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2.1
Ring Chromosome 19

Presentation

The detail raw data are presented in [Table 1a] (presence: √; absence: -). Del(5q/20q), dir(9p/12p), -(18/19/Y), and, at least, one marker was consistently present in 88% of the cells evaluated. [cancerjournal.net]

Interestingly, apparently identical cytogenetic abnormalities were detected in the patient's mother, who presented with normal stature, few dysmorphic features, and normal cognition without microcephaly. [ncbi.nlm.nih.gov]

Dyserythropoiesis was present, with megaloblastoid change and binuclear erythrocytes. Lymphoid aggregates and extrinsic cells were not present. Marrow fibrosis was not seen. Megakaryocytes were present, but reduced in number. [hoajonline.com]

Two important clinical characteristics which were commonly present in our case and other patients are developmental delay and microcephaly. [eymj.org]

Entire Body System

  • Disability

    We report on a patient with severe intellectual disability, microcephaly, short stature, and dysmorphic features who, based on standard karyotyping, has two cytogenetic abnormalities: an apparently balanced paracentric inversion of chromosome 7, inv(7 [ncbi.nlm.nih.gov]

    My amnio result came back all clear for the major common disabilities, but gave us this result of which there are only a few cases known to medics in the world. The most likely result is intellectual disability, but how profound is not known. [community.babycentre.co.uk]

    The degree of disability and individual health needs varies for people with PCDH19 Epilepsy. [epilepsy.com]

    To the best of our knowledge, the present patient represents a new case of intellectual disability and minor dysmorphic features associated with r(21) and the first case of mosaicism studied in different tissues. [omicsonline.org]

    Family Membership is open to those affected by a Rare Chromosome Disorder or certain Autosomal Dominant Single Gene Disorders causing as a minimum learning disability/developmental delay, among other symptoms. [rarechromo.org]

  • Developmental Delay

    Children with mild developmental delay without dysmorphic features do not often have identifiable underlying aetiological factors. [ncbi.nlm.nih.gov]

    When we investigated diverse chromosome loci which are associated with the phenotype of developmental delay, deletion rather than duplication appeared to be predominantly related with the developmental delay, 16, 17 thus leading to a possibility that [eymj.org]

    […] disorder cases: ring chromosome 19 and partial duplication 2q. ( 16179226 ) Hermsen M.A....Toral J.F. 2005 3 Malignant refractory epilepsy in identical twins mosaic for a supernumerary ring chromosome 19. ( 15270770 ) Shahwan A....King M.D. 2004 4 Mild developmental [malacards.org]

    Later in childhood, developmental delay, particularly of language skills. [ssmc-tl.com]

    Family Membership is open to those affected by a Rare Chromosome Disorder or certain Autosomal Dominant Single Gene Disorders causing as a minimum learning disability/developmental delay, among other symptoms. [rarechromo.org]

  • Short Stature

    We report on a patient with severe intellectual disability, microcephaly, short stature, and dysmorphic features who, based on standard karyotyping, has two cytogenetic abnormalities: an apparently balanced paracentric inversion of chromosome 7, inv(7 [ncbi.nlm.nih.gov]

    stature, low weightClinodactylyPMDD–46,XX,r(11)(p15q25); chromosome instability; and father with normal karyotypePatient 2: 33 years/F (mother of patients nos 1 and 3)– Cafe au lait spotMicrocephaly, short stature–Low IQ–46,XX,r(11)(p15q25); chromosome [edmcasereports.com]

    stature, microcephaly, hyperactive, clinodactyly of V finger, normal mental/motor development, short attention span, hyperactive behaviour p22.3 q36.3 12431259 Edit 2 8922097_1 46, XY, r(7)(p22.3q36.3) [80%]/ 45, XY, -7 [20%] short stature, facial dysmorphism [chr7.org]

    Typically the seizures are resistant to treatment with anti-epileptic drugs.Other symptoms may include: [1] [5] Microcephaly Lymphedema Facial abnormalities Immune deficiencies Abnormalities of retina Slow growth Short stature Cause The syndrome is caused [checkrare.com]

    Patients with type 1 have generally a normal phenotype, with only occasional reports of short stature. The type 2 ring is associated with a wide variety of phenotypes, with varying severity. [omicsonline.org]

Gastrointestinal

  • Vomiting

    At 6 months weight loss associated with recurrent vomiting; language delay; repeated adenoids problems, hearing loss diagn at 3 y. [ssmc-tl.com]

    No seizures, regression of milestones, hiccups, food intolerance, vomiting, lethargy, rashes, or an unusual odor to the hair, ears, skin, or urine that might suggest an inborn error of metabolism were observed. [nature.com]

  • Failure to Thrive

    […] growth failure is more common among patients with large ring chromosomes, than among those with small ones (Kosztolanyi 1987). [en.wikibooks.org]

Cardiovascular

  • Hypertension

    At age of 71y height of 132 cm, head circumference of 52.5 cm, blood pressure of 180/110 mm Hg, poor peripheral circulation, earIy hypertensive changes in both optic fundi, poor vision, Upward slanting palpebral fissures, large tongue, protruding lower [ssmc-tl.com]

    […] intrauterine growth retardation, short stature, moderate mental retardation, multiple minor anomalies, pigmentation anomalies pter qter 10594874 Edit 38 7172483 46, XX, r(7) [96]/ 47, XX, r(7), +r(7) [3]/ 46, XX, der(7)r(7) [1] short stature, systemic hypertension [chr7.org]

    Case presentation We report a case of a 78 year old female with a medical history of hypertension and congestive heart failure. She was status post pacemaker and defibrillator implantation from an unknown date. [hoajonline.com]

    The child was delivered by cesarean section at 34 weeks because of gestational hypertension and fetal decelerations. She weighed 1,900 g and was 42 cm long. Apgar scores were 8 and 8. She passed newborn screening and had a normal echocardiogram. [nature.com]

  • Heart Disease

    disease, situs inversus, capillary hemangiomata, respiratory problems, renal problems, low birth weight, growth retardation, microcephaly p22 q36 1746606, 8362903, 10982483 case 9 [8362903, 10982483] de novo Edit 7 8362903 46, XY, r(7)(p22q36) [95%]/ [chr7.org]

Ears

  • Low Set Ears

    Symptoms - Chromosome 19 ring syndrome The list of signs and symptoms mentioned in various sources for Chromosome 19 ring syndrome includes the 20 symptoms listed below: * Small head * High forehead * Low set ears * Posteriorly rotated ears * Widely spaced [checkorphan.org]

    […] p11.2 q11.21 13680362 case 13 Edit 30 18049079_B.D. _2 46, XY, upd(7), +r(7)(p11.2q21) pat Russell-Silver syndrome, intrauterine growth retardation, feeding difficulties, retarded bone age, growth retardation, motor development delay, low set ears/ear [chr7.org]

    The forehead was broad, previously described preauricular tags were present, ears were borderline low-set with over-folded helices and a deep vertical groove behind the right ear helix, the nasal bridge was broad, the upper lip was thin with a slightly [nature.com]

    […] chubby cheeks, long philtrum, protruding tongue, prominent lower lip, receding chin, low-set asymmetric and dysmorphic ears with prominent helix, spaced nipples, and tapering fingers (Fig. 1). [ssmc-tl.com]

Skin

  • Cutis Laxa

    laxa * Pulmonic stenosis * Hypoplastic right ventricle * Coronary artery fistula * Growth retardation * Motor retardation * Mental retardation * Deafness * Autism Causes - Chromosome 19 ring syndrome * Clubfoot * Deafness * Growth retardation * High [checkorphan.org]

Musculoskeletal

  • Macrocephaly

    Major features of 19p13.13 deletion syndrome include an unusually large head size (macrocephaly), tall stature, delayed development of speech and motor skills (such as sitting and walking), and intellectual disability that is usually moderate in severity [ghr.nlm.nih.gov]

    2::)* cep probes wcp 19, centromere near cosmids see below {28} overweight, mentally retarded with macrocephaly, hypertelorism, antimongoloid slants, epilepsy (convulsive seizures with or without hyperthermia from 1y) 19-W- p12/ 4-1 female/ 15y PBL de [ssmc-tl.com]

    The patient presented with mental retardation and macrocephaly, and weight was reported to be three standard deviations above the mean. [nature.com]

Psychiatrical

  • Psychomotor Retardation

    Article / Publication Details First-Page Preview Abstract We report a 12-month-old infant evaluated for severe hypotonia, psychomotor retardation, and facial dysmorphisms, including round face, high prominent forehead, downward slanted palpebral fissures [karger.com]

    Severe psychomotor retardation in a boy with a small supernumerary marker chromosome 19p. Cytogenet Genome Res 2008; 121 :298–301. 23. [nature.com]

    Severe psychomotor retardation in a boy with a small supernumerary marker chromosome 19p. Cytogenet Genome Res. 2008;121(3-4):298-301. Stratton RF, DuPont BR, Olsen AS, Fertitta A, Hoyer M, Moore CM. Interstitial duplication 19p. [fish.uniklinikum-jena.de]

Face, Head & Neck

  • Hypertelorism

    Article / Publication Details First-Page Preview Abstract We report a 12-month-old infant evaluated for severe hypotonia, psychomotor retardation, and facial dysmorphisms, including round face, high prominent forehead, downward slanted palpebral fissures, hypertelorism [karger.com]

    2::)* cep probes wcp 19, centromere near cosmids see below {28} overweight, mentally retarded with macrocephaly, hypertelorism, antimongoloid slants, epilepsy (convulsive seizures with or without hyperthermia from 1y) 19-W- p12/ 4-1 female/ 15y PBL de [ssmc-tl.com]

    Father''s phenotype was not unusual but the child was mentally retarded with generalized hypotonia, microcephaly, epicanthus, hypertelorism, cryptorchidism and obesity. Subject S.D. in this report. 46,XY,r(17). [ncbi.nlm.nih.gov]

    […] al. 1994) Criteria for diagnosis of CES include; Ocular coloboma of the iris and or retina Anal atresia (with or without fistula) Preauricular skin tags and pits Heart defects (especially total anomalous pulmonary venous return Dysmorphic features (hypertelorism [en.wikibooks.org]

    He was born small for gestational age, and had some dysmorphic features (hypertelorism, anti-Mongolian slants, and minor nose and mouth malformations). [nature.com]

  • Broad Nasal Bridge

    Figure 1: The proband showing curly hair, thin upper lip, broad nasal bridge and tip. Figure 2: Array-CGH analysis showing the complete monosomy of chromosome 21. [omicsonline.org]

    On physical examination, craniofacial dysmorphic features such as broad nasal bridge, high forehead with posterior hairline, and upward directed corners of the eyes were noticed but the degree of dysmorphism was relatively mild. [eymj.org]

  • High and Prominent Forehead

    At 15y height >95th centile, high forehead, down-slanting palpebral fissures, wide diastema between upper incisors, high palate, short fraenulum of the upper lip, prominent lips and scoliosis, long and tapering fingers, fifth finger campodactyly, hallux [ssmc-tl.com]

  • Frontal Bossing

    Dysmorphism included high forehead with frontal bossing, voluminous ocular globes, hypertelorism, low-set ears with hypoplastic helix, wide, flat nasal bridge with bulging alae nasi, long and smooth philtrum, thin upper lip, and microretrognathia. [nature.com]

Neurologic

  • Global Developmental Delay

    developmental delays and epilepsy 2q24.2-32.2 deletion 2q37.3 deletion Duplication at 2q37.3 of 2.3 mb and a deletion2q37.3 of 2.4 mb P Arm 2p16.3 deletion DUPLICATIONS Q Arm 2q37.3 duplication DELETIONS P Arm 3p21 Microduplication 3 p26.3-p26.2 Deletion [arcan.org.au]

    Later in childhood, developmental delay, particularly of language skills. [ssmc-tl.com]

    Complex markers Case 6. ( Figure 2 ) aCGH showed a de novo 14.2 Mb gain of the short arm of chromosome 18p11.32p11.21 in a patient with global developmental delay, mental retardation, and up-slanting palpebral fissures. [nature.com]

Treatment

Treatment - Chromosome 19 ring syndrome Not supplied. Resources - Chromosome 19 ring syndrome Not supplied. [checkorphan.org]

The information is not intended to be a substitute for professional medical care, nor is it intended to be used as a basis for diagnosis or treatment. [socialstyrelsen.se]

Typically the seizures are resistant to treatment with anti-epileptic drugs.Other symptoms may include: [1] [5] Microcephaly Lymphedema Facial abnormalities Immune deficiencies Abnormalities of retina Slow growth Short stature Cause The syndrome is caused [checkrare.com]

Seizure medication is the first line of treatment to prevent seizures and stop seizure clusters. Some of the medicines used for this syndrome include: benzodiazepines, levetiracetam, valproate, phenytoin, phenobarbital, and lamotrigine. [epilepsy.com]

[Epub ahead of print] Simultaneous inhibition of IGF1R and EGFR enhances the efficacy of standard treatment for colorectal cancer by the impairment of DNA repair and the induction of cell death Oberthür R, Seemann H, Gehrig J, Rave-Fränk M, Bremmer F, [humangenetik-umg.de]

Prognosis

Prognosis - Chromosome 19 ring syndrome Not supplied. Treatment - Chromosome 19 ring syndrome Not supplied. Resources - Chromosome 19 ring syndrome Not supplied. [checkorphan.org]

MLL) can occur in acute myeloid leukemia cases and are associated with a poor prognosis in all leukemias. [hoajonline.com]

The present case with three times of IPSS-R complex aberrations is expected to exhibit very poor prognosis and faster transformation to AML. [cancerjournal.net]

[…] are rare in occurrence supernumerary ring chromosomes often gradually disappear in vivo and only cells with normal karyotype are eventually observed (Michalski K et al. 1993 cited Hoo et al. 1980) not very many reports makes it difficult to predict prognosis [en.wikibooks.org]

Molecular characterization of 39 de novo sSMC: contribution to prognosis and genetic counselling, a prospective study. Clin Genet. 2013 Mar 11. doi: 10.1111/cge.12138. [fish.uniklinikum-jena.de]

Etiology

Expression analyses identify MLL as a prominent target of 11q23 amplification and support an etiologic role for MLL gain of function in myeloid malignancies. Blood. 2004; 103 :229-35. | Article | PubMed [hoajonline.com]

Epidemiology

The discussion covers the phenotype spectrum, epidemiology, mode of inheritance, pathogenesis, and clinical profile of each condition, all of which is accompanied by a wealth of illustrations. [books.google.com]

Management In terms of the management of ring chromosome 14 syndrome, anticonvulsive medication for seizures, as well as, proper therapy to help prevent respiratory infections in the affected individual are management measures that can be taken. [7] Epidemiology [checkrare.com]

Prevention

Chromosome 19 ring syndrome * Clubfoot * Deafness * Growth retardation * High forehead * High nasal bridge * Low set ears * Mental retardation * Motor retardation * Posteriorly rotated ears * Redundant neck skin * Small head * Syndactyly * Widely spaced eyes Prevention [checkorphan.org]

Is chronic lung disease in low birth weight infants preventable? A survey of eight centers. ‎ Página 84 - Tanner JM, Whitehouse RH, Marubini E, Resele LF. The adolescent growth spurt of boys and girls of the Harpenden growth study. ‎ [books.google.es]

[…] karyotyping ; [8] while once born, one can do the following to ascertain a diagnosis of the condition: [7] MRI EEG Management In terms of the management of ring chromosome 14 syndrome, anticonvulsive medication for seizures, as well as, proper therapy to help prevent [checkrare.com]

Seizure medication is the first line of treatment to prevent seizures and stop seizure clusters. Some of the medicines used for this syndrome include: benzodiazepines, levetiracetam, valproate, phenytoin, phenobarbital, and lamotrigine. [epilepsy.com]

To prevent bias in the study’s results, the researchers excluded participants who reported that they had received a likely diagnosis of dementia or a dementia-like condition, such as Alzheimer’s. [keck.usc.edu]

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2.1
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