Presentation
This case presents all defining features of ARC syndrome (including liver, skin and articular manifestations) with predominantly renal impairment at presentation. This novel mutation may be associated with a pronounced renal phenotype in ARC. [ncbi.nlm.nih.gov]
In addition, our case is the first case presented with congenital lower limb anomaly. One of the most common manifestations of ARC syndrome is arthrogryposis which was present at birth in our case. [gmj.ir]
Hence we conclude that there is large spectrum of clinical presentation, early identification of this disorder aid to customise treatment, no major response to current treatment strategies, counselling of the parents regarding the present child as well [casereports.in]
Clinical description The phenotype is variable, even within the same family and cases may go undiagnosed as not all the patients present with the three cardinal features. [rarediseases.info.nih.gov]
[More] We report a case of a term baby presenting with neonatal cholestasis and upper limb flexion deformity on day 4 of life. [gulfdoctor.net]
Entire Body System
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Pathologist
In the latter role he oversees a staff of 40 staff pathologists and technicians and trains fellows and residents in pediatric pathology. [books.google.com]
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Vietnamese
Dutch English Estonian Finnish French German Greek Hebrew Hindi Hungarian Icelandic Indonesian Italian Japanese Korean Latvian Lithuanian Malagasy Norwegian Persian Polish Portuguese Romanian Russian Serbian Slovak Slovenian Spanish Swedish Thai Turkish Vietnamese [dictionary.sensagent.com]
Course
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Severe Clinical Course
Unlike the cases reported in literature, our case exhibits a more severe clinical course together with the multiple fractures. We believe that the G514S mutation in the VPS33B gene may be responsible for this clinical situation. [ijcasereportsandimages.com]
Musculoskeletal
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Normal Stature
Attainment and maintenance of normal stature with alkali therapy in infants and children with classic renal tubular acidosis. J Clin Invest 1978;61: 09-27. [ PUBMED ] [ FULLTEXT ] 13. Chensey RW, Kaplan BS, Phlep M, et al. [sjkdt.org]
Workup
Zhou and Zhang Italian Journal of Pediatrics 2014, 40:77 Page 6 of 7 Diagnostic clues and workup after the surgery, and his scaly skin was also normal in In general, case reports of patients with ARC syndrome 6 months. [anyflip.com]
Serum
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Base Deficit
In the blood biochemistry examination, the findings were: pH 7.25, bicarbonate 11.3 mmol/l, base deficit 10.3, urine pH 5, potassium 2.8 mEq/L (3.5–5.5 mEq/L), chlorine 126 mEq/L (98–106 mEq/L), phosphorus 0.7 mg/dl (1:36–2:26 mg/dl), sodium 151 mEq/L [ijcasereportsandimages.com]
Treatment
Management and treatment There is no specific treatment for the disease. [rarediseases.info.nih.gov]
This case report contributes to a better understanding of this rare disorder, describes a novel mutation in the VPS33B gene and presents an innovative rescue treatment approach. [ncbi.nlm.nih.gov]
As there is no specific effective treatment for renal dysfunction and cholestasis, orthopaedic intervention should be postponed until long-term survival is expected, though this is unlikely. [unboundmedicine.com]
Readers will come away with a full overview of the diagnosis and treatment of cholestatic liver diseases. [books.google.com]
Prognosis
Prognosis Most patients die within the first year of life despite supportive care for metabolic acidosis and cholestasis and those surviving longer show cirrhosis and severe developmental delay. Last updated: 6/5/2010 [rarediseases.info.nih.gov]
Prognosis - Arthrogryposis renal dysfunction cholestasis syndrome Not supplied. Treatment - Arthrogryposis renal dysfunction cholestasis syndrome Not supplied. Resources - Arthrogryposis renal dysfunction cholestasis syndrome [checkorphan.org]
The prognosis of this disorder is extremely poor, as patients die in infancy. Most deaths are due to recurrent infection, acidosis and critical bleeding [ 2 ]. [casereports.in]
What is the prognosis? In a child with normal intelligence, with appropriate treatment, independent ambulation and function can be expected. [orthoseek.com]
Etiology
Etiology Mutations in the VPS33B gene (15q26.1), involved in intracellular protein trafficking and membrane fusion, have been found in 75% of ARC families, as well as mutations in the VIPAR gene (C14ORF133), encoding a protein that complexes with VPS33B [rarediseases.info.nih.gov]
Etiology The Pena-Shokeir syndrome is not a unitary entity but is etiologically heterogeneous. Maternal myasthenia gravis has been diagnosed in some cases, and experiments in animal models show that curarization of the mother induces fetal akinesia. [orpha.net]
It is the purpose of this review to summarize and update what is known about the etiology, diagnosis, natural history, and orthopaedic management of children with these diagnoses. [doi.org]
Arthrogryposis in children: Etiological assessments and preparation of a protocol for etiological investigations. Arch Pediatr. 2018 Jun 15. [Medline]. Hall JG. [emedicine.medscape.com]
Epidemiology
Epidemiology The prevalence is unknown but less than 100 patients have been reported in the literature so far. [rarediseases.info.nih.gov]
Summary Epidemiology The syndrome is rare: about 100 cases have been described in the literature. About 30% are stillborn, and the majority of those live-born die of the complications of pulmonary hypoplasia. [orpha.net]
Epidemiology Prevalence ist still unknown. About 100 cases are published so far. Systematic References: 1. [moldiag.com]
Lethal congenital contracture syndrome (LCCS) and other lethal arthrogryposes in Finland--an epidemiological study. Am J Med Genet A. 2006 Sep 1. 140A(17):1834-9. [Medline]. Lin IW, Chueh HY, Chang SD, Cheng PJ. [emedicine.medscape.com]
Pathophysiology
They have expanded their research programme to look at mechanisms which control the development of biliary epithelial cells, the underlying mechanisms for the pathophysiology of malnutrition in children with liver disease and the natural history and management [books.google.com]
[…] characterized by multiple joint contractures found throughout the body at birth. [1] The designation is currently used in connection with a very heterogeneous series of disorders that all include the common feature of multiple congenital joint contractures. [2] Pathophysiology [emedicine.medscape.com]
Prevention
Prevention - Arthrogryposis renal dysfunction cholestasis syndrome Not supplied. Diagnosis - Arthrogryposis renal dysfunction cholestasis syndrome Not supplied. Prognosis - Arthrogryposis renal dysfunction cholestasis syndrome Not supplied. [checkorphan.org]
Thus, the diagnosis of this syndrome requires a careful evaluation of the venal function in cases of congenital arthrogryposis, and a mandatory genetic counseling of affected family for prevention of familial occurance. [chikd.org]
The syndrome is also associated with recurrent infections and sepsis, the latter of which the Centers for Disease Control and Prevention describes as an "overwhelming and life-threatening response to infection." [news-medical.net]
[…] phosphorous. [9] On the other hand, decreased citrate excretion ultimately leads to decreased luminal citrate, nephrocalcinosis and metabolic bone disease, which is a universal finding in distal RTA (DRTA), unless early base therapy is instituted for prevention [sjkdt.org]
Early in life, physical therapy to stretch contractures can improve the range of motion of affected joints and prevent muscle atrophy. Splits can also be used in combination with these stretching exercises. [rarediseases.info.nih.gov]