Case Report: Congenital Arthrogryposis and Unilateral Absences of Distal Arm in Congenital Zika Syndrome.

Zika virus was recognized as a teratogen in 2015, when prenatal Zika infection was associated with neonatal microcephaly. The transmission, virulence, tropism, and consequences of Zika virus infection during pregnancy are currently studied. Decreased neural progenitor cells, arrest in neuronal migration and/or disruption of the maturation process of the fetus central nervous system have been associated. Congenital Zika Syndrome produces a fetal brain disruption sequence resulting in structural brain abnormalities, microcephaly, intracranial calcifications, fetal akinesia and arthrogryposis. Vascular abnormalities like unique umbilical artery and decreased cerebral vascular flow have been described in some patients. This article reports a Zika positive patient with sequence of fetal brain disruption, arthrogryposis and absence of distal third of the right forearm. This report expands the clinical observations of congenital Zika syndrome that may be related to disruptive vascular events.

Maya gene variants related to the risk of type 2 diabetes in a family-based association study.

Mexican Maya populations have a notably high prevalence of type 2 diabetes (T2D) as a consequence of the interaction between environmental factors and a genetic component. To assess the impact of 24 single nucleotide variants (SNVs) located in 18 T2D risk genes, we conducted a family-based association evaluation in samples from Maya communities with a high incidence of the disease. A total of four hundred individuals were recruited from three Maya communities with a high T2D incidence. Family pedigrees (100) and 49 nuclear families were included. Genotyping was performed by allelic discrimination with TaqMan probes. This study also included the family-based association test (FBAT) statistic U to assess the genetic associations with T2D, and the multivariate statistical and haplotype analyses. A positive association with TD2 risk was found for WFS1 rs6446482 (p = 0.046, Z = 1.994) under an additive model, and SIRT1 rs7896005 (p = 0.038, Z = 2.073) under the dominant model. Multivariate model analysis, including T2D status, age, and body mass index (BMI), displayed significant covariance in PPARGC-1α rs8192678; SIRT1 rs7896005; TCF7L2 rs7903146 and rs122243326; UCP3 rs3781907; and HHEX rs1111875 with a P < 0.05. This study revealed an association of SIRT1 and WFS1 with T2D risk.

Genetic variation of FTO: rs1421085 T>C, rs8057044 G>A, rs9939609 T>A, and copy number (CNV) in Mexican Mayan school-aged children with obesity/overweight and with normal weight.

OBJECTIVES: Genetic variation of the fat mass and obesity associated gene (FTO) has been identified as a risk factor for obesity and obesity traits. Distribution of FTO single nutleotide polymorphisms (SNPs) rs1421085T>C, rs9939609T>A, rs8057044G>A and copy number variation (CNV) was evaluated in association with childhood obesity or overweight status in children with Mayan ethnicity. METHODS: We included 318 school-aged children with obesity or overweight status (body mass index [BMI]: >85th percentile) and 303 children with normal weight (BMI: 15th-85th percentile). Genotyping was performed using real-time polymerase chain reaction (RT-PCR) with TaqMan probes. The cross-sectional study was carried out using univariate and multivariate logistic regression models adjusted for gender. RESULTS: FTO-SNP rs1421085 showed significant differences between children with obesity and children with normal weight for the heterozygous genotype (P = 0.003) and for allele frequencies (P = 0.023). Adjusting by gender, significant differences were found in frequencies of the hetezygous genotype of SNPs rs9939609 (P = 0.023) and rs1421085 (P = 0.003) as well as in allele frequencies (P = 0.042 and P = 0.013, respectively) between girls with obesity and girls without obesity. In contrast, SNP rs8057044 was significantly different only between heterozygous overweight versus normal weight boys (P = 0.035) and for the allele frequency of rs8057044 (P = 0.021). The mean relative CNV was significantly higher in male overweight children than in boys with normal weight (P = 0.000). CONCLUSIONS: The FTO SNP rs1421085 is a genetic factor associated with obesity in Mayan school-aged children. FTO SNPs rs1421085 and rs9939609 affect genetic susceptibility for obesity only in girls, whereas, SNP rs8057044 and CNV are associated with overweight status only in boys.

Birth Defects Associated With Congenital Zika Virus Infection in Mexico.

Part of the work agenda of international health authorities is to define the clinical spectrum of the congenital Zika syndrome (CZS) in different territories. We describe the clinical variability that gave rise to the suspicion of CZS in 3 newborn patients in the south of Mexico with active transmission of Zika. All of them presented Zika RNA by reverse transcription-polymerase chain reaction and positive antibodies for IgM by enzyme-linked immunosorbent assay. None of the mothers tested positive for active viremia, only one mother had Zika-symptoms and titers of Zika-positive IgM. Intrauterine growth restriction, brain disruption sequence, and intracranial calcifications are the clinical characteristics common in all. One patient had neural tube defect and other, arthrogryposis. Because the majority of pregnant women will be asymptomatic to Zika, we must be alert to the clinical variability of the birth defects associated to pregnancy Zika infection. Reports of clinical cases encourage the medical community to make diagnostic decisions.

Analysis of Thiopurine S-Methyltransferase Deficient Alleles in Acute Lymphoblastic Leukemia Patients in Mexican Patients.

BACKGROUND AND AIMS: It has been demonstrated that heterozygote and homozygote thiopurine S-methyltransferase (TPMT) mutant allele carriers are at high risk to develop severe and potentially fatal hematopoietic toxicity after treatment with standard doses of 6-mercaptopurine (6-MP) and methotrexate (MX). Those drugs are the backbone of acute lymphoblastic leukemia (ALL) and several autoimmune disease treatments. We undertook this study to determine the frequency of the TPMT deficient alleles in children with ALL and non-ALL subjects from Mexico City and Yucatan, Mexico. METHODS: We included 849 unrelated subjects, of which 368 ALL children and 342 non-ALL subjects were from Mexico City, and 60 ALL cases and 79 non-ALL individuals were from Yucatan. Genotyping of the rs1800462, rs1800460 and rs1142345 SNPs was performed by 5'exonuclease technique using TaqMan probes (Life Technologies Foster City, CA). RESULTS: The mutant TPMT alleles were present in 4.8% (81/1698 chromosomes) and only 0.2% were homozygote TPMT*3A/TPMT*3A. We did not find statistically significant differences in the distribution of the mutant alleles between patients from Mexico City and Yucatan in either ALL cases or non-ALL. Nonetheless, the TPMT*3C frequency in ALL patients was higher than non-ALL subjects (p = 0.03). To note, the null homozygous TPMT*3A/TPMT*3A genotype was found in 2.5% of the non-ALL subjects. CONCLUSIONS: TPMT mutant alleles did not exhibit differential distribution between both evaluated populations; however, TPMT*3C is overrepresented in ALL cases in comparison with non-ALL group. Assessing the TPMT mutant alleles could benefit the ALL children and those undergoing 6-MP and MX treatment.

Focal dermal hypoplasia without focal dermal hypoplasia.

Focal dermal hypoplasia (FDH; Goltz-Gorlin syndrome) is an X-linked dominant disorder affecting mainly tissues of ectodermal and mesodermal origin. The phenotype is characterized by hypoplastic linear skin lesions, eye malformations, hair and teeth anomalies, and multiple limbs malformations. The disorder is caused by PORCN mutations. Here we describe a mother and daughter with FDH in whom a c.938T>G in PORCN was detected. Neither of the two had FDH, but otherwise the phenotype was classical. Focal skin hypoplasia is a hallmark of FDH but the present family indicates that FDH should also be considered in absence of this skin manifestation.

Distribution of three SNPs related to low bone mineral density in Amerindian groups and Mestizos from Mexico.

OBJECTIVES: Some Single nucleotide polymorphisms (SNPs) of several candidate genes have been associated with low bone mineral density (BMD) and fracture risk. As the genetic variability of such SNPs in Hispanic and Native American populations is scarce, we analyzed the three SNPs that have been related with bone mass disorders (Sp1, A163G, and BsmI) located in the genes of Type I Collagen (COL1A1), Osteoprotegerin (OPG), and Vitamin D receptor (VDR) in Mexican Mestizos (people resulting from post-Columbian admixture) and five Amerindian populations. METHODS: We genotyped these three SNPs by Polymerase chain reaction (PCR) and Restriction fragment length polymorphisms (RFLPs) in 523 individuals from five Mexican Amerindian groups (Nahua, Maya, Purépecha, Tarahumara, and Huichol) and 227 western Mestizos (Jalisco state). RESULTS: The modal allele was the same in all the six populations for Sp1-COL1A1 (S > 77%), A163G-OPG (A > 80%), and BsmI-VDR (b > 62%). Genotype distribution was in Hardy-Weinberg equilibrium in all SNPs/populations, excepting Sp1-COL1A1 in the Purépecha group and BsmI-VDR in Mestizo. In terms of the presumably Sp1-COL1A1 risk allele to low BMD (allele "s"), the Purépecha group showed the highest allele (23%) and homozygous (14.5%) frequencies. If the role of this allele as a genetic predisposing factor to low BMD were confirmed, this would mean increased susceptibility of Purépechas with regard to Europeans (14.5 vs. 6.8%). CONCLUSIONS: This finding presumably could influence the genetic susceptibility to low BMD in Purépechas. For the SNPs, BsmI-VDR and A163G-OPG, relative homogeneity was observed among the Mexican populations analyzed here.

Paraoxonase 1 polymorphisms and haplotypes and the risk for having offspring affected with spina bifida in Southeast Mexico.

BACKGROUND: Spina bifida (SB) is a common congenital malformation in Southeast Mexico. Parents of children with SB reside in areas with frequent pesticide spraying or have agriculture activities, suggesting potential exposure to pesticides. Paraoxonase 1 (PON1) is the responsible enzyme for deactivation of organophosphates (OP) in the central nervous system. Polymorphisms of PON1 genes influence the catalytic activity and plasma protein level of the enzyme, therefore, genotypic characterization of PON1 gene represents a potential predictor for susceptibility to OP-related effects. METHODS: The frequency of PON1 haplotypes and polymorphisms (-108CT, L55M, and Q192R) were determined in this study. A case-control study was performed to evaluate the risk for having offspring affected by SB in 152 cases and 160 control parents. Polymorphisms were determined by PCR amplification and restriction fragment length polymorphism and Real Time-PCR. Odds ratios and confidence interval 95% were estimated. RESULTS: Genotype frequencies for the three PON1 polymorphisms were distributed according to Hardy-Weinberg expectations (p > 0.05) and were significantly different between cases and controls (p < 0.05). The heterozygous CT genotype of -108CT polymorphism, the RR genotype of Q192R polymorphism, both LM and MM genotypes of L55M polymorphism, and the haplotypes 221 and 222 (for -108CT, L55M, and Q192R) were associated with the risk for having a child affected by SB (p < 0.02). The heterozygous -108CT genotype was associated only maternally, whereas the heterozygous L55M genotype was relevant only in the fathers. The RR homozygous genotype was relevant both in mothers and fathers, suggesting the importance of this substrate-specific polymorphism. CONCLUSION: Results suggest that PON1 polymorphisms are relevant risk factors for having offspring affected with SB in this population from Southeast Mexico.

[Effect of the Gly972Arg, SNP43 and Prol2Ala polymorphisms of the genes IRS1, CAPN10 and PPARG2 on secondary failure to sulphonylurea and metformin in patients with type 2 diabetes in Yucatán, México]. / Efecto de los polimorfismos Gly972Arg del gen IRS1, SNP43 del gen CAPN10 y Prol2Ala del gen PPARG2 sobre la falla secundaria a sulfonilureas y metformina en pacientes con diabetes tipo 2 de Yucatán, Mexico.

In Yucatán, 52% of patients with type 2 diabetes (DT2) present secondary failure to treatment associated with sulphonylurea and metformin. A possible explanation may be due to polymorphisms in the genes IRS1, CAPN10, PPARG2, which are involved in pancreatic beta cell dysfunction and a poor response to the action of insulin. The association of the polymorphisms Gly972Arg, SNP43, and Pro12Ala, of the genes IRS1, CAPN10, PPARG2, with the risk of failure to sulphonylurea and metformin therapies was determinated in patients with DT2 in Yucatán, México. One hundred and thirty and two subjects with DT2 were classified in groups of responders (HbA1c < 8%) and non-responders (HbA1c > 8%) to the treatment, according to the control of hyperglucemia with sulphonylurea and metformin. Demographic, anthropometric and metabolic data were obtained from each subject. The polymorphisms were identified by means of DNA analysis by PCR/RFLP and PCR/OAL. Genotypic and allelic frequencies and the Hardy-Weinberg equilibrium were determined. Statistical analyses consisted of X2 and multiple logistic regression tests (Epi-Info 2000 and SPSS version 12). Obese subjects carrying the genotype AA SNP43 showed 4.69 times more risk of failure to respond to treatment (p = 0.027), when compared with subjects sharing GA genotype: X2 (OR = 4.69, IC: 1.15-20.59) and multiple logistic regression, p = 0.048, (OR = 3.72, IC: 1.009-13.718). The interaction between genotype AA and the BMI > 27 showed also a significant difference (p = 0.009). The findings suggest the fact that polymorphism SNP43 may influence the response to treatment with sulphonylurea and metformin, the expression being dependent on obesity.

Efecto de los polimorfismos Gly972Arg del gen IRS1, SNP43 del gen CAPN10 y Pro12Ala del gen PPARG2 sobre la falla secundaria a sulfonilureas y metformina en pacientes con diabetes tipo 2 de Yucatán México / Effect of the Gly972Arg, SNP43 and Pro12Ala polymorphisms of the genes IRS1, CAPN10 and PPARG2 on secondary failure to sulphonylurea and metformin in patients with type 2 diabetes in Yucatán México

La diabetes tipo 2 (DT2) es elevada en Yucatán; 52% de los afectados presentan falla al tratamiento con sulfonilureas y metformina. Una posible explicación es por polimorfismos en los genes IRS1, CAPN10, PPARG2, involucrados en la disfunción de la célula b pancreática y respuesta baja a la acción de insulina. Se determinó la asociación de los polimorfismos Gly972Arg, SNP43 y Pro12Ala con el riesgo a la falla al tratamiento con sulfonilurea y metformina, en pacientes con DT2 de Yucatán, México. Se estudiaron ciento treinta y dos pacientes, clasificados con base al control de la hiperglucemia con sulfonilureas y metformina, en grupos de respondedores (HbA1c<8%) y no respondedores (HbA1c > 8%) al tratamiento. De cada sujeto, se obtuvieron datos demográficos, antropométricos, clínicos y metabólicos. Los polimorfismos se identificaron mediante el análisis del ADN por PCR/RFLP y PCR/OAL. Se calcularon las frecuencias genotípicas y alélicas y el equilibrio de Hardy-Weinberg. Se analizó estadísticamente con X² y regresión logística múltiple (Epi-Info 2000 y SPSS versión 12). Se observó diferencia significativa (p = 0,027) en el riesgo a la falla al tratamiento 4,69 veces mayor en sujetos obesos con genotipo AA SNP43, comparado con sujetos con genotipo GA: X² (OR= 4,69, IC: 1,15-20,59) y regresión logística múltiple, p= 0,048, (OR= 3,72, IC: 1,009-13,718). Se identificó interacción entre el genotipo AA y el IMC>27 (p=0,009). Los hallazgos sugieren que el polimorfismo SNP43 podría influir en la respuesta al tratamiento con sulfonilureas y metformina, con expresión dependiente de obesidad.

In Yucatán, 52% of patients with type 2 diabetes (DT2) present secondary failure to treatment associated with sulphonylurea and metformin. A possible explanation may be due to polymorphisms in the genes IRS1, CAPN10, PPARG2, which are involved in pancreatic b cell dysfunction and a poor response to the action of insulin. The association of the polymorphisms Gly972Arg, SNP43, and Pro12Ala, of the genes IRS1, CAPN10, PPARG2, with the risk of failure to sulphonylurea and metformin therapies was determinated in patients with DT2 in Yucatán, México. One hundred and thirty and two subjects with DT2 were classified in groups of responders (HbA1c< 8%) and non-responders (HbA1c> 8%) to the treatment, according to the control of hyperglucemia with sulphonylurea and metformin. Demographic, anthropometric and metabolic data were obtained from each subject. The polymorphisms were identified by means of DNA analysis by PCR/RFLP and PCR/OAL. Genotypic and allelic frequencies and the Hardy-Weinberg equilibrium were determined. Statistical analyses consisted of X² and multiple logistic regression tests (Epi-Info 2000 and SPSS version 12). Obese subjects carrying the genotype AA SNP43 showed 4.69 times more risk of failure to respond to treatment (p=0.027), when compared with subjects sharing GA genotype: X² (OR= 4.69, IC: 1.15-20.59) and multiple logistic regression, p= 0.048, (OR= 3.72, IC: 1.009-13.718). The interaction between genotype AA and the BMI> 27 showed also a significant difference (p=0.009). The findings suggest the fact that polymorphism SNP43 may influence the response to treatment with sulphonylurea and metformin, the expression being dependent on obesity.

A1298C polymorphism of the MTHFR gene and neural tube defects in the state of Yucatan, Mexico.

BACKGROUND: Methylenetetrahydrofolate reductase (MTHFR) of the folate metabolism pathway is a candidate gene for neural tube defects (NTDs). Frequency of the second common polymorphism, A1298C, in the MTHFR gene is not well known in Mexico. Conflicting results exist regarding the association of A1298C-MTHFR with NTDs. One explanation for this controversy might be that alleles are differently distributed among various populations. The aim of the study was to determine the frequency of the A1298C-MTHFR polymorphism and its association with NTDs in a population of Yucatan, Mexico. METHODS: Genotyping was performed by use of polymerase chain reaction with restriction fragment length polymorphisms using MbOII endonuclease (PCR-RFLPs MbOII). Allele and genotype frequencies were compared between cases with NTDs, their mothers and fathers with matched controls based on an association analysis using EpiInfo software. RESULTS: A1298C genotypes were distributed according to Hardy-Weinberg expectations for all studied groups. Frequencies of allele C and heterozygous AC genotype were significantly higher in males (p = .006 and p = .011, respectively) in control group. Significant differences were not observed between cases and controls, except in mothers of NTD cases compared with mothers of healthy offspring for both allele C and heterozygous AC genotype (p = .009 and p = .01, respectively). CONCLUSIONS: The polymorphism A1298C-MTHFR is not associated with NTDs, except for mothers, suggesting only a maternal association with having NTD-affected offspring in the Yucatan population. The frequency of allele C in the control population was 10%, which is significantly lower than in other reported control populations worldwide (p < .01).

Fundamentos y actualidades del asesoramiento genético / Foundation and actuality about genetic counseling

Los avances en el conocimiento de los mecanismos de producción de las enfermedades hereditarias, y la aplicación de los principios de genética en diferentes disciplinas no tratadas de manera común por los genetistas, han ampliado la utilidad del asesoramiento genético. Por estas razones, en la actualidad es mayor el número de familias que buscan asesoría genética por defectos al nacimiento, enfermedades genéticas, así como por causas tan diversas como cáncer, trastornos psiquiátricos, neurodegenerativos, cardiacos, abortos, óbitos, embarazo en edad avanzada, exposición a teratógenos y otros factores de riesgo. El asesoramiento genético es un proceso de comunicación acerca de los problemas humanos asociados con la ocurrencia, o riesgo de ocurrencia y repetición, de un desorden genético familiar. Debe ser proporcionado con imparcialidad, para alcanzar la finalidad de ayudar al individuo, o la familia, para afrontar su situación relacionada con la enfermedad, por medio de información clara para comprender los aspectos médicos, modo de herencia y riesgos de repetición que les permita tomar decisiones razonadas acerca del motivo de su consulta. En esta revisión se abordan los fundamentos en los que se basa el asesoramiento genético, las características de los diferentes modos de herencia tradicionales (herencia mendeliana, cromosómica y multifactorial), novedosos (inestabilidad del genoma, herencia mitocondrial, cambios epigenéticos), y teratogénicos, los principios éticos elementales relacionados con este tema, y se hacen consideraciones acerca de la necesidad de formación de profesionales en salud entrenados para proporcionar consejo genético bajo la supervisión de genetistas clínicos.

Síndrome del anillo en una paciente con mosaico del cromosoma 4 en anillo / Ring syndrome in a patient with a mosaic ring 4 chromosome

Introducción. El síndrome del anillo es ocasionado por la formación en anillo de un cromosoma autosómico. Independientemente del cromosoma involucrado, las manifestaciones clínicas principales son falla extrema en el crecimiento y apariencia normal, puede haber inteligencia normal o retardo mental de grado variable. En este trabajo se presenta una paciente con anillo del cromosoma 4 en mosaico y que presenta las características del síndrome del anillo.Caso clínico. Se trató de paciente femenina con retardo mental moderado, talla, peso y perímetro cefálico bajos, hipoplasia malar, cifoescoliosis y separación amplia entre primero y segundo ortejos, con desarrollo sexual secundario normal. Su cariotipo fue 46, XX r(4)p16;q35/46,XX.Conclusiones. El fenotipo de esta paciente puede considerarse normal, su manifestación física más evidente fue grave retardo en el crecimiento. La inestabilidad de los cromosomas en anillo explica esta característica. Debe considerarse este síndrome cuando hay talla baja grave, en ausencia de dismorfias o con algunas inespecíficas.

Prevalencia de intercambio de cromátides hermanas en una población libre de exposición a agentes clastogénicos / Frequency of sister chromotid exchange in a population free of exposure to clastogenic agents

Introducción. El intercambio entre cromátides hermanas (ICH) es un evento celular normal, con frecuencia basal relativamente constante de ICH espontáneos por metafase, variable en células de tejidos diferentes. Factores individuales y por proceso de laboratorio pueden hacer variar la frecuencia basal de ICH. La exposición a agentes clastogénicos es capaz de incrementarla. En este trabajo se describe la prevalencia de ICH en una población libre de exposición a agentes clastogénicos conocidos. Material y métodos. Se incluyó 50 individuos sanos de uno u otro sexo, de 10 a 59 años. A cada uno se les realizó dos cultivos de sangre, a los que se agregó bromodeoxiuridina a las 0 y 24 h respectivamente, para la obtención de metafases con tinción diferencial de cromátides. De cada cultivo se analizaron 25 metafases para determinar el promedio del ICH/células/individuo. Resultados el promedio de ICH/célula/individuo en los cultivos de 0 y 24 h fue 4.21ñ1.20 y 3.9ñ0.94 respectivamente, con intervalo y DE de 2.12ñ1.12 a 7.4ñ3.31 en los cultivos de 0 h. En los cultivos de 24 h el intervalo y DE encontrados fueron de 2.12ñ1.3 a 7.08ñ2.75. La diferencia entre los dos cultivos no fue significativa (p<0.10). El grupo de edad con mayor número de ICH fue de 20 a 29 años, sin encontrarse diferencias significativas entre cada decenio de edad. Tampoco se encontró diferencias significativas entre géneros. Discusión. Los resultados encontrados son similares a los encontrados en otras poblaciones, a excepción del decenio de edad con el pico máximo de ICH. Estos resultados permiten tener confiabilidad en el procedimiento utilizado

Severe congenital hypoacusia in a patient with mosaic ring chromosome 7

Hipoacusia severa congénita en un paciente con mosaico del cromosoma siete en anillo. Introducción. Los cromosomas en anillo son aberraciones cromosómicas que pueden encontrarse como hallazgo en pacientes con talla baja, dismorfias menores e inteligencia normal. Los anillos del cromosoma 7 son raros. Los allazgos mas frecuentes en estos casos incluyen: talla baja, microcefalia y alteraciones dermatológicas. Caso Clínico. En este artículo presentamos a un niño con mosaico del cromosoma siete en anillo, quien tuvo hipoacusia y manchas hiprómicas en la piel. Presentó otras manifestaciones clínico similares a las descritas previamente en pacientes con la misma aberración cromosómica: talla, peso y perímetro cefálico bajos, retraso mental, anomalías dermatológicas y algunas dismorfias. Discusión. Aunque la mayoría de las manifestacione presente en este paciente se han descrito con anterioridad, este es el primer caso en el que se encuentra hipoacusia, y el segundo con manchas hipocrómicas. Nosotros proponemos que esta manifestación dérmica quede incluida entre la variabilidad de expresiones dermatológicas del cromosoma siete en anillo. Además, recomendamos realizar búsqueda intencionada de alteraciones auditivas en pacientes con anomalías de cromosoma siete que involucren regiones subteloméricas

Prevalencia de mosaicos en 100 individuos con diagnóstico de Síndrome de Down / Prevalence of mosics in 100 subjects with a diagnostic of Down syndrome

Introducción. El mosaicismo es la presencia en un mismo individuo, de dos o mas poblaciones celulares con diferente constitución cromosómica. Del 2 al 3 por ciento de los sujetos con síndrome de Down son mosaicos. Es probable que la prevalencia de mosaicos sea mayor, ya que el número de células que se analizan con fines de diagnóstico, no permite detectar los mosaicos con una proporción baja de una segunda línea celular. Objetivo. El objetivo del presente trabajo es determinar la prevalencia de mosaicos en 100 sujetos con diagnóstico de Síndrome de Down. Material y métodos. A cada paciente se le realizó cariotipo en sangre periférica. Se examinaron 100 células en metafase con tinción común con giemsa, para detectar mosaicos del 3 por ciento o mayores. Se consideró como una segunda clona, en el caso de células hiperdiploides o pseudodiploides, a la presencia de dos células por lo menos con la misma alteración, y en el caso de células hipodiplodes cuando al menos en tres células esté ausente el o los mismos cromosomas. Resultados. El 39 por ciento de los sujetos resultaron mosaicos, de éstos 35 por ciento presentaron dos líneas celulares y en 4 por ciento se encontraron tres líneas celulares y en 4 por ciento se encontraron tres líneas celulares. El 87 por ciento de los mosaicos con dos líneas celulares fueron una mezcla de células trisómicas y normales, una tercera línea celular con el 21 adicional y ausencia de un cromosoma del grupo C o bien, presentaba dos cromosomas del grupo G adicionales. Discusión. Consideramos que la alta frecuencia de mosaicos observada en este trabajo, con respecto a los descrito, guarda relación directa con número de células analizadas. El origen probable para la mayoría de estos mosaicos, fue a partir de un cigoto trisómico que perdió el cromosoma extra por rezago anafásico en divisiones posteriores a la primera, ya que las células trisómicas se encontraron en proporción mayor con respecto a la línea normal. Por otro lado, el riesgo de recurrencia es diferente de acuerdo al hallazgo citogenético, por lo que es importante determinar la proporción de cada una de las líneas celulares, pues son una base para determinar el pronóstico de estos pacientes

Investigación citogenética en parejas con pérdidas gestacionales espontáneas recurrentes (PGER) / Cytogenetic study in couples with recurring spontaneous gestational losses

La complicación más común del embarazo es la pérdida gestacional espontánea en cualquiera de sus manifestaciones. Una de las causas de pérdidas gestacionales es la presencia de aberración cromosómica constitucional en un progenitor. Su identificación permite proporcionar riesgos específicos para la reproducción del individuo portador de la aberración cromosómica. En este trabajo se estudió a un grupo de parejas con PGER, para conocer el número de sujetos portadores de aberración cromosómica como causa de estas pérdidas. Se incluyó a 173 parejas con dos o más PGER. A todos los sujetos se les efectuó cariotipo de sangre periférica, que se analizó con bandas G y C. Se encontraron aberraciones cromosómicos diferentes en cinco mujeres (2.9 por ciento). En todos los varones y en 168 mujeres el resultado del cariotipo fue normal. En 2.8 de todos los sujetos incluidos se observaron polimorfismos cromosómicos. Estos resultados son similares a los encontrados en otras poblaciones. El análisis cromosómico efectuado en forma rutinaria en parejas con pérdidas gestacionales sin causa determinada, permite identificar individuos portadores de aberraciones cromosómicas como etiología de este trastorno en la reproducción.