A girl with pervasive developmental disorder and complex chromosome rearrangement involving 8p and 10p
L Zwaigenbaum1, L K Sonnenberg, T Heshka
1Pediatrics, Hamilton Health Sciences and McMaster University, Hamilton, Ont., Canada.
Insights
A rare complex chromosome rearrangement in a 4-year-old girl with pervasive developmental disorder (PDD) highlights potential genetic links. Aberrations in chromosomes 8p and 10p may contribute to developmental delays and distinctive facial features.
Area of Science:
- Genetics
- Developmental Biology
- Clinical Medicine
Background:
- Complex chromosome rearrangements (CCRs) are rare structural variations that can lead to diverse clinical phenotypes.
- Pervasive developmental disorder (PDD) is a group of neurodevelopmental disorders characterized by difficulties in social interaction, communication, and behavior.
- Velopharyngeal insufficiency (VPI) is a condition affecting speech, often associated with hypernasality.
Observation:
- A 4-year-old girl presented with VPI, distinctive facial features (long face, broad nasal bridge, protuberant ears), bifid uvula, strabismus, and joint laxity.
- She exhibited developmental delay, with language and cognitive skills significantly below average, meeting criteria for PDD.
- Her karyotype revealed a de novo, apparently balanced CCR involving chromosomes 8 and 10: 46,XX, der(8)(10pter- >10pl2.32::8p12- >8qter), der(l0)(8pter- >8p21.3::10p12.32- >10p11.23::8p21.3- > 8p12::10p11.23- >l0qter).
- Fluorescence in situ hybridization (FISH) analysis excluded microdeletions at 22q11.2 and 10p13p14.
Findings:
- The CCR involved translocations and insertions between chromosome segments 8p12, 8p21.3, 10p11.23, and 10p12.32.
- The patient displayed autistic behaviors, including poor eye contact, atypical communication, repetitive behaviors, and sensory processing difficulties.
- The findings suggest a potential correlation between specific chromosomal aberrations at 8p12, 8p21.3, 10p11.23, and/or 10p12.32 and the development of PDD with associated cognitive and facial anomalies.
Implications:
- This case underscores the importance of detailed cytogenetic analysis in diagnosing complex developmental disorders.
- Identifying specific chromosomal regions involved in CCRs can improve our understanding of genotype-phenotype correlations in neurodevelopmental disorders.
- Further research into these chromosomal regions may reveal novel genetic factors contributing to PDD and associated dysmorphic features.
Abstract:
We report a 4-year-old girl with a de novo, apparently balanced complex chromosome rearrangement. She initially presented for assessment of velopharyngeal insufficiency due to hypernasal speech. She has distinctive facial features (long face, broad nasal bridge, and protuberant ears with simplified helices), bifid uvula, strabismus, and joint laxity. She is developmentally delayed, with language and cognitive skills approximately 2 SD below the mean expected for her age, and meets ADI, ADOS, and DSM-IV criteria for pervasive developmental disorder. She has poor eye contact, atypical communication and social interaction, repetitive behaviours and significant difficulties with processing sensory input. Her karyotype is characterized by the presence of two derivative chromosomes; 46,XX, der(8)(10pter- >10pl2.32::8p12- >8qter), der(l0)(8pter- >8p21.3::10p12.32- >10p11.23::8p21.3- > 8p12::10p11.23- >l0qter). The der(8) is a result of translocation of the segment 10p12.32-pter onto 8p12. The der(l0) has two 8p segments collectively from 8p12-pter in that the segment 8p21.3-pter is translocated onto 10p12.32 and the segment 8p12-p21.3 is inserted at 10p11.23. FISH analysis showed no microdeletion of the major locus at 22q11.2 nor for the minor locus at 10p13p14. This case suggests that aberrations at 8p12, 8p21.3, 10p11.23 and/or 10p12.32 may result in pervasive developmental disorder, associated with mild cognitive delay and specific facial anomalies.
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