Abstract

Kagami–Ogata syndrome (KOS) is a rare imprinting disorder characterized by skeletal abnormalities, dysmorphic facial features, growth retardation and developmental delay. The genetic etiology of KOS includes paternal uniparental disomy 14 [upd(14)pat], epimutations and microdeletions affecting the maternally derived imprinted region of chromosome 14q32.2. More than seventy KOS cases have been reported thus far; however, only 10, including two familial, are associated with upd(14)pat harboring Robertsonian translocation (ROB). Here, we reported a male infant with clinical manifestations of facial dysmorphism, bell-shaped small thorax, and omphalocele. Karyotype analyses identify a balanced ROB involving the long arms of chromosomes 13 and 14 both in the patient and his father. We further confirm the pattern of upd(14)pat utilizing DNA polymorphic markers. In conclusion, our case report provides a new male KOS case caused by upd(14)pat with paternally inherited Robertsonian translocation, which represents the second male case officially reported. Notably, a KOS case due to upd(14)pat and ROB is rare. An accurate diagnosis requires not only the identification of the characteristic clinical features but also systemic cytogenetic and molecular studies.

Highlights

  • Genomic imprinting is an epigenetic phenomenon that restricts the expression of genes in an imprinted region to a single parental allele (1)

  • Among all the published Kagami–Ogata syndrome (KOS) cases, more than 60% were caused by upd(14)pat, nearly 25% due to by microdeletions of chromosome 14q32 imprinted region, about 10% derived from epimutations (6, 11)

  • Intergenic differentially methylated region (IG-DMR) between DLK1 and MEG3 as well as the post fertilization-derived secondary MEG3-DMR are of great importance for controlling imprinting (12, 13)

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Summary

INTRODUCTION

Genomic imprinting is an epigenetic phenomenon that restricts the expression of genes in an imprinted region to a single parental allele (1). Parental karyotype was performed on seven patients, and the results showed that five were de novo, and the other two were inherited from the father We presented another male patient with characteristic KOS features caused by upd(14)pat and balanced ROB inherited from the father. This male infant was born at 36 weeks and 6 days of gestation by a cesarean section due to prenatal findings of congenital anomalies and polyhydramnios. The infant was discharged home on low-flow nasal cannula with supplemental oxygen, monitor and suction equipment on day 36 of life Due to his multiple congenital anomalies, routine chromosome analysis was performed on peripheral blood and the results revealed an abnormal male karyotype with a balanced ROB:45,XY,der(13;14)(q10;q10) (Figure 2A). He is 20-month-old and seems to be reassuring so far

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