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Coffin-Lowry Syndrome
Coffin-Lowry syndrome

Presentation

The facial features are generally not present at birth, but become apparent by the second year of life, after which they become more pronounced. [accessanesthesiology.mhmedical.com]

This case demonstrates the variability in presentation of CLS, and that skeletal findings may be misleading in infancy. © 2017 Wiley Periodicals, Inc. [ncbi.nlm.nih.gov]

Entire Body System

  • Short Stature

    Cof·fin-Low·ry syn·drome ( kof'ĭn low'rē ), [MIM*303600] characterized by coarse facial features with bulbous nose, large ears, and thick lips; short stature; tapered fingers; skeletal anomalies and mental retardation. [medical-dictionary.thefreedictionary.com]

    Individuals with Coffin-Lowry syndrome may have physical features such as large hands with short, thin fingers, short stature, small/underdeveloped upper jaw, prominent brow, and downward slanting eyelid folds. [ideas.org.au]

    KBG syndrome is characterized by macrodontia of the upper incisors, short stature, skeletal anomalies, and intellectual disability. [dnatesting.uchicago.edu]

    Coffin-Lowry Syndrome is characterized by mental retardation, skeletal abnormalities, delayed bone development, short stature, tapered fingers, large ears, orbital hypertelorism, anteverted nares, and a prominent frontal region. [ncbi.nlm.nih.gov]

  • Trisomy 21

    ---------- There are three types of Down syndrome, garden variety Trisomy 21, mosaicism and translocation. [lookfordiagnosis.com]

    21, cretinism, mucopolysaccharidosis, Soto's syndrome, fragile X syndrome, and, in adult patients, acromegaly (,,). [jped.com.br]

  • Dentist

    Thus, the dentist may play an important role in assisting in the diagnosing of CLS. [ncbi.nlm.nih.gov]

    The book will appeal to clinical geneticists, pediatricians, neurologists, head and neck surgeons, otolarynologists, and dentists. The 4th edition, which published in 2001, has sold 2,600 copies. [books.google.it]

  • Single Transverse Palmar Crease

    transverse palmar crease 0000954 Sporadic No previous family history 0003745 Telecanthus Corners of eye widely separated 0000506 Thick eyebrow Bushy eyebrows Dense eyebrow Heavy eyebrows Prominent eyebrows Thick eyebrows [ more ] 0000574 Thick nasal [rarediseases.info.nih.gov]

Gastrointestinal

  • Failure to Thrive

    Other findings can include failure to thrive, feeding difficulties, short stature, ophthalmologic abnormalities, microcephaly and hearing loss. [dnatesting.uchicago.edu]

    Additionally, some infants and children with Coffin-Siris syndrome have frequent respiratory infections, difficulty feeding, and an inability to gain weight at the expected rate (failure to thrive). [medlineplus.gov]

    Feeding difficulties often lead to failure to thrive in infancy. More than 99% of affected individuals have a contiguous gene deletion of the Williams-Beuren syndrome critical region (WBSCR) that encompasses the elastin gene ( ELN ). [ncbi.nlm.nih.gov]

Skin

  • Cutis Laxa

    laxa Loose and inelastic skin 0000973 Cutis marmorata 0000965 Decreased body weight Decreased weight Low body weight Low weight Weight less than 3rd percentile [ more ] 0004325 Delayed closure of the anterior fontanelle Later than typical closing of [rarediseases.info.nih.gov]

    LAXA RNG130 CHERATODERMIE PALMOPLANTARI EREDITARIE RN0520 XERODERMA PIGMENTOSO RN0530 CHERATOSI FOLLICOLARE ACUMINATA RN0540 CUTE MARMORATA TELEANGECTASICA CONGENITA RN0550 DARIER, MALATTIA DI RN0570 EPIDERMOLISI BOLLOSA EREDITARIA RN0580 ERITROCHERATODERMIA [amaram.it]

Ears

  • Hearing Impairment

    Audiological tests revealed profound hearing impairment. Anomalous labyrinths were shown by CT scan of the temporal bones. It is inferred that deafness is one of the symptoms of this syndrome. [ncbi.nlm.nih.gov]

    Other features may include hearing impairment, awkward gait, and heart and kidney involvement. Onset in postnatal period. It is transmitted with X-linked intermediate inheritance. We thank Pavlo Milan for information submitted. Bibliography G. S. [whonamedit.com]

    Other features may include feeding and respiratory problems, developmental delay, hearing impairment, awkward gait, stimulus-induced drop episodes, and heart and kidney involvement. [ninds.nih.gov]

    Sucking/feeding difficulties, poor growth, ophthalmologic abnormalities, hearing impairment, and spinal anomalies are common findings. Both autosomal dominant and autosomal recessive inheritance patterns have been reported. [uniprot.org]

Musculoskeletal

  • Coxa Valga

    valga 0002673 Cutis laxa Loose and inelastic skin 0000973 Cutis marmorata 0000965 Decreased body weight Decreased weight Low body weight Low weight Weight less than 3rd percentile [ more ] 0004325 Delayed closure of the anterior fontanelle Later than [rarediseases.info.nih.gov]

  • Muscle Hypotonia

    Muscle hypotonia and decreased or abolished muscle stretch reflexes are noted, whereas eye movements and sometimes verbal communication are possible. 8 TABLE 2. [pediatrics.aappublications.org]

  • Thin Fingers

    Individuals with Coffin-Lowry syndrome may have physical features such as large hands with short, thin fingers, short stature, small/underdeveloped upper jaw, prominent brow, and downward slanting eyelid folds. [ideas.org.au]

Face, Head & Neck

  • Hypertelorism

    A 6 year-old, and a 3 year-old boy both had distinct clinical features of Coffin-Lowry syndrome; severe mental and motor retardation, microcephaly, prominent forehead, hypertelorism, large mouth, large ears, large soft hands, puffy tapered fingers, and [ncbi.nlm.nih.gov]

    Furthermore, a coarse face with prominent brow, hypertelorism and thick nasal tissues, can be present. Cognitive function in female heterozygotes is normal or mildly impaired. Diagnosis Is based on clinical examination. [nature.com]

  • Coarse Face

    Typically, male patients are of short stature and exhibit a characteristic coarse face with a prominent forehead, orbital hypertelorism, downslanting palpebral fissures, thick lips, a thick nasal septum with anteverted nares, and irregular or missing [ncbi.nlm.nih.gov]

    Carrier females have mild intellectual impairment and short stature, coarse face, prominent lips, soft fleshy hands with thick tapering fingers. [ggc.org]

    Furthermore, a coarse face with prominent brow, hypertelorism and thick nasal tissues, can be present. Cognitive function in female heterozygotes is normal or mildly impaired. Diagnosis Is based on clinical examination. [nature.com]

Neurologic

  • Seizure

    In the large database of the Coffin-Lowry Syndrome Foundation family support group, 34 of 170 (20%) individuals with CLS and known age had 'drop attacks' and an additional 9 (5%) of these had additional epileptic seizures. [ncbi.nlm.nih.gov]

    Epileptic seizures in CLS are rarely reported. [karger.com]

    A trial of Topiramate and levetiracetam failed to control her seizures, but after initiation of lamotrigine therapy and escalation to 75 mg q12 hourly, there were no clinical seizures and repeated electroencephalogram showed generalized cortical slowing [alliedacademies.org]

    DOORS syndrome (deafness, osteodystrophy, mental retardation, and seizures) syndrome is characterized by sensorineural deafness, shortened terminal phalanges with small fingernails and toenails, intellectual disability, and seizures. [dnatesting.uchicago.edu]

Workup

X-Ray

  • Delayed Bone Age

    Involvement of the musculoskeletal system presents as short thorax, bifid sternum, pectus excavatum or carinatum, vertebral dysplasia, kyphosis, scoliosis, delayed bone age, ligamental calcifications, hyperextensible joints, muscle atrophy, large and [accessanesthesiology.mhmedical.com]

    Patients are usually short with delayed bone age; joints are hyperextensible. The cognitive function of affected males is usually severely impaired. Patients are hypotonic and may have “drop attacks”. Sensorineural hearing loss has been described. [genedx.com]

    Diagnostic methods Diagnosis is usually based on the clinical presentation and radiological findings (cranial hyperostosis, abnormal shape and end plates of the vertebral bodies, delayed bone age, metacarpal pseudoepiphyses, and tufting of the distal [orpha.net]

Treatment

Read More Read Less Treatment Treatment There is no cure and no standard course of treatment for Coffin-Lowry syndrome. Treatment is symptomatic and supportive, and may include physical and speech therapy and educational services. [ninds.nih.gov]

Treatment There is no cure and no standard course of treatment for Coffin-Lowry syndrome. Treatment is symptomatic and supportive, and may include physical and speech therapy and educational services. [brainfacts.org]

There is no specific treatment for Coffin-Lowry syndrome. [ideas.org.au]

TREATMENT There is no cure and no standard course of treatment for CLS. Benzodiazepine medication is sometimes prescribed. Treatment is symptomatic and supportive, and may include physical and speech therapy and educational services. [secure.ssa.gov]

Prognosis

Prognosis Prognosis The prognosis for individuals with Coffin-Lowry syndrome varies depending on the severity of symptoms. Early intervention may improve the outlook for patients. Life span is reduced in some individuals with Coffin-Lowry syndrome. [ninds.nih.gov]

Prognosis The prognosis for individuals with Coffin-Lowry syndrome varies depending on the severity of symptoms. Early intervention may improve the outlook for patients. Life span is reduced in some individuals with Coffin-Lowry syndrome. [brainfacts.org]

However, there remains a paucity of long-term follow-up information on older patients with which to counsel affected families about prognosis. There is also much to be learned about genotype-phenotype correlations. [ncbi.nlm.nih.gov]

Bardet-Biedl Syndrome (BBS): Causes, Symptoms, Diagnosis, Treatment, Prognosis This article does not provide medical advice. See disclaimer [epainassist.com]

Etiology

However, the etiology of the very first familial case, which was described in 1971 by Lowry with detailed phenotype and coined the term CLS, has remained unknown. [ncbi.nlm.nih.gov]

Also Read: Piriformis Syndrome Massage Treatment Carpal Tunnel Syndrome Delayed Sleep Phase Syndrome (DSPS or DSPD): Diagnosis, Treatment, Prognosis Irritable Bowel Syndrome (IBS): Classification and Types, Pathophysiology, Etiology, Risk Factors, Symptoms [epainassist.com]

Etiology CLS is caused by mutations in the RPS6KA3 gene (Xp22.2-p22.1), which encodes RSK2, a growth-factor-regulated protein kinase. RPS6KA3 mutations are highly heterogeneous and lead to loss of phosphotransferase activity in the RSK2 kinase. [orpha.net]

Etiology and reduced pre- and perinatal optimality. Acta Paediatr 84:1153-1159 (1995). Stephenson JB, Hoffman MC, Russell AJ, Falconer J, Beach RC, et al: The movement disorders of Coffin-Lowry syndrome. Brain Dev 27:108-113 (2005). [karger.com]

Its etiology is unknown, but it is believed to have an autosomal recessive mode of inheritance. Patients with this syndrome are chromosomally normal. The location of the Coffin-Siris gene has tentatively been identified (3–6). [journals.lww.com]

Epidemiology

Gov't Review MeSH terms Abnormalities, Multiple/genetics Bone Diseases, Developmental/diagnosis Bone Diseases, Developmental/epidemiology Bone Diseases, Developmental/genetics Coffin-Lowry Syndrome/diagnosis* Coffin-Lowry Syndrome/epidemiology Coffin-Lowry [ncbi.nlm.nih.gov]

The anomalies are organized by anatomical system and presented in a consistent manner, including details of the clinical presentation, epidemiology, embryology, treatment and prevention for each anomaly. [books.google.it]

Summary Epidemiology The exact prevalence is not known but is estimated to be 1/50,000 to 1/100,000. [orpha.net]

Lhatoo SD, Sander JW: The epidemiology of epilepsy and learning disability. Epilepsia 42(suppl 1):6-9, discussion 19-20 (2001). Lowry B, Miller JR, Fraser FC: A new dominant gene mental retardation syndrome. [karger.com]

Pathophysiology

The pathophysiology of SIDEs is not well understood. Copyright © 2012 Elsevier Masson SAS. All rights reserved. [ncbi.nlm.nih.gov]

Also Read: Piriformis Syndrome Massage Treatment Carpal Tunnel Syndrome Delayed Sleep Phase Syndrome (DSPS or DSPD): Diagnosis, Treatment, Prognosis Irritable Bowel Syndrome (IBS): Classification and Types, Pathophysiology, Etiology, Risk Factors, Symptoms [epainassist.com]

The pathophysiology of SIDEs is not well understood. [pediatrics.aappublications.org]

Their pathophysiology is not clear so far. They have been termed cataplexy, hyperekplexia, nonepileptic collapses with atonia, or exaggerated startle responses [Havaligi et al., 2007]. [karger.com]

Prevention

Early recognition of Coffin-Lowry syndrome is important for genetic counseling and prevention of severe skeletal malformations. [ncbi.nlm.nih.gov]

Prevention Can I prevent CLS in my child? Scientists don’t know what causes the genetic mutation or sporadic cases. Therefore, there is no way to prevent Coffin-Lowry syndrome. [my.clevelandclinic.org]

Children with Coffin-Lowry syndrome must receive extensive dental check-up and preventive dental care. They should also have access to speech and language therapies. [medindia.net]

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