Follow-up of an intelligent odd-mannered teenager with del(3)(p26). Remarks on authorship and ethical commitment

Abstract

A male teenager formerly found to have a 46,XY,del(3)(p26)de novo karyotype was restudied. At the age of 148/12 yr, he attends the last grade of middle school and was a cooperating teenager with slender habitus, severe myopia, prominent nose, sacral dimples, pubertal stage Tanner III, and multiple surgical scars. Neuropsychological studies revealed a full scale IQ of 95 with slow performance (WISC-IV Spanish test) as well as an internalizing behavioral profile, poor social skills, a mild attention deficit, somatic complaints, and a feminized gender role. FISH with the 3p subtelomeric probe revealed that the deleted chromosome actually lacked the specific signal (n=10 cells). The patient's average intelligence confirms that euchromatic imbalances do not necessarily cause mental retardation and suggests that his deletion actually included the CALL gene, the Contactin 4 gene and other 3p26 genes related to intellectual capabilities; yet, the resulting hemizygosity either did not lead to haploinsufficiency or was minimally expressed. Moreover, the patient's peculiar cognitive and behavioral profile suggests that the 3p26 deletion is associated with a distinctive neuropsychological phenotype. Incidentally we comment on authorship and publication ethics in order to urge our institutional ethics committee to arbitrate authorship conflicts and thereby be consistent with its ethical commitment.