{"id":582,"date":"2024-01-09T15:27:43","date_gmt":"2024-01-09T21:27:43","guid":{"rendered":"https:\/\/wp.uthscsa.edu\/chromosome-18\/?page_id=582"},"modified":"2024-01-18T09:45:35","modified_gmt":"2024-01-18T15:45:35","slug":"ring-18-treatment-and-surveillance-2","status":"publish","type":"page","link":"https:\/\/wp.uthscsa.edu\/chromosome-18\/resources\/clinical-management-guides\/ring-18-treatment-and-surveillance-2\/","title":{"rendered":"Ring 18- Treatment and Surveillance"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row][vc_column width=&#8221;2\/3&#8243;][vc_single_image image=&#8221;813&#8243; img_size=&#8221;full&#8221;][vc_column_text]<u>ICD-10 = Q99.9 or Q93.89<\/u><\/p>\n<p>People with Ring 18 have missing material from both ends of the chromosome. However not everyone has genes that are missing from both ends of the chromosome. But the vast majority do have missing genes from both the p arm and the q arm. Each person with Ring 18 has a different combination of 18p and 18q deletions meaning that no two people have the same genetic cause for their medical and developmental issues. In addition, about half of the people with Ring 18 are mosaic for their condition. This means that all of the cells in their body do not have the same genetic make up. The different cells in their body could be completely normal, have one Ring 18, or 2 Ring 18 chromosomes or have only a single copy of chromosome 18. People who are mosaic will also have different levels of mosaicism in different tissues of the body or even within different parts of the same tissue. All these variations make people with Ring 18 a very heterogeneous group.<\/p>\n<p>We have not identified any features in people with Ring 18 that are not also found in people with 18p deletions or 18q deletions. Therefore, in order to provide maximal information on this ultra\u2010rare condition that occurs on 1 in 300,000 births, we are presenting information, first about 18p deletions then about 18q deletions.<\/p>\n<p>See the\u00a0<a href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/wp-content\/uploads\/sites\/247\/2024\/01\/Ring-18-management-guide-8-2020.pdf\">downloadable PDF document<\/a>\u00a0for the details.<\/p>\n<p>Updated 2020[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/3&#8243;]<nav id=\"subnav\" class=\"null\" aria-label=\"Sub navigation for Chromosome 18 Subnav\"><ul id=\"menu-chromosome-18-subnav\" class=\"subnav vertical menu accordion-menu\" data-accordion-menu><li id=\"menu-item-506\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-home menu-item-506\"><a href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/\">Home<\/a><\/li>\n<li id=\"menu-item-507\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-has-children 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Map<\/a><\/li>\n\t\t<li id=\"menu-item-859\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-859\"><a href=\"https:\/\/genome.ucsc.edu\/cgi-bin\/hgTracks?db=hg19&#038;lastVirtModeType=default&#038;lastVirtModeExtraState=&#038;virtModeType=default&#038;virtMode=0&#038;nonVirtPosition=&#038;position=chr18%3A1%2D78077248&#038;hgsid=1884265652_EZW3C1gYccZy8K8mq1vjkNvPnA1w\">Phenotype Duplication Map<\/a><\/li>\n\t<\/ul>\n<\/li>\n\t<li id=\"menu-item-735\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-735\"><a href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/research-1\/publications\/\">Publications<\/a><\/li>\n<\/ul>\n<\/li>\n<li id=\"menu-item-509\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-has-children menu-item-509\"><a href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/our-program\/\">Our Program<\/a>\n<ul class=\"sub-menu\">\n\t<li id=\"menu-item-650\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-650\"><a href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/our-program\/current-studies\/\">Current Studies<\/a><\/li>\n<\/ul>\n<\/li>\n<li id=\"menu-item-510\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-510\"><a href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/enrollment\/\">Enrollment<\/a><\/li>\n<li id=\"menu-item-511\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-has-children menu-item-511\"><a href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/resources\/\">Resources<\/a>\n<ul class=\"sub-menu\">\n\t<li id=\"menu-item-651\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-has-children menu-item-651\"><a href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/resources\/clinical-management-guides\/\">Clinical Management Guides<\/a>\n\t<ul class=\"sub-menu\">\n\t\t<li id=\"menu-item-666\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-666\"><a href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/resources\/clinical-management-guides\/18q-summary\/\">What is 18q: A Sixty-Second Summary<\/a><\/li>\n\t\t<li id=\"menu-item-656\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-656\"><a href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/resources\/clinical-management-guides\/distal-18q-treatment-and-surveillance\/\">Distal 18q- Treatment and Surveillance<\/a><\/li>\n\t\t<li id=\"menu-item-657\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-657\"><a href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/resources\/clinical-management-guides\/proximal-18q-treatment-and-surveillance\/\">Proximal 18q- Treatment and Surveillance<\/a><\/li>\n\t\t<li id=\"menu-item-667\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-667\"><a href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/resources\/clinical-management-guides\/ring-18-summary\/\">What is Ring 18: A Sixty-Second Summary<\/a><\/li>\n\t\t<li id=\"menu-item-659\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-659\"><a href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/resources\/clinical-management-guides\/ring-18-treatment-and-surveillance-2\/\">Ring 18- Treatment and Surveillance<\/a><\/li>\n\t\t<li id=\"menu-item-850\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-850\"><a href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/resources\/clinical-management-guides\/ring-18-distal-treatment-and-surveillance\/\">Ring 18 Distal- Treatment and Surveillance<\/a><\/li>\n\t\t<li id=\"menu-item-665\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-665\"><a href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/resources\/clinical-management-guides\/18p-summary\/\">What is 18p: A Sixty-Second Summary<\/a><\/li>\n\t\t<li id=\"menu-item-655\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-655\"><a 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href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/resources\/clinical-management-guides\/tetrasomy-18p-treatment-and-surveillance-2\/potential-conditions\/\">Potential Conditions in a Neonate<\/a><\/li>\n\t\t\t<li id=\"menu-item-661\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-661\"><a href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/resources\/clinical-management-guides\/tetrasomy-18p-treatment-and-surveillance-2\/immediate-referrals\/\">Immediate Referrals to<\/a><\/li>\n\t\t<\/ul>\n<\/li>\n\t\t<li id=\"menu-item-851\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-851\"><a href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/resources\/clinical-management-guides\/tetrasomy-18p-treatment-and-surveillance-2\/\">Tetrasomy 18p: Treatment and Surveillance<\/a><\/li>\n\t\t<li id=\"menu-item-668\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-668\"><a href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/resources\/clinical-management-guides\/trisomy-18p-summary\/\">What is Trisomy 18p: A Sixty-Second Summary<\/a><\/li>\n\t\t<li id=\"menu-item-664\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-664\"><a href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/resources\/clinical-management-guides\/trisomy-18p-treatment-and-surveillance\/\">Trisomy 18p: Treatment and Surveillance<\/a><\/li>\n\t<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li id=\"menu-item-512\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-512\"><a href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/contact-us\/\">Contact Us<\/a><\/li>\n<li id=\"menu-item-669\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-669\"><a href=\"https:\/\/www.chromosome18.org\/\">Chromosome 18 Registry &amp; Research Society<\/a><\/li>\n<\/ul><\/nav> \n        <a class=\"callout panel-mobile text-center colorized\" href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/wp-content\/uploads\/sites\/247\/2024\/01\/Ring-18-management-guide-8-2020.pdf\" >\n            <span class=\"fa-stack fa-2x\">\n            <i class=\"fas fa-circle fa-stack-2x\"><\/i>\n            <i class=\"fas fa-fas fa-file fa-stack-1x fa-inverse\"><\/i>\n            <\/span><h3 class=\" \">Ring 18 Treatment &amp; Surveillance PDF<\/h3>\n        <\/a>[\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row][vc_column width=&#8221;2\/3&#8243;][vc_single_image image=&#8221;813&#8243; img_size=&#8221;full&#8221;][vc_column_text]ICD-10 = Q99.9 or Q93.89 People with Ring 18 have missing material from both ends of the chromosome. However not everyone has genes that are missing from both ends of the chromosome. But the vast majority do have missing genes from both the p arm and the q arm. Each person with [&hellip;]<\/p>\n","protected":false},"author":326,"featured_media":398,"parent":569,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-templates\/basic-page.php","meta":{"footnotes":""},"categories":[],"class_list":["post-582","page","type-page","status-publish","has-post-thumbnail","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Ring 18- Treatment and Surveillance - Chromosome 18<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/resources\/clinical-management-guides\/ring-18-treatment-and-surveillance-2\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ring 18- Treatment and Surveillance - Chromosome 18\" \/>\n<meta property=\"og:description\" content=\"[vc_row][vc_column width=&#8221;2\/3&#8243;][vc_single_image image=&#8221;813&#8243; img_size=&#8221;full&#8221;][vc_column_text]ICD-10 = Q99.9 or Q93.89 People with Ring 18 have missing material from both ends of the chromosome. However not everyone has genes that are missing from both ends of the chromosome. But the vast majority do have missing genes from both the p arm and the q arm. Each person with [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/resources\/clinical-management-guides\/ring-18-treatment-and-surveillance-2\/\" \/>\n<meta property=\"og:site_name\" content=\"Chromosome 18\" \/>\n<meta property=\"article:modified_time\" content=\"2024-01-18T15:45:35+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/wp.uthscsa.edu\/chromosome-18\/wp-content\/uploads\/sites\/247\/2022\/04\/1650.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1000\" \/>\n\t<meta property=\"og:image:height\" content=\"667\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/wp.uthscsa.edu\\\/chromosome-18\\\/resources\\\/clinical-management-guides\\\/ring-18-treatment-and-surveillance-2\\\/\",\"url\":\"https:\\\/\\\/wp.uthscsa.edu\\\/chromosome-18\\\/resources\\\/clinical-management-guides\\\/ring-18-treatment-and-surveillance-2\\\/\",\"name\":\"Ring 18- Treatment and Surveillance - Chromosome 18\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/wp.uthscsa.edu\\\/chromosome-18\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/wp.uthscsa.edu\\\/chromosome-18\\\/resources\\\/clinical-management-guides\\\/ring-18-treatment-and-surveillance-2\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/wp.uthscsa.edu\\\/chromosome-18\\\/resources\\\/clinical-management-guides\\\/ring-18-treatment-and-surveillance-2\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/wp.uthscsa.edu\\\/chromosome-18\\\/wp-content\\\/uploads\\\/sites\\\/247\\\/2022\\\/04\\\/1650.jpg\",\"datePublished\":\"2024-01-09T21:27:43+00:00\",\"dateModified\":\"2024-01-18T15:45:35+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/wp.uthscsa.edu\\\/chromosome-18\\\/resources\\\/clinical-management-guides\\\/ring-18-treatment-and-surveillance-2\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/wp.uthscsa.edu\\\/chromosome-18\\\/resources\\\/clinical-management-guides\\\/ring-18-treatment-and-surveillance-2\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/wp.uthscsa.edu\\\/chromosome-18\\\/resources\\\/clinical-management-guides\\\/ring-18-treatment-and-surveillance-2\\\/#primaryimage\",\"url\":\"https:\\\/\\\/wp.uthscsa.edu\\\/chromosome-18\\\/wp-content\\\/uploads\\\/sites\\\/247\\\/2022\\\/04\\\/1650.jpg\",\"contentUrl\":\"https:\\\/\\\/wp.uthscsa.edu\\\/chromosome-18\\\/wp-content\\\/uploads\\\/sites\\\/247\\\/2022\\\/04\\\/1650.jpg\",\"width\":1000,\"height\":667},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/wp.uthscsa.edu\\\/chromosome-18\\\/resources\\\/clinical-management-guides\\\/ring-18-treatment-and-surveillance-2\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/wp.uthscsa.edu\\\/chromosome-18\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Resources\",\"item\":\"https:\\\/\\\/wp.uthscsa.edu\\\/chromosome-18\\\/resources\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Clinical Management Guides\",\"item\":\"https:\\\/\\\/wp.uthscsa.edu\\\/chromosome-18\\\/resources\\\/clinical-management-guides\\\/\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Ring 18- Treatment and Surveillance\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/wp.uthscsa.edu\\\/chromosome-18\\\/#website\",\"url\":\"https:\\\/\\\/wp.uthscsa.edu\\\/chromosome-18\\\/\",\"name\":\"Chromosome 18\",\"description\":\"Chromosome 18 Clinical Research Center\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/wp.uthscsa.edu\\\/chromosome-18\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Ring 18- Treatment and Surveillance - Chromosome 18","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/wp.uthscsa.edu\/chromosome-18\/resources\/clinical-management-guides\/ring-18-treatment-and-surveillance-2\/","og_locale":"en_US","og_type":"article","og_title":"Ring 18- Treatment and Surveillance - Chromosome 18","og_description":"[vc_row][vc_column width=&#8221;2\/3&#8243;][vc_single_image image=&#8221;813&#8243; img_size=&#8221;full&#8221;][vc_column_text]ICD-10 = Q99.9 or Q93.89 People with Ring 18 have missing material from both ends of the chromosome. However not everyone has genes that are missing from both ends of the chromosome. But the vast majority do have missing genes from both the p arm and the q arm. 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