Clinicopathological features of 45,X/46,Xidic(Y) mosaicism and therapeutic implications

case report

Authors

  • Henrique Soares Hospital de São João, Faculdade de Medicina da Universidade do Porto
  • Ana Maia Hospital de São João, Faculdade de Medicina da Universidade do Porto
  • Miguel Campos Hospital de São João, Faculdade de Medicina da Universidade do Porto
  • Sofia Dória Hospital de São João, Faculdade de Medicina da Universidade do Porto
  • José Manuel Lopes Hospital de São João, Faculdade de Medicina da Universidade do Porto
  • Manuel Fontoura Hospital de São João, Faculdade de Medicina da Universidade do Porto

Keywords:

Mosaicism, In situ hybridization, fluorescence, Gonadoblastoma, Turner syndrome, Nevus

Abstract

CONTEXT: 45,X/46,Xidic(Y) mosaicism demands careful and thorough study because of both its variable clinical features and its potential complications. CASE REPORT: The present case relates to a three-year-old girl with the mosaic karyotype 46,X,idic(Y)(q11.2)[23]/45,X[6]. She had no signs of virilization or Turner’s syndrome phenotype, but she was referred to our hospital because she presented reduced growth rate, abnormal facies and a melanotic nevus. After examination, she underwent prophylactic gonadectomy because of the risk of gonadoblastoma. Cytogenetic analysis on the streak gonads and blood showed signifi cant differences in the 45,X cell line between these two tissues. The presence of the sex-determining region Y (SRY) gene did not determine male differentiation, which meant in the present case that the predominance of the X cell line in the gonadal tissue was probably due to the determining factor for female sexual differentiation.

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Author Biographies

Henrique Soares, Hospital de São João, Faculdade de Medicina da Universidade do Porto

MD. Resident in Pediatrics, Department of Pediatrics, Hospital de São João, Porto, Portugal.

Ana Maia, Hospital de São João, Faculdade de Medicina da Universidade do Porto

MD. Consultant Pediatrician, General Pediatrics Unit, Department of Pediatrics, Hospital de São João, Porto, Portugal.

Miguel Campos, Hospital de São João, Faculdade de Medicina da Universidade do Porto

MD. Consultant Pediatric Surgeon, Department of Pediatric Surgery, Hospital de São João, Porto, Portugal.

Sofia Dória, Hospital de São João, Faculdade de Medicina da Universidade do Porto

MSc. Assistant professor of Genetics, Department of Genetics, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.

José Manuel Lopes, Hospital de São João, Faculdade de Medicina da Universidade do Porto

MD, PhD. Associate professor of Pathology and Chief Pathologist, Department of Pathology, Hospital de São João, Faculdade de Medicina da Universidade do Porto; and Instituto de Patologia e Imunologia da Universidade do Porto (IPATIMUP), Porto, Portugal.

Manuel Fontoura, Hospital de São João, Faculdade de Medicina da Universidade do Porto

MD, PhD. Associate professor of Pediatrics and Chief Pediatrician, Pediatric Endocrinology Unit, Department of Pediatrics, Hospital de São João, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.

References

Kelly TE, Franko JB, Rogol A, Golden WL. Discor- dant phenotypes and 45,X/46,X,idic(Y). J Med Genet. 1998;35(10):862-4.

Willis MJ, Bird LM, Dell’aquilla M, Jones MC. Natural his- tory of prenatally diagnosed 46,X,isodicentric Y. Prenat Diagn. 2006;26(2):134-7.

DesGroseilliers M, Beaulieu Bergeron M, Brochu P, Lemyre E, Lemieux N. Phenotypic variability in isodicentric Y patients: study of nine cases. Clin Genet. 2006;70(2):145-50.

Bouayed Abdelmoula N, Amouri A. Les chromosomes Y dicen- triques. [Dicentric Y chromosomes. First part: cytogenetic and molecular aspects]. Ann Biol Clin (Paris). 2005;63(3):263-78.

Abulhasan SJ, Tayel SM, al-Awadi SA. Mosaic Turner syndrome: cytogenetics versus FISH. Ann Hum Genet. 1999;63(Pt 3): 199-206.

Bağci G, Acar H, Tomruk H. Different chromosome Y ab- normalities in Turner syndrome. Genet Couns. 2001;12(3):255-61.

Queipo G, Nieto K, Grether P, et al. Unusual mixed gonadal dysgenesis associated with Müllerian duct persistence, polygo- nadia, and a 45,X/46,X,idic(Y)(p) karyotype. Am J Med Genet A. 2005;136(4):386-9.

Sugarman ID, Crolla JA, Malone PS. Mixed gonadal dysgenesis and cell line differentiation. Case presentation and literature review. Clin Genet. 1994;46(4):313-5.

Telvi L, Lebbar A, Del Pino O, Barbet JP, Chaussain JL. 45,X/46,XY mosaicism: report of 27 cases. Pediatrics. 1999;104(2 Pt 1):304-8

Guedes AD, Bianco B, Lipay MV, et al. Determination of the sexual phenotype in a child with 45,X/46,X,Idic(Yp) mosaicism: importance of the relative proportion of the 45,X line in gonadal tissue. Am J Med Genet A. 2006; 140A(17):1871-5.

Bianco B, Lipay MV, Melaragno MI, Guedes AD, Verreschi IT. Detection of hidden Y mosaicism in Turner’s syndrome: importance in the prevention of gonadoblastoma. J Pediatr Endocrinol Metab. 2006;19(9):1113-7.

Ferrão L, Lopes ML, Limbert C, et al. Pesquisa de sequências do cromossoma Y em indivíduos com síndroma de Turner. [Screening for Y chromosome sequences in patients with Turner syndrome]. Acta Med Port. 2002;15(2):89-100.

Bergendi E, Plöchl E, Vlasak I, Rittinger O, Muss W. A Turner-like phenotype in a girl with an isodicentric fluorescent Y chromosome mosaicism. Klin Padiatr. 1997;209(3):133-6.

Brant WO, Rajimwale A, Lovell MA, et al. Gonadoblastoma and Turner syndrome. J Urol. 2006;175(5):1858-60.

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Published

2008-09-09

How to Cite

1.
Soares H, Maia A, Campos M, Dória S, Lopes JM, Fontoura M. Clinicopathological features of 45,X/46,Xidic(Y) mosaicism and therapeutic implications: case report. Sao Paulo Med J [Internet]. 2008 Sep. 9 [cited 2025 Mar. 9];126(5):297-9. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/2002

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Section

Case Report