Presentation
We present a further male patient with MCPHA born to distantly consanguineous parents in Ontario, Canada with Amish ancestors. Microcephaly was evident at 21 weeks gestation on ultrasound. [ir.lib.uwo.ca]
Such testing may provide or suggest a diagnosis not previously considered (e.g., mutation of a different gene or genes that results in a similar clinical presentation). For an introduction to comprehensive genomic testing click here. [ncbi.nlm.nih.gov]
Although present at birth, malformation/deformation/or chromosomal abnormality may not be identified until later in life. [medicbind.com]
The documents contained in this web site are presented for information purposes only. The material is in no way intended to replace professional medical care by a qualified specialist and should not be used as a basis for diagnosis or treatment. [orpha.net]
Microcephaly is divided into primary microcephaly, which is present at birth, and secondary microcephaly, which develops postnatally 4. [centogene.com]
Entire Body System
- Poor Feeding
Showing of 33 | 80%-99% of people have these symptoms Cerebellar vermis hypoplasia 0001320 Death in infancy Infantile death Lethal in infancy [ more ] 0001522 Feeding difficulties Feeding problems Poor feeding [ more ] 0011968 Irritability Irritable 0000737 [rarediseases.info.nih.gov]
Liver, Gall & Pancreas
- Hepatomegaly
They may also have an unusually small lower jaw and chin (micrognathia) and an enlarged liver (hepatomegaly). Affected infants may have seizures and difficulty maintaining their body temperature. [ghr.nlm.nih.gov]
[…] have these symptoms Cleft soft palate 0000185 Decreased fetal movement Less than 10 fetal movements in 12 hours 0001558 Decreased skull ossification Decreased bone formation of skull 0004331 Generalized tonic-clonic seizures Grand mal seizures 0002069 Hepatomegaly [rarediseases.info.nih.gov]
Myopathic facies Generalized muscle weakness Muscular dystrophy Ventriculomegaly Strabismus Epileptic encephalopathy Progressive neurologic deterioration Hepatic failure Elevated hepatic transaminase Respiratory failure Hypoplasia of the corpus callosum Hepatomegaly [mendelian.co]
Mild hepatomegaly has been observed in several affected individuals, usually during acute illnesses associated with metabolic acidosis. 2-ketoglutaric acidosis has been demonstrated in a number of Amish infants with this disorder (a variable finding). [ncbi.nlm.nih.gov]
Neurologic
- Irritability
Showing of 33 | 80%-99% of people have these symptoms Cerebellar vermis hypoplasia 0001320 Death in infancy Infantile death Lethal in infancy [ more ] 0001522 Feeding difficulties Feeding problems Poor feeding [ more ] 0011968 Irritability Irritable 0000737 [rarediseases.info.nih.gov]
Often they become very irritable starting in the second or third month of life. [ghr.nlm.nih.gov]
The single affected individual described by Siu et al [2010] had irritability and profound developmental delay. The Amish patients were able to breast/bottle feed early on, but developed severe irritability and seizures. [ncbi.nlm.nih.gov]
Case studies report that the infant has seizures early on, is cold all the time, becomes irritable at ages 12 - 16 weeks, and dies before the age of one year. [owlcation.com]
- Global Developmental Delay
COENZYME Q10 DEFICIENCY, PRIMARY, 5; COQ10D5 Is also known as ; Related symptoms: Autosomal recessive inheritance Seizures Global developmental delay Generalized hypotonia Feeding difficulties SOURCES: MONDO ORPHANET OMIM UMLS More info about COENZYME [mendelian.co]
developmental delay 0011344 Sloping forehead Inclined forehead Receding forehead [ more ] 0000340 30%-79% of people have these symptoms Agenesis of corpus callosum 0001274 Limb hypertonia Increased muscle tone of arm or leg 0002509 Lissencephaly Fewer [rarediseases.info.nih.gov]
In patients with microcephaly and global developmental delay, the prevalence of an underlying metabolic disorder ranges from 1–5% but evidence is limited due to the rare nature of most metabolic disorders [ 23 ]. [mdpi.com]
- Flaccid Paralysis
A disease characterized by recurrent episodes of flaccid paralysis and encephalopathy associated with bilateral striatal necrosis and chronic progressive polyneuropathy Cellular location: Mitochondrion inner membrane; Multi-pass membrane protein Tissue [slc.bioparadigms.org]
A disease characterized by recurrent episodes of flaccid paralysis and encephalopathy associated with bilateral striatal necrosis and chronic progressive polyneuropathy. Belongs to the mitochondrial carrier family. [mybiosource.com]
[review] a pathogenic missense mutation in the SLC25A19 gene was identifiedin 4 patients who suffered from recurrent episodes of flaccid paralysis and encephalopathy associated with bilateral striatal necrosis and chronic progressive polyneuropathy Solute [antikoerper-online.de]
Workup
Any further studies and workup should be directed by the presence of signs or symptoms pointing to an underlying diagnosis and are usually used as confirmatory testing for certain conditions. [mdpi.com]
Treatment
CLOSE Medical Disclaimer The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. [diseaseinfosearch.org]
MANAGEMENT: Treatment of manifestations: Treatment is supportive only. Phenobarbital has been used to treat a few children with seizures. Physical therapy may alleviate contractures or other secondary neurologic manifestations. [ncbi.nlm.nih.gov]
Treatment depends upon the problem. In many cases, treatment only helps with symptoms. It may include antiseizure medicines, shunts to drain fluid from the brain, and physical therapy. There are head malformations that do not involve the brain. [medlineplus.gov]
The text concludes by examining the important clinical implications of the recent advances in the field, from recognition of the genetic causes in individual patients to development of new treatments and interventions. [books.google.com]
You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments. [rarediseases.info.nih.gov]
Prognosis
Prognosis Prognosis is very poor: the average life span of affected infants is between five and six months. The documents contained in this web site are presented for information purposes only. [orpha.net]
Prognosis Microcephaly is a lifelong condition with no known cure. The prognosis is usually worse for children who experienced an intrauterine infection or have a chromosomal or metabolic abnormality. [mdpi.com]
Prognosis Prognosis is very poor: the average life span of affected infants is between five and six months. Last updated: 12/31/2010 This table lists symptoms that people with this disease may have. [rarediseases.info.nih.gov]
Prognosis. After the first two or three months of life, increasing irritability of unknown causes commonly develops [Kelley et al 2002]. [ncbi.nlm.nih.gov]
[…] head circumference more than three standard deviations below the mean for the age and sex. [6] There is no specific treatment that returns the head size to normal. [1] In general, life expectancy for individuals with microcephaly is reduced and the prognosis [en.wikipedia.org]
Etiology
General pathology > Genetic and developmental anomalies > amish type microcephaly MIM.607196 17q25.3 Wednesday 11 May 2005 Synopsis severe congenital microcephaly 2-ketoglutaric aciduria Etiology mutations in the SLC25A19 gene (MIM.606521), which encodes [humpath.com]
The book begins by examining the genetic architecture and etiology of neurodevelopmental disorders. [books.google.com]
Etiology Microcephaly has been stratified and studied differently based on the etiology and the timing of onset. [mdpi.com]
Etiology All affected infants are homozygous for the same mutation of the SLC25A19 gene on chromosome 17 (17q25.3). Genetic counseling The condition follows an autosomal recessive pattern of inheritance. [orpha.net]
Epidemiology
Summary Epidemiology It has been described only in the Old Order Amish of Lancaster County Pennsylvania. In this population, birth prevalence is about 1/500. [orpha.net]
Epidemiology It has been described only in the Old Order Amish of Lancaster County Pennsylvania. In this population, birth prevalence is about 1/500. [rarediseases.info.nih.gov]
"Methodologic issues in epidemiologic studies of congenital microcephaly". Early Hum Dev. 69 (1): 91–105. doi : 10.1016/S0378-3782(02)00065-8. ^ Opitz, J. M.; Holt, M. C. (1990). "Microcephaly: general considerations and aids to nosology". [en.wikipedia.org]
Pathophysiology
J Clin Endocrinol Metab 93:2084–2088 CrossRef PubMed Google Scholar Werner ER, Blau N, Thöny B (2011) Tetrahydrobiopterin: biochemistry and pathophysiology (review). [link.springer.com]
Microcephaly is the only proven malformation, or congenital abnormality, found in the children of Hiroshima and Nagasaki. [26] Other relations [ edit ] Intracranial volume also affects this pathology, as it is related with the size of the brain. [27] Pathophysiology [en.wikipedia.org]
Prevention
0% Emergent - ED Care Needed - Preventable/Avoidable - 0% Emergent - ED Care Needed - Not Preventable/Avoidable - 0% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary diagnosis [codelay.com]
Additionally, increasing resources are being made available for the prevention and research of Zika virus including mosquito prevention and identification, and limiting travel to highly endemic areas. [mdpi.com]
Certain physicians have taken up practice in Amish communities in order to study the birth defects prevalent in them and to offer hope of treatment and prevention. [owlcation.com]
However, differences in practice between Amish affiliations may prevent such intermarriage from occurring. Marriage between communities such as Lancaster County and Holmes County, Ohio, occur only rarely. [amishamerica.com]