Inheritance Criteria(?)
Sporadic(?)
No family history.
Autosomal Dominant(?)
Two other family members required. When Viable Homozygotes box is checked and Males Worse Affected box is checked, the criteria for AD are only met if there is direct male to male transmission as opposed to male to child(?) transmission or paternal.
Otherwise the criteria are met for X-linked Dominant inheritance (even though either is possible).
If the family is consanguineous, a paternal affected relative is insufficient to satisfy the male to child transmission criterion. Now need direct male to male, indirect male to child and at least one female, or no maternal non siblings affected (making Maternal inheritance less likely)
and at least one female (excluding X-linked recessive inheritance). This is because X-linked and Maternal families may now have a number of affected paternal members even though the paternal side
cannot pass to the case via the father.
Autosomal Recessive(?)
At least one sibling affected, and no family members other than siblings affected. In consanguineous families, brothers and sisters remain the only candidates to inherit both
copies of the mutated gene; instead the apparent frequency of Autosomal Recessive disease is increased because the second copy of the mutation may pass
down the other side of the family rather than only occur by chance.
X-linked Recessive(?)
When Males Worse Affected box is checked, there is no way to satisfy XR; essentially all such cases are considered XD.
X-linked Dominant(?)
At least two other family members affected. When Males Worse Affected box is checked, male to daughter(?) transmission is possible. As a simplification it is assumed that the penetrance is unchanged for males,
so they may still be unaffected carriers. Those families considered AD without males worse affected become XD if there is no direct male to male transmission but only male to daughter transmission.
Since males and females may now be affected, all families that would be considered XR or maternal when not males worse affected are now considered XD. Note that checking males worse is essentially forcing XD
unless there is some proof otherwise (i.e direct male to male transmission). So if the probability for AD is much higher than XD consider ignoring males worse and accepting as AD. The males worse should be regarded as a
test to see if checking this option suddenly makes XD the most likely option, having previously been excluded by the presence of an affected male.
In consanguineous families, two maternal or paternal side females or males will satisfy as long as no direct male to male transmission, e.g. male cousin of uncle. Male cases no longer exclude paternal relatives because the
case could have inherited from an unaffected maternal grandparent and mother.
Maternal(?)
When Males Worse Affected box is checked, there is no way to satisfy maternal inheritance criteria; essentially all such cases are considered XD. When checking
these boxes one is specifically testing for XD, and it may fail this test only if sporadic, familial, no relatives affected other than sibs, or if there is direct male to male transmission excluding XD and proving AD inheritance.
Familial(?)
Other family members affected but not satisfying any of the criteria above, e.g. one non-sib family
member only, or both grandparents affected, or both maternal and paternal members affected when non-consanguineous.