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Boer LL, Winter E, Gorissen B, Oostra RJ. Phenotypically Discordant Anomalies in Conjoined Twins: Quirks of Nature Governed by Molecular Pathways? Diagnostics (Basel) 2023; 13:3427. [PMID: 37998563 PMCID: PMC10669976 DOI: 10.3390/diagnostics13223427] [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: 10/03/2023] [Revised: 10/24/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023] Open
Abstract
A multitude of additional anomalies can be observed in virtually all types of symmetrical conjoined twins. These concomitant defects can be divided into different dysmorphological patterns. Some of these patterns reveal their etiological origin through their topographical location. The so-called shared anomalies are traceable to embryological adjustments and directly linked to the conjoined-twinning mechanism itself, inherently located within the boundaries of the coalescence area. In contrast, discordant patterns are anomalies present in only one of the twin members, intrinsically distant from the area of union. These dysmorphological entities are much more difficult to place in a developmental perspective, as it is presumed that conjoined twins share identical intra-uterine environments and intra-embryonic molecular and genetic footprints. However, their existence testifies that certain developmental fields and their respective developmental pathways take different routes in members of conjoined twins. This observation remains a poorly understood phenomenon. This article describes 69 cases of external discordant patterns within different types of otherwise symmetrical mono-umbilical conjoined twins and places them in a developmental perspective and a molecular framework. Gaining insights into the phenotypes and underlying (biochemical) mechanisms could potentially pave the way and generate novel etiological visions in the formation of conjoined twins itself.
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Affiliation(s)
- Lucas L. Boer
- Department of Medical Imaging, Section Anatomy and Museum for Anatomy and Pathology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Eduard Winter
- Pathologisch-Anatomische Sammlung im Narrenturm-NHM, 1090 Vienna, Austria
| | - Ben Gorissen
- Department of Medical Imaging, Section Anatomy and Museum for Anatomy and Pathology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Roelof-Jan Oostra
- Department of Medical Biology, Sections Clinical Anatomy & Embryology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
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2
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Yang YD, Li DZ. Sonographic detection of monochorionic monozygotic twins discordant for sex: Implications for prenatal genetic counseling. Eur J Obstet Gynecol Reprod Biol 2021; 260:236-238. [PMID: 33722426 DOI: 10.1016/j.ejogrb.2021.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 03/03/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Yan-Dong Yang
- Ultrasound Department, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Dong-Zhi Li
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong, China.
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3
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Palomaki GE, Chiu RWK, Pertile MD, Sistermans EA, Yaron Y, Vermeesch JR, Vora NL, Best RG, Wilkins-Haug L. International Society for Prenatal Diagnosis Position Statement: cell free (cf)DNA screening for Down syndrome in multiple pregnancies. Prenat Diagn 2020; 41:1222-1232. [PMID: 33016373 DOI: 10.1002/pd.5832] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 09/27/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Glenn E Palomaki
- Department of Pathology and Laboratory Medicine, Women & Infants Hospital and the Alpert Medical School at Brown University, Providence, Rhode Island, USA
| | - Rossa W K Chiu
- Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Mark D Pertile
- Victorian Clinical Genetics Services (VCGS), Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Erik A Sistermans
- Department of Clinical Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Yuval Yaron
- Prenatal Genetic Diagnosis Unit, Genetic Institute, Tel Aviv Medical Center, Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | | | - Neeta L Vora
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Robert G Best
- University of South Carolina SOM Greenville, Greenville, South Carolina, USA
| | - Louise Wilkins-Haug
- Division of Maternal Fetal Medicine and Reproductive Genetics, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Shi X, Liu Q, He W, Liu Y, Rao T, Fang L, Wu J. Prenatal and perinatal outcomes of twin pregnancy discordant for one fetus with nuchal translucency above the 95th percentile. J Matern Fetal Neonatal Med 2020; 35:3152-3157. [PMID: 32907415 DOI: 10.1080/14767058.2020.1814242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To compare prenatal and perinatal outcomes of twin pregnancies in which one twin the nuchal translucency (NT) was above the 95th percentile in dichorionic twins (DCT) and monochorionic twins (MCT). METHOD In this retrospective study, 93 twin pregnancies (186 fetuses) in which one twin the NT was above the 95th percentile and the co-twin had normal NT were analyzed. Results of of G-banding and Chromosomal microarray (CMA), ultrasound findings and pregnancy outcomes were reviewed. RESULTS Totally, 57 pregnancies (114 fetuses) were DCT and 36 pregnancies (72 fetuses) were MCT. Karyotyping and CMA results shown that clinically significant chromosomal abnormalities were found in 16 fetuses, including 13 aneuploidies, 2 chromosomal mosaic and 1 pathological Copy number variations (CNVs) (14 were DCT and 2 were MCT). Overall, the incidence of fetal chromosomal abnormalities was 12.3% (14/114) in DCT and 2.8%(2/72) in MCT (χ2 = 3.932, p = 0.047). Among the cases with normal prenatal diagnosis result, structural abnormalities were found in four fetuses (4.0%, 4/100) in DCT and two fetuses (2.9%, 2/70) in MCT (p > 0.999). There were one intrauterine fetal demises (IUFD) and two miscarry in DCT. One IUFD, three subsequently developed Twin-to-Twin Transfusion Syndrome (TTTS) and four developed selective intrauterine growth restriction (sIUGR) in MCT. Totally, the overall fetal survival rate was 85.1% (97/114) in DCT and 80.6% (58/72) in MCT (χ2 = 0.653, p = 0.419). CONCLUSION Compared to MCT, the incidence of chromosomal abnormalities in DCT discordant for one fetus with NT above the 95th percentile was higher. The risk of structural abnormalities and the rate of fetal survival for both MCT and DCT was similar.
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Affiliation(s)
- Xiaomei Shi
- Gentic Medical Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Qian Liu
- Gentic Medical Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Wei He
- Gentic Medical Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Yishan Liu
- Gentic Medical Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Tengzi Rao
- Gentic Medical Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Liyuan Fang
- Gentic Medical Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Jing Wu
- Gentic Medical Center, Guangdong Women and Children Hospital, Guangzhou, China
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da Silva Francisco Junior R, Dos Santos Ferreira C, Santos E Silva JC, Terra Machado D, Côrtes Martins Y, Ramos V, Simões Carnivali G, Garcia AB, Medina-Acosta E. Pervasive Inter-Individual Variation in Allele-Specific Expression in Monozygotic Twins. Front Genet 2019; 10:1178. [PMID: 31850058 PMCID: PMC6887657 DOI: 10.3389/fgene.2019.01178] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 10/24/2019] [Indexed: 01/19/2023] Open
Abstract
Despite being developed from one zygote, heterokaryotypic monozygotic (MZ) co-twins exhibit discordant karyotypes. Epigenomic studies in biological samples from heterokaryotypic MZ co-twins are of the most significant value for assessing the effects on gene- and allele-specific expression of an extranumerary chromosomal copy or structural chromosomal disparities in otherwise nearly identical germline genetic contributions. Here, we use RNA-Seq data from existing repositories to establish within-pair correlations for the breadth and magnitude of allele-specific expression (ASE) in heterokaryotypic MZ co-twins discordant for trisomy 21 and maternal 21q inheritance, as well as homokaryotypic co-twins. We show that there is a genome-wide disparity at ASE sites between the heterokaryotypic MZ co-twins. Although most of the disparity corresponds to changes in the magnitude of biallelic imbalance, ASE sites switching from either strictly monoallelic to biallelic imbalance or the reverse occur in few genes that are known or predicted to be imprinted, subject to X-chromosome inactivation or A-to-I(G) RNA edited. We also uncovered comparable ASE differences between homokaryotypic MZ twins. The extent of ASE discordance in MZ twins (2.7%) was about 10-fold lower than the expected between pairs of unrelated, non-twin males or females. The results indicate that the observed within-pair dissimilarities in breadth and magnitude of ASE sites in the heterokaryotypic MZ co-twins could not solely be attributable to the aneuploidy and the missing allelic heritability at 21q.
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Affiliation(s)
| | - Cristina Dos Santos Ferreira
- Laboratório de Biotecnologia, Núcleo de Diagnóstico e Investigação Molecular, Universidade Estadual do Norte Fluminense, Campos dos Goytacazes, Brazil
| | - Juan Carlo Santos E Silva
- Laboratório de Biotecnologia, Núcleo de Diagnóstico e Investigação Molecular, Universidade Estadual do Norte Fluminense, Campos dos Goytacazes, Brazil
| | - Douglas Terra Machado
- Laboratório de Biotecnologia, Núcleo de Diagnóstico e Investigação Molecular, Universidade Estadual do Norte Fluminense, Campos dos Goytacazes, Brazil
| | - Yasmmin Côrtes Martins
- Laboratório de Bioinformática, Laboratório Nacional de Computação Científica, Petrópolis, Brazil
| | - Victor Ramos
- Department of Genetics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Gustavo Simões Carnivali
- Department of Computational Science, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Beatriz Garcia
- Laboratório de Biotecnologia, Núcleo de Diagnóstico e Investigação Molecular, Universidade Estadual do Norte Fluminense, Campos dos Goytacazes, Brazil
| | - Enrique Medina-Acosta
- Laboratório de Biotecnologia, Núcleo de Diagnóstico e Investigação Molecular, Universidade Estadual do Norte Fluminense, Campos dos Goytacazes, Brazil
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Homatter C, Robillard PY, Omarjee A, Schweizer C, Boukerrou M, Cuillier F, Doray B, Randrianaivo H, Bertaut-Nativel B, Dumont C. Discordant malformations in monochorionic twins: a retrospective cohort study in La Reunion Island. J Matern Fetal Neonatal Med 2019; 33:4069-4075. [PMID: 30880510 DOI: 10.1080/14767058.2019.1594767] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Discordant malformation between monochorionic twins is a rare and unknown phenomenon.Objectives: To estimate the incidence of discordant monochorionic twins and to describe their characteristics.Study design: A retrospective multicenter cohort of pregnancies between 2002 and 2015 in La Reunion Island was analyzed, thanks to a population-based register. Only monochorionic pregnancies were included in order to analyze specifically monozygotic twins. We defined as discordant twin pairs those in which different malformations were identified for each twin and those with only one fetus showing a malformation.Results: During the study period, 203,807 births occurred, including 410 monochorionic twin pairs. Congenital anomalies rate for monochorionic twin pairs was 10.7%. We included 38 monochorionic twin pairs with discordant phenotypes, which represent 9.3% of monochorionic twin pairs and 86.4% of monochorionic twin pairs affected by congenital anomalies. Among them, both twins were affected by different congenital anomalies in 7 pairs (18.4%), and only one twin was affected in 31 pairs (81.6%). We identified 20 congenital heart anomalies (44.4%), 5 brain anomalies (11.1%), 5 genital anomalies (11.1%), 4 axial bones and skull anomalies (8.9%), 4 limb anomalies (8.9%), 4 facial anomalies (8.9%), 3 urological anomalies (6.6%), 2 thoracic anomalies (4.4%), 1 bile duct anomaly (2,2%), 1 abdominal parietal defect (2.2%), and 1 aneuploidy (2.2%). Among them, 3 (6.6%) fetuses had an association of malformations. Among the 45 fetuses with malformations, 37 fetuses (82.2%) were born alive and 21 (46.6%) had postnatal surgery.Conclusions: Despite a supposed identical genome, discordant congenital anomalies in monochorionic twin pregnancies are not exceptional and related to genetic and epigenetic mechanisms. Sonographers and pediatricians should know that in monochorionic twin a pair, the occurrence of discordant phenotypes is high (9.3%).
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Affiliation(s)
- Céline Homatter
- Service de Gynécologie - Obstétrique, Centre Hospitalier Universitaire Sud-Réunion, Saint-Pierre, France
| | - Pierre-Yves Robillard
- Service de Réanimation Néonatale, Centre Hospitalier Universitaire Sud-Réunion, Saint-Pierre, France.,Centre d'Études Périnatales Océan Indien, Centre Hospitalier Universitaire Sud-Réunion, Saint-Pierre, France
| | - Asma Omarjee
- Service de Gynécologie - Obstétrique, Centre Hospitalier Universitaire Sud-Réunion, Saint-Pierre, France
| | - Chloé Schweizer
- Service de Gynécologie - Obstétrique, Centre Hospitalier Universitaire Sud-Réunion, Saint-Pierre, France
| | - Malik Boukerrou
- Service de Gynécologie - Obstétrique, Centre Hospitalier Universitaire Sud-Réunion, Saint-Pierre, France.,Centre d'Études Périnatales Océan Indien, Centre Hospitalier Universitaire Sud-Réunion, Saint-Pierre, France
| | - Fabrice Cuillier
- Service de Gynécologie - Obstétrique, Centre Hospitalier Universitaire Félix Guyon, Bellepierre, France
| | - Bérénice Doray
- Service de Génétique Médicale, Centre Hospitalier Universitaire Félix Guyon, Bellepierre, France.,CIC-EC Inserm CIC1410, Centre de Recherche Médicale et en Santé, Centre Hospitalier Universitaire Sud-Réunion, Saint-Pierre, France
| | - Hanitra Randrianaivo
- Registre des malformations congénitales de l'Ile de la Réunion, REMACOR, Saint-Pierre, France
| | | | - Coralie Dumont
- Service de Gynécologie - Obstétrique, Centre Hospitalier Universitaire Sud-Réunion, Saint-Pierre, France.,Centre d'Études Périnatales Océan Indien, Centre Hospitalier Universitaire Sud-Réunion, Saint-Pierre, France
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7
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Copy Number Variants and Exome Sequencing Analysis in Six Pairs of Chinese Monozygotic Twins Discordant for Congenital Heart Disease. Twin Res Hum Genet 2018; 20:521-532. [PMID: 29192580 PMCID: PMC5729853 DOI: 10.1017/thg.2017.57] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Congenital heart disease (CHD) is one of the most common birth defects. More than 200 susceptibility loci have been identified for CHDs, yet a large part of the genetic risk factors remain unexplained. Monozygotic (MZ) twins are thought to be completely genetically identical; however, discordant phenotypes have been found in MZ twins. Recent studies have demonstrated genetic differences between MZ twins. We aimed to test whether copy number variants (CNVs) and/or genetic mutation differences play a role in the etiology of CHDs by using single nucleotide polymorphism (SNP) genotyping arrays and whole exome sequencing of twin pairs discordant for CHDs. Our goal was to identify mutations present only in the affected twins, which could identify novel candidates for CHD susceptibility loci. We present a comprehensive analysis for the CNVs and genetic mutation results of the selected individuals but detected no consistent differences within the twin pairs. Our study confirms that chromosomal structure or genetic mutation differences do not seem to play a role in the MZ twins discordant for CHD.
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8
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Zou Z, Huang L, Lin S, He Z, Luo Y. Unusual twinning: Additional findings during prenatal diagnosis of twin zygosity by single nucleotide polymorphism (SNP) array. Prenat Diagn 2018; 38:428-434. [PMID: 29569732 DOI: 10.1002/pd.5255] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 03/16/2018] [Accepted: 03/19/2018] [Indexed: 01/11/2023]
Affiliation(s)
- Zhiyong Zou
- Department of Obstetrics & Gynecology; The First Affiliated Hospital of Sun Yat-Sen University; Guangzhou China
| | - Linhuan Huang
- Department of Obstetrics & Gynecology; The First Affiliated Hospital of Sun Yat-Sen University; Guangzhou China
| | - Shaobin Lin
- Department of Obstetrics & Gynecology; The First Affiliated Hospital of Sun Yat-Sen University; Guangzhou China
| | - Zhiming He
- Department of Obstetrics & Gynecology; The First Affiliated Hospital of Sun Yat-Sen University; Guangzhou China
| | - Yanmin Luo
- Department of Obstetrics & Gynecology; The First Affiliated Hospital of Sun Yat-Sen University; Guangzhou China
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9
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Aneuploidy in dizygotic twin sheep detected using genome-wide single nucleotide polymorphism data from two commonly used commercial vendors. Animal 2018. [PMID: 29540254 DOI: 10.1017/s1751731118000204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Early detection of karyotype abnormalities, including aneuploidy, could aid producers in identifying animals which, for example, would not be suitable candidate parents. Genome-wide genetic marker data in the form of single nucleotide polymorphisms (SNPs) are now being routinely generated on animals. The objective of the present study was to describe the statistics that could be generated from the allele intensity values from such SNP data to diagnose karyotype abnormalities; of particular interest was whether detection of aneuploidy was possible with both commonly used genotyping platforms in agricultural species, namely the Applied BiosystemsTM AxiomTM and the Illumina platform. The hypothesis was tested using a case study of a set of dizygotic X-chromosome monosomy 53,X sheep twins. Genome-wide SNP data were available from the Illumina platform (11 082 autosomal and 191 X-chromosome SNPs) on 1848 male and 8954 female sheep and available from the AxiomTM platform (11 128 autosomal and 68 X-chromosome SNPs) on 383 female sheep. Genotype allele intensity values, either as their original raw values or transformed to logarithm intensity ratio (LRR), were used to accurately diagnose two dizygotic (i.e. fraternal) twin 53,X sheep, both of which received their single X chromosome from their sire. This is the first reported case of 53,X dizygotic twins in any species. Relative to the X-chromosome SNP genotype mean allele intensity values of normal females, the mean allele intensity value of SNP genotypes on the X chromosome of the two females monosomic for the X chromosome was 7.45 to 12.4 standard deviations less, and were easily detectable using either the AxiomTM or Illumina genotype platform; the next lowest mean allele intensity value of a female was 4.71 or 3.3 standard deviations less than the population mean depending on the platform used. Both 53,X females could also be detected based on the genotype LRR although this was more easily detectable when comparing the mean LRR of the X chromosome of each female to the mean LRR of their respective autosomes. On autopsy, the ovaries of the two sheep were small for their age and evidence of prior ovulation was not appreciated. In both sheep, the density of primordial follicles in the ovarian cortex was lower than normally found in ovine ovaries and primary follicle development was not observed. Mammary gland development was very limited. Results substantiate previous studies in other species that aneuploidy can be readily detected using SNP genotype allele intensity values generally already available, and the approach proposed in the present study was agnostic to genotype platform.
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10
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Uysal NŞ, Gülümser Ç, Çelik ZY, Zeyneloğlu HB, Yanık FFB. Fetal sex discordance in a monochorionic twin pregnancy following intracytoplasmic sperm injection: A case report of chimerism and review of the literature. J Obstet Gynaecol Res 2017; 44:576-582. [DOI: 10.1111/jog.13514] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 08/26/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Nihal Ş. Uysal
- Department of Obstetrics and Gynecology; Faculty of Medicine, Başkent University; Ankara Turkey
| | - Çağrı Gülümser
- Department of Obstetrics and Gynecology; Faculty of Medicine, Başkent University; Ankara Turkey
| | - Zerrin Y. Çelik
- Department of Medical Genetics; Faculty of Medicine, Başkent University; Ankara Turkey
| | - Hulusi B. Zeyneloğlu
- Department of Obstetrics and Gynecology; Faculty of Medicine, Başkent University; Ankara Turkey
| | - Filiz F. B. Yanık
- Department of Obstetrics and Gynecology; Faculty of Medicine, Başkent University; Ankara Turkey
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11
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Tauzin M, Felix A, Michot C, Dedieu C, Aoust L, Fortas F, Guillier C, Ngo J, Wachter PY, Petermann L, Kermorvant-Duchemin E. Le monde des jumeaux : aspects épidémiologiques et génétiques, enjeux obstétricaux, risques spécifiques et devenir. Arch Pediatr 2017; 24:1299-1311. [DOI: 10.1016/j.arcped.2017.09.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 06/28/2017] [Accepted: 09/27/2017] [Indexed: 11/16/2022]
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12
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Mayeur Le Bras A, Petit F, Benachi A, Bedel B, Oucherif S, Martinovic J, Armanet N, Tosca L, Gautier V, Parisot F, Labrune P, Tachdjian G, Brisset S. Confined blood chimerism in a monochorionic dizygotic sex discordant twin pregnancy conceived after induced ovulation. ACTA ACUST UNITED AC 2016; 106:298-303. [DOI: 10.1002/bdra.23457] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 07/31/2015] [Accepted: 09/04/2015] [Indexed: 11/05/2022]
Affiliation(s)
- Anne Mayeur Le Bras
- Service d'Histologie Embryologie et Cytogénétique; Hôpitaux Universitaires Paris Sud; Site Antoine Béclère, APHP Clamart France
| | - François Petit
- Laboratoire de Génétique Moléculaire; Hôpitaux Universitaires Paris Sud; Site Antoine Béclère, APHP Clamart France
| | - Alexandra Benachi
- Service de Gynécologie-Obstétrique; Hôpitaux Universitaires Paris Sud; Site Antoine Béclère, APHP Clamart France
| | - Bettina Bedel
- Service de Gynécologie-Obstétrique; Hôpitaux Universitaires Paris Sud; Site Antoine Béclère, APHP Clamart France
| | - Salima Oucherif
- Service de Néonatalogie; Hôpitaux Universitaires Paris Sud; Site Antoine Béclère, APHP Clamart France
| | - Jelena Martinovic
- Unité de Fœtopathologie; Hôpitaux Universitaires Paris Sud; Site Antoine Béclère, APHP Clamart France
| | - Narjes Armanet
- Service d'Histologie Embryologie et Cytogénétique; Hôpitaux Universitaires Paris Sud; Site Antoine Béclère, APHP Clamart France
| | - Lucie Tosca
- Service d'Histologie Embryologie et Cytogénétique; Hôpitaux Universitaires Paris Sud; Site Antoine Béclère, APHP Clamart France
| | - Valérie Gautier
- Service d'Histologie Embryologie et Cytogénétique; Hôpitaux Universitaires Paris Sud; Site Antoine Béclère, APHP Clamart France
| | - Frédéric Parisot
- Service d'Histologie Embryologie et Cytogénétique; Hôpitaux Universitaires Paris Sud; Site Antoine Béclère, APHP Clamart France
| | - Philippe Labrune
- Service de Pédiatrie; Hôpitaux Universitaires Paris Sud; Site Antoine Béclère, APHP Clamart France
| | - Gérard Tachdjian
- Service d'Histologie Embryologie et Cytogénétique; Hôpitaux Universitaires Paris Sud; Site Antoine Béclère, APHP Clamart France
| | - Sophie Brisset
- Service d'Histologie Embryologie et Cytogénétique; Hôpitaux Universitaires Paris Sud; Site Antoine Béclère, APHP Clamart France
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13
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Linskens IH, de Mooij YM, Twisk JW, Kist WJ, Oepkes D, van Vugt JM. Discordance in Nuchal Translucency Measurements in Monochorionic Diamniotic Twins as Predictor of Twin-to-Twin Transfusion Syndrome. Twin Res Hum Genet 2012; 12:605-10. [DOI: 10.1375/twin.12.6.605] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjective:Discordance in nuchal translucency measurements in monochorionic diamniotic twin pregnancies was assessed as predictor of Twin-to-Twin Transfusion Syndrome.Study Design:A total of 61 monochorionic diamniotic twins were enrolled. Nuchal translucency (NT) and crown-rump-length (CRL) discordance was calculated as the percentage of delta NT and CRL (absolute difference NT/CRL fetus 1 and fetus 2) of the largest measurement, and correlated with subsequent development of Twin-to-Twin Transfusion Syndrome.Results:Twin-to-Twin Transfusion Syndrome developed in 14/61 (23%) of cases. A NT discordance of 20% or more best predicted Twin-to-Twin Transfusion Syndrome development, with a sensitivity of 64% and a specificity of 78%. We found a positive predictive value of 50% and negative predicted value of 86% for Twin-to-Twin Transfusion Syndrome development if NT discordance was 20% or more.Conclusion:NT discordance of more than 20% in monochorionic diamniotic twins is associated with an increased risk for subsequent development of Twin-to-Twin Transfusion Syndrome, and with earlier presentation of symptoms.
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14
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Gentilin B, Guerneri S, Bianchi V, Natacci F, Colombo A, Fogliani R, Fortuna R, Coviello DA, Curcio C, Lalatta F. Discordant Prenatal Phenotype and Karyotype of Monozygotic Twins Characterized by the Unequal Distribution of Two Cell Lines Investigated by Different Methods: A Review. Twin Res Hum Genet 2012; 11:352-6. [DOI: 10.1375/twin.11.3.352] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractWe present the case of a monozygotic twin pregnancy discordant for phenotype and karyotype. A chorionic villus sample was performed at the 11th week of gestation in a primigravida because of cystic hygroma detected by ultrasound in one twin of a monochorionic, biamniotic pregnancy. Rapid testing by means of quantitative fluorescence polymerase chain reaction and conventional karyotyping, obtained by both short- and long-term culture, revealed a homogeneous monosomy X (45,X). Amniocentesis was performed separately for both twins before termination and showed an homogeneous monosomy X in one sample and a 46,X,del(X)(p11.1) karyotype in the other one. Postmortem fetal tissues culture confirmed the discordant karyotype between the two embryos. Placental samples obtained after termination revealed the cell line which was not detected at chorionic villus sampling. Based on this and previous reports, we suggest that in cases of a phenotypic discordance detected at ultrasound in the first trimester, it is advisable to perform a karyotype analysis on amniocytes because it better reflects fetal constitution rather than chorionic villi or lymphocytes in case of heterokaryotipic monosomy X monochorionic twins.
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Reuss A, Gerlach H, Bedow W, Landt S, Kuhn U, Stein A, Reschke M, Albrecht B, Westrich V, Trawicki W, Eiben B. Monozygotic twins discordant for trisomy 18. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2011; 38:727-728. [PMID: 21370302 DOI: 10.1002/uog.8978] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/15/2011] [Indexed: 05/30/2023]
Abstract
We report on the pre- and postnatal cytogenetic, molecular genetic and clinical findings in monochorionic-diamniotic twins discordant for trisomy 18. Structural anomalies were identified in one of the twins on prenatal ultrasound examination at 20 weeks' gestation and sampling of amniotic fluid from both sacs was performed for karyotyping. This revealed trisomy 18 in the twin with abnormalities and a normal karyotype in the other twin. Elective Cesarean section was performed at 31 + 5 weeks and the aneuploid twin died shortly after delivery. The surviving twin showed low-grade mosaicism for trisomy 18 on postnatal analysis but has shown normal development. For prenatal diagnosis in monochorionic-diamniotic twin pregnancy the sampling of both amniotic sacs is recommended, especially if one twin has structural anomalies on ultrasound scan.
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Affiliation(s)
- A Reuss
- Praxis Central, Essen, Germany.
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Tauwinklova G, Gaillyova R, Travnik P, Oracova E, Vesela K, Hromadova L, Vesely J, Musilova P, Rubes J, Kadlecova J, Slamova I, Makaturova E, Vranova V. Monozygotic twins with discordant karyotypes following preimplantation genetic screening and single embryo transfer: case report. J Assist Reprod Genet 2010; 27:649-55. [PMID: 20700760 DOI: 10.1007/s10815-010-9462-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2010] [Accepted: 07/21/2010] [Indexed: 10/19/2022] Open
Abstract
PURPOSE to report a case of monozygotic monochorial diamniotic twins with discordant karyotypes. METHODS AND RESULTS the pregnancy was achieved following a treatment cycle with intracytoplasmic sperm injection (ICSI) and preimplantation genetic screening (PGS) for chromosomes X, Y, 13, 16, 18, 21, 22. One embryo euploid for studied chromosomes was transferred. Prenatal ultrasonography revealed monozygotic twins. One fetus had growth retardation, multiple organ abnormalities and polyhydramnion. The other twin had normal ultrasound appearance. Delivery on week 29 of gestation resulted in the birth of two females, a stillborn twin with karyotype 45,XX,-13[12]/46,XX,r(13)[3] and a healthy twin with normal karyotype. CONCLUSIONS the discordance in the twins' karyotypes originated from a mosaic embryo. Structural chromosomal abnormality of the affected twin could not be revealed using standard PGS investigation. Embryo splitting occurred probably due to apoptotic process in an early stage of embryo development. Apoptosis represents one of the possible mechanisms which can explain the embryo twinning process globally.
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Abstract
The risk of fetal loss is multiplied by 4 in monochorionic pregnancies by comparison with dichorionic one. The incidence of selective growth retardation (sIUGR) is between 12.5 to 25%. This variation is explained by the mixture between pure twin-to-twin transfusion syndrome (TTTS) and pregnancies without TTTS but with a pure sIUGR. The ability to diagnose prenatally sIUGR is low; the positive predictive value is only 37% (EL4). The umbilical flow velocity waveforms with absent diastolic flow (Type II) or with diastolic intermittent flow (Type III) is clearly a strong risk factor of mortality of the IUGR and also a risk factor of leucomalacia of the bigger fetus (EL3). The observed incidence of malformations in twins is 4.05% versus 2.38% for singletons (OR=1.7 [IC 95% 1.47-1.97]). Furthermore, the rate of fetal malformations is higher in monochorionic pregnancies by comparison with dichorionic one, 6.33% versus 3.43% (OR=1.8 [IC 95% 1.3-2.5]) (EL3). In the majority of the cases, the malformation is concerning only one fetus. The most frequent malformations are those of the central nervous system by comparison with singletons, those of the urinary tract and the cardiovascular malformations. Monozygotic pregnancies are not necessarily phenotypically and genetically identical. In situation of asymmetrical malformation, it is necessary to propose fetal karyotype of the malformed fetus. In case aneuploidy of the malformed fetus, secondarily it will be necessary to explore the other apparently normal one. Uniparental disomy should be suspected in such situation (EL3). In TRAP sequence, an intensive follow up should be organised with serial measurement of the respective size of the acardiac fetus and the normal one, Doppler exploration should be done to look for early sign of cardiac decompensation (expert viewpoint). In dichorionic pregnancies, when the malformation is threatening the whole pregnancy like anencephaly, a selective feticide allow a prolongation of the pregnancy, but with a risk of fetal loss of 8% and a risk of iatrogenic prematurity of 12%. In such situation, it could be wise to evaluate the evolution or to wait until the third trimester to undergo the procedure (EL3). In monochorionic pregnancies, in the same situation of anencephalic fetus the best option is bipolar cord coagulation. The result seems to be better after 18 weeks of gestation (EL4). There is a 20% risk of premature rupture of membrane. In the up to date analysis of the literature, there is no formal indication of selective feticide expect case of TRAP sequence with cardiac decompensation of the normal fetus. The very special situation of sIUGR is the object of a randomized trial. In all cases the active participation of the patients to the therapeutic option is mandatory (expert viewpoint).
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Wuttikonsammakit P, Tanawattanacharoen S, Uerpairojkit B. Monochorionic twins with the same blood karyotype of 46,XY/47,XYY but different phenotypes. J Obstet Gynaecol Res 2010; 36:178-82. [DOI: 10.1111/j.1447-0756.2009.01115.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kimani JW, Yoshiura KI, Shi M, Jugessur A, Moretti-Ferreira D, Christensen K, Murray JC. Search for genomic alterations in monozygotic twins discordant for cleft lip and/or palate. Twin Res Hum Genet 2010; 12:462-8. [PMID: 19803774 DOI: 10.1375/twin.12.5.462] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Phenotypically discordant monozygotic twins offer the possibility of gene discovery through delineation of molecular abnormalities in one member of the twin pair. One proposed mechanism of discordance is postzygotically occurring genomic alterations resulting from mitotic recombination and other somatic changes. Detection of altered genomic fragments can reveal candidate gene loci that can be verified through additional analyses. We investigated this hypothesis using array comparative genomic hybridization; the 50K and 250K Affymetrix GeneChip(R) SNP arrays and an Illumina custom array consisting of 1,536 SNPs, to scan for genomic alterations in a sample of monozygotic twin pairs with discordant cleft lip and/or palate phenotypes. Paired analysis for deletions, amplifications and loss of heterozygosity, along with sequence verification of SNPs with discordant genotype calls did not reveal any genomic discordance between twin pairs in lymphocyte DNA samples. Our results demonstrate that postzygotic genomic alterations are not a common cause of monozygotic twin discordance for isolated cleft lip and/or palate. However, rare or balanced genomic alterations, tissue-specific events and small aberrations beyond the detection level of our experimental approach cannot be ruled out. The stability of genomes we observed in our study samples also suggests that detection of discordant events in other monozygotic twin pairs would be remarkable and of potential disease significance.
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Affiliation(s)
- Jane W Kimani
- Department of Pediatrics, University of Iowa, Iowa 52242, United States of America
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Bohec C, Douet-Guilbert N, Basinko A, Le Bris MJ, Marcorelles P, Audrézet MP, Tetefort R, Bages K, Collet M, Morel F, De Braekeleer M. Difficult diagnosis and management of an heterokaryotypic monochorionic twin pregnancy with discordant fetal sex and 45,X/47,XYY karyotypes. Fetal Pediatr Pathol 2010; 29:424-30. [PMID: 21043568 DOI: 10.3109/15513815.2010.505630] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We report twins for whom ultrasound examinations revealed a Turner syndrome in the female fetus and a normal male fetus. A selective pregnancy termination was decided on the female fetus with hydrops. The death of both twins called in question the chorionic diagnosis. Amniotic fluid cytogenetic analysis revealed a 45,X karyotype in the female twin and a 47,XYY karyotype in the male twin. Molecular cytogenetic analysis on genital and renal cells showed different levels of 45,X/47,XYY mosaicism in both twins; molecular analysis on the amniocytes showed monozygosity. Monozygotic twins with discordant sex are very rare. This study showed the difficult diagnosis and management of a monochorionic twin pregnancy with discordant fetal sex.
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Affiliation(s)
- Caroline Bohec
- Department of Gynecology, Obstetrics and Reproductive Medicine, Centre Hospitalier Universitaire Brest, Brest, France
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Quel prélèvement choisir pour les grossesses gémellaires : choriocentèse ou amniocentèse ? ACTA ACUST UNITED AC 2009; 38:S39-44. [DOI: 10.1016/s0368-2315(09)73558-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Machin G. Non-identical monozygotic twins, intermediate twin types, zygosity testing, and the non-random nature of monozygotic twinning: A review. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2009; 151C:110-27. [DOI: 10.1002/ajmg.c.30212] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Barré M, Le Caignec C, Rival JM, Le Vaillant C, Salomon LJ, Boscher C, Philippe HJ, Ville Y, Vialard F, Winer N. [Monozygotic heterocaryotic twins: prenatal diagnosis and management]. Presse Med 2009; 38:1170-3. [PMID: 19375887 DOI: 10.1016/j.lpm.2008.12.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2008] [Revised: 11/26/2008] [Accepted: 12/15/2008] [Indexed: 10/20/2022] Open
Affiliation(s)
- Maxime Barré
- Pôle Mère-Enfant (Obstétrique et Pédiatrie) et Service de Génétique, CHU Nantes, F-44093 Nantes, France
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Taylor DM, Thum MY, Abdalla H. Dichorionic triamniotic triplet pregnancy with monozygotic twins discordant for trisomy 13 after preimplantation genetic screening: case report. Fertil Steril 2008; 90:2017.e5-9. [PMID: 18402943 DOI: 10.1016/j.fertnstert.2008.01.095] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2007] [Revised: 01/28/2008] [Accepted: 01/28/2008] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To report the first dichorionic triamniotic triplet pregnancy discordant for trisomy 13 after in vitro fertilization (IVF) treatment with preimplantation genetic screening (PGS). DESIGN Case report. SETTING Private IVF center. PATIENT(S) A 40-year-old para 1+6 woman. INTERVENTION(S) IVF combined with PGS for chromosomes 13, 16, 18, 21, and 22, resulting in the transfer of two embryos. MAIN OUTCOME MEASURE(S) Prenatal fetal ultrasonography revealed a dichorionic triamniotic triplet pregnancy. An amniocentesis, performed at 15-weeks' gestation, confirmed that the singleton and one monozygotic twin were normal but the other monozygotic twin was trisomy 13. RESULT(S) After diagnosis and counseling, selective termination of the trisomy 13 monozygotic twin was performed at 16 weeks and 4 days. At 18 weeks and 4 days the co-twin died. A healthy boy was delivered by elective caesarean section at 36-weeks' gestation. CONCLUSION(S) Assisted reproductive techniques that breach the embryo's zona pellucida such as assisted hatching and PGS embryo biopsy increase the incidence of monozygotic twins. Due to high levels of mosaicism in human preimplantation embryos, PGS cannot ensure that embryos diagnosed as normal and selected for transfer do not contain abnormal cells. Hence, further reports of discordant monozygotic twins following PGS are expected, emphasizing the need for appropriate counseling of patients wishing to embark on an IVF/PGS treatment cycle.
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Affiliation(s)
- Deborah M Taylor
- The Lister Fertility Clinic, Lister Hospital, London, United Kingdom.
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Fernández-Martínez FJ, Galindo A, Moreno-Izquierdo A, Gómez-Rodríguez MJ, Moreno-García M, Grañeras A, Barreiro E. Application of QF-PCR for the prenatal assessment of discordant monozygotic twins for fetal sex. Prenat Diagn 2007; 27:648-52. [PMID: 17451190 DOI: 10.1002/pd.1746] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To establish the utility of quantitative fluorescent polymerase chain reaction (QF-PCR) in order to determine the zygosity of multiple pregnancies, as well as to define the origin of the most frequent aneuploidies in amniotic fluid samples. METHODS We describe the case of a monochorionic (MC) diamniotic (DA) pregnancy with phenotypically discordant twins (nuchal cystic hygroma and non-immune hydrops in twin A and no anomalies in twin B). QF-PCR was performed for rapid prenatal diagnosis in uncultured amniocytes and subsequently in cultured cells. Polymorphic markers for chromosomes X, Y, 13, 18 and 21 were used for determination of zygosity as well as sex chromosome aneuploidy. RESULTS Twin A showed a Turner Syndrome (TS) mosaicism pattern by QF-PCR in uncultured amniocytes. The monozygotic origin of the pregnancy was determined. Interphase fluorescence in situ hybridization (I-FISH) in this sample showed a mosaicism X0/XY (83/17%). Cytogenetic analysis revealed a 45,X0 karyotype in twin A and a 46,XY karyotype in twin B. CONCLUSIONS QF-PCR is a reliable tool for the determination of the zygosity independently of the chorionicity and the fetal sex in case of twin pregnancy. Testing both direct and cultured cells can provide useful results for genetic counselling in chromosomal mosaicisms.
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Grynberg M, Graesslin O, Teyssedre J, Quereux C, Gaillard D, Carré-Pigeon F. Prenatal diagnosis in monozygotic twins with Down syndrome who had different phenotypes. Prenat Diagn 2007; 27:552-4. [PMID: 17345584 DOI: 10.1002/pd.1711] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We report the case of monozygotic (MZ) male twin fetuses with different Down syndrome (DS) phenotypes. Prenatal fetal sonography showed a bichorial biamniotic pregnancy with increased nuchal translucency in twin A and a cervical cystic hygroma and heart defect in twin B. Cytogenetic analysis performed after double amniocentesis showed free and homogeneous trisomy 21 in both twins. Monozygosity was confirmed by molecular analysis. The pregnancy was terminated at 17 weeks of gestation (WG). Postmortem analysis confirmed the phenotypic discordance. To our knowledge, this is the first reported prenatal diagnosis of MZ male twins with different Down syndrome phenotypes but identical karyotypes. We discuss the mechanisms involved in phenotypic discordance of monozygotic twins and particularly the role of environmental factors.
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Affiliation(s)
- M Grynberg
- CHU Reims, Institut mère-enfant Alix de Champagne, Service de Gynécologie-Obstétrique, 45 rue Cognacq-Jay, F-51092 Reims, France
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Cheng PJ, Shaw SW, Shih JC, Soong YK. Monozygotic twins discordant for monosomy 21 detected by first-trimester nuchal translucency screening. Obstet Gynecol 2006; 107:538-41. [PMID: 16449179 DOI: 10.1097/00006250-200602001-00041] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Chromosomal abnormality in one fetus of a monozygotic twin pregnancy is rare, and discussion of prenatal detection of such a case offers some insight into this clinical problem. CASE A 28-year-old gravida 1 had ultrasound screening at 11 weeks of gestation that revealed a monochorionic, diamniotic twin pregnancy with increased nuchal translucency (7.7 mm) in one fetus. Subsequent evaluation showed one 45,XY,-21 karyotype and one normal male karyotype. The pregnancy was monozygous by DNA analysis. The affected neonate died 5 minutes after delivery of both twins by cesarean. CONCLUSION Monochorionic twins discordant for fetal abnormalities can be evaluated with molecular analysis. Study of such cases may reveal the extent to which an early diagnosis can lead to therapeutic interventions to support survival of the viable twin.
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Affiliation(s)
- Po-Jen Cheng
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taiwan.
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Bourthoumieu S, Esclaire F, Yardin C. Chimerism in twins: Caution is needed in interpretation of karyotypes. Am J Med Genet A 2006; 140:533-5. [PMID: 16470796 DOI: 10.1002/ajmg.a.31111] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Kato T, Iwamoto K, Kakiuchi C, Kuratomi G, Okazaki Y. Genetic or epigenetic difference causing discordance between monozygotic twins as a clue to molecular basis of mental disorders. Mol Psychiatry 2005; 10:622-30. [PMID: 15838537 DOI: 10.1038/sj.mp.4001662] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Classical twin research focused on differentiating genetic factors from environmental factors by comparing the concordance rate between monozygotic (MZ) and dizygotic twins. On the other hand, recent twin research tries to identify genetic or epigenetic differences between MZ twins discordant for mental disorders. There are a number of reports of MZ twins discordant for genetic disorders caused by genetic or epigenetic differences of known pathogenic genes. In the case of mental disorder research, for which the causative gene has not been established yet, we are trying to identify the 'pathogenic gene' by comprehensive analysis of genetic or epigenetic difference between discordant MZ twins. To date, no compelling evidence suggesting such difference between MZ twins has been reported. However, if the genetic or epigenetic difference responsible for the discordant phenotype is found, it will have impact on the biology of mental disorder, in which few conclusive molecular genetic evidences have been obtained.
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Affiliation(s)
- T Kato
- Laboratory for Molecular Dynamics of Mental Disorders, RIKEN Brain Science Institute, Saitama, Japan.
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Rustico MA, Baietti MG, Coviello D, Orlandi E, Nicolini U. Managing twins discordant for fetal anomaly. Prenat Diagn 2005; 25:766-71. [PMID: 16170860 DOI: 10.1002/pd.1260] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
An excess of structural anomalies is observed in twins compared to singletons. Approximately 1-2% of twin pregnancies may face the dilemma of expectant management versus selective termination following diagnosis of an anomaly affecting only one fetus. If the option of selective fetocide is considered, the main variable determining the technique to achieve this aim is chorionicity. In a dichorionic pregnancy, passage of substances from one twin into the circulation of the co-twin is unlikely due to the lack of placental anastomoses, hence KCl can be injected safely into the circulation of the affected twin to produce fetal asystole. In monochorionic twin pregnancies, selective termination needs to be performed by ensuring complete and permanent occlusion of both the arterial and venous flows in the umbilical cord of the affected twin, in order to avoid acute haemorrhage from the co-twin into the dying fetus, which may lead to death or organ damage. Bipolar cord coagulation under ultrasound guidance is associated with approximately 70-80% survival rates.
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Affiliation(s)
- M A Rustico
- University of Milano, Department of Obstetrics and Gynaecology, Ospedale V. Buzzi, Milano, Italy
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Bourthoumieu S, Yardin C, Terro F, Gilbert B, Laroche C, Saura R, Vincent MC, Esclaire F. Monozygotic twins concordant for blood karyotype, but phenotypically discordant: A case of “mosaic chimerism”. Am J Med Genet A 2005; 135:190-4. [PMID: 15832362 DOI: 10.1002/ajmg.a.30674] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We report on 23 years old discordant monozygotic (MZ) twins, one with minor anomalies and mental delay, the other one being normal. Both had 46,XX,dup(11)(p12p15)/46,XX mosaicism in blood, with a similar proportion of abnormal cells (respectively, 16% and 17%). However, interphase fluorescence in situ hybridization (FISH) analysis performed on buccal smear and urinary sediment using specific probes located at the duplicated region showed that mosaicism was only present in the abnormal twin, with 68% abnormal cells. We hypothesize that the postzygotic chromosomal rearrangement may have occurred early in one embryo after the twinning event, and the blood mosaicism observed in both twins would have resulted from blood exchanges via placental anastomoses. This hypothesis of chimerism is strongly supported by twin-to-twin transfusion syndrome observed during fetal life of our twins. This case and those previously reported lead us to suggest that blood is particularly unsuitable for cytogenetic investigations of twins.
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Abstract
A monochorionic twin pregnancy had normal male karyotype on chorionic villous sampling. At delivery, one twin presented as morphologically normal, the other as trisomy 21. A twinning event and chromosome division error shortly after conception resulted in monozygotic twins with discordant tissue karyotypes and blood chromosome chimerism for trisomy 21.
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Affiliation(s)
- Colm P F O'Donnell
- Department of Neonatal Pediatrics, Royal Women's Hospital, University of Melbourne, 132 Grattan Street, Carlton, Victoria 3053, Australia.
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Chen CP, Chang TY, Chern SR, Town DD, Pan CW, Lee MS, Wang W. Early second-trimester diagnosis of monozygotic twins discordant for cystic hygroma colli and Turner syndrome. Prenat Diagn 2003; 23:352-3. [PMID: 12673645 DOI: 10.1002/pd.573] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Current awareness in prenatal diagnosis. Prenat Diagn 2002; 22:949-55. [PMID: 12398087 DOI: 10.1002/pd.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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