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13q deletion syndrome resulting from balanced chromosomal rearrangement in father: the significance of parental karyotyping

机译:13克删除综合征,由父亲的平衡染色体重排成为患者:父母核型分析的重要性

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Background:Retinoblastoma is a malignancy of the eye in children characterized by biallelic inactivation of the retinoblastoma 1 gene (RB1), located at chromosome 13q14.2. Children with interstitial chromosome 13q deletions that include the RB1 gene show a predisposition to develop retinoblastoma and variable other features. Large 13q deletions with severe clinical phenotype are nearly always the result of a de novo mutation, i.e. the pathogenic alteration is not detected in parents. This results in a low risk for siblings to develop 13q deletion syndrome.Result:Here, we describe a patient with profound muscle hypotonia, severe developmental delay and bilateral retinoblastoma carrying a large deletion in 13q13.3q14 with the size of 16?Mb, involving the RB1 gene. Neither parent showed retinoblastoma, muscle hypotonia or developmental delay. Chromosome analysis and Fluorescence in situ hybridization (FISH) showed a balanced complex chromosomal rearrangement (CCR) between chromosome 12 and 13 [ins(12;13)(q21.2;q12.3q14.3)] and an additional balanced translocation of chromosome 7 and 15 [t(7;15)(q31.2;q25.3)] in the healthy father. Malsegregation of the paternal insertional translocation involving chromosome 12 and 13 resulted in a 13q deletion syndrome of the child [46,XY,ins(12;13)(q21.2;q12.3q14.3)].Conclusion:Balanced translocations in parents are a rare cause of de novo RB1 deletions in offspring. This case report emphasizes the need for parental chromosomal analysis and FISH in parents of children diagnosed with 13q deletion syndrome or large RB1 gene deletions to precisely determine the recurrence risk in siblings. Guidelines for genetic testing should be revised accordingly.? The Author(s) 2020.
机译:背景:视网膜母细胞瘤是儿童的眼睛恶性肿瘤,其特征在于视网膜母细胞瘤1基因(RB1),位于13 Q14.2的染色体上。具有间隙染色体的儿童13Q缺失,包括RB1基因显示出开发视网膜母细胞瘤和可变其他特征的易感性。具有严重的临床表型的大13季度缺失几乎始终是DE Novo突变的结果,即父母未检测到致病性改变。这导致兄弟姐妹的风险很低,以发展13季度缺失综合征。结果:在这里,我们描述了一个患有深远肌肉低温的患者,严重发育延迟和双侧视网膜母细胞瘤在13 Q13.3 Q14中携带大量缺失,涉及16?MB的大小,涉及RB1基因。父母均未显示视网膜母细胞瘤,肌肉肺炎或发育延迟。原位杂交(鱼类)的染色体分析和荧光显示染色体12和13(12; 13)(Q21.2; Q12.314.3)之间平衡的复杂染色体重排(CCR)(Q21.2; Q12.314.3)]和染色体的额外平衡易位在健康的父亲中,7和15 [T(7; 15)(Q31.2; Q25.3)]。患有染色体12和13患者的父亲插入易位的物质中继导致孩子的13季度缺失综合征[46,XY,INS(12; 13)(Q21.2; Q12.314.3)]。结论:父母的平衡易位是De Novo RB1在后代删除的罕见原因。本案例报告强调需要患有13季度缺失综合征或大型RB1基因缺失的儿童父母的亲本染色体分析和鱼类,以精确确定兄弟姐妹的复发风险。应相应修订基因检测指南。作者2020年。

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