In males affected by a special form of X-linked mental retardation a characteristic chromosomal abnormality can be demonstrated, - i.e. a fragile site on the long arm of the X chromosome, fra(X) (q27 or 28) (marker-X chromosome). Male carriers are physically normal, but in most cases show macroorchidism. The demonstration of the marker-X chromosome requires special cell culture conditions, above all a folic acid-deficient medium. The frequency of cells with fragile X chromosome varies interindividually, ranging from 2 to 50%. In female heterozygous carriers the number of cells with fra(X) decreases with age and cannot be demonstrated in some cases. Distribution and frequency of X-linked mental retardation with marker-X chromosome and macro-orchidism are discussed, as well as possibilities of prenatal diagnosis of this disorder.

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