Представлен клинический случай синдрома Шерешевского-Тернера (СШТ) у матери и двух её дочерей. При стандартном цитогенетическом исследовании c использованием GTG-окрашивания у всех пациенток выявлен мозаичный кариотип с двумя клеточными линиями, один клон с Х моносомией (45,Х), другой - с наличием кольцевой Х-хромосомы 46,Х,r(Х)(p22.3q28). Методом флуоресцентной in situ гибридизации установлено, что в лимфоцитах периферической крови и в клетках буккального эпителия у всех пациенток присутствует мозаицизм Х/Х,r(Х). Количество клеток, содержащих кольцевую хромосому Х, в лимфоцитах пациенток сходно (8-11%), а в буккальном эпителии вариабельно (26-47%). Анализ инактивации Х-хромосомы (XCI), выполненный матери и ее старшей дочери, позволил установить, что кольцевая хромосома Х преимущественно инактивирована. Все три пациентки имеют схожий фенотип с характерными для СШТ признаками. Однако репродуктивная функция, по крайней мере, у матери и ее старшей дочери сохранена. Обсуждаются тканевая вариабельность гоносомного мозаицизма и семейные случаи СШТ с кольцевой хромосомой Х из литературы. The article presents a clinical case of Turner syndrome (TS) in a mother and her two daughters. Standard cytogenetic examination using by GTG-staining technique found mosaic karyotype with two cell lines, one clone with monosomy X (45,X) and other one with ring X-chromosome - 46,X,r(X)(p22.3q28). Fluorescent in situ hybridization revealed gonosomal mosaicism mos X/X,r(X) in peripheral blood lymphocytes and buccal epithelial cells in all patients. There number of cells containing ring X chromosome were similar in lymphocytes (8-11%), and were more varied in buccal epithelium (26-47%) between patients. Analysis of X chromosome inactivation (XCI), performed in the mother and her eldest daughter, revealed skewed inactivation of ring X chromosome. The patients had a similar phenotype signs characterized to Turner syndrome, but fertility was preserved at least in the mother and her eldest daughter. Reported in the literature familial TS cases with ring X chromosome are reviewed.
Background. 46,XX male syndrome (XX sex reversal) or 46,ХХ testicular disorder of sex development (DSD) – a genetic disorder that characterized by primary hypogonadism and male infertility because of severe spermatogenesis defects. 46,XX testicular DSD is resulted from unbalanced microstructural sex chromosome abnormalities, mostly X-Y translocations involving SRY gene. Genetic heterogeneity and phenotypic variability, particularly the effect of the genotype on semen parameters in XX sex reversed patients are not sufficiently studied.Aim. Genetic and semen examination in patients with 46,ХХ testicular DSD.Materials and methods. 32 patients with 46,XX testicular DSD and 2 men with mosaicism 46,XX/46,XY were examined. Cytogenetics, molecular genetics and spermatology examination (standard semen analysis and quantitative karyological analysis of immature germ cells) were performed.Results. The presence of the SRY gene was detected in 23 (82.1 %) of 28 patients who underwent a molecular genetic study, and 5 patientswere SRY-negative. Azoospermia and severe oligozoospermiawere diagnosed in 24 (75 %) and 8 (25 %) patients, respectively. Quantitative karyological analysis of immature germ cells allowed to reveal cryptozoospermia in 3 patients with initially diagnosed azoospermia (according to a standard semen analysis). Severe oligozoospermia and cryptozoospermia were mentioned both in some of SRY-positive and SRY-negative patients.Conclusion. 46,XX testicular DSD is characterized by severe degree of spermatogenesis defects (azoospermia and extremely severe oligozoospermia). Small number of germ cells detected in ejaculate in some patients with 46,XX testicular DSD, including SRY-negative individuals, indicates partial preservation ofspermatogenesisin the absence of Y chromosome genes.
The 5p inverted duplication deletion syndrome, also known as inv dup del 5p, is a rare genetic disorder with a prevalence of below 1:1 000 000, whose underlying abnormality lies in a segmental trisomy and simultaneous segmental monosomy of the short arm of chromosome 5. The syndrome was first described by A. Kleczkowska et al. in 1987. According to the literature, large duplications of the chromosome 5 short arm are associated with pronounced phenotypic manifestations, delayed speech and mental development, as well as congenital cardiac, brain and musculoskeletal malformations. We present a description of a clinical case of extended inverted duplication with deletion of the chromosome 5 short arm in a girl with a mild phenotype and no visceral or musculoskeletal abnormalities; we also discuss the pathogenetic mechanisms of chromosomal rearrangement, and conduct a comparative analysis of phenotypic manifestations based on the available literature. Comprehensive molecular cytogenetic assessments have demonstrated that the duplicated site has a length of 29 Mb (5p13.3p15.33), and the deleted site of the subtelomeric region distal to 5p15.33 has a length of 110 kb.
Представлен случай сочетанной хромосомной патологии - частичной трисомии по субтеломерному участку длинного плеча хромосомы 5 и по протяжённому участку хромосомы 9 у новорождённого ребёнка с множественными врождёнными пороками развития и кариотипом 47,XY,t(5;9)(q35;q31),+der(9)t(5;9)(q35;q31)pat. Причиной хромосомного дисбаланса явилось редкое нарушение формирования гамет в мейозе II отца, являющегося носителем аутосомной реципрокной транслокации t(5;9)(q35;q31). Здоровые носители идентичной транслокации t(5;9)(q35;q31) были выявлены в трёх поколениях этой семьи. В статье описаны клинические проявления у пациента, обсуждаются возможные пути формирования такой хромосомной перестройки, а также проводится сравнительная характеристика фенотипических признаков на основе данных литературы. We report on a case of combined chromosomal pathology - partial trisomy on the terminal part of the long arm of chromosome 5 and partial trisomy on chromosome 9 in a newborn with multiple congenital malformations and karyotype 47,XY,t(5;9)(q35;q31),+der(9)t(5;9)(q35;q31)pat. The cause of the chromosomal pathology was a rare abnormality of the formation of gametes in the father’s meiosis II. He is the carrier of the autosomal reciprocal translocation t(5;9)(q35;q31). Healthy carriers of the identical t(5;9)(q35;q31) translocation were identified in three generations of this family. The clinical manifestations of the patient, the possible ways of forming the rearrangement of chromosomes, and the comparison of phenotypes based on the literature data are discussed.
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