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Published 4 June 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.05.2009.1914]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

Familial 4.3 Mb duplication of 21q22 sheds new light on the Down syndrome critical region

Anne Ronan1, Kerry Fagan2, Louise Christie1, Jeffrey Conroy3, Norma J Nowak3,4, Gillian Turner1

1 Hunter Genetics Unit, Waratah, New South Wales, Australia
2 Department of Cytogenetics, Hunter Area Pathology Service, New Lambton, New South Wales, Australia
3 Microarray and Genomics Facility, Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Buffalo, New York, USA
4 Center of Excellence in Bioinformatics and Life Sciences, University at Buffalo, Buffalo, New York, USA

Correspondence to:
Anne Ronan, aronan{at}bigpond.com

SUMMARY

A 4.3 Mb duplication of chromosome 21 bands q22.13–q22.2 was diagnosed by interphase fluorescent in situ hybridisation (FISH) in a 31 week gestational age baby with cystic hygroma and hydrops; the duplication was later found in the mother and in her 8-year-old daughter. All had the facial gestalt of Down syndrome (DS). This is the smallest accurately defined duplication of chromosome 21 reported with a DS phenotype. The duplication encompasses the gene DYRK1 but not DSCR1 or DSCAM. Previous karyotype analysis and telomere screening of the mother, and karyotype analysis and metaphase FISH of a chorionic villus sample, had all failed to reveal the duplication. The findings in this family add to the identification and delineation of a "critical region" for the DS phenotype on chromosome 21.


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