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Chen Q, Chen Y, Shi L, Tao Y, Li X, Zhu X, Yang Y, Xu W. Uniparental disomy: expanding the clinical and molecular phenotypes of whole chromosomes. Front Genet 2023; 14:1232059. [PMID: 37860673 PMCID: PMC10582337 DOI: 10.3389/fgene.2023.1232059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/22/2023] [Indexed: 10/21/2023] Open
Abstract
Uniparental disomy (UPD) refers to as both homologous chromosomes inherited from only one parent without identical copies from the other parent. Studies on clinical phenotypes in UPDs are usually focused on the documented UPD 6, 7, 11, 14, 15, and 20, which directly lead to imprinting disorders. This study describes clinical phenotypes and genetic findings of three patients with UPD 2, 9, and 14, respectively. Chromosomal microarray (CMA), UPDtool, methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) and whole-exome sequencing (WES) analysis were performed to characterize the genetic etiology. The CMA revealed a homozygous region involving the whole chromosome 2 and 9, a partial region of homozygosity in chromosome 14. UPD-tool revealed a paternal origin of the UPD2. MS-MLPA showed hypomethylation of imprinting gene MEG3 from maternal origin in the UPD14 case. In addition, UPD14 case displayed complex symptoms including growth failure, hypotonia and acute respiratory distress syndrome (ARDS), accompanied by several gene mutations with heterozygous genotype by WES analysis. Furthermore, we reviewed the documented UPDs and summarized the clinical characteristics and prognosis. This study highlighted the importance to confirm the diagnosis and origin of UPD using genetic testing. Therefore, it is suggested that expanding of the detailed phenotypes and genotypes provide effective guidance for molecule testing and genetic counseling, and promote further biological investigation to the underlying mechanisms of imprinted disorders and accompanied copy number variations.
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Affiliation(s)
- Qi Chen
- Genetic and Prenatal Diagnosis Center, Fourth Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Yunpeng Chen
- Genetic and Prenatal Diagnosis Center, Fourth Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Lin Shi
- Department of Ultrasound, Fourth Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Ying Tao
- Genetic and Prenatal Diagnosis Center, Fourth Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Xiaoguang Li
- Genetic and Prenatal Diagnosis Center, Fourth Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Xiaolan Zhu
- Reproductive Medicine Center, Fourth Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Yan Yang
- Genetic and Prenatal Diagnosis Center, Fourth Affiliated Hospital of Jiangsu University, Zhenjiang, China
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Chen CP, Wu FT, Wang LK, Pan YT, Lee MS, Wang W. High-level mosaic trisomy 14 at amniocentesis in a pregnancy associated with congenital heart defects and intrauterine growth restriction on fetal ultrasound. Taiwan J Obstet Gynecol 2023; 62:594-596. [PMID: 37407202 DOI: 10.1016/j.tjog.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2023] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVE We present high-level mosaic trisomy 14 at amniocentesis in a pregnancy associated with congenital heart defects (CHD) and intrauterine growth restriction (IUGR). CASE REPORT A 34-year-old, primigravid woman underwent amniocentesis at 17 weeks of gestation because of advanced maternal age. This pregnancy was conceived by in vitro fertilization and embryo transfer (IVF-ET). Amniocentesis revealed a karyotype of 47,XX,+14[9]/46,XX[13], consistent with 40.9% (9/22 colonies) mosaicism for trisomy 14. Simultaneous array comparative genomic hybridization (aCGH) on the DNA extracted from uncultured amniocytes revealed 61% mosaicism for trisomy 14. Prenatal ultrasound at 22 weeks of gestation showed a malformed fetus with double outlet of right ventricle (DORV), ventricular septal defect (VSD), pulmonary stenosis and severe IUGR with the growth parameters equivalent to 18 weeks of gestation. The pregnancy was terminated at 23 weeks of gestation, and a 278-g female fetus was delivered with facial dysmorphism of hypertelorism, low-set small ears and wide depressed nasal bridge. Quantitative fluorescent polymerase chain reaction (QF-PCR) analysis on the DNA extracted from parental bloods, cord blood, umbilical cord and placenta confirmed a maternal origin of the extra chromosome 14 and excluded uniparental disomy (UPD) 14. The umbilical cord had a karyotype of 47,XX,+14[7]/ 46,XX[13], and the placenta had a karyotype of 47,XX,+14[4]/46,XX[36]. CONCLUSIONS High-level mosaic trisomy 14 at amniocentesis can be associated with abnormal ultrasound findings of CHD and IUGR.
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Affiliation(s)
- Chih-Ping Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; Institute of Clinical and Community Health Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Medical Laboratory Science and Biotechnology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
| | - Fang-Tzu Wu
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Liang-Kai Wang
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yen-Ting Pan
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Meng-Shan Lee
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Wayseen Wang
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
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Prenatal diagnosis and molecular cytogenetic characterization of a familial small supernumerary marker chromosome derived from the acrocentric chromosome 14/22. Taiwan J Obstet Gynecol 2022; 61:364-367. [DOI: 10.1016/j.tjog.2022.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2022] [Indexed: 11/20/2022] Open
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Garza-Mayén G, Ulloa-Avilés V, Villarroel CE, Navarrete-Meneses P, Lieberman-Hernández E, Abreu-González M, Márquez-Quiroz L, Azotla-Vilchis C, Cifuentes-Goches JC, Del Castillo-Ruiz V, Durán-McKinster C, Pérez-Vera P, Salas-Labadía C. UPD(14)mat and UPD(14)mat in concomitance with mosaic small supernumerary marker chromosome 14 in two new patients with Temple syndrome. Eur J Med Genet 2021; 64:104199. [PMID: 33746039 DOI: 10.1016/j.ejmg.2021.104199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/03/2021] [Accepted: 03/14/2021] [Indexed: 10/21/2022]
Abstract
Temple syndrome (TS14) can be originated by maternal uniparental disomy (UPD(14)mat), paternal deletion, or epimutation, leading to disturbances in 14q32.2 imprinted region. The most frequent phenotypic manifestations are prenatal and postnatal growth failure, hypotonia, developmental delay, small hands/feet, precocious puberty, and truncal obesity. However, the diagnosis can be challenging due to the clinical overlap with other imprinting disorders such as Silver-Russell or Prader-Willi syndromes. Although rare, TS14 has been also reported in patients with concomitant UPD(14)mat and mosaic trisomy 14. In the present report, the clinical and genetic profiles of two new patients with TS14 are described. SNParray and MS-MLPA, allowed the determination of segmental UPD(14)mat and the hypomethylation of MEG3 gene. Additionally, in one of our patients we also observed by cytogenetics a small supernumerary marker chromosome that led to partial trisomy 14 in mosaic. Only few patients with concomitant UPD(14)mat and mosaic partial trisomy 14 have been reported. Our patients share cardinal TS14 phenotypic features that are associated to the genetic abnormalities detected; however, we also observed some clinical features such as fatty liver disease that had not previously been reported as part of this syndrome. The detailed clinical, cytogenetical and molecular description of these two new patients, contributes to a more accurately delineation of this syndrome.
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Affiliation(s)
- G Garza-Mayén
- Departamento de Genética Humana, Instituto Nacional de Pediatría. Ciudad de México, Mexico.
| | - V Ulloa-Avilés
- Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría. Ciudad de México, 04530, Mexico
| | - C E Villarroel
- Departamento de Genética Humana, Instituto Nacional de Pediatría. Ciudad de México, Mexico
| | - P Navarrete-Meneses
- Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría. Ciudad de México, 04530, Mexico
| | - E Lieberman-Hernández
- Departamento de Genética Humana, Instituto Nacional de Pediatría. Ciudad de México, Mexico
| | - M Abreu-González
- Genos Médica, Centro Especializado en Genética. Ciudad de México, Mexico
| | - L Márquez-Quiroz
- Genos Médica, Centro Especializado en Genética. Ciudad de México, Mexico
| | - C Azotla-Vilchis
- Genos Médica, Centro Especializado en Genética. Ciudad de México, Mexico
| | | | - V Del Castillo-Ruiz
- Departamento de Genética Humana, Instituto Nacional de Pediatría. Ciudad de México, Mexico
| | - C Durán-McKinster
- Departamento de Dermatología, Instituto Nacional de Pediatría. Ciudad de México, Mexico
| | - P Pérez-Vera
- Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría. Ciudad de México, 04530, Mexico.
| | - C Salas-Labadía
- Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría. Ciudad de México, 04530, Mexico.
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Lindgren V, Cobian K, Bhat G. Temple syndrome resulting from uniparental disomy is undiagnosed by a methylation assay due to low-level mosaicism for trisomy 14. Am J Med Genet A 2021; 185:1538-1543. [PMID: 33595182 DOI: 10.1002/ajmg.a.62128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 01/14/2021] [Accepted: 02/01/2021] [Indexed: 01/03/2023]
Abstract
We describe a patient with Temple syndrome resulting from maternal uniparental disomy of chromosome 14 who also has low-level mosaicism for trisomy 14. UPD was initially suspected when SNP microarray analysis detected a large region of homozygosity on chromosome 14 and the patient's clinical features were consistent with the phenotype of upd(14)mat. However, SNP arrays cannot prove UPD, as homozygosity may also result from identity by descent. Methylation assays diagnose imprinting disorders such as Prader-Willi, Angelman and Temple syndromes; they detect methylation defects that occur in imprinted loci, which have parent-of-origin-specific expression and have the advantage of making a diagnosis without parental samples. However, in this patient methylation analysis using endpoint PCR detected biparental inheritance. Therefore, sequencing analysis was performed and diagnosed upd(14)mat. Re-examination of the microarray suggested that the explanation for the discrepancy between the array and methylation testing was low-level mosaicism for trisomy 14 and fluorescence in situ hybridization testing detected a trisomic cell line. Thus, this patient's Temple syndrome is a result of a maternal M1 error, which gave a trisomic zygote, followed by loss of the paternal chromosome 14 in an early mitotic division to give maternal UPD with low-level mosaicism for trisomy 14. The methylation assay detected the paternal allele in the trisomic line. The diagnostic failure of the methylation assay in this patient highlights a significant shortcoming of methylation endpoint analysis, especially for Temple syndrome, and underscores the need to use other methods in cases with mosaicism.
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Affiliation(s)
- Valerie Lindgren
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Katherine Cobian
- Department of Pediatrics, Section of Genetics, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Gifty Bhat
- Department of Pediatrics, Section of Genetics, University of Illinois at Chicago, Chicago, Illinois, USA
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Romero VI, Pozo JC, Saenz S, Llamos-Paneque A, Liehr T, Hosomichi K, Tajima A. A toddler with phylloid-type pigmentary mosaicism and ambiguous genitalia resulting from trisomy 14 induced by a der(Y)t(Y;14). Hum Genome Var 2020; 7:28. [PMID: 33062287 PMCID: PMC7519037 DOI: 10.1038/s41439-020-00113-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/14/2020] [Accepted: 07/15/2020] [Indexed: 11/23/2022] Open
Abstract
A 1-year-old baby with phylloid-type pigmentary mosaicism, hypotonia, ambiguous genitalia, and a positive screening test for congenital adrenal hyperplasia was referred. Previous sonograph, cytogenetics, and metabolic profile were inconclusive, therefore we performed an additional karyotype and a molecular cytogenetics studies. A mosaic karyotype 45,X/46,X,der(Y)t(Y;14) was characterized in peripheral blood. Congenital adrenal hyperplasia genes were sequenced and the results were negative. The ambiguous genitalia was the result of the special gonosomal mosaicism. The low level of trisomy 14 led to minor physical characteristics and mild mental retardation; also, Turner syndrome features can be expected rather than severe trisomy 14 stigmata.
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Affiliation(s)
- V. I. Romero
- School of Medicine, Universidad San Francisco de Quito, Quito, Ecuador
| | - J. C. Pozo
- School of Medicine, Universidad San Francisco de Quito, Quito, Ecuador
| | - S. Saenz
- School of Medicine, Universidad San Francisco de Quito, Quito, Ecuador
| | - A. Llamos-Paneque
- Specialty Army Hospital No. 1. Medical Genetic Services, Sciences of Life Faculty, School of Dentistry, International University of Ecuador, Quito, Ecuador
| | - T. Liehr
- Institute of Human Genetics, Jena University Hospital, Friedrich Schiller University, Am Klinikum 1, D-07747 Jena, Germany
| | - K. Hosomichi
- Department of Bioinformatics and Genomics, Kanazawa University, Kanazawa, Japan
| | - A. Tajima
- Department of Bioinformatics and Genomics, Kanazawa University, Kanazawa, Japan
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Mohamed AM, Eid MM, Eid OM, Hussein SH, Mossaad AM, Abdelfattah U, Sharafuddin MA, El Halafawy YM, Elbanoby TM, Abdel-Salam GMH. Two Abnormal Cell Lines of Trisomy 14 and t(X;14) with Skewed X-Inactivation. Cytogenet Genome Res 2020; 160:124-133. [PMID: 32187602 DOI: 10.1159/000506430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2020] [Indexed: 01/29/2023] Open
Abstract
Trisomy 14 is incompatible with live, but there are several patients reported with mosaic trisomy 14. We aimed to study the pattern of X inactivation and its effect on a translocated autosome and to find out an explanation of the involvement of chromosome 14 in 2 different structural chromosomal abnormalities. We report on a girl with frontal bossing, hypertelorism, low-set ears, micrognathia, cleft palate, congenital heart disease, and abnormal skin pigmentations. The patient displayed iris, choroidal, and retinal coloboma and agenesis of the corpus callosum and cerebellar vermis hypoplasia. Cytogenetic analysis revealed a karyotype 45,X,der(X)t(X;14)(q24;q11)[85]/46,XX,rob(14;14)(q10;q10),+14[35]. Array-CGH for blood and buccal mucosa showed high mosaic trisomy 14 and an Xq deletion. MLPA detected trisomy 14 in blood and buccal mucosa and also showed normal methylation of the imprinting center. FISH analysis confirmed the cell line with trisomy 14 (30%) and demonstrated the mosaic deletion of the Xq subtelomere in both tissues. There was 100% skewed X inactivation for the t(X;14). SNP analysis of the patient showed no region of loss of heterozygosity on chromosome 14. Also, genotype call analysis of the patient and her parents showed heterozygous alleles of chromosome 14 with no evidence of uniparental disomy. Our patient had a severe form of mosaic trisomy 14. We suggest that this cytogenetic unique finding that involved 2 cell lines with structural abnormalities of chromosome 14 occurred in an early postzygotic division. These 2 events may have happened separately or maybe there is a kind of trisomy or monosomy rescue due to dynamic cytogenetic interaction between different cell lines to compensate for gene dosage.
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Massara LS, Delea M, Espeche L, Bruque CD, Oliveri J, Brun P, Furforo L, Dain L, Rozental S. Double Autosomal/Gonosomal Mosaic Trisomy 47,XXX/47,XX,+14 in a Newborn with Multiple Congenital Anomalies. Cytogenet Genome Res 2019; 159:137-142. [PMID: 31786569 DOI: 10.1159/000504238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2019] [Indexed: 11/19/2022] Open
Abstract
Chromosomal trisomies are the most frequent major chromosomal anomalies in humans and can be present in a mosaic or a non-mosaic constitution. We report the first case of a newborn girl presenting with multiple congenital anomalies and a double mosaic trisomy involving chromosome 14 and the X chromosome detected by array CGH. Karyotype analysis revealed a double mosaic with 2 independent abnormal cell lines and the absence of 46,XX and 48,XXX,+14 cell lineages. The patient showed most of the clinical characteristics of mosaic trisomy 14. Analysis of autosomal DNA markers in the proband's blood sample did not support the presence of chimerism. Further analysis of chromosome X DNA markers suggests that the extra X chromosome most probably arose as a consequence of nondisjunction in meiosis II in the maternal lineage.
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