Mosaic trisomy 18 in a five-month-old infant

Ana Laura Fitas1, Mafalda Paiva, Ana Isabel Cordeiro

  • 1Área de Pediatria Médica, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisboa, Portugal.

Insights

Mosaic trisomy 18, a rare condition, presents varied symptoms. This case highlights a unique combination of dysmorphic features and a complex cardiac defect, expanding the known clinical spectrum.

Area of Science:

  • Genetics
  • Pediatrics
  • Clinical Medicine

Background:

  • Mosaic trisomy 18 is a chromosomal abnormality where individuals possess both trisomy 18 and normal cell lines.
  • Clinical manifestations are highly variable, ranging from mild to severe.
  • This condition accounts for approximately 5% of all trisomy 18 cases.

Purpose of the Study:

  • To describe a unique case of mosaic trisomy 18 in a five-month-old infant.
  • To document previously undescribed dysmorphic features and cardiac abnormalities associated with this condition.
  • To contribute to the understanding of the phenotypic spectrum and natural history of mosaic trisomy 18.

Main Methods:

  • Clinical examination of a five-month-old infant presenting with vomiting and feeding difficulties.
  • Detailed assessment of dysmorphic features, developmental delay, and hypotonia.
  • Cytogenetic analysis of peripheral lymphocytes and skin fibroblasts to determine trisomy 18 levels.

Main Results:

  • The infant presented with undernourishment, axial hypotonia, developmental delay, hypopigmentation, and craniofacial dysmorphies.
  • A complex cardiac defect including atrial and ventricular septal defects, pulmonary artery stenosis, and a bicuspid aortic valve was identified.
  • Cytogenetic analysis confirmed mosaic trisomy 18 with 90% trisomy in lymphocytes and 17% in fibroblasts.

Conclusions:

  • This case expands the known phenotypic spectrum of mosaic trisomy 18.
  • The described dysmorphic feature and cardiac abnormality represent novel findings for this condition.
  • Further research is needed to fully elucidate the natural history and clinical variability of mosaic trisomy 18.

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