Presentation
The presentation of basic science underlying clinical otorhinolaryngology has been expanded, and molecular mechanisms and genetics of disease are presented. [books.google.ro]
Presented in a highly visual and practical format, Integrated Clinical Orthodontics uses clinical case presentations to illustrate the rationale and application of the integrated approach to a variety of clinical scenarios. [books.google.de]
The present case not only exemplified characteristic features of AFA syndrome but also presented with features like notching of maxillary anteriors, elongated uvula, dystrophic nails and postaxial polydactyly of left foot; which have never been reported [e-kjgm.org]
Finally, findings from both genetic linkage and association analyses in humans will be presented implicating variation in chromosomal locations with the Class III phenotype, including 1p35, 1p36. 4p16.1, 6q25, 12q13, 14q24.3-31.2 and 19p13.2 in Asian [eurekaselect.com]
Entire Body System
- Pain
Pain is severe and most often located in the abdomen and the hands and feet (peripheral neuropathy). Often pain needs to be treated with IV morphine or other equally strong narcotics. Insomnia is common. [oneminutehistory.blogspot.com]
These include: headache, described more often as "head pain" (due to dural tension) muscle pain, often misdiagnosed as fibromyalgia joint pain arthritis vertebral fractures with or without loss of bone mineral density carpal tunnel syndrome cardiovascular [radiopaedia.org]
Mol Pain. 12:17448069166526282016. View Article : Google Scholar : PubMed/NCBI 12 Faden MA, Krakow D, Ezgu F, Rimoin DL and Lachman RS: The Erlenmeyer flask bone deformity in the skeletal dysplasias. Am J Med Genet A 149A. 1334–1345. 2009. [spandidos-publications.com]
Although the proband (III-5) presented with headaches and very occasional diffuse bone pain, only two other affected individuals (IV-9, IV-20) complained occasionally of these symptoms. [academic.oup.com]
Complications often include chronic pain affecting physical activity, fatigue, sleep disorders, early osteoarthritis and osteoporosis, and cardiovascular symptoms (chest pain, palpitations, postural instability). [findzebra.com]
- Tall Stature
The same excess of growth hormone in individuals whose epiphyses have not fused will result in gigantism (excessively tall stature). [radiopaedia.org]
Tall stature with thick large lips, medullary carcinoma of the thyroid gland is common as well as mucosal neuromas which are found on the lips, anterior dorsum of the tongue and buccal mucosa. [quizlet.com]
- Asymptomatic
In many cases, individuals may exhibit no symptoms (asymptomatic). Affected individuals may also experience rhinitis, hepatosplenomegaly, anemia and extramedullary hematopoiesis. [rarediseases.org]
Only 1 patient (Patient 42) had brain magnetic resonance imaging at the time of this retrospective study, and she had asymptomatic linear periventricular hyperintensities of the white matter at age 7 years. [journals.lww.com]
- Congestive Heart Failure
Minor Criteria: 1) Obesity and/or insulin resistance and/or Type 2 Diabetes 2) History of dilated cardiomyopathy with congestive heart failure 3) Hearing loss 4) Hepatic dysfunction 5) Renal failure 6) Advanced bone age Variable supportive evidence: Recurrent [findzebra.com]
Jaw & Teeth
- Macrostomia
[…] cleft palate, small open mouth, myopathic facies, retrognathia, prominent nose with squared-off nasal tip UNK Treacle TCOF1 5q32-q33.1 154500 Treacher Collins mandibulofacial dysostosis 154500 AD malar hypoplasia, cleft palate, mandibular hypoplasia, macrostomia [en.wikibooks.org]
Hypoplasia of facial bones especially the malar bones and mandible, macrostomia,blind fistulas between the angles of the mouth and the angles of the ears are certain features. [slideshare.net]
Cardiovascular
- Hypertension
Hypertension Genetic association of ARHGAP21 gene variant with mandibular prognathism. Perillo, L ; Monsurrò, A ; Bonci, E ; Torella, A ; Mutarelli, M ; Nigro, V. [pesquisa.bvsalud.org]
[…] headache, described more often as "head pain" (due to dural tension) muscle pain, often misdiagnosed as fibromyalgia joint pain arthritis vertebral fractures with or without loss of bone mineral density carpal tunnel syndrome cardiovascular cardiomegaly hypertension [radiopaedia.org]
View Article : Google Scholar : PubMed/NCBI 9 Kuroyanagi Y, Kawasaki H, Noda Y, Ohmachi T, Sekiya S, Yoshimura K, Ohe C, Michigami T, Ozono K and Kaneko K: A fatal case of infantile malignant osteopetrosis complicated by pulmonary arterial hypertension [spandidos-publications.com]
The heart races and tachycardia (high heart rate) and hypertension (high blood pressure) are not uncommon even when an attack is not occurring. Psychiatric problems can occur and can sometimes be the only manifestation of the disease. [oneminutehistory.blogspot.com]
In some cases, cirrhosis, portal hypertension and liver failure can occur. Chronic respiratory illness, pulmonary hypertension, and hypertriglyceridemia are frequent. Slowly progressive nephropathy can lead to end stage renal failure. [findzebra.com]
Musculoskeletal
- Macrocephaly
Affiliated tissues include skin and eye, and related phenotypes are macrocephaly and obesity Description from OMIM: 606772 Human phenotypes related to Mental Retardation, Obesity, Mandibular Prognathism, and Eye and Skin Anomalies: 33 (show all 17) # [malacards.org]
It is characterized by overgrowth with advanced bone age, macrocephaly, characteristic facial appearance, and learning diff… Publisher Full Text New Search Next [unboundmedicine.com]
Eclabion, Ectropion, And Mental Retardation Intellectual Disability-Hypotonia-Skin Hyperpigmentation Syndrome Kleefstra Syndrome Klippel-Feil Syndrome 4, Autosomal Recessive, With Myopathy And Facialdysmorphism Koolen-De Vries Syndrome Lamellar Ichthyosis Macrocephaly-Spastic [familydiagnosis.com]
Macrocephaly MedGen UID: 745757 • Concept ID: C2243051 • Finding Occipitofrontal (head) circumference greater than 97th centile compared to appropriate, age matched, sex-matched normal standards. [ncbi.nlm.nih.gov]
It has also been proposed that the acronym stand for Macrocephaly, Obesity, Mental (intellectual) disability, and Ocular abnormalities because overgrowth (macrosomia) did not appear to be a feature in all affected individuals. [findzebra.com]
Eyes
- Visual Impairment
impairment 33 HP:0000505 8 cone-shaped epiphysis 33 HP:0010579 9 reduced visual acuity 33 HP:0007663 10 telecanthus 33 HP:0000506 11 dental crowding 33 HP:0000678 12 blepharophimosis 33 HP:0000581 13 hallux valgus 33 HP:0001822 14 esotropia 33 HP:0000565 [malacards.org]
Visual impairment MedGen UID: 22663 • Concept ID: C0042798 • Finding Reduced ability to perceive visual stimuli. Reduced visual acuity MedGen UID: 65889 • Concept ID: C0234632 • Finding Diminished clarity of vision. [ncbi.nlm.nih.gov]
[…] hypertrophy Depressed nasal ridge Mitral regurgitation Triphalangeal thumb Macrocytic anemia Tracheomalacia Acute leukemia Esophagitis Cleft soft palate Esophageal stricture Fetal distress Persistence of hemoglobin F Neutropenia Absent hair Cardiomyopathy Visual [mendelian.co]
Prevalence and causes of visual impairment in craniosynostotic syndromes. Clin Experiment Ophthalmol. 2006 Jul. 34(5):434-40. [Medline]. Gray TL, Casey T, Selva D, Anderson PJ, David DJ. Ophthalmic sequelae of Crouzon syndrome. [emedicine.medscape.com]
- Blepharoptosis
A mother and daughter, both of normal intelligence, presented with central forehead depression, mid-face hypoplasia, and blepharoptosis. The fact that they have an identically deformed face implied a genetic basis. [e-acfs.org]
[…] atrophia, primary or secondary malignancy, orbital venous malformations, bone growth arrest following radiation therapy, congenital aetiologies (minor forms of hemifacial microsomia, plagiocephaly, microphthalmos etc.) and pseudoenophthalmos (unilateral blepharoptosis [findzebra.com]
Skin
- Hyperkeratosis
Follicular hyperkeratosis was present on cheeks, preauricular, temporal, and submandibular areas with a background of erythema and brownish pigmentation similar to Erythromelanosis follicularis faciei et colli. [ijpd.in]
Absence of cutaneous and radiographic findings like papular mucinosis, hyperkeratosis, generalized hypertrophy of epidermal appendages and periosteal thickening of skull or the long bones ruled out pachydermoperiostosis. [e-kjgm.org]
They have high number of actinbacills actinomycetemcoomitans-immunodeficiency (WBC) decr chemotaxis Focal Palmoplantar and gingival hyperkeratosis autosomal dominant inheritance pattern chracterized by hyperkeratinazation of palms/soles and labial/lingual [quizlet.com]
However, the lack of hyperkeratosis or ichthyosis and the resulting characteristic facial appearance, the lack of distal extremity swelling, and the presence of holoprosencephaly distinguished the disorder from the Neu-Laxova syndrome. [findzebra.com]
- Sparse Eyebrows
Patient-1 The elder sibling, 18-year-old female (35 kg, 161 cm), whose parents were first cousins, had a progeroid appearance, downward slanting palpebral fissures, broad flat nose, sparse eyebrows, a vertically depressed frontal bone (delayed anterior [ijpd.in]
Although a few reported cases have sparse or fine hair, almost all affected individuals have normal hair, sweat glands, and ability to tolerate heat. [mendelian.co]
Neurologic
- Nystagmus
A large pedigree in which eight individuals in three generations had lentigenes was reported by Pipkin and Pipkin. 3 Seven affected members had nystagmus, and photographs of some members gave evidence of mandibular prognathism. [jamanetwork.com]
Figure 1: Crouzon syndrome showing bilateral proptosis and convergent squint Click here to view Hypertelorism, pendular nystagmus, and convergent squint were noted. Lagophthalmos was present in her right eye [Figure 2]. [mjdrdypu.org]
Variable neurologic findings included dysphagia, nystagmus, abnormal gait, and abnormal involuntary movements. [findzebra.com]
Symptoms that affect the eyes may include wasting away (atrophy) of the retina, eyes that appear widely spaced (hypertelorism), eyes that protrude from their orbits (exophthalmos), cross-eyes (strabismus), involuntary rhythmic movements of the eyes (nystagmus [rarediseases.org]
- Involuntary Movements
Variable neurologic findings included dysphagia, nystagmus, abnormal gait, and abnormal involuntary movements. [findzebra.com]
Treatment
Make informed clinical choices for each patient, from diagnosis and treatment selection through post-treatment strategies and management of complications, with new evidence-based criteria throughout. [books.google.com]
Pedigree: Autosomal dominant Autosomal recessive Treatment Treatment Options: There is no treatment for the syndrome but cochlear implants might be helpful. [disorders.eyes.arizona.edu]
Usually, treatment is based on psychological treatment combined with surgery. However, there is no cure for such chromosomal events, so patients are only offered palliative treatments. REFERENCES Almeida Júnior, V. R.; Maciel, A. S.; Castro, C. H. [scielo.conicyt.cl]
Outcomes in Freeman-Sheldon Syndrome Recruiting NCT01144741 15 Treatment of Class III Malocclusion Using Modified Fixed Mandibular Retractor Appliance Active, not recruiting NCT03354442 Not Applicable 16 Treatment of Skeletal Class III Malocclusion Using [malacards.org]
A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. [limamemorial.org]
Prognosis
PMID: 23714981 Prognosis Blackburn PR, Tischer A, Zimmermann MT, Kemppainen JL, Sastry S, Knight Johnson AE, Cousin MA, Boczek NJ, Oliver G, Misra VK, Gavrilova RH, Lomberk G, Auton M, Urrutia R, Klee EW J Biol Chem 2017 Mar 3;292(9):3866-3876. [ncbi.nlm.nih.gov]
Outlook (Prognosis) Frequent follow-up with a variety of specialist doctors is important to having a good outcome. [limamemorial.org]
Treatment and prognosis The treatment of choice is resection of the secreting adenoma, usually via the transsphenoidal approach. [radiopaedia.org]
Prognosis depends on malformation severity. [2], [8] Prophylactic dental care is essential. Some teeth may need to be extracted to relieve crowding as the child develops. Functional space maintainer can also be used. [mjdrdypu.org]
This study highlights the importance of the phenotype-genotype correlation using molecular diagnostic techniques, such as CMA, and its impact on precise diagnosis, treatment, prognosis, and genetic counseling for patients and their families. © 2019 S. [karger.com]
Etiology
Etiology: Autosomal dominant – hereditary. [slideshare.net]
However, there is great interest in the genetic component of the etiology and numerous studies suggest that genetic components play an important role in its etiology. [medigoo.com]
However, there is great interest in the genetic component of the etiology and numerous studies suggest that genetic components play an important role in its etiology [7] – [10]. [journals.plos.org]
Familial aggregation studies suggest that familial environmental factors and/or heredity can play a substantial role in the etiology of Class III phenotype. [eurekaselect.com]
Epidemiology
F - 47, XYY Epidemiology: 1 / 1 000 male births. [atlasgeneticsoncology.org]
The discussion covers the phenotype spectrum, epidemiology, mode of inheritance, pathogenesis, and clinical profile of each condition, all of which is accompanied by a wealth of illustrations. [books.google.ro]
Obesity, Mandibular Prognathism, and Eye and Skin Anomalies: Name: Mental Retardation, Obesity, Mandibular Prognathism, and Eye and Skin Anomalies 58 Intellectual Disability-Obesity-Prognathism-Eye and Skin Anomalies Syndrome 60 Characteristics: Orphanet epidemiological [malacards.org]
Statistical analysis for genetic epidemiology. Rel. 2.2. Computer program package available from the Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH. Saunders SR, Popovich F, Thompson GW (1980). [studyres.com]
Prevalence of class I, class II, and class III malocclusions (Angle) in an urban population; an epidemiological study. J Dent Res 44: 947 - 953. [journals.sagepub.com]
Pathophysiology
Pathophysiology: Crouzon syndrome is caused by mutations in the fibroblast growth factor receptor-2 (FGFR2) gene but exhibits locus heterogeneity with causal mutations in FGFR2 and FGFR3 in different affected individuals. [dolphintherapy.eu]
Pathophysiology Craniosynostosis is an important cause of childhood morbidity. [8] Crouzon syndrome arises from mutations in the fibroblast growth factor receptor-2 ( FGFR2 ) gene. [emedicine.medscape.com]
ALTHOUGH DISEASES THAT result in increased bone density are uncommon, elucidation of their clinical presentation and pathophysiology may improve our understanding of bone cell function and regulation and provide insights about the interaction of osteoclasts [academic.oup.com]
Bangstad et al. (1989) suggested that a generalized cell membrane defect was responsible for the pathophysiologic abnormality in these patients. [findzebra.com]
Prevention
Prevention Couples with a family history of this syndrome might consider genetic counseling before becoming pregnant. Staying out of the sun and using sunscreen can help prevent new basal cell skin cancers. Avoid radiation such as x-rays. [limamemorial.org]
IPV is essentially a violation of human rights and a preventable... [evidence.nhs.uk]
Genetically programmed large lower jaw growth cannot be prevented. Maxillofacial surgeons have been doing large lower jaw surgery for decades and often do several hundred per year. This surgery may be done at age 16 in females and age 21 in males. [clubbraces.com]
Preventive regimen consists of regular follow-up. Speech therapy can help children learn to communicate. Supportive treatment includes special education for children with mental retardation. People with this syndrome usually have a normal lifespan. [mjdrdypu.org]
Associated with the use of orthodontic therapy, surgical procedures are effective to prevent jaws and dentofacial biggest problems. [scielo.conicyt.cl]