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精神運動発達遅滞,けいれんにて小児科に入院中の患児で,非常にまれな染色体構造をもち,眼多発奇形を認めた1例を報告する.
症例 は2歳男児,37週2,600g正常分娩.黄疸の遷延のため小児科にて精査,全身的に外表奇形,臓器奇形を認めなかったが眼科的に両眼隔離と瞼裂縮小,眼振,小眼球,小角膜,瞳孔膜遺残,球状水晶体,乳頭脈絡膜コロボーマを両眼に認めた.染色体分析の結果,父母は正常,症例には45,XY,−22,−14,+der (22)(22qter→22p13::14q112→14qter)の核型を79%認め,45,XY,−1,−14,+der (1)(1q ter→1p 363::14q 11.2→14qter)を21%に認めた.この奇形はこの染色体異常に特異的なものではないが,染色体異常による眼発生異常と考えられた.
A male infant, weighing 2, 600g and born after an uneventful 37-week pregnancy, manifested mul-tiple ocular malformations, mental retardation, con-vulsion an unusual chromosomal abnormality. The ocular manifestations included hypertelorism, ble-pharophimosis, nystagmus, microphthalmia, micro-cornea, persistent pupillary membrane, spheropha-kia, high myopia and coloboma of the optic disc and the choroid. Sustained jaundice, mental retarda-tion and convulsion were the chief systemic involve-ments. High-resolution, ysis showed a unique mosaic pattern : 79% with 45, XY, -22, -14, + der (22) (22qter-22p13 :: 14q11.2-14qter), and 21% with 45, XY,-1, -14,+ der (1) (1qter- 1p36.3 :: 14q11.2- 14qter) Both the parents manifested normal chromosal pattern. The observed developmental disorders appeared to be related to the chromosomal abnor-malities, though not in a well-defined, specific way.
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