title: Double trisomy 48,XXX,+18 with multiple dysmorphic features.
abstract: BACKGROUND
  Chromosomal abnormality is a common cause of congenital anomalies, psychiatric disorders, and mental retardation. However, the double trisomy 48,XXX,+18 is a rare chromosome abnormality.
  
  
  METHODS
  Case report and literature review.
  
  
  RESULTS
  A 7-hour-old girl presented to our unit because of poor response after birth. She presented with multiple dysmorphic features, including small for gestational age infant, flat nasal bridge, widely-spaced eyes, the left thumb deformities, flat facial profile, raised sternum, ventricular septal defect, the third lateral brain ventricle enlargement, and small liver. This case expands the spectrum of malformations reported in association with the double trisomy 48,XXX,+18. The literature on 16 fetuses or infants with the 48,XXX,+18 were also reviewed.
  
  
  CONCLUSIONS
  These data suggested that in patients with clinical features similar to trisomy 18, especially with anomalies of the ears and/or reproductive malformations, double trisomy (48,XXX,+18) should be considered and karyotyping should be performed although it is a rare disease.
authors.affiliation: Department of Pediatrics, Children's Hospital, Zhejiang University School of Medicine and the Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, Hangzhou, China.
authors.forename: Zi-Yan
authors.initials: ZY
authors.lastname: Jiang
authors.forename: Xiao-Hui
authors.initials: XH
authors.lastname: Wu
authors.forename: Chao-Chun
authors.initials: CC
authors.lastname: Zou
mesh_terms: D000015:Abnormalities, Multiple / Q000235:genetics*; D002887:Chromosomes, Human, Pair 18 / Q000235:genetics; D041321:Chromosomes, Human, X / Q000235:genetics*; D020732:Cytogenetic Analysis; D004431:Ear, External / Q000002:abnormalities; D005260:Female; D006330:Heart Defects, Congenital / Q000235:genetics; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007621:Karyotyping; D014314:Trisomy / Q000235:genetics*; D000073842:Trisomy 18 Syndrome
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