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Diploid-triploid mosaicism (DTM) is a chromosome disorder. Individuals with diploid-triploid syndrome have some cells with three copies of each chromosome for a total of 69 chromosomes (called triploid cells) and some cells with the usual 2 copies of each chromosome for a total of 46 chromosomes (called diploid cells).
Having two or more different cell types is called mosaicism. Diploid-triploid mosaicism can be associated with truncal obesity, body/facial asymmetry, weak muscle tone (hypotonia), delays in growth, mild differences in facial features, fusion or webbing between some of the fingers and/or toes (syndactyly) and irregularities in the skin pigmentation.
Intellectual disabilities may be present but are highly variable from person to person ranging from mild to more severe.
The chromosome disorder is usually not present in the blood; a skin biopsy, or analyzing cells in the urine is needed to detect the triploid cells.
A regular human carries 23 pairs of chromosomes in his or her cells. Cells containing two pairs of chromosomes are known as diploid cells. Those with diploid triploid mosaicism have some cells which are triploid, meaning that they have three copies of chromosomes, or a total of 69 chromosomes. Triploidy is distinct from trisomy, in which only one chromosome exists in three pairs. A well-known example of trisomy is trisomy 21 or Down syndrome.
Triploidy may be suggested by dramatically elevated levels of serum alpha-fetoprotein. On obstetric ultrasonography, abnormalities of the skeleton, central nervous system, heart, abdomen, and kidneys are visible in the most severe cases beginning at 12-14 weeks of pregnancy. Placental abnormalities associated with a triploid pregnancy become visible at 12-14 weeks. Placentomegaly or intrauterine growth restriction are the typical findings that prompt evaluation for triploidy, though oligohydramnios may be the first sign in some cases. Placentomegaly is not pathognomonic for triploidy because in some cases, the placenta senesces.
Triploidy must be distinguished from trisomy 13 and trisomy 18, which may appear similar on sonography. Genetic testing allows for a definitive diagnosis.
Most fetuses with triploidy do not survive to birth, and those that do usually pass within days. As there is no treatment for Triploidy, palliative care is given if a baby survives to birth. If Triploidy is diagnosed during the pregnancy, termination is often offered as an option due to the additional health risks for the mother (preeclampsia, a life-threatening condition, or choriocarcinoma, a type of cancer). Should a mother decide to carry until term or until a spontaneous miscarriage occurs, doctors will monitor her closely in case either condition develops.
Mosaic triploidy has an improved prognosis, but affected individuals have moderate to severe cognitive disabilities.
Polyploid cells and organisms are those containing more than two paired (homologous) sets of chromosomes. Most species whose cells have nuclei (Eukaryotes) are diploid, meaning they have two sets of chromosomes—one set inherited from each parent. However, polyploidy is found in some organisms and is especially common in plants. In addition, polyploidy occurs in some tissues of animals that are otherwise diploid, such as human muscle tissues. This is known as endopolyploidy. Species whose cells do not have nuclei, that is, Prokaryotes, may be polyploid organisms, as seen in the large bacterium "Epulopiscium fishelsoni" . Hence ploidy is defined with respect to a cell. Most eukaryotes have diploid somatic cells, but produce haploid gametes (eggs and sperm) by meiosis. A monoploid has only one set of chromosomes, and the term is usually only applied to cells or organisms that are normally diploid. Male bees and other Hymenoptera, for example, are monoploid. Unlike animals, plants and multicellular algae have life cycles with two alternating multicellular generations. The gametophyte generation is haploid, and produces gametes by mitosis, the sporophyte generation is diploid and produces spores by meiosis.
Polyploidy refers to a numerical change in a whole set of chromosomes. Organisms in which a particular chromosome, or chromosome segment, is under- or overrepresented are said to be aneuploid (from the Greek words meaning "not", "good", and "fold"). Therefore, the distinction between aneuploidy and polyploidy is that aneuploidy refers to a numerical change in part of the chromosome set, whereas polyploidy refers to a numerical change in the whole set of chromosomes.
Polyploidy may occur due to abnormal cell division, either during mitosis, or commonly during metaphase I in meiosis. In addition, it can be induced in plants and cell cultures by some chemicals: the best known is colchicine, which can result in chromosome doubling, though its use may have other less obvious consequences as well. Oryzalin will also double the existing chromosome content.
Polyploidy occurs in highly differentiated human tissues in the liver, heart muscle and bone marrow. It occurs in the somatic cells of some animals, such as goldfish, salmon, and salamanders, but is especially common among ferns and flowering plants (see "Hibiscus rosa-sinensis"), including both wild and cultivated species. Wheat, for example, after millennia of hybridization and modification by humans, has strains that are diploid (two sets of chromosomes), tetraploid (four sets of chromosomes) with the common name of durum or macaroni wheat, and hexaploid (six sets of chromosomes) with the common name of bread wheat. Many agriculturally important plants of the genus "Brassica" are also tetraploids.
Polyploidization is a mechanism of sympatric speciation because polyploids are usually unable to interbreed with their diploid ancestors. An example is the plant "Erythranthe peregrina". Sequencing confirmed that this species originated from "E. x robertsii", a sterile triploid hybrid between "E. guttata" and "E. lutea," both of which have been introduced and naturalised in the United Kingdom. New populations of "E. peregrina" arose on the Scottish mainland and the Orkney Islands via genome duplication from local populations of "E. x robertsii". Because of a rare genetic mutation, "E. peregrina" is not sterile.
Polyploid types are labeled according to the number of chromosome sets in the nucleus. The letter "x" is used to represent the number of chromosomes in a single set.
- triploid (three sets; 3"x"), for example seedless watermelons, common in the phylum Tardigrada
- tetraploid (four sets; 4"x"), for example Salmonidae fish, the cotton "Gossypium hirsutum "
- pentaploid (five sets; 5"x"), for example Kenai Birch ("Betula papyrifera" var. "kenaica")
- hexaploid (six sets; 6"x"), for example wheat, kiwifruit
- heptaploid or septaploid (seven sets; 7"x")
- octaploid or octoploid, (eight sets; 8"x"), for example "Acipenser" (genus of sturgeon fish), dahlias
- decaploid (ten sets; 10"x"), for example certain strawberries
- dodecaploid (twelve sets; 12"x"), for example the plants "Celosia argentea" and "Spartina anglica" or the amphibian "Xenopus ruwenzoriensis".
Urine catecholamine level can be elevated in pre-clinical neuroblastoma. Screening asymptomatic infants at three weeks, six months, and one year has been performed in Japan, Canada, Austria and Germany since the 1980s. Japan began screening six-month-olds for neuroblastoma via analysis of the levels of homovanillic acid and vanilmandelic acid in 1984. Screening was halted in 2004 after studies in Canada and Germany showed no reduction in deaths due to neuroblastoma, but rather caused an increase in diagnoses that would have disappeared without treatment, subjecting those infants to unnecessary surgery and chemotherapy.
Another way to detect neuroblastoma is the mIBG scan (meta-iodobenzylguanidine), which is taken up by 90 to 95% of all neuroblastomas, often termed "mIBG-avid." The mechanism is that mIBG is taken up by sympathetic neurons, and is a functioning analog of the neurotransmitter norepinephrine. When it is radio-ionated with I-131 or I-123 (radioactive iodine isotopes), it is a very good radiopharmaceutical for diagnosis and monitoring of response to treatment for this disease. With a half-life of 13 hours, I-123 is the preferred isotope for imaging sensitivity and quality. I-131 has a half-life of 8 days and at higher doses is an effective therapy as targeted radiation against relapsed and refractory neuroblastoma.
Amniocentesis and chorionic villus sampling are procedures conducted to assess the fetus. A sample of amniotic fluid is obtained by the insertion of a needle through the abdomen and into the uterus. Chorionic villus sampling is a similar procedure with a sample of tissue removed rather than fluid. These procedures are not associated with pregnancy loss during the second trimester but they are associated with miscarriages and birth defects in the first trimester. Miscarriage caused by invasive prenatal diagnosis (chorionic villus sampling (CVS) and amniocentesis) is rare (about 1%).
A review article in The New England Journal of Medicine based on a consensus meeting of the Society of Radiologists in Ultrasound in America (SRU) has suggested that miscarriage should be diagnosed only if any of the following criteria are met upon ultrasonography visualization: