Detection of recurrent 4p16.3 microdeletion with 2p25.3 microduplication by multiplex ligation-dependent probe amplification and array comparative genomic hybridization in a fetus from a family with Wolf-Hirschhorn syndrome

Taiwan J Obstet Gynecol. 2016 Feb;55(1):104-8. doi: 10.1016/j.tjog.2015.12.006.

Abstract

Objective: We present prenatal diagnosis, genetic counseling, and molecular cytogenetic features of familial recurrence of Wolf-Hirschhorn syndrome (WHS).

Materials and methods: A 31-year-old woman was referred to a hospital at 24 weeks of gestation because of abnormal ultrasound findings in the fetus. Her first child was a boy who had growth retardation, mental defect, and a distinctive facial appearance. Based on the conventional cytogenetic analysis, the combined use of multiplex ligation-dependent probe amplification (MLPA) and array comparative genomic hybridization (aCGH) facilitated the prenatal diagnosis and genetic counseling in the fetus. Results of the standard G-banging karyotype analysis of the fetus, the parents, and the boy were normal.

Results: The MLPA analysis revealed the same 4p microdeletion accompanied by 2p microduplication in the fetus and the boy. The aCGH analysis revealed a 3.57-Mb 4p16.3 microdeletion or arr [hg19] 4p16.3 (71,552-3,636,893) x1 in the fetus and a 3.29-Mb 4p16.3 microdeletion or arr [hg19] 4p16.3 (71,148-3,360,737) x1 in the boy. The 3.57-Mb 4p16.3 microdeletion encompassed 39 OMIM genes. The 3.29-Mb 4p16.3 microdeletion encompassed 36 OMIM genes. They both included LETM1 and WHSC1. The 2p25.3 microduplication was smaller than 666 kb and encompassed only one OMIM gene, ACP1.

Conclusion: The combined use of MLPA and aCGH is an effective way to diagnose recurrent WHS. Although WHS is typically caused by a de novo deletion, prenatal diagnosis and genetic counseling are necessary in the next pregnancy in families that have suffered such cases.

Keywords: Wolf–Hirschhorn syndrome; array comparative genomic hybridization; genetic counseling; multiplex ligation-dependent probe amplification; prenatal diagnosis.

Publication types

  • Case Reports

MeSH terms

  • Abortion, Eugenic
  • Adult
  • Child
  • Chromosome Deletion*
  • Chromosome Duplication*
  • Chromosomes, Human, Pair 2*
  • Chromosomes, Human, Pair 4*
  • Comparative Genomic Hybridization
  • Female
  • Fetal Diseases / diagnostic imaging
  • Fetal Diseases / genetics*
  • Genetic Counseling
  • Humans
  • Male
  • Multiplex Polymerase Chain Reaction
  • Pregnancy
  • Ultrasonography, Prenatal
  • Wolf-Hirschhorn Syndrome / diagnostic imaging
  • Wolf-Hirschhorn Syndrome / genetics*