Korean J Lab Med.  2010 Oct;30(5):521-524. 10.3343/kjlm.2010.30.5.521.

Blood Chimerism in a Dizygotic Dichorionic Pregnancy

• Jang JH
• Jung H
• Kim JH
• Park WS
• Kim SH

• KMID: 1022045
• DOI: http://doi.org/10.3343/kjlm.2010.30.5.521

Abstract

Blood chimerism in twins is known to occur through the transfer of hematopoietic stem cells between the fetuses via a common placenta. We present a case of blood chimerism in a dizygotic dichorionic twin pregnancy. The female twin was delivered at 34 weeks of gestation, and the male twin was stillborn. Pathologic examination confirmed dichorionic diamniotic placentas. The karyotype of the female child was obtained using peripheral blood sample, and it revealed a mixture of 46,XX and 46,XY cells (chi 46,XY[13]/46,XX[7]). FISH analysis performed on the buccal cells by using CEP X/Y probe (Abbott Molecular Inc., USA) revealed 100% XX signals (nuc ish Xcen(DXZ1x2)[500]). Gross examination of the external genitalia and abdominal ultrasonography revealed no definitive abnormal findings in relation to sex differentiation. When XX/XY chimerism is present in blood lymphocytes, careful examination of external genitalia and reproductive organs and further studies are required to detect chimerism in non-hematopoetic tissues. This is a rare case of blood chimerism in dichorionic placentas, in contrast to those in monochorionic placentas.

Keyword

Blood chimerism; Dizygotic dichorionic twins; Vascular anastomosis

MeSH Terms

Adult
Blood Group Incompatibility/*genetics/ultrasonography
Chimerism/*embryology
Diseases in Twins/*genetics/ultrasonography
Female
Fertilization in Vitro
Gestational Age
Humans
In Situ Hybridization, Fluorescence
Infant, Newborn
Karyotyping
Male
Pregnancy
Twins, Dizygotic/*genetics
Ultrasonography, Prenatal

Figure

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  Fig. 1. G-banded karyotype of the patient's peripheral blood showing an admixture of 46,XY (A) and 46,XX (B) (chi 46,XY[13]/46,XX[7]).

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  Fig. 2. FISH X/Y showing that all interphase nuclei have XX signals (nuc ish Xcen(DXZ1×2)[500]).

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