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Hao N, Lou H, Li M, Zhang H, Chang J, Qi Q, Zhou X, Bai J, Guo J, Wang Y, Zhang Y, Jiang Y. Analysis of complex chromosomal rearrangement involving chromosome 6 via the integration of optical genomic mapping and molecular cytogenetic methodologies. J Hum Genet 2024; 69:3-11. [PMID: 37821671 DOI: 10.1038/s10038-023-01197-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 10/13/2023]
Abstract
Complex chromosomal rearrangements (CCRs) can result in spontaneous abortions, infertility, and malformations in newborns. In this study, we explored a familial CCR involving chromosome 6 by combining optical genomic mapping (OGM) and molecular cytogenetic methodologies. Within this family, the father and the paternal grandfather were both asymptomatic carriers of an identical balanced CCR, while the two offspring with an unbalanced paternal-origin CCR and two microdeletions presented with clinical manifestation. The first affected child, a 5-year-old boy, exhibited neurodevelopmental delay, while the second, a fetus, presented with hydrops fetalis. SNP-genotype analysis revealed a recombination event during gamete formation in the father that may have contributed to the deletion in his offspring. Meanwhile, the couple's haplotypes will facilitate the selection of normal gametes in the setting of assisted reproduction. Our study demonstrated the potential of OGM in identifying CCRs and its ability to work with current methodologies to refine precise breakpoints and construct accurate haplotypes for couples with a CCR.
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Affiliation(s)
- Na Hao
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | | | - Mengmeng Li
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hanzhe Zhang
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiazhen Chang
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Qingwei Qi
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiya Zhou
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | | | | | - Yaru Wang
- Ecobono (Beijing) Biotech Co., Ltd, Beijing, China
| | - Yanli Zhang
- Peking Jabrehoo Med Tech Co., Ltd, Beijing, China
| | - Yulin Jiang
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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2
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Lam CW, Chan CY, Wong KC, Chang STL. Postzygotic inactivating mutation of KIF13A located at chromosome 6p22.3 in a patient with a novel mosaic neuroectodermal syndrome. J Hum Genet 2021; 66:825-829. [PMID: 33526817 DOI: 10.1038/s10038-020-00883-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/02/2020] [Accepted: 11/19/2020] [Indexed: 11/09/2022]
Abstract
Hypomelanosis of Ito (HMI) is part of a neuroectodermal syndrome characterized by distinctive skin manifestations with or without multisystemic involvements. In our undiagnosed diseases program, we have encountered a 3-year-old girl presenting with characteristic skin hypopigmentation suggesting HMI and developmental delay. An exome and genome approach utilizing next-generation sequencing revealed a heterozygous de novo frameshift variant in the KIF13A gene, i.e., NM_022113.6: c.2357dupA, resulting in nonsense-mediated decay. The low mutant allelic ratio suggested that the mutation has occurred postzygotically leading to embryonic mosaicism. Functionally, K1F3A regulates cell membrane blebbing and migration of neural crest cells by controlling recycling of RHOB to the plasma membrane and is also involved in melanosome biogenesis. Importantly, hypopigmentation of the skin has been reported in chr 6p22.3-p23 microdeletion syndrome supporting the association of KIF13A haploinsufficiency with the novel neuroectodermal syndrome. With the increased availability of genome sequencing, we envisage more genetic causes of HMI will be identified in the future.
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Affiliation(s)
- Ching-Wan Lam
- Department of Pathology, The University of Hong Kong, Hong Kong, China.
| | - Candace Yim Chan
- Department of Pathology, Princess Margaret Hospital, Hong Kong, China.,Department of Pathology, Queen Mary Hospital, Hong Kong, China
| | - Ka-Chung Wong
- Department of Pathology, Queen Mary Hospital, Hong Kong, China
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3
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Bouzon AC, Meireles BCDS, Souza IV, Dias FV, Goldschmidt B. Palmoplantar depigmentation in Macaca fascicularis following Blaschko linear pattern. J Med Primatol 2019; 49:52-55. [PMID: 31657466 DOI: 10.1111/jmp.12445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 09/24/2019] [Indexed: 11/30/2022]
Abstract
Hypomelanosis of Ito is a rare neurocutaneous syndrome, characterized by streaks and swirls of hypopigmentation arranged in a Blaschkoid pattern. Other associated anomalies are observed. We report a case of a male cynomolgus monkey (Macaca fascicularis) who presented the characteristic of hypomelanosis of Ito with palmoplantar involvement and polythelia.
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Affiliation(s)
- Aline Crespo Bouzon
- Serviço de Criação de Primatas Não-Humanos, ICTB, FIOCRUZ, Rio de Janeiro, Brasil
| | | | - Igo Vieira Souza
- Serviço de Criação de Primatas Não-Humanos, ICTB, FIOCRUZ, Rio de Janeiro, Brasil
| | | | - Beatriz Goldschmidt
- Serviço de Criação de Primatas Não-Humanos, ICTB, FIOCRUZ, Rio de Janeiro, Brasil
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4
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Yu DA, Kwon O, Kim KH. Hypomelanosis of Ito with Multiple Congenital Anomalies. Ann Dermatol 2019; 31:576-580. [PMID: 33911653 PMCID: PMC7992565 DOI: 10.5021/ad.2019.31.5.576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 01/15/2019] [Accepted: 03/18/2019] [Indexed: 11/08/2022] Open
Abstract
Hypomelanosis of Ito (HI) is a neurocutaneous disorder, also known as incontinentia pigmenti achromians. HI has been associated with chromosomal abnormalities, especially mosaicism. Herein, we report a case of HI with multiple congenital anomalies. A 2-month-old girl presented with multiple linear and whorling hypopigmentation on the face, trunk, and both extremities and patch alopecia on the scalp. Moreover, she had conical teeth, aniridia of the both eyes, and multiple musculoskeletal problems, including syndactyly and coccyx deviation. Cytogenetic analysis on peripheral blood was normal 46, XX, and no mutation was found in IKBKG gene test.
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Affiliation(s)
- Da-Ae Yu
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Ohsang Kwon
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Kyu Han Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
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5
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Karaman B, Kayserili H, Ghanbari A, Uyguner ZO, Toksoy G, Altunoglu U, Basaran S. Pallister-Killian syndrome: clinical, cytogenetic and molecular findings in 15 cases. Mol Cytogenet 2018; 11:45. [PMID: 30140312 PMCID: PMC6098576 DOI: 10.1186/s13039-018-0395-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 08/08/2018] [Indexed: 01/27/2023] Open
Abstract
Background Pallister Killian syndrome (PKS, OMIM 601803) is a rare genetic disorder with a distinct phenotype caused by tissue- limited mosaicism tetrasomy of the short arm of chromosome 12, which usually cytogenetically presents as an extra isochromosome 12p.Wide phenotypic variability in PKS has been reported, ranging from pre-to perinatal death due to multiple congenital anomalies, especially diaphragmatic hernia, and classic phenotypes including seizures, severe developmental delay, macrosomia at birth, deafness, and distinct dysmorphic features, such as coarse face, temporal alopecia, a small nose with anteverted nostrils, long philtrum, and hypo-/hyper- pigmented streaks on the skin. Results Karyotypes obtained from cultured peripheral lymphocytes of 13 cases, who were diagnosed as PKS, were normal, while karyotypes obtained from cultured skin samples and buccal mucosa revealed the supernumerary mosaic i(12p). Mosaic karyotype was found in both fibroblast and buccal mucosa in 14 of 15 patients in our series, whereas in one stillbirth, following the clinical diagnosis of PKS, skin and buccal smear samples were taken, and all karyotypes from cultured fibroblasts revealed a supernumerary i(12p), while I-FISH study showed 60% mosaicism in mucosal cells. Conclusions We here share the clinical, cytogenetic and molecular cytogenetic findings of 15 cases with PKS phenotype and the parental origin of seven i(12p) identified by molecular analyses. To our knowledge, this is the largest series of PKS patients with parental origin study from a single center. We believe that our study makes a significant contribution to the literature because we specifically found no differences in the phenotypes of cases with either a maternal or paternal origin of the extra element and differential imprinting appeared not to be a factor.
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Affiliation(s)
- Birsen Karaman
- 1Department of Medical Genetics, Istanbul Medical Faculty, Istanbul University, Millet cad.34039 Capa, İstanbul, Turkey
| | - Hülya Kayserili
- 1Department of Medical Genetics, Istanbul Medical Faculty, Istanbul University, Millet cad.34039 Capa, İstanbul, Turkey.,2Medical Genetics Department & Genetic Diagnosis Center, Koç University School of Medicine, 34010 İstanbul, Turkey
| | - Asadollah Ghanbari
- 1Department of Medical Genetics, Istanbul Medical Faculty, Istanbul University, Millet cad.34039 Capa, İstanbul, Turkey
| | - Zehra Oya Uyguner
- 1Department of Medical Genetics, Istanbul Medical Faculty, Istanbul University, Millet cad.34039 Capa, İstanbul, Turkey
| | - Güven Toksoy
- 1Department of Medical Genetics, Istanbul Medical Faculty, Istanbul University, Millet cad.34039 Capa, İstanbul, Turkey
| | - Umut Altunoglu
- 1Department of Medical Genetics, Istanbul Medical Faculty, Istanbul University, Millet cad.34039 Capa, İstanbul, Turkey
| | - Seher Basaran
- 1Department of Medical Genetics, Istanbul Medical Faculty, Istanbul University, Millet cad.34039 Capa, İstanbul, Turkey
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6
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Possible Correlation between Hypomelanosis of Ito and Wilms’ Tumor. Case Rep Pediatr 2018; 2018:5938120. [PMID: 30123603 PMCID: PMC6079615 DOI: 10.1155/2018/5938120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 06/27/2018] [Indexed: 11/17/2022] Open
Abstract
Hypomelanosis of Ito is a neurocutaneous disorder characterized by skin manifestations in a characteristic pattern associated with musculoskeletal and central nervous system symptoms. Our patient was diagnosed with Wilms' tumor stage I at age two and was also found to have distinct streaked areas of skin hyper- and hypopigmentation suggestive of Hypomelanosis of Ito. We believe that our patient's clinical diagnoses of Hypomelanosis of Ito and Wilms' tumor are interlinked. The connecting factor is yet to be identified. Our patient does not have a deletion of 11p13 associated with a defect in WT1, the Wilms' tumor suppressor gene. As such, it is quite possible that what made her more susceptible to the development of Wilms' tumor was her Hypomelanosis of Ito, which is implicated in a number of other organ dysfunctions.
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7
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Park SM, Rho D, Lee HJ, Jin H, You HS, Shim WH, Kim GW, Kim HS, Kim BS, Kim MB, Ko HC. A case of pigmentary mosaicism associated with diploid/triploid mixoploidy. Int J Dermatol 2018; 57:1120-1122. [PMID: 29624651 DOI: 10.1111/ijd.13981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 02/01/2018] [Accepted: 02/24/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Sung-Min Park
- Department of Dermatology, Pusan National University Hospital, Busan, Korea.,Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Dongyoung Rho
- Department of Dermatology, Pusan National University Hospital, Busan, Korea.,Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hyun-Joo Lee
- Department of Dermatology, Pusan National University Hospital, Busan, Korea
| | - Hyunju Jin
- Department of Dermatology, Pusan National University Hospital, Busan, Korea.,Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hyang-Suk You
- Department of Dermatology, Pusan National University Hospital, Busan, Korea
| | - Woo-Haing Shim
- Department of Dermatology, Pusan National University Hospital, Busan, Korea.,Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Gun-Wook Kim
- Department of Dermatology, Pusan National University Hospital, Busan, Korea
| | - Hoon-Soo Kim
- Department of Dermatology, Pusan National University Hospital, Busan, Korea
| | - Byung-Soo Kim
- Department of Dermatology, Pusan National University Hospital, Busan, Korea
| | - Moon-Bum Kim
- Department of Dermatology, Pusan National University Hospital, Busan, Korea
| | - Hyun-Chang Ko
- Department of Dermatology, Pusan National University Hospital, Busan, Korea.,Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea.,Research institute for Convergence of biomedical science and technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
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8
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Kromann AB, Ousager LB, Ali IKM, Aydemir N, Bygum A. Pigmentary mosaicism: a review of original literature and recommendations for future handling. Orphanet J Rare Dis 2018; 13:39. [PMID: 29506540 PMCID: PMC5839061 DOI: 10.1186/s13023-018-0778-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 02/19/2018] [Indexed: 12/02/2022] Open
Abstract
Background Pigmentary mosaicism is a term that describes varied patterns of pigmentation in the skin caused by genetic heterogeneity of the skin cells. In a substantial number of cases, pigmentary mosaicism is observed alongside extracutaneous abnormalities typically involving the central nervous system and the musculoskeletal system. We have compiled information on previous cases of pigmentary mosaicism aiming to optimize the handling of patients with this condition. Our study is based on a database search in PubMed containing papers written in English, published between January 1985 and April 2017. The search yielded 174 relevant and original articles, detailing a total number of 651 patients. Results Forty-three percent of the patients exhibited hyperpigmentation, 50% exhibited hypopigmentation, and 7% exhibited a combination of hyperpigmentation and hypopigmentation. Fifty-six percent exhibited extracutaneous manifestations. The presence of extracutaneous manifestations in each subgroup varied: 32% in patients with hyperpigmentation, 73% in patients with hypopigmentation, and 83% in patients with combined hyperpigmentation and hypopigmentation. Cytogenetic analyses were performed in 40% of the patients: peripheral blood lymphocytes were analysed in 48%, skin fibroblasts in 5%, and both analyses were performed in 40%. In the remaining 7% the analysed cell type was not specified. Forty-two percent of the tested patients exhibited an abnormal karyotype; 84% of those presented a mosaic state and 16% presented a non-mosaic structural or numerical abnormality. In patients with extracutaneous manifestations, 43% of the cytogenetically tested patients exhibited an abnormal karyotype. In patients without extracutaneous manifestations, 32% of the cytogenetically tested patients exhibited an abnormal karyotype. Conclusion We recommend a uniform parlance when describing the clinical picture of pigmentary mosaicism. Based on the results found in this review, we recommend that patients with pigmentary mosaicism undergo physical examination, highlighting with Wood’s light, and karyotyping from peripheral blood lymphocytes and skin fibroblasts. It is important that both patients with and without extracutaneous manifestations are tested cytogenetically, as the frequency of abnormal karyotype in the two groups seems comparable. According to the results only a minor part of patients, especially those without extracutaneous manifestations, are tested today reflecting a need for change in clinical practice. Electronic supplementary material The online version of this article (10.1186/s13023-018-0778-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna Boye Kromann
- Department of Dermatology and Allergy Centre, J.B. Winsløws Vej 4 , Entrance 142, 5000, Odense C, Denmark
| | - Lilian Bomme Ousager
- Department of Clinical Genetics, J.B. Winsløws Vej 4, Entrance 24, 5000, Odense C, Denmark
| | - Inas Kamal Mohammad Ali
- Department of Dermatology and Allergy Centre, J.B. Winsløws Vej 4 , Entrance 142, 5000, Odense C, Denmark
| | - Nurcan Aydemir
- Department of Dermatology and Allergy Centre, J.B. Winsløws Vej 4 , Entrance 142, 5000, Odense C, Denmark
| | - Anette Bygum
- Department of Dermatology and Allergy Centre, J.B. Winsløws Vej 4 , Entrance 142, 5000, Odense C, Denmark.
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9
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Abstract
Genetic mosaicism is defined as the existence of at least two genetically distinct cell populations within one individual. Mosaic presentation of genetic disorders is common and is often particularly obvious in the skin, because there it will generate recognizable patterns. Recognizing those can frequently assist in establishing a diagnosis. In this review, we discuss the mechanisms that give rise to genetic mosaicism. We describe its most frequent cutaneous manifestations that are relevant to paediatric practice. While most mosaic genetic diseases are rare, it is important to recognize them so that patients and parents may receive appropriate genetic counselling. Moreover, recent developments are now resulting in novel, targeted treatments for such disorders that promise to considerably improve patients' lives.
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10
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El-Sawy T, He L, Chiang MF, Anyane-Yeboa K, Morel KD, Folberg R, Marr BP, Abramson D. Retinoblastoma presenting in a child with hypomelanosis of Ito. Open Ophthalmol J 2012; 5:55-8. [PMID: 22216075 PMCID: PMC3249652 DOI: 10.2174/1874364101105010055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Revised: 09/03/2011] [Accepted: 09/03/2011] [Indexed: 11/22/2022] Open
Abstract
Purpose: To describe a case of a child with a known history of pigmentary mosaicism suggestive of Hypomelanosis of Ito presenting with unilateral leukocoria, who was ultimately diagnosed with retinoblastoma. Methods: A report of a 16-month-old girl with pigmentary mosaicism and unilateral retinoblastoma. Results: A previously healthy 16-month-old girl with a diagnosis of a mosaic hypopigmentation at the age of 6 months based on a linear and whorled pattern of skin hypopigmentation along the lines of Blaschko, presented with unilateral strabismus, leukocoria, retinal detachment, and sub-retinal exudation. Hypomelanosis of Ito and other similar neurocutaneous syndromes are known to be associated with abnormal retinal pigmentation, vascular abnormalities, and retinal detachment. Examination included a fluorescein angiogram, ultrasonography, and an MRI of the brain and orbits that demonstrated features consistent with retinoblastoma. Given these findings and a flat electroretinogram, the eye was enucleated with final pathologic confirmation of retinoblastoma. Conclusions: Previously unreported presentation of unilateral retinoblastoma in a child with pigmentary mosaicism.
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Affiliation(s)
- Tarek El-Sawy
- Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA
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11
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Affiliation(s)
- Gerhard Kurlemann
- Neuropediatric Department, University Hospital Munster, Munster, Germany.
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12
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Abstract
The skin gives us an opportunity to study pathologies unapparent in other systems such as patterned disorders. Among the best-identified patterns of skin disorders are the well-known lines of Blaschko, but other types of skin-patterned lesions have also been recognized. This short review will describe and discuss these different patterns and their pathophysiologic mechanisms, such as somatic mosaicism and X-chromosome associated mosaicism. Cutaneous patterned disorders are thought to be associated usually with inherited diseases per se, but in fact they are also reported in so-called acquired diseases. These cases suggest the existence of an underlying defect in a gene closely associated with the disease pathogenesis. The study of these acquired patterned disorders in the future may help us to understand the biologic foundations and pathogenesis of common human diseases.
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13
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Boonen SE, Hoffmann AL, Donnai D, Tümer Z, Ravn K. Diploid/triploid mosaicism: a rare event or an under-diagnosed syndrome? Eur J Med Genet 2011; 54:374-5. [PMID: 21252005 DOI: 10.1016/j.ejmg.2011.01.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2010] [Accepted: 01/08/2011] [Indexed: 11/25/2022]
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14
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Castronovo P, Delahaye-Duriez A, Gervasini C, Azzollini J, Minier F, Russo S, Masciadri M, Selicorni A, Verloes A, Larizza L. Somatic mosaicism in Cornelia de Lange syndrome: a further contributor to the wide clinical expressivity? Clin Genet 2010; 78:560-4. [DOI: 10.1111/j.1399-0004.2010.01408.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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Somatic gene mutation and human disease other than cancer: An update. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2010; 705:96-106. [DOI: 10.1016/j.mrrev.2010.04.002] [Citation(s) in RCA: 147] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Revised: 03/29/2010] [Accepted: 04/08/2010] [Indexed: 12/24/2022]
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16
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Abstract
The aetiology of pattern-formation in human naevoid skin disease remains unknown. However, it is likely that the majority of previously proposed mechanisms - those that simply rely on passive clonal trafficking in embryogenesis - are incomplete. A more comprehensive explanation for pattern-formation in naevi invokes the principle of self-organization. We define two types of patterning: anatomical and functional. Anatomical patterning is where the abnormal clone is limited to regions of pathologic skin, while functional patterning is where the abnormal clone and pathologic skin are spatially uncorrelated. From a theoretical perspective self-organized naevoid patterns may be either secondary to local interactions between normal and aberrant genotypes or due to the interaction between aberrant genotypes and the presence of normal embryonic patterning cues. The latter possibility suggests the critical observation and analysis of patterns in naevoid skin disease may lead to unique insights into key aspects of early human embryogenesis.
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Affiliation(s)
- Stephen J Gilmore
- Dermatology Research Centre, The University of Queensland, School of Medicine, Princess Alexandra Hospital, Brisbane, Australia.
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17
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Assogba K, Ferlazzo E, Striano P, Calarese T, Villeneuve N, Ivanov I, Bramanti P, Sessa E, Pacheva I, Genton P. Heterogeneous seizure manifestations in Hypomelanosis of Ito: report of four new cases and review of the literature. Neurol Sci 2009; 31:9-16. [PMID: 19902142 DOI: 10.1007/s10072-009-0160-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2008] [Accepted: 09/15/2009] [Indexed: 11/24/2022]
Abstract
Hypomelanosis of Ito (HI) is a rare neuroectodermal disorder often associated with mental retardation and epilepsy. We report on four new HI patients presenting with heterogeneous seizure manifestations and we review the literature concerning epileptic seizures in HI. At one extreme, there are patients with generalized seizures well controlled by drug treatment, whereas at the opposite there are patients with severe, often pharmacoresistant, focal seizures. The genetic substrate for HI syndrome is not homogenous and only partially understood. Further researches are required to shed light on the pathogenesis of HI phenotypes.
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Affiliation(s)
- Komi Assogba
- Centre Saint-Paul, Hôpital Henri Gastaut, Marseille, France
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18
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Strømme P, van der Hagen CB, Haakonsen M, Risberg K, Hennekam R. Follow-up of a girl with cleft lip and palate and multiple malformations: Trisomy 20 mosaicism. ACTA ACUST UNITED AC 2009; 39:178-9. [PMID: 16019751 DOI: 10.1080/02844310510006141] [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] [Indexed: 10/23/2022]
Abstract
We describe a 16(1/2) -year-old girl with multiple anomalies including cleft lip and palate and a normal karyotype in blood lymphocytes. Because of hyperpigmention along the lines of Blaschko, her karyotype in skin fibroblasts was examined, which showed mosaicism for trisomy 20. This is the first report to our knowledge of this karyotype where hyperpigmentation and facial clefting occurred together.
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Affiliation(s)
- Petter Strømme
- Department of Pediatrics, Ullevål University Hospital, Oslo, Norway.
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19
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Abstract
Skin and teeth not only share several characteristics in their development but also have a similar ontogenetic origin from the ectoderm. Thus, numerous congenital diseases, such as genetic, infectious, inflammatory, and immune disorders affect both skin and teeth. Particularly skin diseases are often identified by the synopsis of systemic symptoms. The understanding and appreciation of dental abnormalities guides dermatologists in the diagnosis and identification of syndromes as well as in finding an optimal therapy.
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20
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The changing phenotype in diploid/triploid mosaicism may mimic genetic syndromes with aberrant genomic imprinting: Follow up in a 14-year-old girl. Eur J Med Genet 2008; 51:573-9. [DOI: 10.1016/j.ejmg.2008.07.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Accepted: 07/13/2008] [Indexed: 11/22/2022]
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21
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Scott A, Micallef C, Hale SL, Watts P. Cortical visual impairment in hypomelanosis of Ito. J Pediatr Ophthalmol Strabismus 2008; 45:240-1. [PMID: 18705622 DOI: 10.3928/01913913-20080701-14] [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] [Indexed: 11/20/2022]
Abstract
Hypomelanosis of Ito is a multisystem disorder that is thought to be due to chromosomal mosaicism. The authors report a case of cortical visual impairment in an infant diagnosed as having hypomelanosis of Ito. Cortical dysplasia was evident on magnetic resonance imaging and its presence in key areas of the visual pathway may explain the patient's cortical visual impairment.
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Affiliation(s)
- Andrew Scott
- Department of Ophthalmology, University Hospital of Wales, Cardiff, UK
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22
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von Sneidern E, Lacassie Y. Is trisomy 14 mosaic a clinically recognizable syndrome?--case report and review. Am J Med Genet A 2008; 146A:1609-13. [PMID: 18449929 DOI: 10.1002/ajmg.a.32334] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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23
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Affiliation(s)
- Rajoo Thapa
- Department of Pediatrics, The Institute of Child Health, Kolkatta, India.
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24
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Tazawa I, Okumoto H, Kashiwagi A. Skin Pigmentary Variants in Rana Nigromaculata. J Clin Biochem Nutr 2006. [DOI: 10.3164/jcbn.38.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Ichiro Tazawa
- Division of Embryology and Genetics, Institute for Amphibian Biology, Graduate School of Science, Hiroshima University
| | - Hitoshi Okumoto
- Division of Embryology and Genetics, Institute for Amphibian Biology, Graduate School of Science, Hiroshima University
| | - Akihiko Kashiwagi
- Division of Embryology and Genetics, Institute for Amphibian Biology, Graduate School of Science, Hiroshima University
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25
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Abstract
PURPOSE OF REVIEW This article reviews the disorders of patterned dyspigmentation and discusses the pathogenesis of the pigmentary changes. RECENT FINDINGS A range of cytogenetic abnormalities has been detected in patterned pigmentary disease. This molecular heterogeneity correlates with the wide spectrum of clinical phenotypes observed. Many of the molecular defects overlap with genes known to play a role in pigmentation. Our understanding of the underlying genetic mechanisms for these mosaic conditions is evolving with advances in technology and dissection of the molecular pathways involved in melanocyte biology. SUMMARY The causal heterogeneity of patterned dyspigmentation promises to reveal clues about the differentiation, function, and control of melanocytes in embryonic and postnatal development.
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Affiliation(s)
- Vivian A Lombillo
- Division of Dermatology, Department of Medicine, University of Washington, Department of Dermatology, Group Health Permanente, Seattle, Washington 98195-6524, USA.
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Niessen RC, Jonkman MF, Muis N, Hordijk R, van Essen AJ. Pigmentary mosaicism following the lines of Blaschko in a girl with a double aneuploidy mosaicism: (47,XX,+7/45,X). Am J Med Genet A 2005; 137A:313-22. [PMID: 16092121 DOI: 10.1002/ajmg.a.30876] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We report on a 6-year-old girl with linear streaks of apparent hypopigmentation and hyperpigmentation following the Blaschko lines, growth retardation, bupthalmos of the left eye, and mild mental retardation. She had a 45,X karyotype in lymphocytes. In cultured fibroblasts a double aneuploidy mosaicism was detected, consisting of a cell line with trisomy for chromosome 7 and a cell line with monosomy for the X-chromosome and no cell line with a normal karyotype. Cutis tricolor or three levels of pigmentation in different skin areas suggested presence of a third, probably normal cell line. Double aneuploidy mosaicism of a cell line with monosomy X and a cell line with trisomy of an autosome is a rare finding. The combination of monosomy X with trisomy of chromosomes 8, 10, 13, 18, and 21 has been reported, but not the combination with trisomy 7. In the 45,X cell line, microsatellite analysis showed loss of the maternal X-chromosome, and presence of a maternal and paternal chromosome 7. The 47,XX,+7 cell line showed a paternal and a maternal X-chromosome, and a paternal and two identical maternal chromosomes 7. Mechanisms that might explain this double aneuploidy mosaicism are discussed.
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Affiliation(s)
- Renée C Niessen
- Department of Clinical Genetics, University Medical Center Groningen, Groningen, The Netherlands.
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28
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Taibjee SM, Bennett DC, Moss C. Abnormal pigmentation in hypomelanosis of Ito and pigmentary mosaicism: the role of pigmentary genes. Br J Dermatol 2004; 151:269-82. [PMID: 15327534 DOI: 10.1111/j.1365-2133.2004.06057.x] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
There is increasing evidence that hypomelanosis of Ito and related disorders such as linear and whorled naevoid hypermelanosis are due to mosaicism for a variety of chromosomal abnormalities. This group of disorders is better termed 'pigmentary mosaicism'. In this review we explain how disparate chromosomal abnormalities might manifest as a common pigmentary phenotype. In particular, we provide evidence supporting the hypothesis that the chromosomal abnormalities reported in these disorders specifically disrupt expression or function of pigmentary genes.
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Affiliation(s)
- S M Taibjee
- Department of Dermatology, Birmingham Children's Hospital, Birmingham, UK.
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29
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Abstract
Dysmorphology is the study of abnormal patterns of human development. A recurrent and recognizable combination of physical and behavioural abnormalities makes up a syndrome. Accurate recognition and diagnosis of syndromes is important because it influences medical management of patients, provides information about prognosis, and allows for genetic counselling including accurate estimation of genetic risk within families and, where possible, prenatal diagnosis. This review examines the diagnostic process in dysmorphology and indicates how skin signs may provide important clues to the clinician.
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Affiliation(s)
- S F Smithson
- Department of Clinical Genetics, St Michael's Hospital, Southwell Street, Bristol BS2 8EG, UK.
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31
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Vatish M, Sebire NJ, Allgood C, McKeown C, Rees HC, Keay SD. Triploid/diploid mosaicism (69XXY/46XX) presenting as severe early onset preeclampsia with a live birth: placental and cytogenetic features. Eur J Obstet Gynecol Reprod Biol 2004; 112:233-5. [PMID: 14746967 DOI: 10.1016/s0301-2115(03)00335-x] [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] [Indexed: 11/23/2022]
Abstract
Triploid/diploid mosaicism was diagnosed following karyotyping of an infant with musculo-skeletal abnormalities delivered because of severe preeclampsia. An area of the placenta appeared unusual with histology suggestive of trophoblastic abnormality. The importance of detailed histopathological examination and ploidy and flow cytometry studies where diagnostic uncertainty exists are highlighted.
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Affiliation(s)
- M Vatish
- Department of Obstetrics and Gynaecology, University Hospitals of Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK
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33
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Flori E, Doray B, Rudolf G, Favre R, Girard-Lemaire F, Schluth C, Zix-Kieffer I, Flori J, Loriot M, Schmitt E, Rumpler Y. Failure of prenatal diagnosis of diploid-triploid mosaicism after amniocentesis. Clin Genet 2003; 63:328-31. [PMID: 12702170 DOI: 10.1034/j.1399-0004.2003.00062.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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34
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van de Laar I, Rabelink G, Hochstenbach R, Tuerlings J, Hoogeboom J, Giltay J. Diploid/triploid mosaicism in dysmorphic patients. Clin Genet 2002; 62:376-82. [PMID: 12431252 DOI: 10.1034/j.1399-0004.2002.620504.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Diploid/triploid mosaicism is a dysmorphology syndrome consisting of mental retardation, truncal obesity, body and/or facial asymmetry, growth retardation, hypotonia, a small phallus, malformed low-set ears and micrognathia. In 75% of the cases, the blood karyotype is normal and the diagnosis can only be established after analysis of cultured fibroblasts. This chromosome abnormality may therefore be underdiagnosed. This paper focuses on the identification of mentally retarded and dysmorphic patients with diploid/triploid mosaicism. Detailed clinical description of well-defined patients may help in deciding if a skin biopsy for karyotyping of fibroblasts should be taken. Three new cases are presented, in which DNA marker analysis showed that the extra set of chromosomes in each case was derived from the mother. We present a review of 25 cases described in the literature and we discuss the inclusion of a second polar body into an early diploid embryo as the most likely mechanism.
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Affiliation(s)
- I van de Laar
- Department of Medical Genetics, University Medical Center, Utrecht, the Netherlands
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35
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Leonard NJ, Tomkins DJ. Diploid/tetraploid/t(1;6) mosaicism in a 17-year-old female with hypomelanosis of Ito, multiple congenital anomalies, and body asymmetry. AMERICAN JOURNAL OF MEDICAL GENETICS 2002; 112:86-90. [PMID: 12239727 DOI: 10.1002/ajmg.10662] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Many types of chromosome mosaicism have been identified in cases of hypomelanosis of Ito, often in association with chromosome instability; however, there have been very few cases with diploid-tetraploid mosaicism described in the literature. We present a patient with a tetraploid mosaicism: a 17-year-old girl who has hypomelanosis of Ito in association with diploid/tetraploid/t(1;6) mosaicism. She had multiple congenital anomalies of omphalocele, exstrophy of bladder, duodenal web, and imperforate anus. These features have not been described previously in diploid-tetraploid mosaicism.
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Affiliation(s)
- N J Leonard
- Edmonton Genetics Clinic, Department of Medical Genetics, University of Alberta, Edmonton, Alberta, Canada.
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36
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Affiliation(s)
- Yuval Yaron
- Prenatal Genetic Diagnosis Unit, Genetic Institute, Tel Aviv Sourasky Medical Center, Israel.
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37
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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.
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Affiliation(s)
- Sirpa Kivirikko
- Department of Clinical Genetics, Helsinki University Central Hospital, Helsinki, Finland.
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38
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Abstract
The term hypomelanosis of Ito is applied to individuals with skin hypopigmentation along the lines of Blaschko. Even though originally described as a purely cutaneous disease, subsequent reports have included a 33% to 94% association with multiple extracutaneous manifestations mostly of the central nervous and musculoskeletal systems leading to frequent characterization as a neurocutaneous disorder. A number of reports claimed familial occurrence and supported single gene inheritance for hypomelanosis of Ito, but none has been proved. Miscellaneous chromosomal mosaicisms have been demonstrated in some but not all affected individuals. Thus, it has been suggested that hypomelanosis of Ito is not a single condition but rather a nonspecific manifestation (ie, a phenotype) of chromosomal mosaicism and that this term should now be dropped. In this article, we review these developments focusing on the neurologic and genetic aspects of hypomelanosis of Ito. Our personal experience with 41 hypomelanosis of Ito patients and literature review led us to conclude that (1) the term hypomelanosis of Ito has been often misapplied to individuals with nonspecific "patchy depigmentation of the skin" who had several conditions of different etiologies; (2) the white matter involvement seen at neuroimaging in most of our hypomelanosis of Ito patients was similar to that reported in well-defined neurocutaneous disorders, including Sjögren-Larsson syndrome and incontinentia pigmenti; (3) whatever figures we take for associated central nervous system abnormalities in hypomelanosis of Ito, these represent the most frequent extracutaneous findings and, therefore, the use of the term neurocutaneous disorder for hypomelanosis of Ito might well be appropriate.
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Affiliation(s)
- M Ruggieri
- Department of Paediatrics, University of Catania, Italy.
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39
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Tunca Y, Wilroy RS, Kadandale JS, Martens PR, Gunther WM, Tharapel AT. Hypomelanosis of ito and a 'mirror image' whole chromosome duplication resulting in trisomy 14 mosaicism. ANNALES DE GENETIQUE 2000; 43:39-43. [PMID: 10818220 DOI: 10.1016/s0003-3995(00)00012-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We describe a female infant with multiple congenital anomalies including unusual hyperpigmentation, tetralogy of Fallot, absent corpus callosum and wide prominent nasal bridge. The infant was initially seen for genetic consultation on day one after birth. Chromosome analysis from cultured lymphocytes showed a normal 46,XX karyotype. However, cultured skin fibroblasts showed mosaicism with 46,XX,add(14)(q32).ish psu dic dup(14)(q32p13)(wcp14+)/46,XX complements. A review of the published report with chromosome mosaicism and hypomelanosis of Ito (HMI) is included. We suggest that the trisomy 14 mosaicism seen in fibroblast cultures has importance in the expression of pigmentation dysplasias in this patient. Pigmentary anomaly may be due to loss or gain of specific genes that influence pigmentation located on the long arm of chromosome 14 in this patient.
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Affiliation(s)
- Y Tunca
- Department of Medical Genetics, Gulhane Medical Faculty, 06018 Etlik, Ankara, Turkey
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40
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Magenis E, Webb MJ, Spears B, Opitz JM. Blaschkolinear malformation syndrome in complex trisomy-7 mosaicism. AMERICAN JOURNAL OF MEDICAL GENETICS 1999; 87:375-83. [PMID: 10594874 DOI: 10.1002/(sici)1096-8628(19991222)87:5<375::aid-ajmg2>3.0.co;2-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Results of repeated peripheral blood chromosome studies were normal in a boy with intrauterine growth retardation, short stature, moderate mental retardation, and multiple minor anomalies. At age 9 years it was recognized that the swirls of pigmentation/depigmentation on his trunk, linear streaks on his limbs, and body asymmetry were suggestive of chromosomal mosaicism. Four skin biopsies were obtained under anesthesia during a dental procedure. All showed mosaicism for a normal cell line, a line with an extra chromosome 7, and a cell line with an extra small ring. In one biopsy, there was a fourth cell line with an extra chromosome 7 and the ring. Fluorescence in situ hybridization (FISH) with a chromosome 7 paint confirmed trisomy 7 and the chromosome 7 derivation of the ring. This young man's intra-uterine and postnatal growth retardation is an aneuploidy effect, whereas his asymmetry reflects a mosaicism effect that should have aroused suspicion of tissue-limited mosaicism before the development of obvious Blaschkolinear skin pigmentary dysplasia.
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Affiliation(s)
- E Magenis
- Department of Molecular and Medical Genetics, Child Development and Rehabilitation Center, Oregon Health Sciences University, Portland, Oregon 97201-2998, USA
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41
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Abstract
Achromic nevus or nevus depigmentosus is a cutaneous abnormality consisting of a hypopigmented macular lesion which can present as circumscribed irregular, oval, or round or as a unilateral band or streak with a blocklike configuration or arranged along one or more Blaschko lines. When it is systematized, it is indistinguishable from hypomelanosis of Ito. Pigmentary anomalies along the lines of Blaschko can be associated with systemic features. For these reasons, 20 children, referred consecutively for evaluation of segmental, linear achromic nevus, were evaluated to define the incidence of associated abnormal systemic features. Extracutaneous abnormalities were present in 2 of 20 children (10%). The anomalies consisted of pes cavus ipsilateral to the hypopigmentation in one child and mental retardation, seizures, and hemihypertrophy in the second. This study confirms that achromic nevus, even when distributed along Blaschko lines, is commonly a benign lesion that is associated with systemic features in a small minority of cases.
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Affiliation(s)
- V Di Lernia
- Department of Dermatology, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
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42
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43
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Happle R. Incontinentia pigmenti versus hypomelanosis of Ito: the whys and wherefores of a confusing issue. AMERICAN JOURNAL OF MEDICAL GENETICS 1998; 79:64-5. [PMID: 9738871 DOI: 10.1002/(sici)1096-8628(19980827)79:1<64::aid-ajmg14>3.0.co;2-k] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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44
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Schroer RJ, Phelan MC, Michaelis RC, Crawford EC, Skinner SA, Cuccaro M, Simensen RJ, Bishop J, Skinner C, Fender D, Stevenson RE. Autism and maternally derived aberrations of chromosome 15q. AMERICAN JOURNAL OF MEDICAL GENETICS 1998; 76:327-36. [PMID: 9545097 DOI: 10.1002/(sici)1096-8628(19980401)76:4<327::aid-ajmg8>3.0.co;2-m] [Citation(s) in RCA: 250] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Of the chronic mental disabilities of childhood, autism is causally least well understood. The former view that autism was rooted in exposure to humorless and perfectionistic parenting has given way to the notion that genetic influences are dominant underlying factors. Still, identification of specific heritable factors has been slow with causes identified in only a few cases in unselected series. A broad search for genetic and environmental influences that cause or predispose to autism is the major thrust of the South Carolina Autism Project. Among the first 100 cases enrolled in the project, abnormalities of chromosome 15 have emerged as the single most common cause. The four abnormalities identified include deletions and duplications of proximal 15q. Other chromosome aberrations seen in single cases include a balanced 13;16 translocation, a pericentric inversion 12, a deletion of 20p, and a ring 7. Candidate genes involved in the 15q region affected by duplication and deletion include the ubiquitin-protein ligase (UBE3A) gene responsible for Angelman syndrome and genes for three GABA(A) receptor subunits. In all cases, the deletions or duplications occurred on the chromosome inherited from the mother.
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Affiliation(s)
- R J Schroer
- Greenwood Genetic Center, South Carolina 29646, USA
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45
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Baselga E, Drolet BA, van Tuinen P, Esterly NB, Happle R. Dyskeratosis congenita with linear areas of severe cutaneous involvement. ACTA ACUST UNITED AC 1998. [DOI: 10.1002/(sici)1096-8628(19980217)75:5<492::aid-ajmg7>3.0.co;2-p] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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46
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Pascual-Castroviejo I, Roche C, Martinez-Bermejo A, Arcas J, Lopez-Martin V, Tendero A, Esquiroz JL, Pascual-Pascual SI. Hypomelanosis of ITO. A study of 76 infantile cases. Brain Dev 1998; 20:36-43. [PMID: 9533559 DOI: 10.1016/s0387-7604(97)00097-1] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We show the complications observed in a large series of children with hypomelanosis of Ito (HI) or incontinentia pigmenti achromians, studied in a neurology service over 30 years. Of the 76 patients, 35 were male (46%) and 41 female (54%) with ages ranging from newborn to 10 years at the time of the first visit. They were thoroughly studied from the clinical, genetic, psychological, neuroradiological, with computed tomography (CT) and/or magnetic resonance imaging (MRI), and electroencephalographic (EEG) points of view. Mental retardation was observed in 43 cases (57%) of whom eight (10%) showed autistic behavior; 16 (21%) were borderline and only 17 (22%) had a normal mental level (IQ > 85). Thirty-seven patients (49%) had seizures, consisting of infantile spasms in six cases (8%). Twelve cases showed macrocephaly and coarse facies, six had microcephaly, and 14 showed hypotonia with pes valgus and genu valgus. Three cases of cerebellar hypoplasia, another of intracranial arteriovenous malformation and another of distal spinal muscular atrophy were observed as well. Some other anomalies, such as syndactyly, clinodactyly, abnormalities of the skeleton, asymmetry of the facies, ears, body and/or extremities, gynecomastia and asymmetrical breasts, short stature, oral alterations, congenital cardiopathies and genital anomalies, were also occasionally found. Three children died, but necropsy was performed only in one. Anatomical and histological studies did not disclose specific findings.
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47
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Curry CJ, Stevenson RE, Aughton D, Byrne J, Carey JC, Cassidy S, Cunniff C, Graham JM, Jones MC, Kaback MM, Moeschler J, Schaefer GB, Schwartz S, Tarleton J, Opitz J. Evaluation of mental retardation: recommendations of a Consensus Conference: American College of Medical Genetics. AMERICAN JOURNAL OF MEDICAL GENETICS 1997; 72:468-77. [PMID: 9375733 DOI: 10.1002/(sici)1096-8628(19971112)72:4<468::aid-ajmg18>3.0.co;2-p] [Citation(s) in RCA: 230] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A Consensus Conference utilizing available literature and expert opinion sponsored by the American College of Medical Genetics in October 1995 evaluated the rational approach to the individual with mental retardation. Although no uniform protocol replaces individual clinician judgement, the consensus recommendations were as follows: 1. The individual with mental retardation, the family, and medical care providers benefit from a focused clinical and laboratory evaluation aimed at establishing causation and in providing counseling, prognosis, recurrence risks, and guidelines for management. 2. Essential elements of the evaluation include a three-generation pedigree: pre-, peri-, and post-natal history, complete physical examination focused on the presence of minor anomalies, neurologic examination, and assessment of the behavioral phenotype. 3. Selective laboratory testing should, in most patients, include a banded karyotype. Fragile X testing should be strongly considered in both males and females with unexplained mental retardation, especially in the presence of a positive family history, a consistent physical and behavioral phenotype and absence of major structural abnormalities. Metabolic testing should be initialed in the presence of suggestive clinical and physical findings. Neuroimaging should be considered in patients without a known diagnosis especially in the presence of neurologic symptoms, cranial contour abnormalities, microcephaly, or macrocephaly. In most situations MRI is the testing modality of choice. 4. Sequential evaluation of the patient, occasionally over several years, is often necessary for diagnosis, allowing for delineation of the physical and behavioral phenotype, a logical approach to ancillary testing and appropriate prognostic and reproductive counseling.
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Affiliation(s)
- C J Curry
- Valley Children's Hospital/UCSF, Fresno, California 93703, USA
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48
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Ono J, Harada K, Kodaka R, Ishida M, Okada S. Regional cortical dysplasia associated with suspected hypomelanosis of Ito. Pediatr Neurol 1997; 17:252-4. [PMID: 9390703 DOI: 10.1016/s0887-8994(97)00084-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A 15-year-old girl with epilepsy, whose skin lesions were reminiscent of hypomelanosis of Ito, is reported. She manifested hypopigmented linear streaks on her upper and lower limbs. Brain magnetic resonance imaging examinations demonstrated poor differentiation of cerebral gray and white matter of her left occipital lobe, with accompanying gliosis. This region also revealed narrowing of sulci, considered to be mass effect. In this region, almost continuous spike discharges were evident on electroencephalograms, and low-perfusion status was observed on single photon emission computed tomography at rest. She also manifested right lower homonymous quadrant anopsia, which may have its origin in the lesion detected, which appeared to be a migration disorder of neuroblasts in our patient, suggesting that the spectrum of hypomelanosis of Ito might be involved.
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Affiliation(s)
- J Ono
- Department of Pediatrics, Faculty of Medicine, Osaka University, Suita, Japan
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49
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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]
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50
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Tagawa T, Futagi Y, Arai H, Mushiake S, Nakayama M. Hypomelanosis of Ito associated with hemimegalencephaly: a clinicopathological study. Pediatr Neurol 1997; 17:180-4. [PMID: 9367304 DOI: 10.1016/s0887-8994(97)00090-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A girl with hypomelanosis of Ito was studied both clinically and at postmortem examination. She manifested severe epilepsy early after birth. Magnetic resonance imaging demonstrated left-sided hemimegalencephaly. The seizures were secondarily generalized or unilateral initially, followed by infantile spasms with asymmetrical hypsarrhythmia at 1.5 months of age. Frequent complex partial seizures, refractory to anti-epileptic drug treatments appeared at 4 months of age. She died of pneumonia at the age of 14 months. Postmortem examination revealed marked asymmetry of the cerebrum and gyral abnormalities in the left cerebral hemisphere. Histopathologically, severe disorganization of the neuronal cytoarchitecture was evident. Absence of delineation between cortical gray and white matter was evident, as was increase and hypertrophy of the neurons and glial cells. We believe that the association of skin and brain lesions was not one of chance; that is, they may share a common pathogenetic mechanism.
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Affiliation(s)
- T Tagawa
- Division of Pediatric Neurology, Osaka Medical Center and Research Institute for Maternal and Child Health; Izumi, Japan
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