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Open Access Case report

A coalescence of two syndromes in a girl with terminal deletion and inverted duplication of chromosome 5

Danijela Krgovic1, Ana Blatnik1, Ante Burmas2, Andreja Zagorac1 and Nadja Kokalj Vokac13*

Author Affiliations

1 Laboratory of Medical Genetics, University Clinical Centre Maribor, Ljubljanska Street 5, 2000 Maribor, Slovenia

2 Paediatric Clinics, University Clinical Centre Maribor, Ljubljanska Street 5, 2000 Maribor, Slovenia

3 Faculty of Medicine, University of Maribor, Slomškov trg 15, 2000 Maribor, Slovenia

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BMC Medical Genetics 2014, 15:21  doi:10.1186/1471-2350-15-21

Published: 11 February 2014

Abstract

Background

Rearrangements involving chromosome 5p often result in two syndromes, Cri-du-chat (CdC) and Trisomy 5p, caused by a deletion and duplication, respectively. The 5p15.2 has been defined as a critical region for CdC syndrome; however, genotype-phenotype studies allowed isolation of particular characteristics such as speech delay, cat-like cry and mental retardation, caused by distinct deletions of 5p. A varied clinical outcome was also observed in patients with Trisomy 5p. Duplications of 5p10-5p13.1 manifest themselves in a more severe phenotype, while trisomy of regions distal to 5p13 mainly causes mild and indistinct features. Combinations of a terminal deletion and inverted duplication of 5p are infrequent in literature. Consequences of these chromosomal rearrangements differ, depending on size of deletion and duplication in particular cases, although authors mainly describe the deletion as the cause of the observed clinical picture.

Case presentation

Here we present a 5-month-old Slovenian girl, with de novo terminal deletion and inverted duplication of chromosome 5p. Our patient presents features of both CdC and Trisomy 5. The most prominent features observed in our patient are a cat-like cry and severe malformations of the right ear.

Conclusion

The cat-like cry, characteristic of CdC syndrome, is noted in our patient despite the fact that the deletion is not fully consistent with previously defined cat-like cry critical region in this syndrome. Features like dolichocephaly, macrocephaly and ear malformations, associated with duplication of the critical region of Trisomy 5p, are also present, although this region has not been rearranged in our case. Therefore, the true meaning of the described chromosomal rearrangements is discussed.

Keywords:
Deletion with inverted duplication of 5p; Cri-du-chat syndrome; Trisomy 5p; Cat-like cry; Ear agenesis