Introduction: Chromosomal aberrations due to complex chromosomal rearrangements (CCRs) can cause abnormal phenotypes if accompanied by microdeletions or microduplications near the breakpoint, or gene breaks. Case Presentation: We report a prenatal diagnostic case of 2q14.3-q22.1 deletion with ultrasound suggestive of absent nasal bone accompanied by CCRs involving 6 chromosomes. Cytogenetic analysis revealed a karyotype of 46,XY,der(1)t(1;2)(p13.3;p11.2),der(2)t(1;2)inv(2)(q12q14.2)del(2)(q14.3q22.1),t(12;16)(q21.2;q12.1),t(13;21)(q32;q22.1). Chromosomal microarray analysis identified a 14.90 Mb deletion on 2q14.3q22.1. The copy number variant was de novo, as determined by karyotype analysis of the parents’ peripheral blood G-banding. Conclusion: The region contains haploinsufficient genes that can cause different phenotypes, mainly associated with neurodevelopmental and autism spectrum disorders. However, the genotype-phenotype correlation is limited in prenatal evaluation. Therefore, the combined use of multiple diagnostic techniques has an important role in the assessment of CCRs and genetic counseling.

1.
Dharmadhikari AV, Kang SH, Szafranski P, Person RE, Sampath S, Prakash SK, et al. Small rare recurrent deletions and reciprocal duplications in 2q21.1, including brain-specific ARHGEF4 and GPR148. Hum Mol Genet. 2012;21(15):3345–55.
2.
Eisfeldt J, Pettersson M, Vezzi F, Wincent J, Käller M, Gruselius J, et al. Comprehensive structural variation genome map of individuals carrying complex chromosomal rearrangements. Plos Genet. 2019;15(2):e1007858.
3.
Eriksson MA, Liedén A, Westerlund J, Bremer A, Wincent J, Sahlin E, et al. Rare copy number variants are common in young children with autism spectrum disorder. Acta Paediatr. 2015;104(6):610–8.
4.
Gimelli S, Stathaki E, Béna F, Leoni M, Di Rocco M, Cuoco C, et al. Recurrent microdeletion 2q21.1: report on a new patient with neurological disorders. Am J Med Genet. 2014;164a(3):801–5.
5.
Kohoutek J, Li Q, Blazek D, Luo Z, Jiang H, Peterlin BM. Cyclin T2 is essential for mouse embryogenesis. Mol Cell Biol. 2009;29(12):3280–5.
6.
Lengyel A, Pinti É, Nebral K, Pikó H, Ujfalusi A, Haas OA, et al. Chromosome 2q14.3 microdeletion encompassing CNTNAP5 gene in a patient carrying a complex chromosomal rearrangement. J Genet. 2021;100(2):66.
7.
Liu P, Carvalho CM, Hastings PJ, Lupski JR. Mechanisms for recurrent and complex human genomic rearrangements. Curr Opin Genet Dev. 2012;22(3):211–20.
8.
Ludington EG, Yu S, Bae HA, Barnett CP. Novel de novo 2q14.3 deletion disrupting CNTNAP5 in a girl with intellectual impairment, thin corpus callosum, and microcephaly. Am J Med Genet. 2020;182(7):1824–8.
9.
McGowan-Jordan J, Ros HJ, Sarah M. An International System for Human Cytogenetic Nomenclature. Basel, Switzerland: Karger; 2020.
10.
Pellestor F, Anahory T, Lefort G, Puechberty J, Liehr T, Hedon B, et al. Complex chromosomal rearrangements: origin and meiotic behavior. Hum Reprod Update. 2011;17(4):476–94.
11.
Pereira MS, Durães C, Catarino TA, Costa JL, Cleynen I, Novokmet M, et al. Genetic variants of the MGAT5 gene are functionally implicated in the modulation of T cells glycosylation and plasma IgG glycome composition in ulcerative colitis. Clin Transl Gastroenterol. 2020;11(4):e00166.
12.
Schuy J, Grochowski CM, Carvalho CMB, Lindstrand A. Complex genomic rearrangements: an underestimated cause of rare diseases. Trends Genet. 2022;38(11):1134–46.
13.
Sundheimer LW, Liu L, Buyalos RP, Hubert G, Al-Safi Z, Shamonki M. Diagnosis of parental balanced reciprocal translocations by trophectoderm biopsy and comprehensive chromosomal screening. J Assist Reprod Genet. 2018;35(1):165–9.
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