Presentation
While patients with PRKAR1A mutations (referred to as ACRDYS type 1) constantly present with significant hormonal resistance, hormonal resistance in patients with PDE4D mutations (referred to as ACRDYS type 2) is rare, and when present, is relatively [orpha.net]
This family presents a further example of autosomal dominant inheritance of acrodysostosis and highlights the difficulty in distinguishing between acrodysostosis and pseudohypoparathyroidism. [ncbi.nlm.nih.gov]
Entire Body System
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Difficulty Walking
She presented at our outpatient department complaining of lowback pain and difficulty walking. She had marked facial and peripheral appearance of acrodysostosis. Spinal MRI revealed extensive spinal stenosis. [ncbi.nlm.nih.gov]
Eyes
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Strabismus
[…] hair color Red head (hair color) [ more ] 0002297 Round face Circular face Round facial appearance Round facial shape [ more ] 0000311 Scoliosis Abnormal curving of the spine 0002650 Short palm 0004279 Short phalanx of finger Short finger bones 0009803 Strabismus [rarediseases.info.nih.gov]
Face, Head & Neck
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Low Nasal Root
nasal root [ more ] 0005280 Depressed nasal ridge Flat nose Recessed nasal ridge [ more ] 0000457 Epiphyseal stippling Speckled calcifications in end part of bone 0010655 Hypoplasia of the maxilla Decreased size of maxilla Decreased size of upper jaw [rarediseases.info.nih.gov]
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Broad, Low Nasal Bridge
In addition, he also had facial abnormalities of frontal bossing, hypertelorism, maxillary hypoplasia, broad low nasal bridge, short upturned nose with anteverted nostrils and triangular mouth. [ncbi.nlm.nih.gov]
Neurologic
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Language Delays
delay Language delayed Language development deficit Late-onset speech development Poor language development Speech and language delay Speech and language difficulties Speech delay [ more ] 0000750 Dental malocclusion Bad bite Malalignment of upper and [rarediseases.info.nih.gov]
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Unable to Walk
She became unable to walk, thereafter she underwent decompression surgery with a diagnosis of degenerative spinal stenosis. She presented at our outpatient department complaining of lowback pain and difficulty walking. [ncbi.nlm.nih.gov]
Workup
Clinical Testing and Workup Prenatal fetal ultrasonography, an exam in which reflected sound waves create an image of the developing fetus, may potentially reveal intrauterine growth retardation and short long bones that are compatible with the diagnosis [rarediseases.org]
X-Ray
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Shortened Long Bone
long bone of hand 0010049 Short metatarsal Short long bone of foot 0010743 Short nose Decreased length of nose Shortened nose [ more ] 0003196 Short stature Decreased body height Small stature [ more ] 0004322 Short toe Short toes Stubby toes [ more [rarediseases.info.nih.gov]
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Soft Tissue Calcification
Furthermore, there were no soft tissue calcifications and no intracranial calcification as can be seen in PH and PPH. Laboratory findings were normal. [ncbi.nlm.nih.gov]
Treatment
Management and treatment There is no specific treatment for acrodysostosis. [orpha.net]
Standard Therapies Treatment The treatment of acrodysostosis is directed toward the specific symptoms that are apparent in each individual. Treatment may require the coordinated efforts of a team of specialists. [rarediseases.org]
Treatment - Acrodysostosis There are no standardized treatment protocols or guidelines for affected individuals. Due to the rarity of the disease, there are no treatment trials that have been tested on a large group of patients. [checkorphan.org]
Make the best clinical decisions with an enhanced emphasis on evidence-based practice and expert opinions on treatment strategies. Zero in on the most relevant and useful references with the aid of a more focused, concise bibliography. [books.google.de]
Treatment The treatment depends greatly on the physical or cognitive defects that are present. Orthopedic treatment and early intervention that are accompanied with special education is highly recommended by most physicians. [medigest.uk]
Prognosis
Prognosis Prognosis is unknown due to a lack of long-term patient data. Functional consequences, however, can decrease a patient's quality of life. The documents contained in this web site are presented for information purposes only. [orpha.net]
Diagnosis - Acrodysostosis Prognosis - Acrodysostosis Problems depend on the degree of skeletal involvement and mental retardation. In general, patients do relatively well. [checkorphan.org]
Expectations (prognosis) Problems depend on the degree of skeletal involvement and intellectual disability. In general, patients do relatively well. [coordinatedhealth.com]
Parents should talk to their children’s physicians and medical team about their specific case, associated symptoms and overall prognosis. [rarediseases.org]
Outlook (Prognosis) Problems depend on the degree of skeletal involvement and intellectual disability. In general, people do well. [baptistjax.com]
Etiology
Etiology Acrodysostosis is caused by heterozygous mutations in either the PRKAR1A (17q24.2) or PDE4D (5q11.2-q12.1) genes. [orpha.net]
Radiographic findings and Gs-alpha bioactivity studies and mutation screening in acrodysostosis indicate a different etiology from pseudohypoparathyroidism. Pediatr Radiol 2001;31:2-9 Grebe H. Die Achondrogenesis : ein einfach rezessives Erbmerkmal. [rrnursingschool.biz]
Radiographic findings and Gs-alpha bioactivity studies and mutation screening in acrodysostosis indicate a different etiology from pseudohypoparathyroidism. Pediatr Radiol 2001 ;31: 2 - 9 9. [doi.org]
Epidemiology
Summary Epidemiology Less than 80 cases have been reported in the literature to date. [orpha.net]
A PRKAR1A mutation has been identified in acrodysostosis with hormone resistance. [4] Epidemiology This disorder is present at birth, however, it may not be understood until several years after birth. [checkrare.com]
Pathophysiology
He has served on NIH review panels in the neuroscience and drug discovery areas, including as founding Chair of the Pathophysiological Basis of Mental Disorders and Addictions study section, and is Associate Editor for the Journal of Pharmacology and [books.google.com]
Molecular analysis of the cyclic AMP-dependent protein kinase A (PKA) regulatory subunit 1A (PRKAR1A) gene in patients with Carney complex and primary pigmented nodular adrenocortical disease (PPNAD) reveals novel mutations and clues for pathophysiology [doi.org]
Prevention
Dietary and lifestyle measures to prevent obesity and supportive care for cognitive functions are recommended. Attention must be given in children to height, growth velocity, and pubertal development. [orpha.net]
[…] resistance, Arkless-Graham syndrome, Maroteaux-Malamut syndrome, Acrodysplasia, Nasal hypoplasia-peripheral dysostosis-intellectual disability syndrome, Peripheral dysostosis-nasal hypoplasia-intellectual disability (PNM) syndrome Symptoms - Acrodysostosis Prevention [checkorphan.org]
Our in vitro studies indicate that PRKAR1A mutants are expressed when transfected in a cell model, and prevent the dissociation of the catalytic subunit of PKA. The impact of the PDE4D mutations on the protein function remains unsolved. [bone-abstracts.org]
Thyroid hormone supplementation and vitamin D supplements may contribute to improve growth and prevent obesity. Early intervention is important to ensure that children with acrodysostosis reach their full potential. [rarediseases.org]
At last, dietary and lifestyle measures are recommended to prevent obesity. Gene PRKAR1A gene, 17q24.2 (OMIM gene/locus number #188830 ). [iofbonehealth.org]