Skip to main content
Journal of Medical Genetics logoLink to Journal of Medical Genetics
. 1998 May;35(5):420–424. doi: 10.1136/jmg.35.5.420

49,XXXXY: a distinct phenotype. Three new cases and review.

J Peet 1, D D Weaver 1, G H Vance 1
PMCID: PMC1051319  PMID: 9610808

Abstract

Over 100 cases of 49,XXXXY syndrome have been published to date. Classic findings include radioulnar synostosis, hypogonadism, and mental retardation. The majority of reported cases have not distinguished the 49,XXXXY syndrome from Klinefelter syndrome (47,XXY), and these patients are frequently labelled as having Klinefelter syndrome or as being a "Klinefelter variant." Because of distinct clinical features, we delineate the 49,XXXXY syndrome as separate from Klinefelter syndrome, and emphasise the prevalence of congenital heart defects. We also report three new cases of 49,XXXXY syndrome and briefly discuss patient management.

Full text

PDF
420

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Borghgraef M., Fryns J. P., Smeets E., Marien J., van Den Berghe H. The 49,XXXXY syndrome. Clinical and psychological follow-up data. Clin Genet. 1988 Jun;33(6):429–434. doi: 10.1111/j.1399-0004.1988.tb03476.x. [DOI] [PubMed] [Google Scholar]
  2. Boyd J. H., Buchin S. Y. The chromosome 49, XXXXY syndrome: report of a case in an adult. Ariz Med. 1976 Jul;33(7):546–550. [PubMed] [Google Scholar]
  3. Cowie V. A., Singh K. R., Wheater R. 49, XXXYY chromosome anomaly in a mentally retarded man. Br J Psychiatry. 1986 Feb;148:210–212. doi: 10.1192/bjp.148.2.210. [DOI] [PubMed] [Google Scholar]
  4. Curfs L. M., Schreppers-Tijdink G., Wiegers A., Borghgraef M., Fryns J. P. The 49,XXXXY syndrome: clinical and psychological findings in five patients. J Ment Defic Res. 1990 Jun;34(Pt 3):277–282. doi: 10.1111/j.1365-2788.1990.tb01539.x. [DOI] [PubMed] [Google Scholar]
  5. Deng H. X., Abe K., Kondo I., Tsukahara M., Inagaki H., Hamada I., Fukushima Y., Niikawa N. Parental origin and mechanism of formation of polysomy X: an XXXXX case and four XXXXY cases determined with RFLPs. Hum Genet. 1991 Apr;86(6):541–544. doi: 10.1007/BF00201538. [DOI] [PubMed] [Google Scholar]
  6. FRACCARO M., KAIJSER K., LINDSTEN J. A child with 49 chromosomes. Lancet. 1960 Oct 22;2(7156):899–902. doi: 10.1016/s0140-6736(60)91963-2. [DOI] [PubMed] [Google Scholar]
  7. Griebel V., Krägeloh-Mann I., Ruitenbeek W., Trijbels J. M., Paulus W. A mitochondrial myopathy in an infant with lactic acidosis. Dev Med Child Neurol. 1990 Jun;32(6):528–531. doi: 10.1111/j.1469-8749.1990.tb16979.x. [DOI] [PubMed] [Google Scholar]
  8. Hayek A., Riccardi V., Atkins L., Hendren H. 49,XXXXY chromossomal anomaly in a neonate. J Med Genet. 1971 Jun;8(2):220–221. doi: 10.1136/jmg.8.2.220. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hecht F. Observations on the natural history of 49,XXXXY individuals. Am J Med Genet. 1982 Nov;13(3):335–336. doi: 10.1002/ajmg.1320130319. [DOI] [PubMed] [Google Scholar]
  10. Huang T. H., Greenberg F., Ledbetter D. H. Determination of the origin of nondisjunction in a 49,XXXXY male using hypervariable dinucleotide repeat sequences. Hum Genet. 1991 Apr;86(6):619–620. doi: 10.1007/BF00201553. [DOI] [PubMed] [Google Scholar]
  11. Karsh R. B. Congenital heart disease in 49, XXXXY syndrome. Pediatrics. 1975 Sep;56(3):462–464. [PubMed] [Google Scholar]
  12. Kleczkowska A., Fryns J. P., Van den Berghe H. X-chromosome polysomy in the male. The Leuven experience 1966-1987. Hum Genet. 1988 Sep;80(1):16–22. doi: 10.1007/BF00451449. [DOI] [PubMed] [Google Scholar]
  13. Kushnick T., Colondrillo M. 49, XXXXY patient with hemifacial microsomia. Clin Genet. 1975 May-Jun;7(5):442–448. doi: 10.1111/j.1399-0004.1975.tb00355.x. [DOI] [PubMed] [Google Scholar]
  14. Leal C. A., Belmont J. W., Nachtman R., Cantu J. M., Medina C. Parental origin of the extra chromosomes in polysomy X. Hum Genet. 1994 Oct;94(4):423–426. doi: 10.1007/BF00201605. [DOI] [PubMed] [Google Scholar]
  15. Linden M. G., Bender B. G., Robinson A. Sex chromosome tetrasomy and pentasomy. Pediatrics. 1995 Oct;96(4 Pt 1):672–682. [PubMed] [Google Scholar]
  16. Lomelino C. A., Reiss A. L. 49,XXXXY syndrome: behavioural and developmental profiles. J Med Genet. 1991 Sep;28(9):609–612. doi: 10.1136/jmg.28.9.609. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Meschede D., Nekarda T., Kececioglu D., Löser H., Vogt J., Miny P., Horst J. Congenital heart disease in the 48,XXYY syndrome. Clin Genet. 1995 Aug;48(2):100–102. doi: 10.1111/j.1399-0004.1995.tb04064.x. [DOI] [PubMed] [Google Scholar]
  18. Morić-Petrović S., Laca Z., Marković S., Marković V. 49, XXXXY karyotype in mentally retarded boy. J Ment Defic Res. 1973 Mar;17(1):73–80. doi: 10.1111/j.1365-2788.1973.tb01187.x. [DOI] [PubMed] [Google Scholar]
  19. Pallister P. D. 49,XXXXY syndrome. Am J Med Genet. 1982 Nov;13(3):337–339. doi: 10.1002/ajmg.1320130320. [DOI] [PubMed] [Google Scholar]
  20. Sarto G. E., Otto P. G., Kuhn E. M., Therman E. What causes the abnormal phenotype in a 49,XXXXY male? Hum Genet. 1987 May;76(1):1–4. doi: 10.1007/BF00283041. [DOI] [PubMed] [Google Scholar]
  21. Scheres J. M., Merkx G. F., Hustinx T. W. Prometaphase banding of human chromosomes with basic fuchsin. Hum Genet. 1982;61(1):8–11. doi: 10.1007/BF00291322. [DOI] [PubMed] [Google Scholar]
  22. Schmidt R., Pajewski M., Rosenblatt M. Epiphysial dysplasia: a constant finding in the XXXXY syndrome. J Med Genet. 1978 Aug;15(4):282–287. doi: 10.1136/jmg.15.4.282. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Sergovich F., Uilenberg C., Pozsonyi J. The 49,XXXXX chromosome constitution: similarities to the 49,XXXXY condition. J Pediatr. 1971 Feb;78(2):285–290. doi: 10.1016/s0022-3476(71)80013-6. [DOI] [PubMed] [Google Scholar]
  24. Sijmons R. H., van Essen A. J., Visser J. D., Iprenburg M., Nelck G. F., Vos-Bender M. L., de Jong B. Congenital knee dislocation in a 49,XXXXY boy. J Med Genet. 1995 Apr;32(4):309–311. doi: 10.1136/jmg.32.4.309. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Singh T. H., Rajkowa S. 49, XXXXY chromosome anomaly: an unusual variant of Klinefelter's syndrome. Br J Psychiatry. 1986 Feb;148:209–210. doi: 10.1192/bjp.148.2.209. [DOI] [PubMed] [Google Scholar]
  26. Villamar M., Benitez J., Fernández E., Ayuso C., Ramos C. Parental origin of chromosomal nondisjunction in a 49,XXXXY male using recombinant-DNA techniques. Clin Genet. 1989 Sep;36(3):152–155. doi: 10.1111/j.1399-0004.1989.tb03181.x. [DOI] [PubMed] [Google Scholar]
  27. Zaleski W. A., Houston C. S., Pozsonyi J., Ying K. L. The XXXXY chromosome anomaly: report of three new cases and review of 30 cases from the literature. Can Med Assoc J. 1966 May 28;94(22):1143–1154. [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Medical Genetics are provided here courtesy of BMJ Publishing Group

RESOURCES