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Krupa Shah, Hitesh Shah
Tibial hemimelia is a rare congenital limb deficiency which is characterised by a hypoplastic/aplastic tibia. It actually represents a spectrum of anomalies, ranging from mild hypoplasia of the tibia to total absence of the tibia. Several classifications based on radiological description exist in the literature. The tibial hemimelia is usually described with preaxial mirror polydactyly, split hand/foot syndrome-ectrodactyly, polydactyly-triphalangeal thumb syndrome (Werner syndrome) and micromelia-trigonal brachycephaly syndrome...
2016: BMJ Case Reports
Tomoko Miyake, Shota Kojima, Tetsuya Sugiyama, Mari Ueki, Jun Sugasawa, Hidehiro Oku, Kensuke Tajiri, Yuka Shigemura, Koichi Ueda, Atsuko Harada, Mami Yamasaki, Takumi Yamanaka, Hidetsuna Utsunomiya, Tsunehiko Ikeda
INTRODUCTION: The incidence of facial cleft is rare and ranges between 1.43 and 4.85 per 100,000 births. To date, there have been few reports of detailed ophthalmologic examinations performed in cases of facial cleft. Here, we report a case of optic-nerve hypoplasia and anterior segment abnormality associated with facial cleft. CASE REPORT: A 9-day-old female infant was delivered by cesarian section at 34 weeks of gestational age (the second baby of twins) and weighed 2,276 g upon presentation...
2016: International Medical Case Reports Journal
Mehmet Sedat Durmaz, Hakan Demirtaş, Salih Hattapoğlu, Taylan Kara, Cemil Göya, Mehmet Emin Adin
Cleft foot deformity, also known as ectrodactyly, is a rare congenital developmental defect of extremities caused by malformation in continuity of apical ectoderm. The syndrome typically involves malformation or absence of the central rays of the feet and is characterized by deformities like median deep clefts of distal extremities. Routine examination of feet during second-trimester ultrasound (US) may increase the detection rates of foot malformations. Many malformations can be diagnosed with 2-dimensional (2D) US, but 3-dimensional (3D) US also helps better understanding of the foot malformations...
2016: Medicina
Gui-Bin Zhang, Hua Wang, Jun Hu, Min-Yin Guo, Ying Wang, Yan Zhou, Zhen Yu, Lin Fu, Yuan-Hua Chen, De-Xiang Xu
Previous studies found that maternal Cd exposure on gestational day (GD)9 caused forelimb ectrodactyly and tail deformity, the characteristic malformations. The aim of the present study was to investigate whether maternal Cd exposure on GD8 induces fetal neural tube defects (NTDs). Pregnant mice were intraperitoneally injected with CdCl2 (2.5 or 5.0mg/kg) on GD8. Neither forelimb ectrodactyly nor tail deformity was observed in mice injected with CdCl2 on GD8. Instead, maternal Cd exposure on GD8 resulted in the incidence of NTDs...
September 1, 2016: Toxicology and Applied Pharmacology
Annabelle Enriquez, Michael Krivanek, Ricarda Flöttmann, Hartmut Peters, Meredith Wilson
We describe two sibling fetuses with urogenital abnormalities detected by prenatal ultrasound, in which post-delivery examination showed split hand and foot malformation, and bilateral cleft lip and palate. These findings are consistent with ectrodactyly-ectodermal dysplasia-cleft lip with or without cleft palate syndrome (EEC). Both fetuses were found to have the same missense mutation in TP63 (c.1051G > A; p.D351N). Parental clinical examinations and lymphocyte DNA analyses were normal. This report illustrates the potential severity of urogenital defects in TP63-related disorders, which may be detectable with fetal ultrasonography...
September 2016: American Journal of Medical Genetics. Part A
Christopher P Barnett, Nathalie J Nataren, Manuela Klingler-Hoffmann, Quenten Schwarz, Chan-Eng Chong, Young K Lee, Damien L Bruno, Jill Lipsett, Andrew J McPhee, Andreas W Schreiber, Jinghua Feng, Christopher N Hahn, Hamish S Scott
Ectrodactyly/split hand-foot malformation is genetically heterogeneous with more than 100 syndromic associations. Acinar dysplasia is a rare congenital lung lesion of unknown etiology, which is frequently lethal postnatally. To date, there have been no reports of combinations of these two phenotypes. Here, we present an infant from a consanguineous union with both ectrodactyly and autopsy confirmed acinar dysplasia. SNP array and whole-exome sequencing analyses of the affected infant identified a novel homozygous Fibroblast Growth Factor Receptor 2 (FGFR2) missense mutation (p...
September 2016: Human Mutation
Héctor M Ramos-Zaldívar, Daniel G Martínez-Irías, Nelson A Espinoza-Moreno, José S Napky-Rajo, Tulio A Bueso-Aguilar, Karla G Reyes-Perdomo, Jimena A Montes-Gambarelli, Isis M Euceda, Aldo F Ponce-Barahona, Carlos A Gámez-Fernández, Wilberg A Moncada-Arita, Victoria A Palomo-Bermúdez, Julia E Jiménez-Faraj, Amanda G Hernández-Padilla, Denys A Olivera, Kevin J Robertson, Luis A Leiva-Sanchez, Edwin Francisco Herrera-Paz
BACKGROUND: Chromosomal region 7q21.3 comprises approximately 5.2 mega base pairs that include genes DLX5/6, SHFM1, and DYNC1I1 associated with split hand/split foot malformation 1. So far, there are reports of eight families with deletion of DYNC1I1 and preserved DLX5/6 associated with ectrodactyly. From these families, only three patients did not present ectrodactyly and, unlike our patient, no other cases have been described as having craniofacial dysmorphology, mitral valve prolapse, kyphoscoliosis, inguinal herniae, or personality disorder...
2016: Journal of Medical Case Reports
Vanessa Barbaro, Annamaria Assunta Nasti, Paolo Raffa, Angelo Migliorati, Patrizia Nespeca, Stefano Ferrari, Elisa Palumbo, Marina Bertolin, Claudia Breda, Francesco Miceli, Antonella Russo, Luciana Caenazzo, Diego Ponzin, Giorgio Palù, Cristina Parolin, Enzo Di Iorio
UNLABELLED: : Ectrodactyly-ectodermal dysplasia-clefting (EEC) syndrome is a rare autosomal dominant disease caused by mutations in the p63 gene. To date, approximately 40 different p63 mutations have been identified, all heterozygous. No definitive treatments are available to counteract and resolve the progressive corneal degeneration due to a premature aging of limbal epithelial stem cells. Here, we describe a unique case of a young female patient, aged 18 years, with EEC and corneal dysfunction, who was, surprisingly, homozygous for a novel and de novo R311K missense mutation in the p63 gene...
August 2016: Stem Cells Translational Medicine
Afnan I Al-Saleem, Asma M Al-Jobair
Congenital malformations might occur because of environmental or genetic factors, and sometimes occur because of unknown causes. Acetazolamide is a carbonic anhydrase inhibitor that is used to treat idiopathic intracranial hypertension, glaucoma, and epilepsy. The use of acetazolamide has not been recommended for pregnant women because of reported teratogenic risks. Congenital malformations, such as ectrodactyly, syndactyly, cleft lip/palate, and retarded incisor teeth development, have been reported in experimental animals...
2016: Drug Design, Development and Therapy
Shanmugasundaram Karthikeyani, Velliangattur Ramasamy Thirumurthy, Bindhoo A Yuvaraja
Rapp-Hodgkin syndrome (RHS) is a rare type of autosomal dominant disorder characterized by association of ectodermal dysplasia (ED) with cleft lip/palate. The main features include dry, brittle hair with alopecia in adulthood, dental anomalies (hypodontia, microdontia with delayed eruption, fissured tongue, and retruded maxilla), hypohidrosis, dysplastic nails, and clefting. Palmar-plantar keratoderma is seen frequently. RHS has signs and symptoms that overlap considerably with those of ankyloblepharon-ED-clefting syndrome and ectrodactyly-ED-clefting syndrome...
April 2016: Journal of the Indian Society of Pedodontics and Preventive Dentistry
Aswini Sivasankaran, Ambika Srikanth, Pooja S Kulshreshtha, Deenadayalu Anuradha, Jayarama S Kadandale, Chandra R Samuel
Split hand/foot malformation (SHFM) or ectrodactyly is a rare genetic condition affecting limb development. SHFM shows clinical and genetic heterogeneity. It can present as an isolated form or in combination with additional anomalies affecting the long bones (nonsyndromic form) or other organ systems including the craniofacial, genitourinary and ectodermal structures (syndromic ectrodactyly). This study reports a girl with SHFM who also exhibited developmental delay, mild dysmorphic facial features and sensorineural hearing loss...
February 2016: Molecular Syndromology
Matthew J Blitz, Burton Rochelson
Introduction Ectrodactyly, also known as split hand/foot malformation, is a rare developmental abnormality of the limbs that consists of absent central digits, a deep median cleft, and fusion of the remaining lateral digits, ultimately producing clawlike extremities. This case represents one of the earliest reported diagnoses of this anomaly to utilize three-dimensional (3D) ultrasonography. Case A nulliparous woman presented at 13 weeks of gestation for first-trimester aneuploidy screening. On two-dimensional (2D) imaging, she was noted to have a fetus with a shortened right upper limb and a malformed right hand with no clearly visualized digits...
March 2016: American Journal of Perinatology Reports
Vanessa Barbaro, Annamaria A Nasti, Claudia Del Vecchio, Stefano Ferrari, Angelo Migliorati, Paolo Raffa, Vincenzo Lariccia, Patrizia Nespeca, Mariangela Biasolo, Colin E Willoughby, Diego Ponzin, Giorgio Palù, Cristina Parolin, Enzo Di Iorio
Ectrodactyly-Ectodermal dysplasia-Clefting (EEC) syndrome is a rare autosomal dominant disease caused by heterozygous mutations in the p63 gene and characterized by limb defects, orofacial clefting, ectodermal dysplasia, and ocular defects. Patients develop progressive total bilateral limbal stem cell deficiency, which eventually results in corneal blindness. Medical and surgical treatments are ineffective and of limited benefit. Oral mucosa epithelial stem cells (OMESCs) represent an alternative source of stem cells capable of regenerating the corneal epithelium and, combined with gene therapy, could provide an attractive therapeutic avenue...
June 2016: Stem Cells
Felix B Brueggemann, Oliver Bartsch
The ectrodactyly, ectodermal dysplasia, and cleft lip/palate syndrome 3 (EEC3; OMIM #604292), the Rapp-Hodgkin syndrome (RHS), and various other syndromes are caused by mutations in the TP63 gene, which encodes a p53-like transcription factor. Here, we report on a woman aged 37 years and her daughter aged 3 years with the previously reported c.1028G>A (p.Arg343Gln) mutation in exon 8 of TP63. The mother lacked ectrodactyly, indicating a diagnosis of RHS, whereas the girl presented with all three major features (ectrodactyly, ectodermal dysplasia, clefting) and different minor features (including small and brittle nails, and recurrent conjunctivitis believed to be because of stenotic and blocked nasolacrimal ducts) of the EEC3 syndrome...
April 2016: Clinical Dysmorphology
Amanda Smith, Thomas R Hunt
Focal dermal hypoplasia (FDH), also known as Goltz syndrome, is a rare condition in which congenital anomalies result in a multitude of defects that affect many systems of the body. These defects can involve the eyes, skin, teeth, and cardiovascular, skeletal, and gastrointestinal systems. There have been many associated abnormalities reported in the literature. An appreciation of the clinical presentation of Goltz syndrome is important because physicians rely heavily on recognition of key physical characteristics in order to help make a diagnosis...
March 2016: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
Daniele Conte, Giulia Garaffo, Nadia Lo Iacono, Stefano Mantero, Stefano Piccolo, Michelangelo Cordenonsi, David Perez-Morga, Valeria Orecchia, Valeria Poli, Giorgio R Merlo
The congenital malformation split hand/foot (SHFM) is characterized by missing central fingers and dysmorphology or fusion of the remaining ones. Type-1 SHFM is linked to deletions/rearrangements of the DLX5-DLX6 locus and point mutations in the DLX5 gene. The ectrodactyly phenotype is reproduced in mice by the double knockout (DKO) of Dlx5 and Dlx6. During limb development, the apical ectodermal ridge (AER) is a key-signaling center responsible for early proximal-distal growth and patterning. In Dlx5;6 DKO hindlimbs, the central wedge of the AER loses multilayered organization and shows down-regulation of FGF8 and Dlx2...
February 15, 2016: Human Molecular Genetics
Debangshu Ghosh, Somnath Saha, Sumit Kumar Basu
Ectrodactyly-ectodermal dysplasia and clefting syndrome or "Lobster claw" deformity is a rare congenital anomaly that affects tissues of ectodermal and mesodermal origin. Nasolacrimal duct (NLD) obstruction with or without atresia of lacrimal passage is a common finding of such a syndrome. The authors report here even a rarer presentation of the syndrome which manifested as bilateral NLD obstruction and lacrimal fistula along with cleft lip and palate, syndactyly affecting all four limbs, mild mental retardation, otitis media, and sinusitis...
October 2015: Indian Journal of Ophthalmology
Fatih Mehmet Kislal, Nilgun Altuntas, Osman Ozdemir, Serdar Ceylaner, Mustafa Hayri Kislal, Nesibe Andiran
The case of a newborn male with trisomy 18 syndrome, having bilateral syndactyly, aplasia and hypoplasia of the foot digits, unilateral ectrodactyly of the left foot and a prominently dorsiflexed hallux, clenched hand with overlapping fingers and general hypertonia, is presented. There are only 5 cases of trisomy 18 syndrome associated with ectrodactyly in the literature. We present a case of trisomy 18 syndrome with unilateral ectrodactyly of the left foot, which is an infrequent association.
August 2015: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Yong Chen, Jie Liu, Zekun Zhang, Jianping Ding
OBJECTIVE: To discussion of hand malformations imaging features and clinical classification, tentatively proposed radiological classification. METHODS: A retrospective analysis of the clinical data and image of 101 cases of hands developmental deformity and admitted to hospital affiliated to 1971-2014 years in The Affiliated Hospital of Hangzhou Normal University and the Third Hospital of Hebei Medical University. It is divided into five types base on imaging features: no formation, hypoplasy, over formation, segmental abnormal or joint, bend or abnormal and comparing with classification of Swanson...
May 19, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Deepak Sharma, Chetan Kumar, Sanjay Bhalerao, Aakash Pandita, Sweta Shastri, Pradeep Sharma
Ectrodactyly, ectodermal dysplasia, and cleft lip/palate syndrome (EEC) syndrome is a rare genetic disorder with an incidence of around 1 in 90,000 in population. It is known with various names including split hand-split foot-ectodermal dysplasia-cleft syndrome or split hand, cleft hand, or lobster claw hand/foot. We report first case of EEC with associated heart disease (Tetralogy of Fallot) who was diagnosed as EEC on the basis of clinical features and EEC was confirmed with genetic analysis.
2015: Frontiers in Pediatrics
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