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Fetal Hydantoin Syndrome

Phenytoin Embryofetopathy


Presentation

  • This case report presents an 8-year-old child born to an epileptic mother with a history of AED therapy, with features suggestive of FHS.[ncbi.nlm.nih.gov]
  • This case report is presented to illustrate a less common orthopodic manifestation of fetal hydantoin syndrome, namely hip dysplasia. CASE REPORT A 23-year-old adopted man presented with a 15-year history of increasing right hip pain.[healio.com]
  • Present On Admission POA Help "Present On Admission" is defined as present at the time the order for inpatient admission occurs — conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery[icd10data.com]
Soft Tissue Swelling
  • Also, the bilateral soft tissue swellings present on the palate suggested some sort of deformity. Failure to thrive, learning disability, and reduction of intellectual ability in infants with FHS are the area of greatest concern.[jisppd.com]
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]
Hunting
  • Plasticity and predetermination of the mesencephalic and trunk neural crest transplanted into the region of the cardiac neural crest Dev Biol 1989 134 : 402–12 13 Kirby M, Hunt P, Wallis K et al.[nature.com]
Turkish
  • Danish 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[dictionary.sensagent.com]
Failure to Thrive
  • Failure to thrive, learning disability, and reduction of intellectual ability in infants with FHS are the area of greatest concern.[jisppd.com]
  • Later there may be continued failure to thrive and developmental and behavioral disorders. Figure 3.2. This infant, age 6 weeks, was born to a mother with severe, chronic alcoholism. There was failure to thrive and hypotonia.[rrnursingschool.biz]
  • Developmental Problems:Infancy-failure to thrive; growth deficiency; tremulous; irritable; unable to modulate environmental input. Childhood-short attention span; developmental delay; speech delay; motor incoordination.[carolguze.com]
Limping Gait
  • However, these symptoms may vary in individual patient. [6] Since the patient's family was not willing for extensive investigations, it was assumed from the limping gait that there could be a skeletal deformity in the hip joint.[jisppd.com]
Foot Deformity
  • Less common manifestations of the syndrome include small head, coloboma, brachycephaly, strabismus, and positional foot deformities. Causes The main cause of the syndrome is phenytoin exposure of the fetus.[dianamossop.com]
Hirsutism
  • Varied malformations due to hydantoin intake during pregnancy include digit and nail hypoplasia, growth retardation, typical facial appearance, rib anomalies, abnormal palmar creases, hirsutism, and low hairlines.[ncbi.nlm.nih.gov]
  • Digital hypoplasia, irregular ossification of the distal phalanges with nail dystrophy, coarse profuse scalp hair, hirsutism, short neck, abdominal hernias, cardiac abnormalities, and pilonidal sinus also have been associated with maternal ingestion of[healio.com]
  • He was noted to have a depressed nasal bridge, coarse scalp hair, hirsutism, nail hypoplasia, and hypoplasia of the fifth digits bilaterally.[nature.com]
  • Note the marked hirsutism, low hairline, low nasal bridge with a short upturned nose ("pug" nose), and long philtrum. Figure 3.10. Hypertrichosis in another infant with the fetal hydantoin syndrome.[rrnursingschool.biz]
  • […] shallow supraorbital ridge with nasal bridge near level of forehead Fetal hydantoin syndrome Prenatal exposure to phenytoin (Dilantin) Depressed nasal bridge, growth deficits, occasional intellectual disability, wide-spaced eyes Genitourinary defects, hirsutism[aafp.org]
Short, Broad Nails
  • ., hypoplastic nail, narrow hyperconvex nail, short broad nail). Figure 1.100. In this infant with the fetal hydantoin syndrome the nails are hypoplastic and distorted or absent over the short hypoplas-tic distal phalanges.[rrnursingschool.biz]
Increased Body Hair
  • Signs of growth delays are evident throughout life, as are the tendencies to grow increased body hair. Almost around 3% of infants who are exposed to Dilantin tend to have severe developmental delays, cleft lip and palate and brain malformations.[hxbenefit.com]

Workup

  • Differential Diagnosis The differential diagnosis for FASD includes a variety of chromosomal abnormalities, exposure to other teratogens, and behavioral and psychiatric diagnoses ( Table 4 ). 2, 22 – 28 If the diagnosis is uncertain, the workup should[aafp.org]
Thrombocytosis
  • An infant boy with fetal hydantoin syndrome was evaluated for the finding of thrombocytosis.[ncbi.nlm.nih.gov]

Treatment

  • Treatment may require the coordinated efforts of a team of specialists.[en.wikipedia.org]
  • To chalk out the treatment plan pediatricians, neurologists, plastic surgeons, oral surgeons, psychologists, and other healthcare professionals need to work together for systematic and comprehensive treatment.[medicalfoster.com]
  • Other treatment is symptomatic and supportive. [1] Last updated: 8/10/2011[rarediseases.info.nih.gov]

Prognosis

  • Parents should talk to their children’s physician and medical team about their specific case, associated symptoms and overall prognosis. Affected infants may be small at birth due to growth deficiency during development (prenatal growth deficiency).[rarediseases.org]

Etiology

  • Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10coded.com]
  • Jump to navigation Jump to search Fetal Hydantoin Syndrome Etiology [ edit ] Prenatal hydantoin (dilantin, phenytoin) exposure History/Epidemiology [ edit ] Phenytoin anticonvulsant first introduced in1938.[en.wikibooks.org]
  • Their etiology is not precisely century with the first clinical recognition of known, so we have included chapters that dis symptoms and patterns for diagnosis of car cuss many aspects of congenital cardiac mal diovascular diseases.[books.google.de]
  • The etiology of birth defects in epileptic women is likely due to many factors including genetic disorders in the mother associated with epilepsy and the potential for teratogenesis due to exposure to anti-seizure medications.[hawaii.edu]

Epidemiology

  • Manson and Frederic clarified teratogenic effects of hydantoin in their epidemiological studies in 1973.[ncbi.nlm.nih.gov]
  • Jump to navigation Jump to search Fetal Hydantoin Syndrome Etiology [ edit ] Prenatal hydantoin (dilantin, phenytoin) exposure History/Epidemiology [ edit ] Phenytoin anticonvulsant first introduced in1938.[en.wikibooks.org]
  • The epidemiology of epilepsy in Rochester, Minnesota, 1935 through 1967. Epilepsia 1975;16:1-66. 2. World Health Organization. Neurological disorders. Public Health Challenges. Geneva: World Health Organization; 2006. 3. Sridharan R, Murthy BN.[jisppd.com]
  • This was a biased study and more recent epidemiological studies suggest that the risk of CHD is actually much lower tan originally reported.[fetalultrasound.com]
Sex distribution
Age distribution

Pathophysiology

  • Common Congenital Anomalies in this textbook describes the different pathophysiologic mechanisms that lead to abnormal fetal development.[hawaii.edu]

Prevention

  • Supplement of GSH, modification of CuZn-SOD enzyme activity and reduction of the absorption of copper may prevent the incidence of fetal hydantoin syndrome during pregnancy.[ncbi.nlm.nih.gov]
  • Early detection and appropriate treatment plan can potentially prevent wide abnormality. Surgical intervention can correct cleft lip and/or cleft palate.[medicalfoster.com]
  • Fetal hydantoin syndrome: A case report 1 Department of Pedodontics and Preventive Dentistry, Manav Rachna Dental College, Faridabad, Haryana, India 2 Department of Oral and Maxillofacial Surgery, Manav Rachna Dental College, Faridabad, Haryana, India[jisppd.com]
  • Also, it is recommended that women taking phenytoin take folic acid supplements, both before conception and during pregnancy as a preventive measure against malformations.[rarediseases.org]

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