Mosaic and partial monosomy of chromosome 21 in a case with low platelets count

BACKGROUND

Monosomy is defined as the presence of only one chromosome instead of two in humans. Partial monosomy occurs when only a portion of the chromosome is present in a single copy, while the rest has two copies. It can occur in unbalanced translocations or deletions.

CASE REPORT

In this report, a 6 years old girl was presented who was referred to the Pediatric Dep, Shahid Sadoughi Hospital,Yazd, Iran, due to multiple congenital anomalies such as: frontal bossing, horizontal palpebral fissure, small deepest eyes, aplastic nasal bridge, broad philtrum, low set ears, large prominent ears, short neck, microcephaly, pectus excavatum, mental retardation, and dislocation of the hip. In peripheral blood smear, platelets were decreased but other hematological levels were normal. The karyotype result indicated a mosaic monosomy and partial monosomy of chromosome 21.

CONCLUSION

According to this and other case reports of monosomy of chromosome 21, this disease had very low prevalence rate among live infants or children. The present case had some congenital anomalies that present with abnormal medical condition. Therefore these patients must be evaluated for chromosomal studies.

Failure of fertilization following intracytoplasmic injection of round-headed sperm

BACKGROUND

Intracytoplasmic sperm injection (ICSI) is a very effective technique for the treatment of male factor infertility, even in severe cases. An exception to this rule is round-headed acrosomeless sperm, for which there is an extremely low success rate. The objective of this study was to report our first experience with ICSI using round-headed spermatozoa.

MATERIALS AND METHODS

A total of four infertile males with globozoospermia underwent the conventional ICSI program during the period from 1995 to 1997. Semen parameters were evaluated according to the WHO criteria. Twenty-eight oocytes were collected following conventional ovarian superovulation.

RESULTS

Volume, pH, and viscosity of the semen were within normal range. Sperm counts and progressive motility were from >1 to 90x10 6 mL, and from 0% to 60%, respectively. Distinct 100% acrosomeless morphology was observed with Giemsa staining. Twenty-two metaphase II oocytes (78.6% of the total) from four ICSI cases were injected with the husbandâs round-headed spermatozoa. Total fertilization failure was observed in all these cases.

CONCLUSION

The results clearly demonstrate the important role of normal head morphology in activating the oocytes, as well as the need to develop a modified but safe ICSI technique, which will be effective in overcoming this severe type of male infertility.

Klippel-Trenaunay syndrome

An unusual and extreme case of Klippel-Trenaunay syndrome is presented. The patient has an extensive capillary hemangioma involving the right side of the body, increases in the length and girth of the right lower limb, gross varicosities of the superficial venous system, and complete absence of the deep venous system of the right lower extremity, with suprapubic shunt of the venous blood to the contralateral external iliac vein. Secondary manifestations are increased sweating and compensatory scoliosis.

Primary empty sella syndrome with panhypopituitarism in a child

A 10-year-old boy presented with marked growth retardation. He was found to have an empty sella demonstrated by CT and Metrizamide cisternography. Endocrinological investigation confirmed the diagnosis of panhypopituitarism. This is the first case reported in a twin and the fifth pediatric case with marked endocrine dysfunction reported in the literature.