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READERS OPINION
A familial rearrangement(3;5;9) with paternal and maternal transmission leading to a duplication 3p/deletion 5p infant
Horacio RiveraI,,II,
Corresponding author
hrivera@cencar.udg.mx

Tel.: 52 33 3618-9410
, María G DomínguezI
I Instituto Mexicano del Seguro Social, División de Genética, CIBO, Guadalajara, México
II Universidad de Guadalajara, Genética Humana, CUCS, Guadalajara, México
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          "en" => "<p id="spara20" class="elsevierStyleSimplePara elsevierViewall">FISH karyotype analyses of the patient &#40;a&#41; and his balanced mother &#40;b-d&#41;&#46; a&#58; The 3p subtel probe &#40;<span class="elsevierStyleItalic">green</span>&#41; hybridized to both the normal 3 and the der&#40;9&#41;&#46; b&#58; The 5p subtel probe &#40;<span class="elsevierStyleItalic">green</span>&#41; hybridized to both the normal 5 and the der&#40;3&#41;&#46; c&#58; The combined cri du chat &#40;<span class="elsevierStyleItalic">green&#47;red</span>&#41;&#47;Sotos &#40;<span class="elsevierStyleItalic">green</span>&#41; probe confirmed the translocation of 5p15&#46;2&#8594;pter onto 3p24&#46;3&#59; i&#46;e&#46;&#44; the der&#40;3&#41; had both 5p or cri du chat signals&#44; whereas the der&#40;5&#41; exhibited only the 5q35 Sotos signal&#46; d&#58; The ABL &#40;<span class="elsevierStyleItalic">red</span>&#41;&#47;BCR probe &#40;<span class="elsevierStyleItalic">green</span>&#41; hybridized to both the normal 9 and the der&#40;5&#41; and to both copies of chromosome 22&#46; DAPI counterstained images are on the <span class="elsevierStyleItalic">right</span>&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="para10" class="elsevierStylePara elsevierViewall">We report a complex rea&#40;3&#59;5&#59;9&#41; observed in an unbalanced child who inherited this mutation from&#160;his mother and maternal grandfather&#46;</p><p id="para20" class="elsevierStylePara elsevierViewall">The propositus&#44; a male infant&#44; was the only child of healthy non-consanguineous parents aged 28 &#40;father&#41; and 24 years&#46; There was no history of miscarriages or malformations on either side of the family&#46; The pregnancy and vaginal delivery were normal&#46; The infant&#39;s birth weight and length were 2&#44;450 g and 45 cm&#44; respectively&#46; Due to a complex heart defect &#40;PDA&#44; VSD&#44; and ASD&#41; and respiratory insufficiency&#44; he was hospitalized for 30 days&#46; Two months later&#44; he underwent surgery to correct the cardiac defects&#46; His psychomotor development was delayed&#46; Clinical examination at 6 months of age revealed severe growth retardation &#40;weight of 4&#46;9 kg&#44; length of 58 cm&#44; OFC of 37 cm&#41;&#44; hypotonia&#44; diminished reflexes&#44; brachycephaly&#44; prominent forehead&#44; bilateral ectropion and blepharophimosis&#44; a small nose with anteverted nares&#44; microstomia&#44; micrognathia&#44; a short neck&#44; dysplastic and cupped ears&#44; an osseous appendix in the sternum&#44; and a single palmar crease in the left hand&#46; The abdomen and external genitalia were normal&#46; The patient had neither a cat-like cry nor telecanthus&#46; One month later&#44; the patient died of hypoventilation&#59; no autopsy was performed&#46;</p><p id="para30" class="elsevierStylePara elsevierViewall">The karyotypes of the patient and several relatives were determined using G-banding and Fluorescence in situ hybridization &#40;FISH&#41;&#46; The probes 3p &#40;Vysis&#44; Abbott Laboratories&#44; Abbott Park&#44; IL&#44; USA&#41;&#47;5p &#40;Cytocell&#44; Cytocell Ltd&#46;&#44; Cambridge&#44; UK&#41; subtel&#44; ABL&#47;BCR &#40;Vysis&#44; Abbott Laboratories&#44; Abbott Park&#44; IL&#44; USA&#41;&#44; and cri du chat&#47;Sotos &#40;Cytocell&#44; Cytocell Ltd&#46;&#44; Cambridge&#44; UK&#41; were used to test both the child and his mother&#59; the mother was also tested with painting probes for chromosomes 3 and 9 &#40;Cytocell&#44; Cytocell Ltd&#46;&#44; Cambridge&#44; UK&#41;&#46; This combined analysis led to the diagnosis of a familial 4-breakpoint rea&#40;3&#59;5&#59;9&#41; in both balanced and unbalanced forms &#40;<a class="elsevierStyleCrossRefs" href="#fig1">Figures 1 and 2</a>&#41;&#46; The patient had a duplication for 3p24&#46;3&#8594;pter concomitant with a deletion for 5p15&#46;2&#8594;pter due to a 46&#44;XY&#44;der&#40;5&#41;der&#40;9&#41;rea&#40;3&#59;5&#59;9&#41;&#40;p24&#59;p13&#46;1p15&#46;2&#59;q22&#41;mat&#46;ish der&#40;5&#41;&#40;5psubtel&#8211;&#44;cri du chat&#8211;&#44;ABL&#43;&#41;der&#40;9&#41;&#40;3psubtel&#43;&#44;5psubtel&#8211;&#44;ABL&#8211;&#41; karyotype&#46; In contrast&#44; the mother&#8242;s balanced complement was 46&#44;XX&#44;rea&#40;3&#59;5&#59;9&#41;&#40;3qter&#8594;3p24&#46;3&#58;&#58;5p15&#46;2&#8594;5pter&#59;5qter&#8594;5p13&#46;1&#58;&#58;9q22&#8594;9qter&#59;9pter&#8594;9q22&#58;&#58;5p13&#46;1&#8594;5p15&#46;2&#58;&#58;3p24&#46;3&#8594;3pter&#41;&#46;ish der&#40;3&#41;&#40;3psubtel&#8211;&#44;5psubtel&#43;&#44;cri du chat&#43;&#41;der&#40;5&#41;&#40;5psubtel&#8211;&#44;cri du chat&#8211;&#44;ABL&#43;&#44;wcp9&#43;&#41;der&#40;9&#41;&#40;3psubtel&#43;&#44;cri du chat&#8211;&#44;ABL&#8211;&#44;wcp3&#43;&#41;&#46; The patient&#39;s maternal grandfather was also a balanced carrier&#44; and the patient&#39;s father had a normal 46&#44;XY karyotype&#46;</p><elsevierMultimedia ident="fig1"></elsevierMultimedia><elsevierMultimedia ident="fig2"></elsevierMultimedia><p id="para40" class="elsevierStylePara elsevierViewall">The non-specific phenotype of the patient&#44; including the lack of the cry and facies characteristic of the 5p deletion syndrome&#44; can more parsimoniously be ascribed to his compound imbalance &#40;<a class="elsevierStyleCrossRef" href="#bib1">1</a>&#41;&#46; The complex heart defect and death in infancy appear to be related to the 3p duplication &#40;<a class="elsevierStyleCrossRef" href="#bib2">2</a>&#41;&#46;</p><p id="para50" class="elsevierStylePara elsevierViewall">Because the 5p segment can be regarded as &#8220;inserted&#8221; into the der&#40;9&#41;&#44; our observation may support the contention that complex chromosome rearrangements &#40;CCR&#41; with at least one insertional translocation can be transmitted either paternally or maternally and are refractory to recombination &#40;<a class="elsevierStyleCrossRef" href="#bib3">3</a>&#41;&#46; The CCR of this patient &#8212; like other 3-chromosome rearrangements &#40;<a class="elsevierStyleCrossRef" href="#bib4">4</a>&#44;<a class="elsevierStyleCrossRef" href="#bib5">5</a>&#41; &#8212; is expected to lead to imbalances predominantly via improper segregation&#46;</p><p id="para60" class="elsevierStylePara elsevierViewall">Even if the unique nature of most CCRs requires the determination of the specific reproductive risks in each individual case &#40;<a class="elsevierStyleCrossRef" href="#bib4">4</a>&#44;<a class="elsevierStyleCrossRef" href="#bib5">5</a>&#41;&#44; in general these risks appear to be greater than the corresponding empirical risks associated with reciprocal translocations&#44; amounting to a &#8764;50&#37; risk of miscarriage and a &#8764;20&#37; risk of an unbalanced live infant &#40;<a class="elsevierStyleCrossRef" href="#bib6">6</a>&#41;&#46; In addition to the gamete that led to the double imbalance in our patient&#44; there are five other &#8220;adjacent-1&#8221; gametes that can be produced by carriers of the present CCR&#59; notably&#44; the counterpart der&#40;3&#41;&#47;5&#47;9 gamete would result in a viable del 3p&#47;dup 5p unbalanced child&#46; The theoretical &#8220;adjacent-2&#8221; &#40;12 different gametes&#41; and asymmetric 4&#58;2&#44; 5&#58;1&#44; or 6&#58;0 segregations &#40;44 gametes&#41; are unlikely to be compatible with postnatal survival &#40;except perhaps trisomy 9&#41;&#46;</p><p id="para70" class="elsevierStylePara elsevierViewall">The involvement of chromosomes 3&#44; 5&#44; and 9 in the present CCR is consistent with the disproportionate participation of these chromosomes among the &#8764;250 CCRs reported to date &#40;<a class="elsevierStyleCrossRef" href="#bib5">5</a>&#44;<a class="elsevierStyleCrossRef" href="#bib7">7</a>&#44;<a class="elsevierStyleCrossRef" href="#bib8">8</a>&#41;&#59; the involvement of these chromosomes is even more disproportionate if all &#8764;40 prenatally diagnosed instances are considered &#40;<a class="elsevierStyleCrossRef" href="#bib9">9</a>&#44;<a class="elsevierStyleCrossRef" href="#bib10">10</a>&#41;&#46; Yet&#44; this specific chromosomal combination has not apparently been described even though these three chromosomes were involved in a single more complex karyotype &#40;<a class="elsevierStyleCrossRef" href="#bib11">11</a>&#41;&#46;</p><p id="para80" class="elsevierStylePara elsevierViewall">Finally&#44; the fact that four de novo CCRs &#40;<a class="elsevierStyleCrossRefs" href="#bib12">12&#8211;15</a>&#41; and one de novo double balanced translocation &#40;<a class="elsevierStyleCrossRef" href="#bib16">16</a>&#41; have been documented in fetuses &#40;four female&#44; one male&#41; conceived after intracytoplasmic sperm injection should not be disregarded&#46;</p><span id="cesec10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle10">AUTHOR CONTRIBUTIONS</span><p id="para90" class="elsevierStylePara elsevierViewall">Rivera H designed the study and wrote the report&#46; Dom&#237;nguez MG performed the chromosomal analyses and critically reviewed the manuscript&#46; Both authors approved the final version of the manuscript&#46;</p></span></span>"
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                              D Lev \n
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                              G Malinger \n
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                            2 => """
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                              M Glazerman \n
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        "texto" => "<p id="para100" class="elsevierStylePara elsevierViewall">We thank Dr&#46; Jos&#233; E&#46; Garc&#237;a-Ortiz for his expert clinical assistance and the patient&#39;s parents for their valuable cooperation&#46;</p>"
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Article information
ISSN: 18075932
Original language: English
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es en pt

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