03/03/2026
📢 New publication alert
Pleased to share our recent case report in the American Journal of Medical Genetics Part A on nucleotide-level breakpoint resolution of a genomically balanced complex chromosomal rearrangement ( ).
What makes this case special is the scale and mechanism: the CCR is balanced yet highly complex, involving 8 chromosomes (1, 4, 5, 6, 7, 15, 16 and X) and multiple breakpoint junctions—the largest reported to date, with a pattern likely driven by .
🔬 Our combinatorial “orthogonal” workflow
To solve this, we used a sequential, layered approach:
1. Conventional karyotyping to detect a CCR initially involving 5 chromosomes
2. Multicolor/spectral FISH toolbox (e.g., whole chromosome painting + multicolor banding) to map derivative chromosomes and refine the structure
3. Chromosomal microarray
4. Long-read on the PacBio Revio platform, followed by a custom SV-calling/curation workflow developed at together with Yale Centre for Genome Analysis, to resolve breakpoints at high resolution
Long-read sequencing expanded the event to 8 chromosomes with 14 breakpoints, including rearrangements that were missed by karyotype due to resolution limits.
💡 Why this matters?
Even when a CCR is “balanced” by copy-number testing, it can be functionally disruptive—in our case, breakpoint mapping implicated disruption of genes including NLGN4X, LAMA4 and ALG6, strengthening genotype–phenotype correlation and informing counseling.
📂 Link to the publication: https://onlinelibrary.wiley.com/doi/abs/10.1002/ajmg.a.70105
Yale University Jayesh Sheth Frenny Sheth Harsh Sheth
Molecular characterization of balanced complex chromosomal rearrangements (CCR) aids in understanding the pathophysiological mechanism and corresponding genotype–phenotype correlations. The present c...