Chromosome 4, trisomy 4q21

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Chromosome 4, trisomy 4q21 is a rare genetic disorder characterized by the presence of an extra copy of genetic material on the long arm (q arm) of chromosome 4, specifically in the region designated as 4q21. This condition is a type of chromosomal abnormality known as a partial trisomy, where only a segment of the chromosome is present in three copies rather than the entire chromosome. The clinical manifestations and severity of symptoms associated with trisomy 4q21 can vary widely among affected individuals.

Symptoms and Diagnosis

The symptoms of trisomy 4q21 can vary significantly but often include developmental delay, intellectual disability, and physical abnormalities. Common physical features may include distinct facial characteristics, skeletal anomalies, heart defects, and other organ abnormalities. Due to the variability in symptoms, the diagnosis of trisomy 4q21 is typically confirmed through genetic testing, such as karyotyping or more advanced genomic techniques like fluorescence in situ hybridization (FISH) or array comparative genomic hybridization (aCGH).

Causes

Trisomy 4q21 results from a duplication of a portion of the q arm of chromosome 4. This duplication can occur randomly during the formation of reproductive cells or early in fetal development. In some cases, it may also result from a balanced translocation in one of the parents, where no genetic material is lost or gained in the parent but can lead to an unbalanced distribution in the offspring.

Treatment and Management

There is no cure for trisomy 4q21, and treatment is symptomatic and supportive. Management may involve a multidisciplinary team including pediatricians, geneticists, surgeons, cardiologists, neurologists, and therapists (physical, occupational, and speech) to address the various symptoms and complications that can arise. Early intervention and supportive therapies can help improve the quality of life and developmental outcomes for individuals with this condition.

Prognosis

The prognosis for individuals with trisomy 4q21 varies depending on the severity of symptoms and associated complications. Some individuals may have mild symptoms and lead relatively normal lives, while others may experience significant physical and intellectual disabilities. Early diagnosis and intervention can play a crucial role in managing the condition and improving the overall prognosis.

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Contributors: Prab R. Tumpati, MD