What karyotype is most likely in a term female newborn with bilateral lower extremity lymphedema and weak femoral pulses?

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Differential Diagnosis for a 1-hour-old Female Newborn with Bilateral Lower Extremity Lymphedema

  • Single most likely diagnosis:
    • 45,X (Turner syndrome): This condition is characterized by lymphedema of the hands and feet at birth, short stature, and other physical abnormalities. The presence of bilateral lower extremity lymphedema in a newborn, along with the patient's short length and low weight, makes Turner syndrome a strong consideration. Karyotype analysis would typically show 45,X, confirming the diagnosis.
  • Other Likely diagnoses:
    • 46,XX (Normal female karyotype with a possible underlying condition causing lymphedema): While the karyotype would be normal, there could be other genetic or congenital conditions leading to lymphedema. However, without additional symptoms or family history, this is less likely to be the primary diagnosis.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
    • None specifically identified in this scenario, as the primary concern is the lymphedema and potential genetic conditions. However, it's crucial to consider other systemic conditions that could present with similar symptoms, even if they are not directly related to karyotype abnormalities.
  • Rare diagnoses:
    • 47,XXX or 47,XXY (Triple X syndrome or Klinefelter syndrome): These conditions are less likely to present with lymphedema as a primary symptom. Triple X syndrome often has mild or no symptoms, and Klinefelter syndrome typically affects males. While not impossible, these are less likely to be the correct diagnosis given the clinical presentation.
    • Other rare genetic syndromes could potentially cause lymphedema, but these would be less common and might require additional symptoms or testing for diagnosis.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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