La duplicación de la región 5q34q35.3 se ha asociado a un fenotipo inverso de síndrome de Sotos, por contener el gen NSD1 en doble dosis. Se presenta a una paciente con retraso global del desarrollo, peso y talla bajos y dismorfias. Cuenta con antecedente de corrección quirúrgica por defectos de septación auriculoventricular (CIA y CIV), así como remodelación por antecedente de cráneo en trébol. El cariotipo con bandas G mostró un resultado 46,XX,add(5)(q35), y para confirmar el origen del material adicional se utilizó sonda de FISH WCP para el cromosoma 5 [46,XX,add(5)(q35).ish dup(5)(q35)(wcp5+)]. Para definir puntos de ruptura y realizar correlación genotipo fenotipo se realizó microarreglo CytoScan HD de Affymetrix, que confirmó la duplicación intersticial de novo de 14Mb 46,XX,add(5)(q35). arr[hg19] 5q34q35.3(163,110,984-177,227,216x3,177,259,401- 179,330,764x3,179,346,465 180,719,789x3)dn, que contiene 80 genes (USCS genome browser, NCBI36/hg19). La descripción de este caso es importante para complementar la delineación del fenotipo, mediante la correlación con la región de la duplicación a nivel de nucleótidos. Cabe resaltar que la paciente demuestra la importancia y la utilidad de las nuevas técnicas de citogenética molecular, con las cuales es posible el análisis detallado de los genes localizados en la región 5q involucrada, así como su correlación con las manifestaciones clínicas.
BackgroundThe 15q11q13 region is subject to imprinting and is involved in various structural rearrangements. Less than 1% of Angelman Syndrome patients are due to translocations involving 15q11q13. These translocations can arise de novo or result from the segregation of chromosomes involved in a familial balanced translocation.ResultsA 5-year-old Mexican girl presented with developmental delay, minor dysmorphic features and history of exotropia. G-banding chromosome analysis established the diagnosis of Angelman Syndrome resulting from a familial translocation t(10;15) involving the 15q11.2 region. The available family members were studied using banding and molecular cytogenetic techniques, including Microarray-based Comparative Genomic Hybridization, which revealed additional unexpected results: a coincidental and smaller 15q deletion, asymptomatic duplications in 15q11.2 and Xp22.31 regions.ConclusionsThis report demonstrates the usefulness of array CGH for a detailed characterization of familial translocations, including the detection of submicroscopic copy number variations, which would otherwise be missed by karyotype analysis alone. Our report also expands two molecularly characterized rare patient cohorts: Angelman Syndrome patients due to familial translocations and patients with 15q11.2 duplications of paternal origin.
Anticancer regimens for Hodgkin lymphoma (HL) patients include highly genotoxic drugs that have been very successful in killing tumor cells and providing a 90% disease-free survival at five years. However, these treatments do not have a specific cell target, damaging both cancerous and normal cells. Thus, HL survivors have a high risk of developing new primary cancers, both hematologic and solid tumors, that have been related to treatment. Several studies have shown that after-treatment, HL patients and survivors present persistent chromosomal instability, including non-clonal chromosomal aberrations. The frequency and type of chromosomal abnormalities appear to depend on the type of therapy and the cell type examined. For example, MOPP chemotherapy affects hematopoietic and germ stem cells leading to long-term genotoxic effects and azoospermia, while ABVD chemotherapy affects transiently sperm cells, with most of the patients showing recovery of spermatogenesis. Both regimens have long-term effects in somatic cells, presenting non-clonal chromosomal aberrations and genomic chaos in a fraction of non-cancerous cells. This is a source of karyotypic heterogeneity that could eventually generate a more stable population acquiring clonal chromosomal aberrations and leading towards the development of a new cancer.
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