1
|
Trevisan V, Meroni A, Leoni C, Sirchia F, Politano D, Fiandrino G, Giorgio V, Rigante D, Limongelli D, Perri L, Sforza E, Leonardi F, Viscogliosi G, Contaldo I, Orteschi D, Proietti L, Zampino G, Onesimo R. Trisomy 22 Mosaicism from Prenatal to Postnatal Findings: A Case Series and Systematic Review of the Literature. Genes (Basel) 2024; 15:346. [PMID: 38540405 PMCID: PMC10970670 DOI: 10.3390/genes15030346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Among aneuploidies compatible with life, trisomy 22 mosaicism is extremely rare, and only about 25 postnatal and 18 prenatal cases have been described in the literature so far. The condition is mainly characterized by facial and body asymmetry, cardiac heart defects, facial dysmorphisms, growth failure, delayed puberty, and variable degrees of neurodevelopmental delay. PROBLEM The scattered information regarding the condition and the dearth of data on its natural history and developmental outcomes restrict genetic counseling, particularly in prenatal settings. Moreover, a prompt diagnosis is frequently delayed by the negative selection of trisomic cells in blood, with mosaicism percentage varying among tissues, which often entails the need for further testing. Purpose/topic: The aim of our work is to provide assistance in prenatal and postnatal genetic counseling by systematically delineating the current knowledge of the condition. This entails defining the prenatal and postnatal characteristics of the condition and presenting novel data from three cases, both prenatally and postnatally. Additionally, we report the developmental outcomes observed in two new patients.
Collapse
Affiliation(s)
- Valentina Trevisan
- Centre for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (C.L.); (V.G.); (D.L.); (L.P.); (G.V.); (G.Z.); (R.O.)
- Genomic Medicine, Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, 00168 Rome, Italy; (F.L.); (D.O.)
| | - Anna Meroni
- Human Genetics, Molecular Medicine Department, University of Pavia and IRCCS Fondazione Policlinico San Matteo, 27100 Pavia, Italy; (A.M.); (F.S.)
| | - Chiara Leoni
- Centre for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (C.L.); (V.G.); (D.L.); (L.P.); (G.V.); (G.Z.); (R.O.)
| | - Fabio Sirchia
- Human Genetics, Molecular Medicine Department, University of Pavia and IRCCS Fondazione Policlinico San Matteo, 27100 Pavia, Italy; (A.M.); (F.S.)
| | - Davide Politano
- Department of Brain and Behavioral Sciences, University of Pavia, IRCCS Mondino, 27100 Pavia, Italy;
| | - Giacomo Fiandrino
- Department of Molecular Medicine, Anatomic Pathology Unit, University of Pavia and Fondazione IRCCS San Matteo Hospital, 27100 Pavia, Italy;
| | - Valentina Giorgio
- Centre for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (C.L.); (V.G.); (D.L.); (L.P.); (G.V.); (G.Z.); (R.O.)
| | - Donato Rigante
- Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, 00168 Rome, Italy;
- Child Neurology and Psychiatry Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (E.S.); (I.C.)
| | - Domenico Limongelli
- Centre for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (C.L.); (V.G.); (D.L.); (L.P.); (G.V.); (G.Z.); (R.O.)
| | - Lucrezia Perri
- Centre for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (C.L.); (V.G.); (D.L.); (L.P.); (G.V.); (G.Z.); (R.O.)
| | - Elisabetta Sforza
- Child Neurology and Psychiatry Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (E.S.); (I.C.)
| | - Francesca Leonardi
- Genomic Medicine, Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, 00168 Rome, Italy; (F.L.); (D.O.)
| | - Germana Viscogliosi
- Centre for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (C.L.); (V.G.); (D.L.); (L.P.); (G.V.); (G.Z.); (R.O.)
| | - Ilaria Contaldo
- Child Neurology and Psychiatry Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (E.S.); (I.C.)
| | - Daniela Orteschi
- Genomic Medicine, Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, 00168 Rome, Italy; (F.L.); (D.O.)
- Genetic Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Luca Proietti
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy;
| | - Giuseppe Zampino
- Centre for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (C.L.); (V.G.); (D.L.); (L.P.); (G.V.); (G.Z.); (R.O.)
- Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, 00168 Rome, Italy;
| | - Roberta Onesimo
- Centre for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; (C.L.); (V.G.); (D.L.); (L.P.); (G.V.); (G.Z.); (R.O.)
| |
Collapse
|
2
|
Kalayinia S, Shahani T, Biglari A, Maleki M, Rokni-Zadeh H, Razavi Z, Mahdieh N. Mosaic trisomy 22 in a 4-year-old boy with congenital heart disease and general hypotrophy: A case report. J Clin Lab Anal 2018; 33:e22663. [PMID: 30259573 DOI: 10.1002/jcla.22663] [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] [Received: 07/04/2018] [Revised: 08/06/2018] [Accepted: 08/06/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Trisomy 22 mosaicism is a rare autosomal anomaly with survival compatibility. Recognition of the complete trisomy 22 which is incompatible with life from the mosaic form is critical for genetic counseling. Affected mosaic cases have prevalent clinical presentations such as webbed neck, developmental delay, abnormal ears, cardiac disorders, and microcephaly. Phenotype of these patients is milder than full chromosomal aneuploidy, and the severity of the phenotype depends on the count of trisomic cells. We describe a 4-year-old boy with mosaic trisomy 22 from healthy parents and no family history of any genetic disorders in the pedigree. METHOD AND RESULTS The patient had determined dysmorphic clinical features including facial asymmetry, cleft palate, gastroenteritis, hydronephrosis, developmental delay, genital anomalies, dysplastic toenails, flattened nasal bridge, congenital heart defect, hearing loss, cryptorchidism, and hypotonic muscle. He is the first reported with hypothyroidism and larynx wall thickness in worldwide and the first with atrial septal defect (ASD) from Iran. Chromosomal analyses using G-banding indicated a de novo Mos 47,XY,+22(6)/46,XY(44) karyotype with no other chromosomal structural changes. CONCLUSIONS Our observations confirm the importance of cytogenetic analyses for determining the cause of congenital anomalies and provide a useful genetic counseling. In addition, due to the fact that some of mosaic trisomy 22 features are unavoidable such as CHD and general hypotrophy, we suggest including echocardiography test for early diagnosis during the clinical assessment.
Collapse
Affiliation(s)
- Samira Kalayinia
- Department of Genetics and Molecular Medicine, School of Medicine, Zanjan University of Medical Sciences (ZUMS), Zanjan, Iran.,Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Tina Shahani
- Department of Genetics and Molecular Medicine, School of Medicine, Zanjan University of Medical Sciences (ZUMS), Zanjan, Iran
| | - Alireza Biglari
- Department of Genetics and Molecular Medicine, School of Medicine, Zanjan University of Medical Sciences (ZUMS), Zanjan, Iran
| | - Majid Maleki
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Rokni-Zadeh
- Department of Medical Biotechnology and Nanotechnology, School of Medicine, Zanjan University of Medical Sciences (ZUMS), Zanjan, Iran
| | - Zahra Razavi
- Pediatric Endocrinologist, Pediatrics Department, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nejat Mahdieh
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
3
|
Thomas S, Parker M, Tan J, Duckett D, Woodruff G. Ocular manifestations of mosaic trisomy 22: A case report and review of the literature. Ophthalmic Genet 2009; 25:53-6. [PMID: 15255116 DOI: 10.1076/opge.25.1.53.29004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Mosaic trisomy 22 is rare, but can be compatible with prolonged life. Patients with mosaic trisomy 22 usually present with intrauterine growth retardation, mental retardation, failure to thrive, and craniofacial asymmetry. We report the case of a five-year-old boy who had a birth weight of 3.8 kg and normal developmental milestones. He presented with unilateral ocular manifestations of ptosis, double elevator palsy, high myopia, and choroidal coloboma involving the macula. Cytogenetic evaluation showed a low level of trisomy 22 in peripheral blood lymphocytes (1 in 100) and in cultured fibroblasts from a conjunctival biopsy of the affected eye (1 in 60). Our case demonstrates the value of chromosomal analysis of the tissues involved rather than just karyotyping of the blood lymphocytes to detect mosaicism in patients with localised and unilateral congenital malformations.
Collapse
Affiliation(s)
- S Thomas
- Department of Ophthalmology, Leicester Royal Infirmary, Leicester, UK
| | | | | | | | | |
Collapse
|
4
|
Ballif BC, Rorem EA, Sundin K, Lincicum M, Gaskin S, Coppinger J, Kashork CD, Shaffer LG, Bejjani BA. Detection of low-level mosaicism by array CGH in routine diagnostic specimens. Am J Med Genet A 2007; 140:2757-67. [PMID: 17103431 DOI: 10.1002/ajmg.a.31539] [Citation(s) in RCA: 223] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The advent of microarray-based comparative genomic hybridization (array CGH) promises to revolutionize clinical cytogenetics because of its ability to rapidly screen the genome at an unprecedented resolution. Yet, the ability of array CGH to detect and evaluate low-level mosaicism is not known. Our laboratory has analyzed over 3,600 clinical cases with the SignatureChip which we developed for the detection of microdeletions, microduplications, aneuploidy, unbalanced translocations, and subtelomeric and pericentromeric copy number alterations. Here, we report 18 cases of mosaicism detected by array CGH in a routine diagnostic setting, 14 of which were not known to us at the time of the analysis. These 14 cases represent approximately 8% of all abnormal cases identified in our laboratory. For each case, fluorescence in situ hybridization (FISH) analysis was performed on PHA-stimulated cultures after mosaic chromosome abnormalities were suspected by array CGH. In all cases, FISH confirmed the mosaic chromosome abnormalities which included a variety of marker chromosomes, autosomal trisomies, terminal and interstitial deletions, and derivative chromosomes. Interestingly, confirmatory FISH analyses on direct blood smears indicated that the percentage of abnormal cells in unstimulated cultures was in some cases different than that found in PHA-stimulated cells. We also report the detection of a previously unsuspected case of an isochromosome 12p (associated with Pallister-Killian syndrome) by array CGH using genomic DNA extracted from peripheral blood. These results support a growing body of data that suggests that stimulated peripheral blood cultures likely distort the percentage of abnormal cells and may, for some chromosome abnormalities, make their detection unlikely by conventional analysis. Thus, array CGH, which is based on genomic DNA extracted directly from uncultured peripheral blood, may be more likely to detect low-level mosaicism for unbalanced chromosome abnormalities than traditional cytogenetic techniques.
Collapse
Affiliation(s)
- Blake C Ballif
- Signature Genomic Laboratories, LLC, Spokane, Washington, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Wang JC, Dang L, Mondal TK, Khan A. Prenatally diagnosed mosaic trisomy 22 in a fetus with left ventricular non-compaction cardiomyopathy. Am J Med Genet A 2007; 143A:2744-6. [DOI: 10.1002/ajmg.a.32004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
6
|
Florez L, Lacassie Y. Mosaic trisomy 22: Report of a patient with normal intelligence. Am J Med Genet A 2005; 132A:223-5. [PMID: 15551336 DOI: 10.1002/ajmg.a.30401] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
7
|
Kivirikko S, Salonen R, Salo A, von Koskull H. Prenatally detected trisomy 7 mosaicism in a dysmorphic child. Prenat Diagn 2002; 22:541-4. [PMID: 12124684 DOI: 10.1002/pd.348] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Trisomy 7 mosaicism was detected prenatally in cultured amniocytes but not in fetal lymphocytes. The child that was born had pigmentary changes of the skin and facial asymmetry suggestive of a chromosomal mosaicism. Skin fibroblasts were studied and trisomy 7 mosaicism was confirmed. At 3 years of age the boy had developed mentally within normal limits. However, dysmorphic findings include sparse hair, short left palpebral fissure, ptosis of the left eyelid, strabismus, enamel dysplasia, low-set and posteriorly rotated ears and undescended testes. These findings share some common features with previously reported cases of trisomy 7 mosaicism.
Collapse
Affiliation(s)
- Sirpa Kivirikko
- Department of Clinical Genetics, Helsinki University Central Hospital, Helsinki, Finland.
| | | | | | | |
Collapse
|
8
|
Basaran N, Berkil H, Ay N, Durak B, Ataman C, Ozdemir M, Ozon YH, Kaya I. A rare case: mosaic trisomy 22. ANNALES DE GENETIQUE 2001; 44:183-6. [PMID: 11755102 DOI: 10.1016/s0003-3995(01)01095-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
A 9-year-old female child of healthy parents (mother: 43 years, father: 44 years) was referred to our center because of severe mental retardation. While pedigree analysis was not contributory, two older sibs were normal and healthy. Physical examination revealed facial dysmorphism, microcephaly and hyperflexibility of all joints. Her chromosome constitution showed a mosaic pattern; mos 46,XX[98]/47,XX,+22[2]. So skin biopsy was performed and mosaic trisomy 22 was confirmed with FISH analysis (46,XX[73]/47,XX,+22[27]). Physical features of this case seemed consistent with her mosaic constitution. This report would be a demonstrative example to show the significant contribution of FISH in states of mosaicism.
Collapse
Affiliation(s)
- N Basaran
- Osmangazi University, Medical Faculty, Department of Medical Genetics, Osmangazi University, Medical Faculty, TR-26480 Eskişehir, Turkey.
| | | | | | | | | | | | | | | |
Collapse
|
9
|
Berghella V, Wapner RJ, Yang-Feng T, Mahoney MJ. Prenatal confirmation of true fetal trisomy 22 mosaicism by fetal skin biopsy following normal fetal blood sampling. Prenat Diagn 1998. [DOI: 10.1002/(sici)1097-0223(199804)18:4<384::aid-pd263>3.0.co;2-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
10
|
Crowe CA, Schwartz S, Black CJ, Jaswaney V. Mosaic trisomy 22: A case presentation and literature review of trisomy 22 phenotypes. ACTA ACUST UNITED AC 1997. [DOI: 10.1002/(sici)1096-8628(19970905)71:4<406::aid-ajmg7>3.0.co;2-r] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|