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Salas-Labadía C, Gómez-Carmona S, Cruz-Alcívar R, Martínez-Anaya D, Del Castillo-Ruiz V, Durán-McKinster C, Ulloa-Avilés V, Yokoyama-Rebollar E, Ruiz-Herrera A, Navarrete-Meneses P, Lieberman-Hernández E, González-Del Angel A, Cervantes-Barragán D, Villarroel-Cortés C, Reyes-León A, Suárez-Pérez D, Pedraza-Meléndez A, González-Orsuna A, Pérez-Vera P. Genetic and clinical characterization of 73 Pigmentary Mosaicism patients: revealing the genetic basis of clinical manifestations. Orphanet J Rare Dis 2019; 14:259. [PMID: 31730496 PMCID: PMC6858688 DOI: 10.1186/s13023-019-1208-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 09/24/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Pigmentary mosaicism constitutes a heterogeneous group of skin pigmentation alterations associated with multisystem involvement. The aim of this study was to establish a complete cytogenetic and molecular characterization of PM patients, emphasizing on searching for possible low chromosomal mosaicism and on establishing an accurate genotype-phenotype correlation. RESULTS A total of 73 patients were included (3 months to 18 years of age), 52% male and 48% female. Observed in 69 (95%) patients, the most frequent pattern of pigmentation was fine and whorled BL, which was associated with disseminated skin extent in 41 (59%) patients. Central nervous system (84%) alterations were the most frequent observed in the group of patients, followed by the musculoskeletal (53%) and ophthalmologic (27%) alterations. Considering the pattern of pigmentation, no significant differences in association with skin extent or extracutaneous manifestations were detected. Following a strict cytogenetic analysis strategy, screening metaphases from three different tissues (peripheral blood, hyperpigmented and hypopigmented skin) we found that 23/73 patients had chromosomal abnormalities classified as follows: 1) Mosaic with 2 or more different cell lines with structural alterations n = 19; 2) Polyploidy (mosaic) n = 1 and 3) Alterations in all cells in three different tissues n = 3. SNP array, array CGH and FISH were useful for the complete characterization of the chromosomal aberrations, for the detection of microdeletions in patients with normal karyotype but with strong clinical suspicious of chromosomal alteration, and for a better establishment of genotype-phenotype correlation. In 2 patients we found genes associated with some of the extracutaneous manifestations (SHH, MNX1, PPP2R2C). CONCLUSIONS This group of 73 patients finely described is the largest series of patients with pigmentary mosaicism reported worldwide. As we showed in this study, the followed analysis strategy allowed the detection of cytogenetic and molecular abnormalities, and made possible the establishment of genotype-phenotype associations in some patients. An important limitation of our study was the analysis of fibroblasts cultures instead of melanocytes and keratinocytes. In some cases the direct molecular DNA analysis of skin biopsy could be another choice.
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Affiliation(s)
- C Salas-Labadía
- Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría, 04530, Ciudad de México, Mexico.
| | - S Gómez-Carmona
- Departamento de Genética Médica, Centro de Rehabilitación e Inclusión Infantil Teletón, Tuxtla Gutiérrez, Chiapas, Mexico.,Departamento de Genética Humana, Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | - R Cruz-Alcívar
- Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría, 04530, Ciudad de México, Mexico.,Laboratorio de Citogenética, Genos Médica, Centro Especializado en Genética, Ciudad de México, Mexico.,Facultad de Ciencias, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - D Martínez-Anaya
- Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría, 04530, Ciudad de México, Mexico
| | - V Del Castillo-Ruiz
- Departamento de Genética Humana, Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | - C Durán-McKinster
- Departamento de Dermatología, Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | - V Ulloa-Avilés
- Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría, 04530, Ciudad de México, Mexico
| | - E Yokoyama-Rebollar
- Departamento de Genética Humana, Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | - A Ruiz-Herrera
- Hospital de Especialidades Pediátrico de León, León, Guanajuato, Mexico
| | - P Navarrete-Meneses
- Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría, 04530, Ciudad de México, Mexico
| | - E Lieberman-Hernández
- Departamento de Genética Humana, Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | - A González-Del Angel
- Laboratorio de Biología Molecular, Departamento de Genética Humana, Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | | | - C Villarroel-Cortés
- Departamento de Genética Humana, Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | - A Reyes-León
- Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría, 04530, Ciudad de México, Mexico
| | - D Suárez-Pérez
- Departamento de Genética Humana, Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | - A Pedraza-Meléndez
- Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría, 04530, Ciudad de México, Mexico.,Posgrado en Ciencias Biológicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - A González-Orsuna
- Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría, 04530, Ciudad de México, Mexico
| | - P Pérez-Vera
- Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría, 04530, Ciudad de México, Mexico.
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