Mental retardation and Ullrich-Turner syndrome in cases with 45,X/46,X, +mar: Additional support for the loss of the X-inactivation center hypothesis
- Virginia Commonwealth Univ., Richmond, VA (United States)
- Children`s Mercy Hospital, Kansas City, MO (United States)
- Hialeah Hospital, FL (United States)
- Univ. of Tennessee, Chattanooga, TN (United States)
Four cases having mosaicism for a small marker or ring [45,X/46,X,+mar or 45,X/46,X,+r] chromosome were ascertained following cytogenetic studies requested because of minor anomalies (cases 1, 3, and 4) and/or short stature (cases 2 and 4). While all 4 cases had traits typical of Ullrich-Turner syndrome (UTS), cases 1, 3, and 4 had manifestations not usually present in UTS, including unusual facial appearance, mental retardation/developmental delay (MR/DD) (cases 3 and 4), and syndactylies (case 1). Using fluorescence in situ hybridization (FISH), each of the markers in these 4 cases was identified as having been derived from an X chromosome. Replication studies demonstrated a probable early replication pattern for the mar/r(X) in cases 1, 3, and 4, while the marker in case 2 was apparently late replicating. To date, 41 individuals having mosaicism for a small mar/r(X) chromosome have been described. Interestingly, most of the 14 individuals having a presumedly active mar/r(X) demonstrated clinical findings atypical of UTS, including abnormal facial changes (11) and MR/DD (13). MR was noted most frequently in those cases having at least 50% mosaicism for the marker or ring. In contrast, atypical UTS facial appearance or MR/DD was not noted in 14 of the 16 cases with UTS who carried a probable late replicating marker or ring. In conclusion, although the phenotype of 45,S/46,X, mar/r(X) individuals appears to be influenced by the genetic content and degree of mosaicism for the mar/r(X), the most significant factor associated with MR/DD appears to be the activity status of the mar/r(X) chromosome. Thus, our 4 cases provide further support for the hypothesis that a lack of inactivation of a small mar/r(X) chromosome may be a factor leading to the MR and other phenotypic abnormalities seen in this subset of individuals having atypical UTS. 46 refs., 6 figs., 3 tabs.
- Sponsoring Organization:
- USDOE
- OSTI ID:
- 62007
- Journal Information:
- American Journal of Medical Genetics, Vol. 52, Issue 2; Other Information: PBD: 15 Aug 1994
- Country of Publication:
- United States
- Language:
- English
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