Prenatal diagnosis of supernumerary marker 15 chromosomes and exclusion of uniparental disomy for chromosome 15

Supernumerary marker chromosomes (SMC) were identified in amniocytes from two unrelated fetuses. Fluorescence in situ hybridization (FISH) characterization of the SMC showed they were derived from chromosome 15; SMC(15). Parental karyotyping demonstrated the SMC(15) to be de novo in one fetus and paternally derived in the other. Previous reports showed that the presence or absence of the Prader-Willi/Angelman syndrome (PWS/AS) critical region, loci D15S11 and distal, in a SMC(15) was associated with an abnormal or normal phenotype, respectively. FISH analysis demonstrated both SMC(15) lacked the D15S11 locus. Because SMC(15) were found at an increased incidence in patients with PWS/AS, we performed methylation analysis at the SNRPN locus to exclude a deletion or uniparental disomy (UPD) of chromosome 15. Both probands showed biparental inheritance at this locus. Based on the FISH and molecular analyses, both fetuses were predicted to have a normal phenotype. The pregnancies were continued and both probands are phenotypically and developmentally normal. These cases illustrate the importance of a combination of family studies, FISH characterization and molecular analyses in SMC(15) identified prenatally. In particular, any chromosome 15 rearrangement identified at prenatal diagnosis should be considered a candidate for UPD15 studies.