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Iordanescu II, Neacsu AT, Catana A, Barabas-CuzmicI Z, Suciu V, Dragomir C, Voicu DE, Severin E, Militaru MS. Challenging diagnoses of tetraploidy/diploidy and trisomy 12: utility of first-tier prenatal testing methods. Front Genet 2023; 14:1258752. [PMID: 38034493 PMCID: PMC10684745 DOI: 10.3389/fgene.2023.1258752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/26/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction: Chromosome mosaicism and low-grade mosaicism present a challenge for diagnosis in the era of SNP array and NGS. Tetraploidy is a rare numerical chromosomal abnormality characterized by the presence of four copies of each chromosome. The prevalence of tetraploidy/diploidy mosaicism cases is extremely rare in the human population. Accurate estimates of the frequency of this chromosomal anomaly are lacking due to its classification as an extremely rare and difficult-to-detect condition. Methods: In this report, we describe two cases involving challenging diagnoses of tetraploidy/diploidy and trisomy 12. We utilized advanced genetic testing techniques, including SNP array, to examine the chromosomal abnormalities in these cases. We compared the results from SNP array to conventional G band karyotyping to assess the utility of first-tier prenatal testing methods. Results:Our analysis revealed two cases of tetraploidy/diploidy and trisomy 12 with atypical presentations. SNP array analysis provided higher resolution and more precise information about the chromosomal anomalies in these cases compared to conventional G band karyotyping. Additionally, the prevalence of tetraploidy/diploidy mosaicism was confirmed to be extremely rare in the population. Discussion: Low-level mosaicism is difficult to diagnose, and in many cases, it has traditionally been identified through techniques such as G band karyotype or FISH. Microarray has become an invaluable diagnostic tool for detecting chromosomal abnormalities, offering high-resolution insights. However, it may not always be able to detect rare occurrences of tetraploidy or tetraploidy/diploidy mosaicism. As a result, it is recommended to perform a G band karyotype analysis after obtaining a negative microarray result before considering other diagnostic methods with a potentially higher yield of diagnosis. For the detection of low-level mosaicism, combined diagnostic methods should be considered. The diagnosis of mosaicism is a multistep process that can be time-consuming, often requiring the application of more than one diagnostic technique. This approach is crucial for accurate diagnosis and comprehensive patient care. Further research is warranted to better understand the underlying mechanisms of these rare chromosomal anomalies and to develop more effective diagnostic strategies for challenging cases.
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Affiliation(s)
- Irina Ioana Iordanescu
- Genetics Department “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- Genetics Department Laboratory, Regina Maria Hospital, Romania
| | | | - Andreea Catana
- Genetics Department Laboratory, Regina Maria Hospital, Romania
- Genetics Departament, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania
| | | | | | | | | | - Emilia Severin
- Genetics Department “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Mariela Sanda Militaru
- Genetics Department Laboratory, Regina Maria Hospital, Romania
- Genetics Departament, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania
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Acreman ML, Bussolaro S, Raymond YC, Fantasia I, Rolnik DL, Da Silva Costa F. The predictive value of prenatal cell-free DNA testing for rare autosomal trisomies: a systematic review and meta-analysis. Am J Obstet Gynecol 2023; 228:292-305.e6. [PMID: 36027954 DOI: 10.1016/j.ajog.2022.08.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The diagnostic accuracy of cell-free fetal DNA in screening for rare autosomal trisomies is uncertain. We conducted a systematic review and meta-analysis aiming to determine the predictive value of cell-free DNA in screening for rare autosomal trisomies. DATA SOURCES PubMed, Embase, and Web of Science were searched from inception to January 2022. STUDY ELIGIBILITY CRITERIA All studies that reported on the diagnostic accuracy of cell-free DNA in the detection of rare autosomal trisomies were included. Case series were included if they contained at least 10 cases with diagnostic test results or postnatal genetic testing. METHODS Study appraisal was completed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Statistical analysis was performed using random-effects meta-analysis of double-arcsine transformed proportions of confirmed results in the fetus out of the positive tests to obtain a pooled estimate of the positive predictive value. RESULTS The search identified 7553 studies, of which 1852 were duplicates. After screening 5701 titles and abstracts, 380 studies proceeded to the full-text screen; 206 articles were retrieved for data extraction, of which another 175 articles were excluded. A total of 31 studies, with a total of 1703 women were included for analysis. The pooled positive predictive value of cell-free DNA for the diagnosis of rare autosomal trisomies was 11.46% (95% confidence interval, 7.80-15.65). Statistical heterogeneity was high (I2=82%). Sensitivity analysis restricted to 5 studies at low risk of bias demonstrated a pooled positive predictive value of 9.13% (95% confidence interval, 2.49-18.76). There were insufficient data to provide accurate ascertainment of sensitivity and specificity because most studies only offered confirmatory tests to women with high-risk results. CONCLUSION The positive predictive value of cell-free DNA in diagnosing rare autosomal trisomies is approximately 11%. Clinicians should provide this information when offering cell-free DNA for screening of conditions outside of common autosomal trisomies.
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Affiliation(s)
- Melissa L Acreman
- Department of Obstetrics and Gynaecology, Ipswich Hospital, Queensland, Australia.
| | - Sofia Bussolaro
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Yvette C Raymond
- Department of Obstetrics and Gynaecology, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Ilaria Fantasia
- Obstetrics and Gynaecology Unit, San Salvatore Hospital, L'Aquila, Italy
| | - Daniel L Rolnik
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
| | - Fabricio Da Silva Costa
- Maternal Foetal Medicine Unit, Gold Coast University Hospital and School of Medicine, Griffith University, Gold Coast, Australia
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Porcar Saura S, Díaz Giménez M, Guillén-Climent S, Villar C, Ruiz Quilez A, Abellán Sanchez MR, Cuesta Peredo A, Martín JM. Trisomy 12p mosaicism syndrome in a patient with hypopigmented cutaneous mosaicism and three cell lines in peripheral blood. J Eur Acad Dermatol Venereol 2023; 37:e54-e58. [PMID: 35993792 DOI: 10.1111/jdv.18555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 08/17/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Saray Porcar Saura
- Department of Dermatology, Clinical University Hospital, University of Valencia, Valencia, Spain
| | - Macarena Díaz Giménez
- Department of Genetics, Clinical University Hospital, University of Valencia, Valencia, Spain
| | - Santiago Guillén-Climent
- Department of Dermatology, Clinical University Hospital, University of Valencia, Valencia, Spain
| | - Cristina Villar
- Deparment of Pediatrics, Clinical University Hospital, University of Valencia, Valencia, Spain
| | - Ana Ruiz Quilez
- Department of Genetics, Clinical University Hospital, University of Valencia, Valencia, Spain
| | | | - Ana Cuesta Peredo
- Department of Genetics, Clinical University Hospital, University of Valencia, Valencia, Spain
| | - Jose M Martín
- Department of Dermatology, Clinical University Hospital, University of Valencia, Valencia, Spain
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Plaza-Benhumea L, Martin-de Saro MD, Sanchez-Acosta CG, Messina-Baas O, Cuevas-Covarrubias SA. Duplication of 12q24.21q24.33 in a Girl with Epilepsy, Expanding the Phenotype. Mol Syndromol 2022; 13:409-418. [PMID: 36588755 PMCID: PMC9801331 DOI: 10.1159/000521640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 12/21/2021] [Indexed: 01/04/2023] Open
Abstract
Introduction Duplication of 12q is characterized by craniofacial dysmorphia, growth failure, occasional brain malformations, abnormalities of the extremities, skeletal and thoracic malformations, cardiovascular defects, anogenital abnormalities like cryptorchidism, psychomotor delay, and intellectual disability. Case presentation We describe a female patient with typical manifestations of duplication 12q and epilepsy. She had a normal 46,XX karyotype. The microarray assay exhibited a 19.35-Mb gain at 12q24.21q24.33 due to ins(21;12)(p11.2;q24.21q24.33)mat. Discussion and Conclusion The duplicated region in the patient encompasses 219 genes, 24 considered as pathological. No relation between epilepsy and the genes reported as pathological has been reported.
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Affiliation(s)
| | | | | | - Olga Messina-Baas
- Hospital General de Mexico, National Autonomous University of Mexico, Mexico City, Mexico
| | - Sergio A. Cuevas-Covarrubias
- Hospital General de Mexico, National Autonomous University of Mexico, Mexico City, Mexico,*Sergio A. Cuevas-Covarrubias,
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Martínez-Hernández A, Martínez-Anaya D, Durán-McKinster C, Del Castillo-Ruiz V, Navarrete-Meneses P, Córdova EJ, Villegas-Torres BE, Ruiz-Herrera A, Juárez-Velázquez R, Yokoyama-Rebollar E, Cervantes-Barragán D, Pedraza-Meléndez A, Orozco L, Pérez-Vera P, Salas-Labadía C. Pigmentary mosaicism as a recurrent clinical manifestation in three new patients with mosaic trisomy 12 diagnosed postnatally: cases report and literature review. BMC Med Genomics 2022; 15:224. [PMCID: PMC9620619 DOI: 10.1186/s12920-022-01382-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 10/22/2022] [Indexed: 11/10/2022] Open
Abstract
Background To date, only twenty-one cases diagnosed postnatally with mosaic trisomy 12 have been reported. The most frequent phenotypic manifestations are developmental delay, dysmorphic facial features, congenital heart defects, digital alterations, and pigmentary disorders. In the present report, detailed clinical and genetic profiles of three unrelated new patients with mosaic trisomy 12 are described and compared with previously reported cases. Case presentation In the present report, we include the clinical, cytogenetic, and molecular description of three Mexican patients diagnosed postnatally with mosaic trisomy 12. At phenotypic level, the three patients present with developmental delay, dysmorphic facial features, congenital heart defects and skin pigmentary anomalies. Particularly, patient 1 showed unique eye alterations as bilateral distichiasis, triple rows of upper lashes, and digital abnormalities. In patient 2 redundant skin, severe hearing loss, and hypotonia were observed, and patient 3 presented with hypertelorism and telecanthus. Hyperpigmentation with disseminated pigmentary anomalies is a common trait in all of them. The cytogenetic study was carried out under the strict criteria of analysis, screening 50–100 metaphases from three different tissues, showing trisomy 12 mosaicism in at least one of the three different tissues analyzed. With SNParray, the presence of low-level mosaic copy number variants not previously detected by cytogenetics, and uniparental disomy of chromosome 12, was excluded. STR markers allowed to confirm the absence of uniparental disomy as well as to know the parental origin of supernumerary chromosome 12. Conclusions The detailed clinical, cytogenetic, and molecular description of these three new patients, contributes with relevant information to delineate more accurately a group of patients that show a heterogeneous phenotype, although sharing the same chromosomal alteration. The possibility of detecting mosaic trisomy 12 is directly associated with the sensitivity of the methodology applied to reveal the low-level chromosomal mosaicism, as well as with the possibility to perform the analysis in a suitable tissue.
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Affiliation(s)
- A. Martínez-Hernández
- grid.452651.10000 0004 0627 7633Laboratorio de Inmunogenómica y Enfermedades Metabólicas, Instituto Nacional de Medicina Genómica SS, Ciudad de Mexico, México
| | - D. Martínez-Anaya
- grid.419216.90000 0004 1773 4473Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría, Ciudad de Mexico, 04530 México
| | - C. Durán-McKinster
- grid.419216.90000 0004 1773 4473Departamento de Dermatología, Instituto Nacional de Pediatría, Ciudad de Mexico, México
| | - V. Del Castillo-Ruiz
- grid.419216.90000 0004 1773 4473Departamento de Genética Humana, Instituto Nacional de Pediatría, Ciudad de Mexico, México
| | - P. Navarrete-Meneses
- grid.419216.90000 0004 1773 4473Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría, Ciudad de Mexico, 04530 México
| | - E. J. Córdova
- grid.452651.10000 0004 0627 7633Consorcio de Oncogenómica, Instituto Nacional de Medicina Genómica SS, Ciudad de Mexico, México
| | - B. E. Villegas-Torres
- grid.452651.10000 0004 0627 7633Instituto Nacional de Medicina Genómica SS, Ciudad de Mexico, México
| | - A. Ruiz-Herrera
- grid.414465.6Hospital de Especialidades Pediátrico de León, León, Guanajuato, México
| | - R. Juárez-Velázquez
- grid.419216.90000 0004 1773 4473Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría, Ciudad de Mexico, 04530 México
| | - E. Yokoyama-Rebollar
- grid.419216.90000 0004 1773 4473Departamento de Genética Humana, Instituto Nacional de Pediatría, Ciudad de Mexico, México
| | - D. Cervantes-Barragán
- grid.502779.e0000 0004 0633 6373Hospital Central Sur de Alta Especialidad, PEMEX, Ciudad de Mexico, México
| | - A. Pedraza-Meléndez
- grid.9486.30000 0001 2159 0001Posgrado en Ciencias Biológicas, Universidad Nacional Autónoma de México, Ciudad de Mexico, México
| | - L. Orozco
- grid.452651.10000 0004 0627 7633Laboratorio de Inmunogenómica y Enfermedades Metabólicas, Instituto Nacional de Medicina Genómica SS, Ciudad de Mexico, México
| | - P. Pérez-Vera
- grid.419216.90000 0004 1773 4473Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría, Ciudad de Mexico, 04530 México
| | - C. Salas-Labadía
- grid.419216.90000 0004 1773 4473Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría, Ciudad de Mexico, 04530 México
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Prenatal Diagnosis and Molecular Cytogenetic Characterization of Copy Number Variations on 4p15.2p16.3, Xp22.31, and 12p11.1q11 in a Fetus with Ultrasound Anomalies: A Case Report and Literature Review. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1761738. [PMID: 32566663 PMCID: PMC7275220 DOI: 10.1155/2020/1761738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 04/18/2020] [Indexed: 11/29/2022]
Abstract
Chromosomal rearrangements, such as duplications/deletions, can lead to a variety of genetic disorders. Herein, we reported a prenatal case with right aortic arch and aberrant left subclavian artery, consisting of a complex chromosomal copy number variations. Routine cytogenetic analysis described the chromosomal karyotype as 46,XY, add (2)(q37) for the fetus. However, the chromosomal microarray analysis (CMA) identified a 22.4 Mb duplication in chromosome 4p16.3p15.2, a 3.96 Mb microduplication in 12p11.1q11, and a 1.68 Mb microdeletion in Xp22.31. Fluorescence in situ hybridization (FISH) using a chromosome 4 painting probe was found to hybridize to the terminal of chromosome 2q on the fetus, thus confirming that the extra genetic materials of chromosome 2 was actually trisomy 4p detected through CMA. Meanwhile, the parental karyotypes were normal, which proved that the add (2) was de novo for fetus. The duplication of Wolf-Hirschhorn syndrome critical region (WHSCR) and X-linked recessive ichthyosis associated with Xp22.31 deletion separately were considered potentially pathogenic causes although other abnormalities involving these syndromes were not observed. For prenatal cases, the combined utilization of ultrasonography, traditional cytogenetic, and molecular diagnosis technology will enhance better diagnostic benefits, offer more detailed genetic counselling, and assess the prognosis of the fetuses.
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Elsheikh A, Al Shehhi M, Goud TM, Itoo B, Al Harasi S. Pallister-Killian Mosaic Syndrome in an Omani Newborn: A Case Report and Literature Review. Oman Med J 2019; 34:249-253. [PMID: 31110634 PMCID: PMC6505352 DOI: 10.5001/omj.2019.47] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Pallister-Killian mosaic syndrome (PKS) is a rare sporadic condition with multiple congenital anomalies and intellectual deficits caused by mosaic tissue-limited tetrasomy of the short arm of chromosome 12 (12p). The clinical features are highly variable, ranging from mild to severe. Diagnosis is usually missed because of the low level of mosaicism in peripheral lymphocytes. We present a case of an Omani newborn with PKS with severe clinical presentation and multisystem involvement that lead to postnatal death. Karyotype and fluorescent in situ hybridization studies confirmed the presence of chromosome 12p duplication. This is the first case of PKS reported in the literature from Oman and the Arab world.
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Affiliation(s)
- Afaf Elsheikh
- National Genetic Center, Royal Hospital, Muscat, Oman
| | | | | | - Bashir Itoo
- Neonatal Intensive Care Unit, Royal Hospital, Muscat, Oman
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Gasparini Y, Montenegro MM, Novo-Filho GM, Ceroni JRM, Honjo RS, Zanardo ÉA, Dias AT, Nascimento AM, Costa TVMM, Madia FA, Chehimi SN, Damasceno JG, Kim CA, Kulikowski LD. Mosaic Trisomy 12 Associated with Overgrowth Detected in Fibroblast Cell Lines. Cytogenet Genome Res 2019; 157:153-157. [PMID: 30933946 DOI: 10.1159/000498836] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2018] [Indexed: 02/04/2023] Open
Abstract
Mosaic trisomy 12 is a rare anomaly, and only 9 cases of live births with this condition have been reported in the literature. The clinical phenotype is variable, including neuropsychomotor developmental delay, congenital heart disease, microcephaly, cutaneous spots, facial asymmetry, prominent ears, hypotonia, retinopathy, and sensorineural hearing loss. A 2-year-old female presented with neuropsychomotor developmental delay, prominent forehead, dolichocephaly, patchy skin pigmentation, and unexpected overgrowth at birth. Cytogenetic analysis of her peripheral blood showed normal results, suggesting the presence of a chromosomal alteration in other tissues. Further studies using G-banding and FISH performed on fibroblasts from both hyper- and hypopigmented regions identified a 47,XX,+12/46,XX karyotype. To the best of our knowledge, no patients with mosaic trisomy 12 associated with overgrowth have been reported to date. Congenital overgrowth and neonatal overgrowth have been frequently linked to Pallister-Killian syndrome (PKS; OMIM 601803). This case suggests the possibility of an association of genes present in the 12p region with fetal overgrowth, considering that chromosomal duplications could lead to an increase in the production of aberrant transcripts and disturbing gene dosage effects. This case highlights the importance of cytogenetic analysis in different tissues to provide relevant information to the specific genotype/phenotype correlation.
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Chen CP, Chern SR, Wu PS, Chen YN, Chen SW, Lee CC, Yang CW, Wang W. Prenatal diagnosis of low-level mosaicism for trisomy 12 associated with a favorable pregnancy outcome. Taiwan J Obstet Gynecol 2016; 55:900-901. [DOI: 10.1016/j.tjog.2016.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2016] [Indexed: 11/25/2022] Open
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