ALTERNATE NAMES
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Chromosome 18p Tetrasomy; Isochromosome 18p; Chromosome 18 Tetrasomy 18p; Tetrasomy
Short Arm of Chromosome 18; 18p Isochromosome; 18p Tetrasomy
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DESCRIPTION
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Tetrasomy 18p is a chromosomal disorder that occurs when the short arm of chromosome 18 (18p) appears
four times (tetrasomy) rather than the normal two times in cells of the body. This
condition usually causes feeding difficulties in infancy, delayed development, intellectual
disability that is often mild to moderate but can be severe, changes in muscle tone,
distinctive facial features, and other birth defects. The signs and symptoms vary
among affected individuals, and may include seizures, recurrent ear infections, mild
to moderate hearing loss, gastrointestinal problems, and growth hormone deficiency.
The prognosis for persons with Tetrasomy 18p varies depending on the involved body
system. However, degrees of cognitive impairment or intellectual disability are life-long.
Psychiatric conditions, such as attention deficit hyperactivity disorder (ADHD) and
anxiety, as well as social and behavioral challenges have also been reported.
Tetrasomy 18p is a rare disorder, known to affect about 250 families worldwide. It
is usually not inherited, as most affected individuals have no history of the disorder
in their family.
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DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND
ICD-9-CM/ICD-10-CM
CODING
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Diagnostic testing: The diagnosis of Tetrasomy 18p is made by physical examination and routine chromosome
analysis from a blood sample, such as fluorescence in situ hybridization (FISH), and
microarray analysis.
Physical findings: Children with Tetrasomy 18p may have:
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Distinctive physical features;
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Birth defects affecting the heart and other organs.
Males with Tetrasomy 18p may be born with undescended testes (cryptorchidism) or hypospadias.
ICD-9: 758.89
ICD-10: Q99.8
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PROGRESSION
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Onset is congenital.
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TREATMENT
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Treatment of Tetrasomy 18p is symptomatic and supportive and requires ongoing routine
care by a multidisciplinary team specializing in the care of children and adults with
multiple system involvement. The treatment depends upon the clinical features present
and may include evaluations by ophthalmology, otolaryngology and audiology, cardiology,
orthopedics, neurology, endocrinology, and gastroenterology. Children may also benefit
from referral for developmental services and specific medical treatment for congenital
anomalies.
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SUGGESTED PROGRAMMATIC
ASSESSMENT*
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Suggested MER for Evaluation:
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Clinical history and examination that describes the diagnostic features of the impairment;
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Developmental assessment or psychological testing to address allegations of mental
impairment may be warranted.
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Suggested Listings for Evaluation:
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DETERMINATION
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LISTING
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REMARKS
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Meets
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12.05
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Listing-level severity must be documented and evaluated under the most affected body
systems.
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110.08 B
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Listing-level severity must be documented and evaluated under the most affected body
systems.
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111.07
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Listing-level severity must be documented and evaluated under the most affected body
systems.
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112.04
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Listing-level severity must be documented and evaluated under the most affected body
systems.
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112.05
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Listing-level severity must be documented and evaluated under the most affected body
systems.
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Equals |
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* Adjudicators may, at their discretion, use the Medical Evidence of Record or the
listings suggested to evaluate the claim. However, the decision to allow or deny the
claim rests with the adjudicator.
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