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Xu C, Li M, Peng J, Zhang Y, Li H, Zheng G, Wang D. Case report: A case report and literature review of complete trisomy 9. Front Genet 2023; 14:1241245. [PMID: 37719705 PMCID: PMC10500842 DOI: 10.3389/fgene.2023.1241245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/08/2023] [Indexed: 09/19/2023] Open
Abstract
Complete trisomy 9 is a rare and lethal chromosomal anomaly characterized by multisystem dysmorphism and central nervous system (CNS) malformations. This study presents a case of complete trisomy 9 with an unusual phenotypic association and investigates the genetic pathways involved in this chromosomal abnormality. Trisomy 9 leads to a wide range of organ abnormalities, and this research contributes to a better understanding of the phenotype associated with this rare aneuploidy. The literature on the phenotypes of fetuses with various systems affected by complete trisomy 9 was reviewed and summarized. Correct diagnosis and appropriate counseling based on the characteristics of previous reports of fetuses with trisomy 9 is essential in maternity care and clinical management. To provide guidance and help for clinical diagnosis, this study aimed to explore the clinical and genetic characteristics of trisomy 9 syndrome to improve clinicians' understanding of the disease.
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Affiliation(s)
- Chenxia Xu
- Prenatal Diagnosis Center, Boai Hospital of Zhongshan, Zhongshan, Guangdong, China
| | - Miaoyuan Li
- Department of Urology, Zhongshan People’s Hospital, Zhongshan, Guangdong, China
- The First School of Clinical Medicine,Jinan University, Guangzhou, Guangdong, China
| | - Jianming Peng
- Prenatal Diagnosis Center, Boai Hospital of Zhongshan, Zhongshan, Guangdong, China
| | - Yanfang Zhang
- Prenatal Diagnosis Center, Boai Hospital of Zhongshan, Zhongshan, Guangdong, China
| | - Haijun Li
- Prenatal Diagnosis Center, Boai Hospital of Zhongshan, Zhongshan, Guangdong, China
| | - Guobing Zheng
- Prenatal Diagnosis Center, Boai Hospital of Zhongshan, Zhongshan, Guangdong, China
| | - Degang Wang
- Prenatal Diagnosis Center, Boai Hospital of Zhongshan, Zhongshan, Guangdong, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
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Pitfalls and management of corrective spinal surgery in trisomy 9 mosaicism: a report of three cases. Spine Deform 2022; 11:759-764. [PMID: 36547810 DOI: 10.1007/s43390-022-00624-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/19/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE The aim of this case series is to present the outcomes of surgical correction of hyperkyphosis, and subsequent management of complications for three patients with a rare chromosomopathy, Trisomy 9 Mosaicism (T9M). METHODS Case series with 2 year outcomes following index surgery. RESULTS Case 1 presented at 9 years of age with 103° of kyphosis (T3-T10), which progressed to 118° despite bracing. Case 2 presented at 7 years of age with 113° of kyphosis (T3-T11). Case 3 presented at 4 years of age with 103° of kyphosis (T1-T11). Cases 1 and 2 underwent T2-L2 posterior instrumented spinal fusion (PISF). Upon follow up, radiographs for Cases 1 and 2 revealed severe, symptomatic proximal junctional kyphosis (PJK) of 71° and 50°, respectively, requiring surgical revision proximally to the C4 level. Case 3 underwent placement of magnetically controlled growing rods given young age and growth potential. Surgical levels for Case 3 were extended from C4-pelvis in an attempt to prevent development of symptomatic PJK. Most recent radiographs for Case 3 taken 21 months postoperatively demonstrate a stable 50° of kyphosis. PJK above C4 was noted but is stable and asymptomatic. CONCLUSION T9M often presents with progressive hyperkyphosis. Despite instrumentation above the upper end vertebra (UEV), PJK may be a common complication in this small patient population. This novel report on spine deformity correction in the T9M population may provide preliminary guidance for the treatment of hyperkyphosis in patients with T9M and help surgeons avoid common pitfalls. LEVEL OF EVIDENCE IV.
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Kim YB, Nam SM, Park ES, Choi CY, Cha HG, Kim JH. Nasal Reconstruction of a Frontonasal Dysplasia via Septal L-Strut Reconstruction Using Costal Cartilage. Cleft Palate Craniofac J 2021; 59:1306-1313. [PMID: 34402319 DOI: 10.1177/10556656211036614] [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: 11/15/2022] Open
Abstract
OBJECTIVE Frontonasal dysplasia (FND) is a rare congenital condition. Its major features include hypertelorism, a large and bifid nasal tip, and a broad nasal root. We present our technique of septal L-strut reconstruction using costal cartilage. DESIGN Retrospective review from June 2008 and August 2017. METHODS Under general anesthesia, 6 patients with FND underwent septal reconstruction using costal cartilage via open rhinoplasty. We reconstructed the nasal and septal cartilaginous framework by placing columellar struts and cantilever-type grafts. RESULTS The patients ranged in age from 6 to 13 years old. All were female. The follow-up period ranged from 8 months to 2 years; we encountered no postoperative complications (infection, nasal obstruction, or recurrence). All patients were satisfied with their nasal appearance. CONCLUSIONS Although the results were not entirely satisfactory from an esthetic point of view, we found that FND can be treated via septal reconstruction with costal cartilage and that the clinical outcomes are reliable and satisfactory. Our approach is a useful option for FND patients.
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Affiliation(s)
- Yong Bae Kim
- WONJIN Plastic Surgery Clinics, Seoul, Republic of Korea
| | - Seung Min Nam
- Department of Plastic and Reconstructive Surgery,26730Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Eun Soo Park
- Department of Plastic and Reconstructive Surgery,26730Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Chang Yong Choi
- Department of Plastic and Reconstructive Surgery,26730Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Han Gyu Cha
- Department of Plastic and Reconstructive Surgery,26730Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Jun Hyun Kim
- Department of Plastic and Reconstructive Surgery,26730Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
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Li M, Glass J, Du X, Dubbs H, Harr MH, Falk M, Smolarek T, Hopkin RJ, Zackai E, Sheppard SE. Trisomy 9 mosaic syndrome: Sixteen additional patients with new and/or less commonly reported features, literature review, and suggested clinical guidelines. Am J Med Genet A 2021; 185:2374-2383. [PMID: 33969943 DOI: 10.1002/ajmg.a.62251] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 11/10/2022]
Abstract
Trisomy 9 mosaic syndrome (T9M) is a rare condition characterized by multiorgan system involvement including craniofacial dysmorphisms, cardiac, genitourinary (GU), skeletal, and central nervous system (CNS) abnormalities. Although more than 100 cases have been reported in the literature, a comprehensive review has not been performed nor have clinical guidelines been established. Therefore, we describe the clinical features of 16 additional patients, review features of previously reported individuals, and suggest clinical guidelines. Our findings expand the clinical phenotype of T9M, including novel features of amblyopia, astigmatism, corectopia of pupil, posterior embryotoxon, and diaphragmatic eventration. Most patients had prenatal and perinatal issues, particularly from respiratory, growth, and feeding standpoints. Although small birth parameters were common, long-term growth trends varied widely. An association with advanced parental ages was also identified. The spectrum of growth and development was wide, ranging from nonverbal patients to those able to participate in educational programs with age-appropriate peers. The severity of clinical outcomes was unrelated to blood lymphocyte mosaicism levels. Microarray analysis had a higher diagnostic rate compared to standard karyotype analysis and should be utilized if this diagnosis is suspected. Future longitudinal studies will be key to monitor long-term outcomes of individuals with T9M and determine best practices for clinical management.
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Affiliation(s)
- Mindy Li
- Division of Genetics, Department of Pediatrics, Rush Medical College and Rush University Medical Center, Chicago, Illinois, USA
| | - Jennifer Glass
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Xiaoli Du
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Holly Dubbs
- Division of Human Genetics, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine and The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Margaret Horton Harr
- Division of Human Genetics, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine and The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Marni Falk
- Division of Human Genetics, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine and The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Teresa Smolarek
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Robert J Hopkin
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Elaine Zackai
- Division of Human Genetics, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine and The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Sarah E Sheppard
- Division of Human Genetics, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine and The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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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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Riley CJ, Moore T, Eagelston L, Burkett D, Auerbach S, Ing RJ. Cardiac Failure in a Trisomy 9 Patient Undergoing Anesthesia: A Case Report. Anesth Prog 2017; 64:29-32. [PMID: 28128660 DOI: 10.2344/anpr-63-04-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
A 27-year-old female with Trisomy 9 mosaicism presented to Children's Hospital Colorado for outpatient dental surgery under general anesthesia. The patient's past medical history was also significant for premature birth, gastroesophageal reflux, scoliosis and kyphosis, obesity, and developmental delay. Per her mother's report, the patient had no cardiac issues. She had undergone multiple previous general anesthetics, some of which documented respiratory complications such as laryngospasm, bronchospasm, and possible aspiration. During this anesthetic, the patient became hypotensive on induction, with sluggish response to intravenous fluids, glycopyrrolate, and ephedrine. Her electrocardiogram demonstrated what appeared to be left bundle branch block at baseline, with possible ST segment changes after induction. Due to her abnormal reaction to the induction and subsequent treatment for hypotension, an echocardiogram was performed. The patient was found to have an ejection fraction of 25%-30%. The anesthetic was uneventful for the remainder of the procedure, and following recovery, the patient was admitted by the heart failure team for further care.
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Affiliation(s)
- Cara J Riley
- Department of Anesthesiology, Children's Hospital Colorado, Aurora, Colorado
| | - Timothy Moore
- Department of Anesthesiology, Children's Hospital Colorado, Aurora, Colorado
| | - Lauren Eagelston
- University of Colorado Medical School, Children's Hospital Colorado, Aurora, Colorado
| | - Dale Burkett
- Department of Cardiology, Children's Hospital Colorado, Aurora, Colorado
| | - Scott Auerbach
- Department of Cardiology, Children's Hospital Colorado, Aurora, Colorado
| | - Richard J Ing
- Department of Anesthesiology, Children's Hospital Colorado, Aurora, Colorado
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7
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Tonni G, Lituania M, Chitayat D, Bonasoni MP, Keating S, Thompson M, Shannon P. Complete trisomy 9 with unusual phenotypic associations: Dandy-Walker malformation, cleft lip and cleft palate, cardiovascular abnormalities. Taiwan J Obstet Gynecol 2015; 53:592-7. [PMID: 25510707 DOI: 10.1016/j.tjog.2014.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Trisomy 9 is a rare chromosomal abnormality usually associated with first-trimester miscarriage; few fetuses survive until the second trimester. We report two new cases of complete trisomy 9 that both present unusual phenotypic associations, and we analyze the genetic pathway involved in this chromosomal abnormality. CASE REPORT The first fetus investigated showed Dandy-Walker malformation, cleft lip, and cleft palate) at the second trimester scan. Cardiovascular abnormalities were characterized by a right-sided, U-shaped aortic arch associated with a ventricular septal defect (VSD). Symmetrical intrauterine growth restriction and multicystic dysplastic kidney disease were associated findings. The second fetus showed a dysmorphic face, bilateral cleft lip, hypoplastic corpus callosum, and a Dandy-Walker malformation. Postmortem examination revealed cardiovascular abnormalities such as persistent left superior vena cava draining into the coronary sinus, membranous ventricular septal defect, overriding aorta, pulmonary valve with two cusps and three sinuses, and the origin of the left subclavian artery distal to the junction of ductus arteriosus and aortic arch. CONCLUSION Complete trisomy 9 may result in a wide spectrum of congenital abnormalities, and the presented case series contributes further details on the phenotype of this rare aneuploidy.
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Affiliation(s)
- Gabriele Tonni
- Department of Obstetrics and Gynecology, Prenatal Diagnostic Service, Guastalla Civil Hospital, Azienda Unità Sanitaria Locale Reggio Emilia, Reggio Emilia, Italy.
| | - Mario Lituania
- Preconceptional and Prenatal Diagnostic Center, Istituto di Ricerca a Carettere Clinico Scientifico Galliera Hospital, Genoa, Italy
| | - David Chitayat
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Maria Paola Bonasoni
- Pathology Service, Istituto di Ricerca a Carettere Clinico Scientifico Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Sarah Keating
- Department of Laboratory Medicine and Pathology, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Megan Thompson
- Department of Laboratory Medicine and Pathology, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Patrick Shannon
- Department of Laboratory Medicine and Pathology, Mount Sinai Hospital, Toronto, Ontario, Canada
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8
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"Mosaic trachea" in a child with trisomy 9 mosaicism. Int J Pediatr Otorhinolaryngol 2010; 74:1193-5. [PMID: 20727599 DOI: 10.1016/j.ijporl.2010.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Revised: 06/27/2010] [Accepted: 07/03/2010] [Indexed: 11/23/2022]
Abstract
Humans with mosaic karyotypes may present with milder forms of birth defects than one would see in non-mosaic individuals. Mosaicism may also affect tissues, resulting in different parts of an organ manifesting varied phenotypes. We present the case of a child born with mosaic trisomy 9 and multiple congenital anomalies. Her trachea displays segmental abnormalities that suggest tissue mosaicism. We describe the endoscopic and cytogenetic findings in this child and propose a possible genetic mechanism to account for the unusual malformations.
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9
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Tiong K, Cotterill A, Falhammar H. Adult case of partial trisomy 9q. BMC MEDICAL GENETICS 2010; 11:26. [PMID: 20158889 PMCID: PMC2850894 DOI: 10.1186/1471-2350-11-26] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Accepted: 02/16/2010] [Indexed: 11/17/2022]
Abstract
Background Complete and partial trisomy 9 is the fourth most common chromosomal disorder. It is also associated with various congenital characteristics affecting the cranio-facial, skeletal, central nervous, gastrointestinal, cardiac and renal systems. Very few cases have been reported in adults. Partial trisomy 9q is also associated with short stature, poor growth and growth hormone deficiency. This is the first reported case of an extensive endocrinology investigation of short stature in trisomy 9q and the outcome of growth hormone treatment. Case Presentation The case involves a 23-year-old female of pure partial trisomy 9q. The case involves a 23-year old female with pure partial trisomy 9q involving a duplication of 9q22.1 to q32, de novo, confirmed by genetic studies using fluorescene in situ hybridization (FISH) method. The diagnosis was at 6 years of age. She did not demonstrate all the congenital morphologies identified with trisomy 9q disorders especially in relation to multi-organ morphologies. There is also a degree of associated intellectual impairment. At prepuberty, she was referred for poor growth and was diagnosed with partial growth hormone deficiency. She responded very well to treatment with growth hormone and is currently living an independent life with some support. Conclusions Trisomy 9q is associated with short stature and failure to thrive. Growth hormone deficiency should be identified in cases of trisomy 9q and treatment offered. This is the first reported case of response to growth hormone replacement in partial trisomy 9.
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Affiliation(s)
- Keith Tiong
- School of Medicine, James Cook University, Queensland, Australia.
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Perez MJ, Schneider A, Chaze AM, Bigi N, Lefort G, Rouleau C, Faure JM, Rahil H, Wadih N, Couture A, Boulot P, Blanchet P, Sarda P, Geneviève D. Epiphyseal punctate calcifications (stippling) in complete trisomy 9. Prenat Diagn 2010; 29:1085-8. [PMID: 19777540 DOI: 10.1002/pd.2350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Marie-José Perez
- Service de Génétique Médicale et Chromosomique, Centre de Référence Maladies Rares Anomalies du Développement et Syndromes Malformatifs Sud-Languedoc Roussillon, Hôpital Arnaud de Villeneuve, CHRU Montpellier, Université Montpellier 1, Montpellier, France
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11
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Ferreres JC, Planas S, Martínez-Sáez EA, Vendrell T, Peg V, Salcedo MT, Ramón Y Cajal S, Torán N. Pathological findings in the complete trisomy 9 syndrome: three case reports and review of the literature. Pediatr Dev Pathol 2008; 11:23-9. [PMID: 18237231 DOI: 10.2350/06-08-0143.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2006] [Accepted: 05/15/2007] [Indexed: 11/20/2022]
Abstract
The term "complete trisomy 9" is used to indicate trisomy of the entire chromosome 9 without evidence of mosaicisms. It is a relatively rare chromosomal abnormality because the vast majority of affected pregnancies result in 1st trimester spontaneous abortions. The purpose of this paper is to delineate the complete trisomy 9 syndrome, based on autopsy findings. We performed an exhaustive review of the literature of complete forms of this trisomy with autopsy examination and added 3 new cases from our center with new findings not previously described.
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Affiliation(s)
- Joan C Ferreres
- Department of Pathology and Genetics Unit, Hospital Universitari Vall d' Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Cantú ES, Eicher DJ, Pai GS, Donahue CJ, Harley RA. Mosaic vs. nonmosaic trisomy 9: report of a liveborn infant evaluated by fluorescence in situ hybridization and review of the literature. AMERICAN JOURNAL OF MEDICAL GENETICS 1996; 62:330-5. [PMID: 8723059 DOI: 10.1002/(sici)1096-8628(19960424)62:4<330::aid-ajmg1>3.0.co;2-v] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
We report on a newborn infant with multiple congenital anomalies and apparent nonmosaic trisomy 9 in the blood (by conventional cytogenetic studies) who died shortly after birth. Clinical observations at birth and autopsy are compared with phenotypes of mosaic and nonmosaic trisomy 9 cases reported previously. Unlike the initial cytogenetic analysis, fluorescence in situ hybridization (FISH) studies of metaphase and interphase blood cells and skin fibroblasts detected the presence of euploid and trisomy 9 cells. These results suggest that earlier reports of trisomy 9, which relied on conventional chromosome analysis of a few metaphase cells and/or only one tissue type, may not have excluded mosaicism, and that trisomy 9 may be viable only in the mosaic state.
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Affiliation(s)
- E S Cantú
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston 29425, USA
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13
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Wooldridge J, Zunich J. Trisomy 9 syndrome: report of a case with Crohn disease and review of the literature. AMERICAN JOURNAL OF MEDICAL GENETICS 1995; 56:258-64. [PMID: 7778585 DOI: 10.1002/ajmg.1320560304] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We report on a 6-year-old boy with mosaic trisomy 9. The patient was born at 42 weeks of gestation to a 27-year-old G1 white woman. Birth weight was 2,820 g, length 52 cm, and Apgar scores were 4 and 6 at 1 and 5 min, respectively. The infant presented with apparently low-set ears, overfolded helices, epicanthal folds, prominent nasal bridge, high-arched palate, micrognathia, bilateral dislocated hips, left genu recurvatum, and cryptorchidism. Chromosome analysis showed an unusual karyotype: 47,XY,+inv(9qh+)/47,XY,+mar. The marker chromosome was thought to be a remnant of the inv(9qh+) chromosome. The mother's karyotype was 46,XX,inv(9qh+), while the father's was 46,XY. At age 5 months, the patient developed seizures and gastroesophageal reflux. Crohn disease was diagnosed at age 2 years, although symptoms began at age 1 year. Recurrent bouts of pneumonia have occurred since the patient's birth. Severe psychomotor retardation was also noted. Trisomy 9 syndrome was first reported in 1973. Over 30 cases have been reported since then. Of these cases reports, only 5 patients were older than 1 year. Inflammatory bowel disease has been reported in association with other chromosome abnormalities, but to our knowledge, has not been reported in trisomy 9 syndrome.
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Affiliation(s)
- J Wooldridge
- Indiana University School of Medicine, Northwest Center for Medical Education, Gary 46408, USA
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14
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Arnold GL, Kirby RS, Stern TP, Sawyer JR. Trisomy 9: review and report of two new cases. AMERICAN JOURNAL OF MEDICAL GENETICS 1995; 56:252-7. [PMID: 7778584 DOI: 10.1002/ajmg.1320560303] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Trisomy 9 is a relatively uncommon chromosome abnormality that may sometimes be seen in the nonmosaic state. We reviewed 23 mosaic and 15 nonmosaic cases of trisomy 9, including 2 new cases, in order to better define the prognosis and phenotype of this disorder. A recognizable trisomy 9 phenotype was identified and included a "bulbous" nose, microphthalmia, and dislocated limbs. Other nonspecific anomalies involving various organ systems were also common. With one exception, all survivors had severe mental impairment. Mosaicism for trisomy 9 predicted longer survival, but the degree of mosaicism in lymphocytes or fibroblasts did not predict survival or degree of impairment. Parental chromosome variations were not uncommon. In contrast to prior reports, no specific prognostic finding was identified. A meiotic origin with loss of a trisomic cell line in mosaic cases is suggested.
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Affiliation(s)
- G L Arnold
- University of Arkansas for Medical Sciences, Little Rock, USA
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15
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Roberts DJ, Sandstrom MM, Van Praagh S. Characteristics of structural heart defects in trisomy 9 and their relationship to those in trisomy 13, 18, and 21. Am Heart J 1993; 125:1681-90. [PMID: 8498311 DOI: 10.1016/0002-8703(93)90759-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The hearts from two live-born full-term infants with nonmosaic trisomy 9 (one complete trisomy 9, one partial trisomy 9) were studied after death. Both demonstrated conal and valvular anomalies associated with ventricular septal defects. These specific malformations are discussed in relation to published cases of trisomy 9 and the cardiac defects of other autosomal trisomies (13, 18, and 21).
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Affiliation(s)
- D J Roberts
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115
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16
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de Michelena MI, Sánchez R, Muñoz P, Cabello E, Rojas P, de Olazaval E. Trisomy 8: an additional case with unique manifestations [correction]. AMERICAN JOURNAL OF MEDICAL GENETICS 1992; 43:697-700. [PMID: 1621760 DOI: 10.1002/ajmg.1320430409] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We report on an infant with multiple congenital anomalies and mosaic trisomy 8 [corrected]. Clinical findings are presented, and compared with those of the 24 cases previously reported. Some unusual characteristics found in this patient include macrocephaly, an extreme degree of palatal hypoplasia, and abnormally shaped long bones.
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Affiliation(s)
- M I de Michelena
- Department of Morphologic Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú
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Marino B, Digilio MC, Giannotti A, Dallapiccola B. Atrioventricular canal associated with trisomy 9. Chest 1989; 96:1420-1. [PMID: 2582851 DOI: 10.1378/chest.96.6.1420] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The features of a newborn with the full clinical aspect of trisomy 9 presenting with an atrioventricular canal is described. This association of anomalies has never been reported before. Interestingly, the patient also had a left-sided obstruction which is known to be more characteristically associated with atrioventricular canal without Down's syndrome.
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Affiliation(s)
- B Marino
- Department of Pediatric Cardiology and Genetics, Bambino Gesu Hospital, Rome, Italy
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Warburg M, Friedrich U. Coloboma and microphthalmos in chromosomal aberrations. Chromosomal aberrations and neural crest cell developmental field. OPHTHALMIC PAEDIATRICS AND GENETICS 1987; 8:105-18. [PMID: 3309769 DOI: 10.3109/13816818709028526] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A survey of more than 500 reports on patients with autosomal chromosomal aberrations associated with microphthalmos and/or coloboma shows that these anomalies are unspecific. Anterior chamber anomalies were common as were abnormal ears, preauricular pits and tags, cleft lip-palate, micrognathia, urogenital malformations, congenital heart disease, atresia of the anus and minor malformations of the hands and feet. It is proposed that the chromosomal aberrations induce faulty development of neural crest cells and rostral neural plate derivatives.
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Affiliation(s)
- M Warburg
- Clinic for the Multiply Handicapped, Gentofte Hospital, Denmark
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Kaminker CP, Daín L, Lamas MA, Sánchez JM. Mosaic trisomy 9 syndrome with unusual phenotype. AMERICAN JOURNAL OF MEDICAL GENETICS 1985; 22:237-41. [PMID: 3931476 DOI: 10.1002/ajmg.1320220204] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We report on a newborn infant with mosaic trisomy 9. The patient shared only a few anomalies with the previously reported cases of this chromosome abnormality but had a severe craniofacial malformation not yet reported in this syndrome.
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Abstract
A case of trisomy 9 showing a complex cardiac malformation is presented with a review of other published cases. A distinct trisomy 9 syndrome can be recognised with intrauterine growth retardation, short survival, consistent facial dysmorphism, congenital heart disease, and abnormalities of the skeletal, genital, and renal systems. There is no evidence for a maternal age effect.
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Soltan HC, Jung JH, Pyatt Z, Singh RP. Partial trisomy 9q resulting from a familial translocation t(9;16)(q32;q24). Clin Genet 1984; 25:449-54. [PMID: 6723106 DOI: 10.1111/j.1399-0004.1984.tb02015.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Partial Trisomy- 9q was observed in an infant with a multiple malformation syndrome who survived to 18 months. Cytogenetic investigations stimulated by the family history of similarly affected individuals revealed a translocation, t(9;16)(q32;q24), identifiable in four generations of the proband's family. A review of our cases with those reported in the literature reveals clinical similarities. This report sets forth a clinical description of the characteristic phenotype of the 9q partial Trisomy syndrome, including findings at post-mortem, documents multigeneration transmission and discusses this syndrome's clinical overlap with other malformation syndromes.
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