nuchal translucency. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2006; 25:1475-80. [PMID: 17060438 DOI: 10.7863/jum.2006.25.11.1475] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- David Escribano Abad
- Ultrasound and Fetal Physiopathology Unit, Department of Obstetrics and Gynecology, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, 28041 Madrid, Spain
| | | | | | | | | | | |
Collapse
|
21
|
Doray B, Girard-Lemaire F, Gasser B, Baldauf JJ, De Geeter B, Spizzo M, Zeidan C, Flori E. Pallister-Killian syndrome: difficulties of prenatal diagnosis. Prenat Diagn 2002; 22:470-7. [PMID: 12116305 DOI: 10.1002/pd.342] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The first prenatal diagnosis of Pallister-Killian syndrome (PKS) was reported by Gilgenkrantz et al. in1985. Since this report, about 60 prenatal cases have been reported but both sonographic and cytogenetic diagnoses remain difficult. Although ultrasound anomalies such as congenital diaphragmatic hernia, polyhydramnios and rhizomelic micromelia in association with fetal overgrowth are very suggestive of the syndrome, they are inconstant and they may even be absent. The mosaic distribution of the supernumerary isochromosome 12p greatly increases these difficulties. No prenatal cytogenetic technique is sensitive enough to ensure prenatal diagnosis and false-negative results have been described on fetal blood, chorionic villi and amniocentesis. We report here two prenatal cases of PKS which illustrate the great variability of the fetal phenotype. In reviewing the 63 reported cases, we attempt to determine ultrasound indicators of the syndrome and to define a cytogenetic strategy. In cases where ultrasound indicators are present, our proposal is first to perform chorionic villus or placental sampling and then amniocentesis when the first cytogenetic result is normal. Fetal blood sampling is the least indicated method because of the low frequency of the isochromosome in lymphocytes. In this cytogenetic strategy, fluorescent in situ hybridization (FISH) and especially interphase FISH on non-cultured cells increases the probability or identifying the isochromosome. A misdiagnosis remains possible when ultrasound is not contributory; the identification of new discriminating ultrasound indicators would be very helpful in this context.
Collapse
Affiliation(s)
- Bérénice Doray
- Laboratoire de Cytogénétique, Hôpital de Hautepierre, Strasbourg, France.
| | | | | | | | | | | | | | | |
Collapse
|
22
|
|