Presentation
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
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Short Stature
Coffin-Lowry syndrome is a rare X-linked disorder characterized by craniofacial and skeletal abnormalities, mental retardation, short stature, and hypotonia. [ncbi.nlm.nih.gov]
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]
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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]
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Infertility
Author information 1 Section of Reproductive Endocrinology, Infertility & Genetics, Department of Obstetrics & Gynecology, Georgia Regents University, Augusta, GA 30912, USA; Department of Neuroscience and Regenerative Medicine, Georgia Regents University [ncbi.nlm.nih.gov]
Gastrointestinal
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Failure to Thrive
Other findings can include failure to thrive, feeding difficulties, short stature, ophthalmologic abnormalities, microcephaly and hearing loss. [dnatesting.uchicago.edu]
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]
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Gagging
Quantitative analysis of GAGs was carried out by measuring optical density at 615 nm of Alcian blue-stained GAG spots on electrophoretograms. [ncbi.nlm.nih.gov]
Fetus
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Fetal Disorder
Prenatal ultrasound has afforded insights into many structural and syndromic fetal disorders. In this report, the ultrasound findings were of assistance when counselling a patient who presented with a history of Coffin-Lowry syndrome (CLS). [ncbi.nlm.nih.gov]
Ears
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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]
impairment, awkward gait, stimulus-induced drop episodes, and heart and kidney involvement. [inman.moneomed.com]
Other features may include feeding and respiratory problems, developmental delay, hearing impairment, awkward gait, stimulus-induced drop episodes, and heart and kidney involvement. [childneurologyfoundation.org]
Musculoskeletal
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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]
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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]
Psychiatrical
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Psychiatric Symptoms
symptoms in a family harbouring a Xp22.12 microduplication encompassing the RPS6KA3 gene Vera Uliana, Francesco Bonatti, Valentina Zanatta, Paola Mozzoni, Davide Martorana & Antonio Percesepe Journal of Genetics (2019) The role of genetics in the establishment [dx.doi.org]
Face, Head & Neck
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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. [dx.doi.org]
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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. [dx.doi.org]
Workup
X-Ray
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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
Some cases of Coffin-Lowry syndrome recognized episodic drops and it tended to be intractable for medical treatment. We reported here a patient with the Coffin-Lowry syndrome associated with obstructive sleep apnea syndrome (OSAS). [ncbi.nlm.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]
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. [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]
Prognosis Prognosis is poor and depends on the severity of the disease. The documents contained in this web site are presented for information purposes only. [orpha.net]
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]
Background A growing number of studies have demonstrated that RPS6KA3 is a molecular etiology of Coffin–Lowry syndrome (CLS) (1, 2), an X-linked semidominant syndrome which was first reported by Coffin in 1966 and characterized by short stature, facial [frontiersin.org]
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]
Summary Epidemiology The exact prevalence is not known but is estimated to be 1/50,000 to 1/100,000. [orpha.net]
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]
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]
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]