Chromosomal trisomies are the most frequent major chromosomal anomalies in humans and can be present in a mosaic or a non-mosaic constitution. We report the first case of a newborn girl presenting with multiple congenital anomalies and a double mosaic trisomy involving chromosome 14 and the X chromosome detected by array CGH. Karyotype analysis revealed a double mosaic with 2 independent abnormal cell lines and the absence of 46,XX and 48,XXX,+14 cell lineages. The patient showed most of the clinical characteristics of mosaic trisomy 14. Analysis of autosomal DNA markers in the proband's blood sample did not support the presence of chimerism. Further analysis of chromosome X DNA markers suggests that the extra X chromosome most probably arose as a consequence of nondisjunction in meiosis II in the maternal lineage.

1.
Aksglaede L, Link K, Giwercman A, Jørgensen N, Skakkebæk NE, Juul A: 47,XXY Klinefelter syndrome : clinical characteristics and age-specific recommendations for medical management. Am J Med Genet C Semin Med Genet 163C:55-63 (2013).
2.
Bozdogan ST, Bisgin A: A rare double aneuploidy case (Down-Klinefelter). J Pediatr Genet 6:241-243 (2017).
3.
Caspersson T, Lindsten J, Zech L, Buckton KE, Price WH: Four patients with trisomy 8 identified by the fluorescence and giemsa banding techniques. J Med Genet 9:1-7 (1972).
4.
DeBrasi D, Genuardi M, D'Agostino A, Calvieri F, Tozzi C, et al: Double autosomal/gonosomal mosaic aneuploidy : study of nondisjunction in two cases with trisomy of chromosome 8. Hum Genet 95:519-525 (1995).
5.
Eventov-Friedman S, Frumkin A, Bar-Oz B, Raas-Rothschild A: Mosaic trisomy 14 in a newborn with multiple malformations: when chromosomal microarray is a clue to diagnosis. Isr Med Assoc J 17:459-460 (2015).
6.
Fujimoto A, Allanson J, Crowe CA, Lipson MH, Johnson VP: Natural history of mosaic trisomy 14 syndrome. Am J Med Genet 44:189-196 (1992).
7.
Hassold T, Hall H, Hunt P: The origin of human aneuploidy: where we have been, where we are going. Hum Mol Genet 16:R203-R208 (2007).
8.
Hook EB: Exclusion of chromosomal mosaicism: tables of 90%, 95%, and 99% confidence limits and comments on use. Am J Hum Genet 29:94-97 (1977).
9.
Hur YJ, Hwang T: Complete trisomy 14 mosaicism: first live-born case in Korea. Korean J Pediatr 55:393-396 (2012).
10.
ISCN 2016: An International System for Human Cytogenomic Nomenclature; McGowen-Jordan J, Simons A, Schmid M (eds). Cytogenet Genome Res 149:1-140 (2016).
11.
Jo WH, Jung MK, Kim KE, Chae HW, Kim DH, et al: XYY syndrome: a 13-year-old boy with tall stature. Ann Pediatr Endocrinol Metab 20:170-173 (2015).
12.
Kalousek DK: Pathogenesis of chromosomal mosaicism and its effect on early human development. Am J Med Genet 91:39-45 (2000).
13.
Leggett V, Jacobs P, Nation K, Scerif G, Bishop DV: Neurocognitive outcomes of individuals with a sex chromosome trisomy : XXX, XYY, or XXY : a systematic review. Dev Med Child Neurol 52:119-129 (2010).
14.
Lynch MF, Fernandes CJ, Shaffer LG, Potocki L: Trisomy 14 mosaicism: a case report and review of the literature. J Perinatol 24:121-123 (2004).
15.
Malan V, Vekemans M, Turleau C: Chimera and other fertilization errors. Clin Genet 70:363-373 (2006).
16.
Mantagos S, McReynolds JW, Seashore MR, Breg R: Complete trisomy 9 in two liveborn infants. J Med Genet 377-382 (1981).
17.
McKinlay Gardner RJ, Amor DJ: Gardner and Sutherland's Chromosome Abnormalities and Genetic Counseling, 5th ed (Oxford University Press, New York 2018).
18.
Nicolaidis P, Petersen MB: Origin and mechanisms of non-disjunction in human autosomal trisomies. Hum Reprod 13:313-319 (1998).
19.
Nielsen J, Wohlert M: Chromosome abnormalities found among 34,910 newborn children: results from a 13-year incidence study in Arhus, Denmark. Hum Genet 87:81-83 (1991).
20.
Parihar M, Koshy B, Srivastava VM: Mosaic double aneuploidy : Down syndrome and XYY. Indian J Hum Genet 19:346-349 (2013).
21.
Rodrigues MA, Morgade LF, Dias LFA, Moreira RV, Maia PD, et al: Low-level trisomy 14 mosaicism in a male newborn with ectrodactyly. Genet Mol Res 15:1-7 (2016).
22.
Salas-Labadia C, Lieberman E, Cruz-Alcivar R, Navarrete Meneses P, Gomez S, et al: Partial and complete trisomy 14 mosaicism: clinical follow-up, cytogenetic and molecular analysis. Mol Cytogenet 7:65 (2014).
23.
Shinawi M, Shao L, Jeng LJB, Shaw CA, Patel A, et al: Low-level mosaicism of trisomy 14: phenotypic and molecular characterization. Am J Med Genet A 146A:1395-1405 (2008).
24.
Suzumori N, Kagami M, Kumagai K, Goto S, Matsubara K, et al: Clinical and molecular findings in a patient with 46,XX/47,XX,+14 mosaicism caused by postzygotic duplication of a paternally derived chromosome 14. Am J Med Genet A 167A:2474-2477 (2015).
25.
Tartaglia NR, Howell S, Sutherland A, Wilson R, Wilson L: A review of trisomy X (47,XXX). Orphanet J Rare Dis 5:8 (2010).
26.
Tonni G, Lituania M, Chitayat D, Paola M, Keating S, et al: Complete trisomy 9 with unusual phenotypic associations : Dandy-Walker malformation, cleft lip and cleft palate, cardiovascular abnormalities. Taiwan J Obstet Gynecol 53:592-597 (2014).
27.
Ushijima K, Yatsuga S, Matsumoto T, Nakamura A, Fukami M, Kagami M: A severely short-statured girl with 47,XX,+14/46,XX,upd(14)mat, mosaicism. J Hum Genet 63:377-381 (2018).
28.
von Sneidern E, Lacassie Y: Is trisomy 14 mosaic a clinically recognizable syndrome? - case report and review. Am J Med Genet A 146A:1609-1613 (2008).
29.
Zhang S, Qin H, Wang J, OuYang L, Luo S, et al: Maternal uniparental disomy 14 and mosaic trisomy 14 in a Chinese boy with moderate to severe intellectual disability. Mol Cytogenet 9:66 (2016).
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