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During the last 15\u2009years, we performed CMA in approximately 8,000 patients with neurodevelopmental and\/or congenital disorders, of which 13 (0.16%) genetically catastrophic complex chromosomal rearrangements were identified. These ultrarare rearrangements showed clustering of breakpoints, characteristic of chromoanagenesis events. Al1 13 complex events display underlying formation mechanisms, originating either by a synchronization of the shattering of clustered chromosome regions in which regional asynchrony of DNA replication may be one of the main causes of disruption. We provide an overview of the copy number profiling in these patients. Although several previous studies have suggested that chromoanagenesis is often a genetic disease source in postnatal diagnostic screening, due to either the challenge of clinical interpretation of these complex rearrangements or the limitation of microarray resolution relative to the small size and complexity of chromogenic induced chromosome abnormalities, bringing further attention and to study its occurrence in the clinical setting is extremely important.<\/jats:p>","DOI":"10.1002\/ajmg.a.62237","type":"journal-article","created":{"date-parts":[[2021,5,14]],"date-time":"2021-05-14T12:06:21Z","timestamp":1620993981000},"page":"2335-2344","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Congenital chromoanagenesis in the routine postnatal chromosomal microarray analyses"],"prefix":"10.1002","volume":"185","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5930-5269","authenticated-orcid":false,"given":"Darine","family":"Villela","sequence":"first","affiliation":[{"name":"The Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology Institute of Biosciences, University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"GeneOne, DASA  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia C.","family":"Mazzonetto","sequence":"additional","affiliation":[{"name":"GeneOne, DASA  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele P.","family":"Migliavacca","sequence":"additional","affiliation":[{"name":"GeneOne, DASA  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1368-2381","authenticated-orcid":false,"given":"Eduardo","family":"Perrone","sequence":"additional","affiliation":[{"name":"GeneOne, DASA  Brazil"},{"name":"Department of Clinical Genetics Federal University of S\u00e3o Paulo (UNIFESP)  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustavo","family":"Guida","sequence":"additional","affiliation":[{"name":"GeneOne, DASA  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Fernanda G.","family":"Milanezi","sequence":"additional","affiliation":[{"name":"GeneOne, DASA  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2567-7360","authenticated-orcid":false,"given":"Alexander A. 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