Year 2025,
Volume: 11 Issue: 1, 86 - 95, 29.06.2025
Diclehan Oral
,
Gülbahar Güzel Erdal
,
İlyas Yücel
,
Mahmut Balkan
,
Füsun Düzcan
References
-
Losa, A., Da Silva Cardoso, J., Leite, S., Barros, A.C., Guedes, A., Rodrigues, C., Borges, T., Oliva-Teles, N., Soares, A.R., Mota, C., “Ambiguous genitalia: an unexpected diagnosis in a newborn”, Cureus,15(10),2023. Doi: 10.7759/cureus.46328.
-
Ferdinands, D.S., De Silva, S., Hewage, A.S., Atapattu N., “Variants in SRY and NR5A1 Genes in Sri Lankan children with 46, XY disorders of sex development: insights into mutation spectrum and diagnostic potential”, Egyptian Journal of Medical Human Genetics, 26(90),2025. Doi: 10.1186/s43042-025-00725-4.
-
Lee, P.A., Nordenström, A., Houk, C.P., Ahmed, S.F., Auchus, R., Baratz, A., Dalke, K., Liao, L.M., Lin-Su, K., Looijenga, L.H. 3rd, Mazur, T., Meyer-Bahlburg, H.F., Mouriquand, P., Quigley, C.A., Sandberg, D.E., Vilain, E., Witchel, S., Global DSD Update Consortium. “Global disorders of sex development update since 2006: perceptions, approach and care”, Hormone Research in Pediatrics, 85(3),158-80,2016. Doi: 10.1159/000442975.
-
Cools, M., Birgit Köhler., "Disorders of sex development", in: Brook's Clinical Pediatric Endocrinology (Ed. M. T. Dattani and C. G. D. Brook), NJ, John Wiley & Sons, 2019, ch 4., pp. 105-131, 2019. https://doi.org/10.1002/9781119152712.ch4
-
Bozkaya, Ö.G. “Pediatrik Genetik”, Dokuz Eylül Üniversitesi Tıp Dergisi, 22(3),171-9,2008.
-
Richards, S., Aziz, N., Bale, S., Bick, D., Das, S., Gastier-Foster, J., Grody, W. W., Hegde, M., Lyon, E., Spector, E., Voelkerding, K., Rehm, H. L., & ACMG Laboratory Quality Assurance Committee, “Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the american college of medical genetics and genomics and the association for molecular pathology”, Genetics in medicine : official journal of the American College of Medical Genetics, 17(5), 405–424, 2015. Doi: 10.1038/gim.2015.30
-
Ahmed, S.F., Alimusina, M., Batista, R.L., Domenice, S., Lisboa Gomes, N., McGowan, R., Patjamontri, S., Mendonca, B.B. “The Use of Genetics for Reaching a Diagnosis in XY DSD”, Sexual Development, 16 (2-3), 207-224, 2022. Doi: 10.1159/000524881.
-
De Gregori, M., Ciccone, R., Magini, P., Pramparo, T., Gimelli, S., Messa, J., Novara, F., Vetro, A., Rossi, E., Maraschio, P., Bonaglia, M. C., Anichini, C., Ferrero, G. B., Silengo, M., Fazzi, E., Zatterale, A., Fischetto, R., Previderé, C., Belli, S., Turci, A., … Zuffardi, O. “Cryptic deletions are a common finding in "balanced" reciprocal and complex chromosome rearrangements: a study of 59 patients”, Journal of medical genetics, 44(12), 750–762, 2007. Doi:10.1136/jmg.2007.052787
-
Tupler, R., Maraschio, P., Gerardo, A., Mainieri, R., Lanzi, G., Tiepolo, L. “A complex chromosome rearrangement with 10 breakpoints: tentative assignment of the locus for Williams syndrome to 4q33--- q35.1”,Journal of medical genetics, 29(4):253-5,1992. Doi: 10.1136/jmg.29.4.253.
-
Ruiz, C., Grubs, R. E., Jewett, T., Cox-Jones, K., Abruzzese, E., Pettenati, M. J., Rao, P. N. “Prenatally diagnosed de novo apparently balanced complex chromosome rearrangements: two new cases and review of the literature”. American journal of medical genetics, 64(3), 478–484,1996. Doi: 10.1002/(SICI)1096-8628(19960823)64:3<478::AID-AJMG6>3.0.CO;2-L.
-
Madan, K., Nieuwint, A.W., van Bever, Y., “Recombination in a balanced complex translocation of a mother leading to a balanced reciprocal translocation in the child. Review of 60 cases of balanced complex translocations”, Human Genetics, 99(6):806-15, 1997. Doi: 10.1007/s004390050453.
-
Xu, F., Wei, F., Grommisch, B., Zhang, H. Z., Li, P.,” Concomitant 1q42. 13-q44 Duplication and 14q32. 33 Deletion: A Case Report and Review of Literature”. North American Journal of Medicine and Science, 10(2), 2017. Doi: 10.7156/najms.2017.1002056.
-
Luo, A., Cheng, D., Yuan, S., Li, H., Du, J., Zhang, Y., Yang, C., Lin, G., Zhang, W., Tan, Y.Q., “Maternal interchromosomal insertional translocation leading to 1q43-q44 deletion and duplication in two siblings”. Molecular Cytogenetics, 4,11-24, 2018. Doi: 10.1186/s13039-018-0371-7.
-
Blackwood, D.H., Fordyce, A., Walker, M.T., St Clair, D.M., Porteous, D.J., Muir W.J. “Schizophrenia and affective disorders--cosegregation with a translocation at chromosome 1q42 that directly disrupts brain-expressed genes: clinical and P300 findings in a family”. The American Journal of Human Genetics, 69(2),428-33, 2001. Doi: 10.1086/321969.
-
Deutsch, S. I., Burket, J. A, Rosse, R. B, Schwartz, B. L. “Genetic variation of chromosome 1q42: etiologic mechanism of congenital disorders of neuronal migration and synaptogenesis”, Current Psychiatry Reviews, 5(4), 236-249, 2009.
-
Silipigni, R., Monfrini, E., Baccarin, M., Giangiobbe, S., Lalatta, F., Guerneri, S., Bedeschi, M.F., “Familial Duplication/Deletion of 1q42.13q43 as Meiotic Consequence of an Intrachromosomal Insertion in Chromosome 1.” Cytogenetic and Genome Research, 153(2):73-80, 2017. Doi: 10.1159/000485226.
-
Mazzeu, J.F., Krepischi-Santos, A.C., Rosenberg, C., Szuhai, K., Knijnenburg, J., Weiss, J.M., Kerkis, I., Mustacchi, Z., Colin, G., Mombach, R., Pavanello Rde, C., Otto, P.A., Vianna-Morgante, A.M., “Chromosome abnormalities in two patients with features of autosomal dominant Robinow syndrome”. American Journal of Human Genetics, 1(15),1790-5, 2007.Doi: 10.1002/ajmg.a.31661.
-
Talkowski, M. E., Mullegama, S. V., Rosenfeld, J. A., van Bon, B. W., Shen, Y., Repnikova, E. A., Gastier-Foster, J., Thrush, D. L., Kathiresan, S., Ruderfer, D. M., Chiang, C., Hanscom, C., Ernst, C., Lindgren, A. M., Morton, C. C., An, Y., Astbury, C., Brueton, L. A., Lichtenbelt, K. D., Ades, L. C., … Elsea, S. H., “Assessment of 2q23.1 microdeletion syndrome implicates MBD5 as a single causal locus of intellectual disability, epilepsy, and autism spectrum disorder”, American Journal of Human Genetics, 89(4),551-63, 2011. Doi: 10.1016/j.ajhg.2011.09.011.
-
Yang, X., Zhang, H., Yu, Y., Zhu, H., Hu, X., Jiang, Y., Wang, R., Liu, R., “Clinical Features of Chromosome 6 Translocation in Male Carriers: A Report of 10 Cases and Review of the Literature” Medical science monitor : international medical journal of experimental and clinical research, 24, 4162–4168, 2018. Doi:10.12659/MSM.
-
Laus, A. C., Baratela, W. A., Laureano, L. A., Santos, S. A., Huber, J., Ramos, E. S., Rebelo, C. C., Squire, J. A., Martelli, L. “Karyotype/phenotype correlation in partial trisomies of the long arm of chromosome 16: case report and review of literatüre”, American journal of medical genetics. Part A, 158A(4), 821–827, 2012. Doi:10.1002/ajmg.a.32988
46, XY,t(1;2;12;6;16)(q42;q23;q22;q13;q13) REPORT OF A CASE WITH SEX DIFFERENTIATION DISORDER (DSD) WITH COMPLEX CHROMOSOMAL REARRANGEMENT
Year 2025,
Volume: 11 Issue: 1, 86 - 95, 29.06.2025
Diclehan Oral
,
Gülbahar Güzel Erdal
,
İlyas Yücel
,
Mahmut Balkan
,
Füsun Düzcan
Abstract
In this study, we present a case of a 7-month-and-26-day-old patient with a novel karyotype associated with a 46,XY disorder of sexual development. This complex chromosomal rearrangements, described as 46,XY,t(1;2;12;6;16)(q42;q23;q22;q13;q13), was confirmed by FISH analysis and has not been previously reported in the literature. The patient exhibited ambiguous genitalia and faced urinary obstruction. No pathogenic variants were detected in genes associated with disorders of sex development in the Next-Generation Sequencing (panel, suggesting that structural rearrangements may disrupt genes critical for sexual and neurological development. Laparoscopic-assisted urogenital mobilisation successfully improved urinary function and genital appearance. This case demonstrates that the pathogenesis of disorders of sex development may involve structural chromosomal abnormalities in addition to gene-level mutations and highlights the importance of genomic rearrangements in disorders of sexual development. The findings emphasise the need for a multidisciplinary approach to the diagnosis and management of complex cases of disorders of sex development. Chromosomal abnormalities should be considered even in the presence of normal sex development genes. This rare karyotype provides new insights into the genetic basis of disorders of sex development, as similar cases have not been documented. We believe that reporting such unique cases will contribute to the understanding of the molecular mechanisms of disorders of sex development and the development of clinical strategies. In summary, we emphasize that structural chromosomal alterations can contribute to disorders of sex development independently of gene mutations and the value of genetic, clinical, and surgical collaboration in patient evaluation. This case expands knowledge of the etiology of disorders of sex development and supports further research on structural genomic alterations.
Ethical Statement
The study was approved by the Medical Ethics Committee. Dicle University Faculty of Medicine Ethics Committee .(Ethics approval code: 125 / Date: 06.02.2020)
References
-
Losa, A., Da Silva Cardoso, J., Leite, S., Barros, A.C., Guedes, A., Rodrigues, C., Borges, T., Oliva-Teles, N., Soares, A.R., Mota, C., “Ambiguous genitalia: an unexpected diagnosis in a newborn”, Cureus,15(10),2023. Doi: 10.7759/cureus.46328.
-
Ferdinands, D.S., De Silva, S., Hewage, A.S., Atapattu N., “Variants in SRY and NR5A1 Genes in Sri Lankan children with 46, XY disorders of sex development: insights into mutation spectrum and diagnostic potential”, Egyptian Journal of Medical Human Genetics, 26(90),2025. Doi: 10.1186/s43042-025-00725-4.
-
Lee, P.A., Nordenström, A., Houk, C.P., Ahmed, S.F., Auchus, R., Baratz, A., Dalke, K., Liao, L.M., Lin-Su, K., Looijenga, L.H. 3rd, Mazur, T., Meyer-Bahlburg, H.F., Mouriquand, P., Quigley, C.A., Sandberg, D.E., Vilain, E., Witchel, S., Global DSD Update Consortium. “Global disorders of sex development update since 2006: perceptions, approach and care”, Hormone Research in Pediatrics, 85(3),158-80,2016. Doi: 10.1159/000442975.
-
Cools, M., Birgit Köhler., "Disorders of sex development", in: Brook's Clinical Pediatric Endocrinology (Ed. M. T. Dattani and C. G. D. Brook), NJ, John Wiley & Sons, 2019, ch 4., pp. 105-131, 2019. https://doi.org/10.1002/9781119152712.ch4
-
Bozkaya, Ö.G. “Pediatrik Genetik”, Dokuz Eylül Üniversitesi Tıp Dergisi, 22(3),171-9,2008.
-
Richards, S., Aziz, N., Bale, S., Bick, D., Das, S., Gastier-Foster, J., Grody, W. W., Hegde, M., Lyon, E., Spector, E., Voelkerding, K., Rehm, H. L., & ACMG Laboratory Quality Assurance Committee, “Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the american college of medical genetics and genomics and the association for molecular pathology”, Genetics in medicine : official journal of the American College of Medical Genetics, 17(5), 405–424, 2015. Doi: 10.1038/gim.2015.30
-
Ahmed, S.F., Alimusina, M., Batista, R.L., Domenice, S., Lisboa Gomes, N., McGowan, R., Patjamontri, S., Mendonca, B.B. “The Use of Genetics for Reaching a Diagnosis in XY DSD”, Sexual Development, 16 (2-3), 207-224, 2022. Doi: 10.1159/000524881.
-
De Gregori, M., Ciccone, R., Magini, P., Pramparo, T., Gimelli, S., Messa, J., Novara, F., Vetro, A., Rossi, E., Maraschio, P., Bonaglia, M. C., Anichini, C., Ferrero, G. B., Silengo, M., Fazzi, E., Zatterale, A., Fischetto, R., Previderé, C., Belli, S., Turci, A., … Zuffardi, O. “Cryptic deletions are a common finding in "balanced" reciprocal and complex chromosome rearrangements: a study of 59 patients”, Journal of medical genetics, 44(12), 750–762, 2007. Doi:10.1136/jmg.2007.052787
-
Tupler, R., Maraschio, P., Gerardo, A., Mainieri, R., Lanzi, G., Tiepolo, L. “A complex chromosome rearrangement with 10 breakpoints: tentative assignment of the locus for Williams syndrome to 4q33--- q35.1”,Journal of medical genetics, 29(4):253-5,1992. Doi: 10.1136/jmg.29.4.253.
-
Ruiz, C., Grubs, R. E., Jewett, T., Cox-Jones, K., Abruzzese, E., Pettenati, M. J., Rao, P. N. “Prenatally diagnosed de novo apparently balanced complex chromosome rearrangements: two new cases and review of the literature”. American journal of medical genetics, 64(3), 478–484,1996. Doi: 10.1002/(SICI)1096-8628(19960823)64:3<478::AID-AJMG6>3.0.CO;2-L.
-
Madan, K., Nieuwint, A.W., van Bever, Y., “Recombination in a balanced complex translocation of a mother leading to a balanced reciprocal translocation in the child. Review of 60 cases of balanced complex translocations”, Human Genetics, 99(6):806-15, 1997. Doi: 10.1007/s004390050453.
-
Xu, F., Wei, F., Grommisch, B., Zhang, H. Z., Li, P.,” Concomitant 1q42. 13-q44 Duplication and 14q32. 33 Deletion: A Case Report and Review of Literature”. North American Journal of Medicine and Science, 10(2), 2017. Doi: 10.7156/najms.2017.1002056.
-
Luo, A., Cheng, D., Yuan, S., Li, H., Du, J., Zhang, Y., Yang, C., Lin, G., Zhang, W., Tan, Y.Q., “Maternal interchromosomal insertional translocation leading to 1q43-q44 deletion and duplication in two siblings”. Molecular Cytogenetics, 4,11-24, 2018. Doi: 10.1186/s13039-018-0371-7.
-
Blackwood, D.H., Fordyce, A., Walker, M.T., St Clair, D.M., Porteous, D.J., Muir W.J. “Schizophrenia and affective disorders--cosegregation with a translocation at chromosome 1q42 that directly disrupts brain-expressed genes: clinical and P300 findings in a family”. The American Journal of Human Genetics, 69(2),428-33, 2001. Doi: 10.1086/321969.
-
Deutsch, S. I., Burket, J. A, Rosse, R. B, Schwartz, B. L. “Genetic variation of chromosome 1q42: etiologic mechanism of congenital disorders of neuronal migration and synaptogenesis”, Current Psychiatry Reviews, 5(4), 236-249, 2009.
-
Silipigni, R., Monfrini, E., Baccarin, M., Giangiobbe, S., Lalatta, F., Guerneri, S., Bedeschi, M.F., “Familial Duplication/Deletion of 1q42.13q43 as Meiotic Consequence of an Intrachromosomal Insertion in Chromosome 1.” Cytogenetic and Genome Research, 153(2):73-80, 2017. Doi: 10.1159/000485226.
-
Mazzeu, J.F., Krepischi-Santos, A.C., Rosenberg, C., Szuhai, K., Knijnenburg, J., Weiss, J.M., Kerkis, I., Mustacchi, Z., Colin, G., Mombach, R., Pavanello Rde, C., Otto, P.A., Vianna-Morgante, A.M., “Chromosome abnormalities in two patients with features of autosomal dominant Robinow syndrome”. American Journal of Human Genetics, 1(15),1790-5, 2007.Doi: 10.1002/ajmg.a.31661.
-
Talkowski, M. E., Mullegama, S. V., Rosenfeld, J. A., van Bon, B. W., Shen, Y., Repnikova, E. A., Gastier-Foster, J., Thrush, D. L., Kathiresan, S., Ruderfer, D. M., Chiang, C., Hanscom, C., Ernst, C., Lindgren, A. M., Morton, C. C., An, Y., Astbury, C., Brueton, L. A., Lichtenbelt, K. D., Ades, L. C., … Elsea, S. H., “Assessment of 2q23.1 microdeletion syndrome implicates MBD5 as a single causal locus of intellectual disability, epilepsy, and autism spectrum disorder”, American Journal of Human Genetics, 89(4),551-63, 2011. Doi: 10.1016/j.ajhg.2011.09.011.
-
Yang, X., Zhang, H., Yu, Y., Zhu, H., Hu, X., Jiang, Y., Wang, R., Liu, R., “Clinical Features of Chromosome 6 Translocation in Male Carriers: A Report of 10 Cases and Review of the Literature” Medical science monitor : international medical journal of experimental and clinical research, 24, 4162–4168, 2018. Doi:10.12659/MSM.
-
Laus, A. C., Baratela, W. A., Laureano, L. A., Santos, S. A., Huber, J., Ramos, E. S., Rebelo, C. C., Squire, J. A., Martelli, L. “Karyotype/phenotype correlation in partial trisomies of the long arm of chromosome 16: case report and review of literatüre”, American journal of medical genetics. Part A, 158A(4), 821–827, 2012. Doi:10.1002/ajmg.a.32988