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Monosomy 21 seen in live born is unlikely to represent true monosomy 21: a case report and review of the literature.
[monosomy 21]
We
report
a
case
of
a
neonate
who
was
shown
with
routine
chromosome
analysis
on
peripheral
blood
lymphocytes
to
have
full
monosomy
21
.
Further
investigation
on
fibroblast
cells
using
conventional
chromosome
and
FISH
analysis
revealed
two
additional
mosaic
cell
lines
;
one
is
containing
a
ring
chromosome
21
and
the
other
a
double
ring
chromosome
21
.
In
addition
,
chromosome
microarray
analysis
(
CMA
)
on
fibroblasts
showed
a
mosaic
duplication
of
chromosome
region
21
q
11
.
2
q
22
.
13
with
approximately
45
%
of
cells
showing
three
copies
of
the
proximal
long
arm
segment
,
consistent
with
the
presence
of
a
mosaic
ring
chromosome
21
with
ring
instability
.
The
CMA
also
showed
complete
monosomy
for
an
8
.
8
 
Mb
terminal
segment
(
21
q
22
.
13
q
22
.
3
)
.
Whilst
this
patient
had
a
provisional
clinical
diagnosis
of
trisomy
21
,
the
patient
also
had
phenotypic
features
consistent
with
monosomy
21
,
such
as
prominent
epicanthic
folds
,
broad
nasal
bridge
,
anteverted
nares
,
simple
ears
,
and
bilateral
overlapping
fifth
fingers
,
features
which
can
also
be
present
in
individuals
with
Down
syndrome
.
The
patient
died
at
4
.
5
months
of
age
.
This
case
highlights
the
need
for
additional
studies
using
multiple
tissue
types
and
molecular
testing
methodologies
in
patients
provisionally
diagnosed
with
monosomy
21
,
in
particular
if
detected
in
the
neonatal
period
.
Diseases
Validation
Diseases presenting
"neonatal period"
symptom
alexander disease
alpha-thalassemia
benign recurrent intrahepatic cholestasis
congenital adrenal hyperplasia
congenital diaphragmatic hernia
congenital toxoplasmosis
cutaneous mastocytosis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
harlequin ichthyosis
hirschsprung disease
homocystinuria without methylmalonic aciduria
junctional epidermolysis bullosa
kabuki syndrome
kallmann syndrome
kindler syndrome
lamellar ichthyosis
megacystis-microcolon-intestinal hypoperistalsis syndrome
monosomy 21
neonatal adrenoleukodystrophy
neuralgic amyotrophy
pyruvate dehydrogenase deficiency
zellweger syndrome
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