Cytogenetic and molecular analysis of dynamic mutation associated with fragile X syndrome

Fragile X syndrome is the most common familial form of mental retardation and known to be associated with the fragile site at Xq27.3 (FRAXA). The syndrome has recently been characterized by a unique genetic mechanism which involves dynamic mutation due to a heritable unstable DNA sequence, p(CCG)n repeat, in the FRAXA locus. We were asked to make a genetic diagnosis on the case of a normal male who has two brothers and a maternal uncle with mental retardation. We performed the pedigree analysis of the fragile X syndrome using both cytogenetic and molecular techniques. The affected two brothers and the uncle showed cytogenetic expression of the fra (X)(q27.3) and carried hypermethylated full mutation in the FRAXA locus. The phenotypically normal mother also exhibited fragile X expression and was found to be a carrier of premutation. Via female transmission, the premutation converted to full mutation and exhibited somatic heterogeneity and hypermethylation. However, both cytogenetic and molecular data did not show any evidence of fragile X mutation in the normal male client and, thus, excluded the possibility of his being a carrier.