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Updated: May 10, 2026

FISH for Pre-implantation Genetic Diagnosis
Published on: February 23, 2011
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.
Abstract:
Individuals with mosaic trisomy 18, only approximately 5% of all trisomy 18 cases, carry both a trisomy 18 and an euploid cell line. Their clinical findings are highly variable, from the absence of dysmorphic features to the complete trisomy 18 syndrome. A five-month-old daughter of a 38-year-old mother, with vomiting and feeding problems, was referred to our department. She was undernourished and had axial hypotony and developmental delay, an irregular pattern of hypopigmentation on the right side of the abdomen, and moderate sagittal body asymmetry with left-side muscular hemihypotrophy. Mild craniofacial dysmorphy included dolichocephaly, frontal bossing, prominent occiput, long downslanting palpebral fissures, hypertelorism, and retrognathia. A complex heart defect with atrial and ventricular septal defects, pulmonary artery stenosis, and bicuspid aortic valve was identified. Cytogenetic analysis revealed mosaic trisomy 18 with trisomy in 90% of peripheral lymphocytes and 17% of skin fibroblasts. This case adds to our knowledge of the phenotypic spectrum and the natural history of mosaic trisomy 18 by adding a dysmorphic feature and a cardiac abnormality that, to the best of our knowledge, had not been previously described.
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