En la herencia ligada al X dominante, clásicamente se ha considerado que el patrón de transmisión se produce de mujeres portadoras a varones afectos, y que por tanto, una mujer portadora tendría una probabilidad de concebir un 50% de varones afectos y un 50% de mujeres portadoras. Sin embargo este supuesto sólo se cumple en el caso de herencia ligada al X recesiva, que sigue un patrón similar al de las enfermedades autosómico recesivas.
Además, existen determinadas circunstancias que pueden dar lugar a un patrón de herencia ligado al X “invertido”, con mujeres afectas y hombres no afectos. Este fenómeno paradójico se produce en varias enfermedades neurológicas relevantes, la más conocida el síndrome de Rett. No existe un mecanismo único que explique este hecho, sino que en función de la enfermedad, su base fisiopatológica es el fenómeno de lionización , la teoría de la adhesión celular, o el fallecimiento masculino precoz.
https://www.mdpi.com/1422-0067/22/17/9610
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