Flashcards in 18.03.44 Chromosome 21 Deck (14):
What is the incidence of Down syndrome?
The chromosome abnormality with the highest incidence at birth is trisomy 21 - 1 in 750 births
What are the possible genetic origins of Down syndrome.
Reciprocal translocation (0.1%)
What is the most common nondisjunction event that can lead to Down syndrome?
Nondisjunction at maternal meiosis 1 accounts for ~70% of NDJ events leading to trisomy 21
20% at meiosis II
5% paternal MI and MII
What is the recurrence risk for T21 that has resulted from a non-disjunction event?
What proprotion of T21 Robertsonian cases arise de novo? What is the most common form?
82% are isochromosome i(21;21)
What are the recurrence risks for T21 associated with inhertied heterologous Robertsonian translocations?
10-15% if maternal
<1% if paternal
What is the recurrence risk associated with the inherited homologous Robertsonian translocation t(21;21)
What proportion of trisomy 21 cases are mosaic?
2%, usually as a result of anaphase lag in trisomic conceptus or nondisjunction in a normal conceptus
What are the characteristic features of Down syndrome?
Frequent single known cause of intellectual disability IQ 25-70. Phenotype is variable
Characteristic facial features: brachycephaly/microcephaly, epicanthic folds, flattened nose, low set ears, protruding tongue
Broad short hands with single palmar crease
infertility in males
cardiac abnormalities (50%) (ASD, 40%, VSD 30%)
Transient leukaemia (10%) at birth
Eye disease (60%)
Hearing loss (70%)
Where on chromosome 21 is the DSCR located?
however suggestive there are multiple susceptibility loci rather than one particular critical region
DYRKA1 gene is thought to play a crucial role in brain development and a strong candidate for LD
ADAMTS1 - candidate for normal growth, fertility, organ morphology and function.
What are the features of monosomy 21?
<9 cases reported
Few survive to term. Die soon after delivery. Cryptic mosaicism in these case can't be excluded.
Only reported autosomy monosomy reported in early miscarriages and perinatally.
Features highly variable, may include: IUGR, severe multiple malformations, complex cardiac abnormalities, skeletal abnormalities, microcephaly, hypotonia eye anomalies.
Describe the types of phenotypes associated with the ring 21 karyotypes: 47,XN,+r(20), 46,XN,r(21), mosaic ring(20)
+r(21) partial trisomy and DS features expected
r(21) replacing a normal chr 21 leads to partial monosomy with a variable phenotype; developmental delay with congenital malformations to normal (particularly those that are inherited). Can lead to infertility or subfertility.
Mosaic: ring can be lost of forms double rings. may lead to 'ring-syndrome'.
Compensatoy isodisomy of ring 21 or 21qdel has been observed.
Describe the features of DYRK1A-related syndrome.
DYRK1A (21q22.13) disruption is associated with distinct syndrome including developmental delay, ID< microcephaly, speech delay, feeding difficulties. Deletions can be larger and include adjacent genes.
Should be considered as a differential diagnosis to Angelman syndrome.