Introduction: 4q35 deletion is a rare chromosomal syndrome with a wide range of phenotypes, which can be challenging to detect through prenatal ultrasound. This study aimed to summarize the fetal phenotypes of patients with 4q35 deletion. Case Presentation: The study included four fetuses with 4q35 deletion, with detailed records of prenatal ultrasound and genetic testing results. These cases included following phenotypes, fetal growth restriction (FGR) (2/4), cystic hygroma (2/4), single umbilical artery (1/4), and fused kidney (1/4). One case was terminated, while the other three were born and showed no obvious abnormalities at the 1-year follow-up. Previous reports have described the fetal phenotype of 4q35 deletion in 6 patients from five families, with prenatal phenotypes including FGR (2/6), cardiac structural abnormalities (1/6), brain ventriculomegaly (1/6), oligohydramnios (1/6), and multicystic dysplastic kidneys (1/6). Conclusion: Overall, the phenotypes of fetuses with 4q35 deletion are diverse, with FGR potentially being a significant phenotype in these cases.

1.
Chien
WH
,
Gau
SS
,
Wu
YY
,
Huang
YS
,
Fang
JS
,
Chen
YJ
, et al
.
Identification and molecular characterization of two novel chromosomal deletions associated with autism
.
Clin Genet
.
2010
;
78
(
5
):
449
56
.
2.
Balikova
I
,
Menten
B
,
de Ravel
T
,
Le Caignec
C
,
Thienpont
B
,
Urbina
M
, et al
.
Subtelomeric imbalances in phenotypically normal individuals
.
Hum Mutat
.
2007
;
28
(
10
):
958
67
.
3.
Abou Jamra
R
,
Becker
T
,
Georgi
A
,
Feulner
T
,
Schumacher
J
,
Stromaier
J
, et al
.
Genetic variation of the FAT gene at 4q35 is associated with bipolar affective disorder
.
Mol Psychiatr
.
2008
;
13
(
3
):
277
84
.
4.
Chen
J
,
Zhang
J
,
Liu
Y
,
Wei
X
,
Yang
Y
,
Zou
G
, et al
.
Fetal growth standards for Chinese twin pregnancies
.
BMC Pregnancy Childbirth
.
2021-06-22
;
21
(
1
):
436
.
5.
Buck Louis
GM
,
Grewal
J
,
Albert
PS
,
Sciscione
A
,
Wing
DA
,
Grobman
WA
, et al
.
Racial/ethnic standards for fetal growth: the NICHD Fetal Growth Studies
.
Am J Obstet Gynecol
.
2015
;
213
(
4
):
449.e1
41
.
6.
Mostacciuolo
ML
,
Pastorello
E
,
Vazza
G
,
Miorin
M
,
Angelini
C
,
Tomelleri
G
, et al
.
Facioscapulohumeral muscular dystrophy: epidemiological and molecular study in a north-east Italian population sample
.
Clin Genet
.
2009
;
75
(
6
):
550
5
.
7.
Munot
P
,
McCrea
N
,
Torelli
S
,
Manzur
A
,
Sewry
C
,
Chambers
D
, et al
.
TRAPPC11-related muscular dystrophy with hypoglycosylation of alpha-dystroglycan in skeletal muscle and brain
.
Neuropath Appl Neuro
.
2022
;
48
(
2
):
e12771
.
8.
Cai
XB
,
Zheng
YH
,
Chen
DF
,
Zhou
FY
,
Xia
LQ
,
Wen
XR
, et al
.
Expanding the phenotypic and genotypic landscape of nonsyndromic high myopia: a cross-sectional study in 731 Chinese patients
.
Invest Ophth Vis Sci
.
2019
;
60
(
12
):
4052
62
.
9.
Finsterer
J
,
Zarrouk-Mahjoub
S
.
Phenotypic spectrum of SLC25A4 mutations
.
Biomed Rep
.
2018
;
9
(
2
):
119
22
.
10.
Kang
SH
,
Kim
GR
,
Seong
M
,
Baek
SH
,
Seol
JH
,
Bang
OS
, et al
.
Two novel ubiquitin-fold modifier 1 (Ufm1)-specific proteases, UfSP1 and UfSP2
.
J Biol Chem
.
2007
;
282
(
8
):
5256
62
.
11.
Di Rocco
M
,
Rusmini
M
,
Caroli
F
,
Madeo
A
,
Bertamino
M
,
Marre-Brunenghi
G
, et al
.
Novel spondyloepimetaphyseal dysplasia due to UFSP2 gene mutation
.
Clin Genet
.
2018
;
93
(
3
):
671
4
.
12.
Lim
HK
,
Huang
SXL
,
Chen
J
,
Kerner
G
,
Gilliaux
O
,
Bastard
P
, et al
.
Severe influenza pneumonitis in children with inherited TLR3 deficiency
.
J Exp Med
.
2019
;
216
(
9
):
2038
56
.
13.
Wang
T
,
Chen
Q
,
Yao
X
,
Kuang
L
,
Gan
R
,
Wang
J
, et al
.
New compound heterozygous CYP4V2 mutations in bietti crystalline corneoretinal dystrophy
.
Gene
.
2021
;
790
:
145698
.
14.
Barco
S
,
Sollfrank
S
,
Trinchero
A
,
Adenaeuer
A
,
Abolghasemi
H
,
Conti
L
, et al
.
Severe plasma prekallikrein deficiency: clinical characteristics, novel KLKB1 mutations, and estimated prevalence
.
J Thromb Haemost
.
2020
;
18
(
7
):
1598
617
.
15.
Mandal
S
,
Gami
S
,
Shah
S
.
A case report on an extremely rare disease: factor XI deficiency
.
Cureus
.
2020
;
12
(
10
):
e10746
.
16.
Rana
KS
,
Holla
RG
.
To determine the frequency of subtelomeric abnormalities in children with idiopathic mental retardation
.
Med J Armed Forces India
.
2011
;
67
(
4
):
326
8
.
17.
Pickard
BS
,
Hollox
EJ
,
Malloy
MP
,
Porteous
DJ
,
Blackwood
DH
,
Armour
JA
, et al
.
A 4q35.2 subtelomeric deletion identified in a screen of patients with co-morbid psychiatric illness and mental retardation
.
BMC Med Genet
.
2004
;
5
(
1
):
21
7
.
18.
Strehle
EM
,
Yu
L
,
Rosenfeld
JA
,
Donkervoort
S
,
Zhou
Y
,
Chen
TJ
, et al
.
Genotype–phenotype analysis of 4q deletion syndrome: proposal of a critical region
.
Am J Med Genet
.
2012
;
158A
(
9
):
2139
51
.
19.
Youngs
EL
,
Henkhaus
RS
,
Hellings
JA
,
Butler
MG
.
12-year-old boy with a 4q35.2 microdeletion and involvement of MTNR1A, FAT1, and F11 genes
.
Clin Dysmorphol
.
2012
;
21
(
2
):
93
6
.
20.
Manolakos
E
,
Kefalas
K
,
Vetro
A
,
Oikonomidou
E
,
Daskalakis
G
,
Psara
N
, et al
.
Prenatal diagnosis of two de novo 4q35-qter deletions characterized by array-CGH
.
Mol Cytogenet
.
2013
;
6
(
1
):
47
5
.
21.
Xiao
G
,
Qiu
X
,
Zhou
Y
,
Tan
G
,
Shen
Y
.
Prenatal diagnosis of a 4.5Mb deletion at chromosome 4q35.1q35.2: case report and literature review
.
Mol Cytogenet
.
2021
;
14
(
1
):
53
6
.
22.
Yakut
S
,
Clarck
OA
,
Sanhal
C
,
Nur
BG
,
Mendilcioglu
I
,
Karauzum
SB
, et al
.
A familial interstitial 4q35 deletion with no discernible clinical effects
.
Am J Med Genet
.
2015
;
167A
(
8
):
1836
41
.
23.
Fu
F
,
Chen
F
,
Li
R
,
Zhang
Y
,
Pan
M
,
Li
D
, et al
.
Prenatal diagnosis of fetal multicystic dysplastic kidney via high-resolution whole-genome array
.
Nephrol Dial Transpl
.
2016
;
31
(
10
):
1693
8
.
24.
Zhu
H
,
Lin
S
,
Huang
L
,
He
Z
,
Huang
X
,
Zhou
Y
, et al
.
Application of chromosomal microarray analysis in prenatal diagnosis of fetal growth restriction
.
Prenat Diagn
.
2016
;
36
(
7
):
686
92
.
25.
Canton
AP
,
Costa
SS
,
Rodrigues
TC
,
Bertola
DR
,
Malaquias
AC
,
Correa
FA
, et al
.
Genome-wide screening of copy number variants in children born small for gestational age reveals several candidate genes involved in growth pathways
.
Eur J Endocrinol
.
2014
;
171
(
2
):
253
62
.
26.
Doan
TNA
,
Akison
LK
,
Bianco-Miotto
T
.
Epigenetic mechanisms responsible for the transgenerational inheritance of intrauterine growth restriction phenotypes
.
Front Endocrinol
.
2022
;
13
(
13
):
838737
.
You do not currently have access to this content.