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Haltrich I, Pikó H, Pamjav H, Somogyi A, Völgyi A, David D, Beke A, Garamvölgyi Z, Kiss E, Karcagi V, Fekete G. Complex X chromosome rearrangement associated with multiorgan autoimmunity. Mol Cytogenet 2015; 8:51. [PMID: 26191082 PMCID: PMC4506572 DOI: 10.1186/s13039-015-0152-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 06/23/2015] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Turner syndrome, a congenital condition that affects 1/2,500 births, results from absence or structural alteration of the second sex chromosome. Turner syndrome is usually associated with short stature, gonadal dysgenesis and variable dysmorphic features. The classical 45,X karyotype accounts approximately for half of all patients, the remainder exhibit mosaicism or structural abnormalities of the X chromosome. However, complex intra-X chromosomal rearrangements involving more than three breakpoints are extremely rare. RESULTS We present a unique case of a novel complex X chromosome rearrangement in a young female patient presenting successively a wide range of autoimmune diseases including insulin dependent diabetes mellitus, Hashimoto's thyroiditis, celiac disease, anaemia perniciosa, possible inner ear disease and severe hair loss. For the genetic evaluation, conventional cytogenetic analysis and FISH with different X specific probes were initially performed. The complexity of these results and the variety of autoimmune problems of the patient prompted us to identify the exact composition and breakpoints of the rearranged X as well as methylation status of the X chromosomes. The high resolution array-CGH (assembly GRCh37/hg19) detected single copy for the whole chromosome X short arm. Two different sized segments of Xq arm were present in three copies: one large size of 80,3 Mb from Xq11.1 to Xq27.3 region and another smaller (11,1 Mb) from Xq27.3 to Xq28 region. An 1,6 Mb Xq27.3 region of the long arm was present in two copies. Southern blot analysis identified a skewed X inactivation with ≈ 70:30 % ratios of methylated/unmethylated fragments. The G-band and FISH patterns of the rearranged X suggested the aspect of a restructured i(Xq) chromosome which was shattered and fortuitously repaired. The X-STR genotype analysis of the family detected that the patient inherited intact maternal X chromosome and a rearranged paternal X chromosome. The multiple Xq breakages and fusions as well as inverted duplication would have been expected to cause a severe Turner phenotype. However, the patient lacks many of the classic somatic features of Turner syndrome, instead she presented multiorgan autoimmune diseases. CONCLUSIONS The clinical data of the presented patient suggest that fragmentation of the i(Xq) chromosome elevates the risk of autoimmune diseases.
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Affiliation(s)
- Irén Haltrich
- 2nd Department of Pediatrics, Semmelweis University, Tűzoltó utca 7-9, 1094 Budapest, Hungary
| | - Henriett Pikó
- Department of Molecular Genetics and Diagnostics, National Center of Public Health, Budapest, Hungary
| | - Horolma Pamjav
- DNA Laboratory, Institute of Forensic Medicine, Network of Forensic Science Institutes, Budapest, Hungary
| | - Anikó Somogyi
- 2nd Department of Medicine, Semmelweis University, Budapest, Hungary
| | - Antónia Völgyi
- DNA Laboratory, Institute of Forensic Medicine, Network of Forensic Science Institutes, Budapest, Hungary
| | - Dezső David
- Department of Human Genetics, Organization National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Artúr Beke
- 1st Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Zoltán Garamvölgyi
- 1st Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Eszter Kiss
- 2nd Department of Pediatrics, Semmelweis University, Tűzoltó utca 7-9, 1094 Budapest, Hungary
| | - Veronika Karcagi
- Department of Molecular Genetics and Diagnostics, National Center of Public Health, Budapest, Hungary
| | - György Fekete
- 2nd Department of Pediatrics, Semmelweis University, Tűzoltó utca 7-9, 1094 Budapest, Hungary
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Nistal M, Paniagua R, González-Peramato P, Reyes-Múgica M. Perspectives in Pediatric Pathology, Chapter 5. Gonadal Dysgenesis. Pediatr Dev Pathol 2015; 18:259-78. [PMID: 25105336 DOI: 10.2350/14-04-1471-pb.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
One of the most challenging areas in pediatric testicular pathology is the appropriate understanding and pathological diagnosis of disorders of sexual development (DSD), and in particular, the issue of gonadal dysgenesis. Here we present the main concepts necessary for their understanding and appropriate classification, with extensive genetic correlations.
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Affiliation(s)
- Manuel Nistal
- 1 Department of Pathology, Hospital La Paz, Universidad Autónoma de Madrid, Calle Arzobispo Morcillo #2, Madrid 28029, Spain
| | - Ricardo Paniagua
- 2 Department of Cell Biology, Universidad de Alcala, Madrid, Spain
| | - Pilar González-Peramato
- 1 Department of Pathology, Hospital La Paz, Universidad Autónoma de Madrid, Calle Arzobispo Morcillo #2, Madrid 28029, Spain
| | - Miguel Reyes-Múgica
- 3 Department of Pathology, Children's Hospital of Pittsburgh of UPMC, One Children's Hospital Drive, 4401 Penn Avenue, Pittsburgh, PA 15224, USA
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Ochalski ME, Engle N, Wakim A, Ravnan BJ, Hoffner L, Rajkovic A, Surti U. Complex X chromosome rearrangement delineated by array comparative genome hybridization in a woman with premature ovarian insufficiency. Fertil Steril 2011; 95:2433.e9-15. [DOI: 10.1016/j.fertnstert.2011.03.082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Revised: 03/21/2011] [Accepted: 03/23/2011] [Indexed: 10/18/2022]
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Weimer J, Shivakumar S, Danda S, Thomas N, Ralui LP, Jonat W, Arnold N. Premature ovarian failure in a patient with a complex chromosome rearrangement involving the critical region Xq24, characterized by analysis using fluorescence in situ hybridization by chromosome microdissection. Fertil Steril 2007; 88:1677.e9-13. [PMID: 17482166 DOI: 10.1016/j.fertnstert.2007.01.098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2006] [Revised: 01/15/2007] [Accepted: 01/15/2007] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To characterize a complex chromosome rearrangement previously detected by G-banding in peripheral blood lymphocytes as 46,X, inv(X)(p11;q2?), inv(4)(q?),ins(8)(q?) in a patient with primary amenorrhea. DESIGN Case report. SETTING University faculty of medicine and hospital. PATIENT(S) A 16-year-old girl with primary amenorrhea. INTERVENTION(S) Microdissection of chromosomes labeled by fluorescence in situ hybridization and by reverse painting. MAIN OUTCOME MEASURE(S) Use of commercial whole-chromosome painting probes for the detection of the aberrant chromosomes 4, 8, and X. Fluorescence probes of the isolated derivative chromosomes are self-generated. RESULT(S) The use of whole-chromosome painting probes allowed reliable identification of all chromosomes involved in the complex chromosome rearrangements. The DNA of those chromosomes was amplified and fluorescence labeled by polymerase chain reaction using degenerated oligonucleotide primers. These probes revealed breakpoints of the complex chromosome rearrangement by hybridization on normal and original chromosomes in 4q31.1, 8q24.1, Xp22.1, Xp11.4, and Xq24. CONCLUSION(S) We report on an Indian patient who has premature ovarian failure with primary amenorrhea as well as a hormone level increased for LH and FSH but decreased for TSH. She has a balanced complex translocation with three breakpoints in the X chromosome that were located by fluorescence in situ hybridization by chromosome microdissection, but no breakpoints localized in the critical regions for premature ovarian failure on the X chromosome. The breakpoint in Xq24 may be associated with the amenorrhea.
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Affiliation(s)
- Jörg Weimer
- University Clinic Schleswig-Holstein, Campus Kiel, Clinic of Gynecology and Obstetrics, Kiel, Germany.
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Hernando C, Plaja A, Català V, Sarret E, Egozcue J, Fuster C. Primary amenorrhea in a woman with a cryptic complex chromosome rearrangement involving the critical regions Xp11.2 and Xq24. Fertil Steril 2004; 82:1666-71. [PMID: 15589876 DOI: 10.1016/j.fertnstert.2004.05.085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2004] [Revised: 05/04/2004] [Accepted: 05/04/2004] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To characterize a complex chromosome rearrangement (CCR) previously detected by G-banding in peripheral blood lymphocytes, as 46,X,-2,-11,-22,-X,+mar 1+mar2+mar3+mar4 in a patient with primary amenorrhea. DESIGN Case report. SETTING University faculty of Medicine and hospital. PATIENT(S) A 36-year-old woman with primary amenorrhea. INTERVENTION(S) Fluorescence in situ hybridization (FISH). MAIN OUTCOME MEASURE(S) Use of commercially available M-FISH probe (24 colors simultaneously) and whole chromosome painting probes for chromosomes 2, 11, 22, and X to characterize the CCR. RESULT(S) The use of conventional and multiple FISH allowed the redefinition of the CCR, showing a cryptic insertion of chromosome 11 in marker 3 previously suspected by M-FISH. The combination of G-banding and FISH data revealed that four chromosomes and seven breakpoints, including 2q21, 2q31, 11q22.1, 11q22.3, 22q13.3, Xp11.21, and Xq24, were implicated in this CCR. CONCLUSION(S) This report confirms the importance of a combination of G-banding and FISH (M-FISH and conventional FISH) techniques to characterize the de novo CCR. These techniques also were useful in defining two possible critical chromosome regions, Xp11.21 and Xq24, in which genes of potential interest for a primary amenorrhea could be located.
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Affiliation(s)
- Cristina Hernando
- Departament Biologia Cellular, Fisiologia i Immunologia, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
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Abstract
A direct intrachromosome insertion of chromosome 7 is described, and previous reports of intrachromosomal insertions are listed. All others were ascertained through a phenotypically abnormal proband. Ours is the first presenting with multiple pregnancy losses. Since the risk of chromosomally abnormal liveborns is appreciable, prenatal diagnosis should be made available to known carriers of chromosome insertions.
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Affiliation(s)
- S A Farrell
- Division of Genetics, Credit Valley Hospital, Mississauga, Ontario, Canada
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Abstract
We describe the phenotype of a child having a recombinant chromosome 3 with a duplication 3q13.2----q25 derived from a paternal inv ins(3)(p25.3q25q13.2). A review of 27 reported cases of intrachromosomal insertions has revealed that for a carrier of intrachromosomal insertion the risk of a child with an unbalanced karyotype is 15%. This risk may be higher for particular insertions. The recombinant chromosome can have a duplication or a deletion of different segments depending on whether the insertion is direct or inverted, paracentric or pericentric, and whether there is meiotic crossing over in the inserted or the interstitial non-inserted segment. Several of the insertions have been difficult to interpret and some of them have been mistaken for paracentric inversions. Caution is therefore indicated in interpreting parental karyotypes of a child with a deletion or a duplication, particularly if it is interstitial. This is because, whereas a risk of recurrence of a child with an unbalanced karyotype is low in de novo cases and for carriers of paracentric inversions, it is high for carriers of insertions.
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Affiliation(s)
- K Madan
- Department of Clinical Genetics, Free University Hospital, Amsterdam, The Netherlands
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Rose NC, Menacker SJ, Schnur RE, Jackson L, McDonald-McGinn DM, Stump T, Emanuel BS, Zackai EH. Ocular albinism in a male with del (6)(q13-q15): candidate region for autosomal recessive ocular albinism? AMERICAN JOURNAL OF MEDICAL GENETICS 1992; 42:700-5. [PMID: 1632442 DOI: 10.1002/ajmg.1320420515] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We describe a boy with an interstitial deletion of 6(q13-q15) and include "coarse" facial features, upslanting palpebral fissures, thin vermilion border of the upper lip, elongated philtrum, developmental delay, and profound hypotonia. The child's eye findings, pedigree, paucity of maternal ocular changes, and lack of melanin macroglobules in the skin suggest that this individual's phenotype is clinically similar to that of autosomal recessive ocular albinism. Though it is possible that this deletion and his ophthalmic disorder are coincidental, we postulate that the ocular albinism may be due to hemizygosity for a paternally derived ocular albinism gene located on chromosome 6 in the region q13-q15. This patient's deletion is secondary to a recombination of a maternal intrachromosomal inverted insertion of this region. Of the 7 reported 6q1 deletions, this is the only case that is due to a familial chromosome rearrangement.
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Affiliation(s)
- N C Rose
- Department of Obstetrics and Gynecology, University of Pennsylvania Medical Center, Philadelphia 19104
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Vekemans M, Morichon-Delvallez N. Duplication of the long arm of chromosome 13 secondary to a recombination in a maternal intrachromosomal insertion (shift). Prenat Diagn 1990; 10:787-94. [PMID: 1963687 DOI: 10.1002/pd.1970101205] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A rare chromosomal aberration consisting of a chromosomal shift was found in a woman who had prenatal diagnosis because she had previously had a malformed girl with phenotypic features compatible with the diagnosis of Patau syndrome. Chromosome analysis using G, C, and NOR banding showed a direct intrachromosomal insertion of bands 13q12 to 13q14 onto the short arm of chromosome 13 at band 13p13. We discuss this observation and compare it with other published reports of chromosomal shifts.
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Affiliation(s)
- M Vekemans
- Centre for Human Genetics, McGill University, Montreal, Canada
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Watson MS, Dowton SB, Rohrbaugh J. Case of direct insertion within a chromosome 3 leading to a chromosome 3p duplication in an offspring. AMERICAN JOURNAL OF MEDICAL GENETICS 1990; 36:172-4. [PMID: 2368804 DOI: 10.1002/ajmg.1320360209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
An infant with developmental delay and multiple minor congenital anomalies had a duplication of bands p11.1----p14.2 in 3p. Maternal chromosome studies demonstrated a direct intrachromosomal insertion within chromosome 3p.
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Affiliation(s)
- M S Watson
- Edward Mallinckrodt Department of Pediatrics, St. Louis Children's Hospital, Washington University School of Medicine, MO 63110
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Affiliation(s)
- M O Savage
- Department of Child Health, St Bartholomew's Hospital, London, UK
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Abuelo DN, Barsel-Bowers G, Richardson A. Insertional translocations: report of two new families and review of the literature. AMERICAN JOURNAL OF MEDICAL GENETICS 1988; 31:319-29. [PMID: 2852898 DOI: 10.1002/ajmg.1320310209] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We describe two families with insertional translocations. In the first, a large family ascertained because of repeated pregnancy loss, the insertional translocation, ins(1;3)(q32;p13pter), was found to be segregating through three generations. In the second family, ascertained through a proposita with congenital malformations, multiple spontaneous abortions also occurred. The father had an insertional translocation, inv 4(p14,q21.1)ins(7,4)(q32;q21.1 q23). These cases illustrate that recurrent fetal wastage may be caused by insertional translocations and in fact may be the only clinical manifestation of this unusual type of chromosome rearrangement.
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MESH Headings
- Chromosomes, Human, Pair 1
- Chromosomes, Human, Pair 3
- Chromosomes, Human, Pair 4
- Chromosomes, Human, Pair 7
- DNA Transposable Elements
- Female
- Humans
- Infant, Newborn
- Karyotyping
- Male
- Pedigree
- Translocation, Genetic
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Affiliation(s)
- D N Abuelo
- Genetic Counseling Center, Rhode Island Hospital, Department of Pediatrics, Providence 02902
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Watt JL, Couzin DA, Lloyd DJ, Stephen GS, McKay E. A familial insertion involving an active nucleolar organiser within chromosome 12. J Med Genet 1984; 21:379-84. [PMID: 6502652 PMCID: PMC1049324 DOI: 10.1136/jmg.21.5.379] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
As far as the authors are aware this is the first report of the insertion of an active NOR into a non-acrocentric chromosome, although a simple translocation involving an active NOR has been previously recorded. More specifically, this case involves the non-reciprocal translocation of the centromere and stalk of an acrocentric into 12p, generating an apparently stable dicentric chromosome. The insertion is seen in three generations and may be relatively genetically benign. The abnormality is fully described by G and sequential C banding, DA/DAPI fluorescence, kinetochore staining, and Ag-NOR staining, and the findings are discussed in the light of the limited published reports of insertion in man.
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Pai GS, Rogers JF, Sommer A. Identical multiple congenital anomalies/mental retardation (MCA/MR) syndrome due to del(2)(q32) in two sisters with intrachromosomal insertional translocation in their father. AMERICAN JOURNAL OF MEDICAL GENETICS 1983; 14:189-95. [PMID: 6829607 DOI: 10.1002/ajmg.1320140125] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
We report two sisters with a deficiency of band 2q32 that resulted from meiotic crossover events in their father, who is a balanced, intrachromosomal insertional translocation heterozygote. This three-break rearrangement involving a single chromosome is among the rarest class of human structural chromosome abnormalities. A review confirms the theoretically predicted high risk of unbalanced progeny for such translocation heterozygotes. Fertility of carriers seems to be unimpaired in either sex. Available information is insufficient to define the effect of insertional translocation on homologue pairing, crossover frequency, and other meiotic phenomena.
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Keitges EA, Palmer CG, Weaver DD. Pericentric X inversion in dizygotic twins who differ in X chromosome inactivation and menstrual cycle function. Hum Genet 1982; 62:210-3. [PMID: 6892018 DOI: 10.1007/bf00333520] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A 21-year-old female dizygotic twin was referred for cytogenetic evaluation because of mild mental retardation. Significant history, clinical, and physical findings included irregular menses, mildly coarse facies, and microcornea. Chromosome analysis revealed a pericentric inversion of the X chromosome, 46, X, inv (X)(p11;q22). Her twin who is phenotypically normal was also found to carry the same inversion. The twins differ significantly in X chromosome inactivation and menstrual cycle function.
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