RESUMO
OBJECTIVE: To describe the parental origin and the mechanism of formation of a 46,X,der(X)(pter-->q21.1::p11.4-->pter)[23]/45,X[8] karyotype in a patient with mild Turner syndrome. DESIGN: Case report. SETTING: A university hospital. PATIENT(S): A 23-year-old woman with normal height, gonadal dysgenesis, and mild Turner stigmata. INTERVENTION(S): Genotype-phenotype correlation, array-based copy number analysis, fluorescence in situ hybridization with locus-specific probes, and microsatellite marker-mediated haplotype analysis subsequent to whole genome amplification of microdissected chromosomes. MAIN OUTCOME MEASURES: Genotype-phenotype correlation, mechanism of formation, and parental origin. RESULT(S): Formation in paternal meiosis by refolding in itself and unequal recombination between Xp and Xq were found as the most likely mechanism of formation. CONCLUSION(S): Formation of der(X) chromosomes in females can be more complex than previously thought. The nearly normal height of this patient could be explained by a combination of trisomy of the Xp-located SHOX gene and mosaicism with a 45,X cell line.
