A female patient with clinical signs and symptoms of a demyelinating n
europathy was shown to have a duplication of the 1.5-Mb region on chro
mosome 17p11.2, typical of the great majority of cases of Charcot-Mari
e-Tooth disease type IA (CMT1A). However, analysis of DNA extracted fr
om peripheral blood revealed a 2:2.4 instead of the usual 2:3 ratio be
tween the 7.8- and 6.0-kb EcoRI fragments in the proximal and distal r
epetitive extragenic palindromic (REP) elements of CMT1A. Detection of
a 3.2-kb EcoRI/SacI kb junction fragment with probe pLR7.8 confirmed
the CMT1A duplication. The dosage of this junction fragment, compared
with a 2.8-kb EcoRI/SacI fragment of the proximal REP elements of CMT1
A, was 2:0.58 instead of the expected 2:1 dosage for heterozygous CMT1
A duplications. We hypothesized that the lower dosages of these restri
ction fragments specific for the CMT1A duplication were due to mosaici
sm; this was confirmed by fluorescence in situ hybridization analysis
with the D17S122-specific probe pVAW409R1. In peripheral blood lymphoc
ytes the percentage of interphase nuclei with a duplication in 17p11.2
was 49%. In interphase nuclei extracted from buccal mucosa, hair-root
cells or paraffin-embedded nervous tissue the duplication was detecta
ble in 51%, 66% and 74%, respectively. This is the first report of mos
aicism in a patient with a CMT1A duplication identified by three diffe
rent and independent techniques.