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A Case of Pseudoisodicentric Chromosome 18q Detected at Prenatal Diagnosis

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초록

Although trisomy 18 (Edwards’ syndrome) or the terminal deletion syndromes of 18p and 18q have been occasionally detected, pseudoisodicentric chromosome 18 is a very rare constitutional chromosomal abnormality. We describe a case of pseudoisodicentric chromosome 18q without mosaicism, which was confirmed from fetal cells in the amniotic fluid used for prenatal diagnosis of multiple congenital anomalies. A 23-yr-old pregnant woman was suspected of having a fetal anomaly at 18+3 weeks gestation. In sonography, the fetus showed multiple anomalies: bilateral overt ventriculomegaly in the brain, ventricular septal defect and valve anomaly in the heart, bilateral club foot, polydactyly, meningocele, and a single umbilical artery. The pregnancy was terminated and a conventional G-banded chromosome study was performed using amniotic fluid. Twenty metaphase cells among the cultured amniocytes showed a 46,XX,psu idic(18)(q22). Consequently, the fetus had partial trisomy (18pter q22) and partial monosomy (18q22 qter). Both parents were confirmed to have a normal karyotype. (Korean J Lab Med 2010;30:440-3)

Abstract

Although trisomy 18 (Edwards’ syndrome) or the terminal deletion syndromes of 18p and 18q have been occasionally detected, pseudoisodicentric chromosome 18 is a very rare constitutional chromosomal abnormality. We describe a case of pseudoisodicentric chromosome 18q without mosaicism, which was confirmed from fetal cells in the amniotic fluid used for prenatal diagnosis of multiple congenital anomalies. A 23-yr-old pregnant woman was suspected of having a fetal anomaly at 18+3 weeks gestation. In sonography, the fetus showed multiple anomalies: bilateral overt ventriculomegaly in the brain, ventricular septal defect and valve anomaly in the heart, bilateral club foot, polydactyly, meningocele, and a single umbilical artery. The pregnancy was terminated and a conventional G-banded chromosome study was performed using amniotic fluid. Twenty metaphase cells among the cultured amniocytes showed a 46,XX,psu idic(18)(q22). Consequently, the fetus had partial trisomy (18pter q22) and partial monosomy (18q22 qter). Both parents were confirmed to have a normal karyotype. (Korean J Lab Med 2010;30:440-3)

참고문헌 (13)

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  8. Meins M, "First non-mosaic case of isopseudodicentric chromosome 18 (psu idic(18)(pter → q22.1::q22.1 → pter) is associated with multiple congenital anomalies reminiscent of trisomy 18 and 18q- syndrome", Am J Med Genet A, 127A, pp.58~64 (2004)
  9. Brandt CA, "Pseudodicentric chromosome 18 diagnosed by chromosome painting and primed in situ labelling (PRINS)", J Med Genet, 31, pp.99~102 (1994)
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  11. Oudesluijs GG, "Mosaic isodicentric chromosome 18q: sixth report and review", Genet Couns, 17, pp.395~400 (2006)
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