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Coexistent mosaic monosomy 21 and fragile X syndrome in a mentally retarded male patient.
[monosomy 21]
Fragile
X
syndrome
(
FXS
)
is
a
well-recognized
mental
retardation
syndrome
with
characteristic
facial
features
and
behavioural
phenotype
.
Monosomy
21
is
a
rare
cytogenetic
aberration
for
which
clinical
features
were
incompletely
defined
since
full
monosomy
21
is
incompatible
with
life
.
A
5
-
year
-old
male
patient
with
FXS
and
low
-grade
mosaicism
for
full
monosomy
21
(
46
,
XY
[
96
%
]
/
45
,
XY
,
-
21
[
4
%
]
)
is
presented
.
He
had
lack
of
speech
and
severely
impaired
social
skills
,
hyperactivity
,
stereotypical
hand
movements
,
a
special
interest
towards
moving
colourful
items
and
a
short
attention
span
for
other
objects
around
.
He
had
macrocephaly
,
a
rather
long
face
,
prominent
occiput
and
prominent
midface
,
retrognathia
,
down-slanting
palpebral
fissures
,
hypertelorism
and
cup-shaped
,
posteriorly
rotated
and
low-set
ears
.
Full
monosomy
in
the
aberrant
cell
line
was
proven
by
whole
chromosome
painting
.
FXS
was
previously
reported
to
accompany
sex
chromosome
aneuploidies
;
however
,
to
the
best
of
our
knowledge
,
the
present
patient
is
the
first
FXS
patient
with
an
aberration
involving
autosomes
.
He
contributes
to
the
current
knowledge
on
monosomy
21
phenotype
,
having
dysmorphic
facial
findings
despite
the
concurrent
phenotypic
expression
of
the
FXS
.
As
a
last
conclusion
,
cytogenetic
analysis
must
be
done
to
all
mentally
retarded
patients
with
minor
dysmorphic
features
.
Diseases
Validation
Diseases presenting
"short attention span"
symptom
monosomy 21
This symptom has already been validated