DOWN SYNDROME

also called Down's syndrome, trisomy 21, or (formerly) Mongolism, congenital disorder caused by an extra chromosome on the chromosome 21 pair, thus giving the person a total of 47 chromosomes rather than the normal 46. Persons born with Down syndrome are characterized by several of the following: broad, flat face; short neck; up-slanted eyes, sometimes with an inner epicanthal fold; low-set ears; small nose and enlarged tongue and lips; sloping underchin; poor muscle tone; mental retardation; heart or kidney malformations or both; and abnormal dermal ridge patterns on fingers, palms, and soles. The mental retardation seen in persons with Down syndrome is usually moderate, though in some it may be mild or severe. Congenital heart disease is found in about 40 percent of people with Down syndrome. Most persons with Down syndrome have an extra (third) chromosomea condition known as trisomyassociated with the chromosome 21 pair. Almost all individuals with Down syndrome have this trisomy, but a small number (perhaps 4 percent) have an abnormality called translocation, in which the extra chromosome in the 21 pair breaks off and attaches itself to another chromosome. The cause of the chromosomal abnormalities in Down syndrome remains unknown. Down syndrome occurs in about 1 in every 800 live births. The incidence of the disorder increases markedly in the offspring of women over the age of 35. This is illustrated by the fact that Down syndrome's incidence in the offspring of young women is only about 1 in 1,000, while its incidence in those of women over age 40 is about 1 in 40. Down syndrome can be diagnosed prenatally by the presence of the abnormal chromosome in samples of fetal cells taken from the amniotic fluid. With modern medical care, most persons with Down syndromeexcept those with major heart defects that cannot be corrected by surgerylive into adulthood. They do have a shorter life expectancy (55) than normal adults, though, because they develop the degenerative conditions of old age prematurely. Because persons with Down syndrome are mentally retarded to varying degrees, some never become self-supporting. The majority can, however, be taught to contribute usefully in the home or in a sheltered working or living environment after they are grown.