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Four X syndrome

MedGen UID:
120544
Concept ID:
C0265496
Disease or Syndrome
Synonyms: 48 XXXX; 48 XXXX syndrome; Tetrasomy X
SNOMED CT: Four X syndrome (10567003); XXXX syndrome (10567003); Tetrasomy X (10567003)
 
Monarch Initiative: MONDO:0019525
Orphanet: ORPHA9

Definition

A sex chromosome anomaly caused by the presence of two extra X chromosomes in females (48,XXXX instead of 46,XX). This disorder is associated with delayed speech, learning difficulties, developmental delay and facial dysmorphism. Although disease severity is variable, the learning difficulties and developmental delay are generally mild to moderate. Commonly associated facial features include hypertelorism, upslanting palpebral fissures, epicanthal folds and a flat nasal bridge. Other anomalies may include dental abnormalities, hypotonia and joint laxity, radioulnar synostosis, heart defects, hip dysplasia, and ovarian dysfunction. An increased susceptibility to infections during childhood has also been reported. [from SNOMEDCT_US]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVFour X syndrome
Follow this link to review classifications for Four X syndrome in Orphanet.

Professional guidelines

PubMed

Liu J
J Matern Fetal Neonatal Med 2023 Dec;36(1):2206943. doi: 10.1080/14767058.2023.2206943. PMID: 37142428
Robertson GL
Handb Clin Neurol 2021;181:239-248. doi: 10.1016/B978-0-12-820683-6.00017-8. PMID: 34238460
Farrugia FA, Martikos G, Tzanetis P, Charalampopoulos A, Misiakos E, Zavras N, Sotiropoulos D
Endocr Regul 2017 Jul 1;51(3):168-181. doi: 10.1515/enr-2017-0018. PMID: 28858847

Recent clinical studies

Etiology

Wren G, Davies W
Eur J Med Genet 2022 Apr;65(4):104459. Epub 2022 Feb 19 doi: 10.1016/j.ejmg.2022.104459. PMID: 35189376
Colombo L, Maltese PE, Castori M, El Shamieh S, Zeitz C, Audo I, Zulian A, Marinelli C, Benedetti S, Costantini A, Bressan S, Percio M, Ferri P, Abeshi A, Bertelli M, Rossetti L
Invest Ophthalmol Vis Sci 2021 Feb 1;62(2):13. doi: 10.1167/iovs.62.2.13. PMID: 33576794Free PMC Article
Lubs HA, Stevenson RE, Schwartz CE
Am J Hum Genet 2012 Apr 6;90(4):579-90. doi: 10.1016/j.ajhg.2012.02.018. PMID: 22482801Free PMC Article
Müller U
Brain 2009 Aug;132(Pt 8):2005-25. Epub 2009 Jul 3 doi: 10.1093/brain/awp172. PMID: 19578124
Hamel CP
Orphanet J Rare Dis 2007 Feb 1;2:7. doi: 10.1186/1750-1172-2-7. PMID: 17270046Free PMC Article

Diagnosis

Neri S, Maia N, Fortuna AM, Damasio J, Coale E, Willis M, Jorge P, Højte AF, Fenger CD, Møller RS, Bayat A
Eur J Med Genet 2022 Nov;65(11):104624. Epub 2022 Sep 18 doi: 10.1016/j.ejmg.2022.104624. PMID: 36130690
Colombo L, Maltese PE, Castori M, El Shamieh S, Zeitz C, Audo I, Zulian A, Marinelli C, Benedetti S, Costantini A, Bressan S, Percio M, Ferri P, Abeshi A, Bertelli M, Rossetti L
Invest Ophthalmol Vis Sci 2021 Feb 1;62(2):13. doi: 10.1167/iovs.62.2.13. PMID: 33576794Free PMC Article
Graham JM Jr, Schwartz CE
Am J Med Genet A 2013 Nov;161A(11):2734-40. Epub 2013 Oct 10 doi: 10.1002/ajmg.a.36183. PMID: 24123922Free PMC Article
Lubs HA, Stevenson RE, Schwartz CE
Am J Hum Genet 2012 Apr 6;90(4):579-90. doi: 10.1016/j.ajhg.2012.02.018. PMID: 22482801Free PMC Article
Hamel CP
Orphanet J Rare Dis 2007 Feb 1;2:7. doi: 10.1186/1750-1172-2-7. PMID: 17270046Free PMC Article

Therapy

Jonkman AH, Alcala GC, Pavlovsky B, Roca O, Spadaro S, Scaramuzzo G, Chen L, Dianti J, Sousa MLA, Sklar MC, Piraino T, Ge H, Chen GQ, Zhou JX, Li J, Goligher EC, Costa E, Mancebo J, Mauri T, Amato M, Brochard LJ; Pleural Pressure Working Group (PLUG)
Am J Respir Crit Care Med 2023 Jul 1;208(1):25-38. doi: 10.1164/rccm.202212-2300OC. PMID: 37097986Free PMC Article
Sandsdal RM, Juhl CR, Jensen SBK, Lundgren JR, Janus C, Blond MB, Rosenkilde M, Bogh AF, Gliemann L, Jensen JB, Antoniades C, Stallknecht BM, Holst JJ, Madsbad S, Torekov SS
Cardiovasc Diabetol 2023 Feb 25;22(1):41. doi: 10.1186/s12933-023-01765-z. PMID: 36841762Free PMC Article
Knight EMP, Amin S, Bahi-Buisson N, Benke TA, Cross JH, Demarest ST, Olson HE, Specchio N, Fleming TR, Aimetti AA, Gasior M, Devinsky O; Marigold Trial Group
Lancet Neurol 2022 May;21(5):417-427. doi: 10.1016/S1474-4422(22)00077-1. PMID: 35429480
Seidi F, Bayattork M, Minoonejad H, Andersen LL, Page P
Sci Rep 2020 Nov 26;10(1):20688. doi: 10.1038/s41598-020-77571-4. PMID: 33244045Free PMC Article
Hanchard NC, Lenza M, Handoll HH, Takwoingi Y
Cochrane Database Syst Rev 2013 Apr 30;2013(4):CD007427. doi: 10.1002/14651858.CD007427.pub2. PMID: 23633343Free PMC Article

Prognosis

Zhao WH, Wang BY, Chen LJ, Fu WJ, Xu J, Liu J, Jin SW, Chen YX, Cao XM, Yang Y, Zhang YL, Wang FX, Zhang PY, Lei B, Gu LF, Wang JL, Zhang H, Bai J, Xu Y, Zhu H, Du J, Jiang H, Fan XH, Li JY, Hou J, Chen Z, Zhang WG, Mi JQ, Chen SJ, He AL
J Hematol Oncol 2022 Jul 6;15(1):86. doi: 10.1186/s13045-022-01301-8. PMID: 35794616Free PMC Article
Colombo L, Maltese PE, Castori M, El Shamieh S, Zeitz C, Audo I, Zulian A, Marinelli C, Benedetti S, Costantini A, Bressan S, Percio M, Ferri P, Abeshi A, Bertelli M, Rossetti L
Invest Ophthalmol Vis Sci 2021 Feb 1;62(2):13. doi: 10.1167/iovs.62.2.13. PMID: 33576794Free PMC Article
Swinney CC, Han DP, Karth PA
Ophthalmic Surg Lasers Imaging Retina 2015 Jun;46(6):650-7. doi: 10.3928/23258160-20150610-09. PMID: 26114846
Restrepo CS, Ocazionez D
Semin Ultrasound CT MR 2011 Oct;32(5):456-69. doi: 10.1053/j.sult.2011.03.007. PMID: 21963166
Hamel CP
Orphanet J Rare Dis 2007 Feb 1;2:7. doi: 10.1186/1750-1172-2-7. PMID: 17270046Free PMC Article

Clinical prediction guides

van Tilburg SJ, Teunissen CE, Maas CCHM, Thomma RCM, Walgaard C, Heijst H, Huizinga R, van Doorn PA, Jacobs BC
EBioMedicine 2024 Apr;102:105072. Epub 2024 Mar 22 doi: 10.1016/j.ebiom.2024.105072. PMID: 38518653Free PMC Article
Neri S, Maia N, Fortuna AM, Damasio J, Coale E, Willis M, Jorge P, Højte AF, Fenger CD, Møller RS, Bayat A
Eur J Med Genet 2022 Nov;65(11):104624. Epub 2022 Sep 18 doi: 10.1016/j.ejmg.2022.104624. PMID: 36130690
Quach TT, Stratton HJ, Khanna R, Kolattukudy PE, Honnorat J, Meyer K, Duchemin AM
Acta Neuropathol 2021 Feb;141(2):139-158. Epub 2020 Nov 23 doi: 10.1007/s00401-020-02244-5. PMID: 33226471Free PMC Article
Casanova JL, Abel L
Semin Immunol 2018 Apr;36:1-12. Epub 2017 Dec 16 doi: 10.1016/j.smim.2017.12.008. PMID: 29254755Free PMC Article
Toutain A, Ayrault AD, Moraine C
Am J Med Genet 1997 Aug 22;71(3):305-14. doi: 10.1002/(sici)1096-8628(19970822)71:3<305::aid-ajmg11>3.0.co;2-o. PMID: 9268101

Recent systematic reviews

Petriti U, Dudman DC, Scosyrev E, Lopez-Leon S
Syst Rev 2023 Jan 16;12(1):5. doi: 10.1186/s13643-023-02169-6. PMID: 36642718Free PMC Article
Shear MA, Swanson K, Garg R, Jelin AC, Boscardin J, Norton ME, Sparks TN
Prenat Diagn 2023 Feb;43(2):133-143. Epub 2023 Jan 8 doi: 10.1002/pd.6298. PMID: 36588186Free PMC Article
Bhandari AP, Nnate DA, Vasanthan L, Konstantinidis M, Thompson J
Cochrane Database Syst Rev 2022 Jun 6;6(6):CD003645. doi: 10.1002/14651858.CD003645.pub4. PMID: 35661343Free PMC Article
Rosa D, Terzoni S, Dellafiore F, Destrebecq A
Occup Med (Lond) 2019 Jun 24;69(4):237-243. doi: 10.1093/occmed/kqz063. PMID: 31132107
Hanchard NC, Lenza M, Handoll HH, Takwoingi Y
Cochrane Database Syst Rev 2013 Apr 30;2013(4):CD007427. doi: 10.1002/14651858.CD007427.pub2. PMID: 23633343Free PMC Article

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