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DOWN SYNDROME
By S G Yadunand
DOWN SYNDROME / MONGOLISM
 Categorised under Cytogenetic abnormalities.
• Numerical abnormality b) Structural abnormality
• Most common Chromosomal disorder
• Common cause for Mental Retardation (I Q >40)
• Delayed Milestones (both physical and mental)
• Cheerful idiot refers to a child with Mongolism
Somatic Cells – Diploid (2N) – 44 Autosomes + 2 Sex
chromosomes (XX/XY) = 46 Chromosomes
Germ Cells – Haploid (N) – 23 Chromosomes
Down Syndrome – 46 + 1 = 47 Chromosomes
CAUSES
• Trisomy of Chromosome 21
in 95% of cases
so total of 47 Chromosomes instead of 46
last series of pregnancy or either first born is affected
associated with pregnancy
risk increases with increase in maternal age
• Translocation of Chromosome 21 with Chromosome 13/14/15
in 4% cases
KEY FEATURES
 MOTHER’S
• A 40+ y/o mother ( during the time of pregnancy )
• Delivery took place at home.
• No proper labour care.
• Last child born.
• Less educated and poor economic family background.
KEY FEATURES
 BABY’S
• Microcephaly with occiput.
• Flat bridge of nose and short nose.
• Protruding tongue.
• Mongoloid strands.
• Epicanthial folds.
• Ear- low set and small.
• Hands- short fingers and broad palm.
• Palm crease- simian crease.
• Feet – wide gape between big and second toes.
• Delay in developmental milestones
• Tend to have more fluid in their neck
COMPLICATIONS
• Coronary heart diseases (50% cases)
• Leukemia ( most of the cases )
• Recurrent respiratory infections
• Intestinal obstruction (due to duodenal atresia)
• Late onset cataract.
DIAGNOSIS
• Chromosomal studies
• Karyotyping
DIFFERENTIAL DIAGNOSIS
• Congenital hypothyroidism
• Turner syndrome
• Edward syndrome
• Spina bifida
• Zellweger syndrome
• Angelman syndrome
Thank you

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Down syndrome

  • 1. DOWN SYNDROME By S G Yadunand
  • 2.
  • 3.
  • 4. DOWN SYNDROME / MONGOLISM  Categorised under Cytogenetic abnormalities. • Numerical abnormality b) Structural abnormality • Most common Chromosomal disorder • Common cause for Mental Retardation (I Q >40) • Delayed Milestones (both physical and mental) • Cheerful idiot refers to a child with Mongolism
  • 5. Somatic Cells – Diploid (2N) – 44 Autosomes + 2 Sex chromosomes (XX/XY) = 46 Chromosomes Germ Cells – Haploid (N) – 23 Chromosomes Down Syndrome – 46 + 1 = 47 Chromosomes
  • 6. CAUSES • Trisomy of Chromosome 21 in 95% of cases so total of 47 Chromosomes instead of 46 last series of pregnancy or either first born is affected associated with pregnancy risk increases with increase in maternal age • Translocation of Chromosome 21 with Chromosome 13/14/15 in 4% cases
  • 7. KEY FEATURES  MOTHER’S • A 40+ y/o mother ( during the time of pregnancy ) • Delivery took place at home. • No proper labour care. • Last child born. • Less educated and poor economic family background.
  • 8. KEY FEATURES  BABY’S • Microcephaly with occiput. • Flat bridge of nose and short nose. • Protruding tongue. • Mongoloid strands. • Epicanthial folds. • Ear- low set and small. • Hands- short fingers and broad palm. • Palm crease- simian crease. • Feet – wide gape between big and second toes. • Delay in developmental milestones • Tend to have more fluid in their neck
  • 9.
  • 10.
  • 11.
  • 12. COMPLICATIONS • Coronary heart diseases (50% cases) • Leukemia ( most of the cases ) • Recurrent respiratory infections • Intestinal obstruction (due to duodenal atresia) • Late onset cataract.
  • 13.
  • 15. DIFFERENTIAL DIAGNOSIS • Congenital hypothyroidism • Turner syndrome • Edward syndrome • Spina bifida • Zellweger syndrome • Angelman syndrome
  • 16.
  • 17.