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Multiple Congenital Anomalies - Hypotonia - Seizures Type 3

MCAHS3


Presentation

  • The severity of the presentations in conjunction with the patients' mutations suggest a genotype-phenotype correlation in which congenital anomalies are only seen in patients with biallelic loss-of-function.[jhu.pure.elsevier.com]
  • He presented several types of seizures. Atrial septal defect type 2 was seen. Elevated alkaline phosphatase level was noted.[databases.lovd.nl]
  • Infants can present with hypotonia that is due to central or peripheral nervous system abnormalities, myopathies, genetic disorders, endocrinopathies, metabolic diseases, and acute or chronic illness (Table 1).[pedsinreview.aappublications.org]
  • Acronym MCAHS1 Synonyms Glycosylphosphatidylinositol biosynthesis defect 3 GPIBD3 Keywords Any medical or genetic information present in this entry is provided for research, educational and informational purposes only.[uniprot.org]
  • The mother and his sister presented no clinical symptom. At 3 months, he resumed severe hypotonia, apnea and respiratory difficulties. Continuous positive airway pressure was initiated.[e-kjp.org]
Turkish
  • [pubmed:23636107] clinical features ...linical-features] {1:Kvarnung et al. (2013)} reported a consanguineous family of Turkish origin in which 4 patients had severe intellectual and motor disability and multiple congenital anomalies.[bio2rdf.org]
Visual Impairment
  • The patient presented with severe hypotonia, microphallus and left cryptorchidism, and was later diagnosed with epilepsy and severe cortical visual impairment.[ncbi.nlm.nih.gov]
  • impairment Skin abnormalities (ichthyosis, etc.)[igd.biken.osaka-u.ac.jp]
  • impairment Status epilepticus Nephrocalcinosis Calcinosis Deep philtrum And 56 more phenotypes.[mendelian.co]
  • […] situ Ranula Abnormal cerebellum morphology Decreased antibody level in blood Palmoplantar keratoderma Acrania Papule Abnormality of the kidney Carcinoma Subcutaneous nodule Oxycephaly Immunodeficiency Dilatation Hernia Diarrhea Tremor Lymphoma Cortical visual[mendelian.co]
Narrow Forehead
  • forehead Open mouth Cortical visual impairment Status epilepticus Nephrocalcinosis Calcinosis Deep philtrum And 56 more phenotypes.[mendelian.co]
  • forehead Cryptorchidism Pes planus Neurological speech impairment Impaired pain sensation Hydronephrosis Broad nasal tip Narrow palate Low-set ears Feeding difficulties Gait ataxia Everted lower lip vermilion Microtia Joint laxity Triangular face Thin[mendelian.co]
Narrow Forehead
  • forehead Open mouth Cortical visual impairment Status epilepticus Nephrocalcinosis Calcinosis Deep philtrum And 56 more phenotypes.[mendelian.co]
  • forehead Cryptorchidism Pes planus Neurological speech impairment Impaired pain sensation Hydronephrosis Broad nasal tip Narrow palate Low-set ears Feeding difficulties Gait ataxia Everted lower lip vermilion Microtia Joint laxity Triangular face Thin[mendelian.co]
Narrow Face
  • The key elements of the clinical phenotype are absolute or relative macrocephaly with a long narrow face; tall forehead; dolicocephalic head shape; an open mouth; small, simple, low-set, prominent ears; and puffy eyelids.[nature.com]

Workup

  • Additional workup of exome sequencing analysis revealed a hemizygous nonsense mutation in PIGA (c.1234C T, p.Arg412 * ). The patient is currently undergoing hospitalization for treatment of respiratory failure and recurrent seizures.[e-kjp.org]
Delayed Bone Age
  • All patients also had some type of skeletal findings, including scoliosis, pectus excavatum, short upper extremities, slender and osteopenic long bones with large secondary ossification centers, wide and long femoral necks, and delayed bone age.[bio2rdf.org]
  • bone age, pectus excavatum and osteopenia), inverted nipples and dysmorphic features including high and narrow forehead, frontal bossing, short nose, depressed nasal bridge, anteverted nares, high palate and wide open mouth consistent with facial hypotonia[mendelian.co]
Delayed Bone Age
  • All patients also had some type of skeletal findings, including scoliosis, pectus excavatum, short upper extremities, slender and osteopenic long bones with large secondary ossification centers, wide and long femoral necks, and delayed bone age.[bio2rdf.org]
  • bone age, pectus excavatum and osteopenia), inverted nipples and dysmorphic features including high and narrow forehead, frontal bossing, short nose, depressed nasal bridge, anteverted nares, high palate and wide open mouth consistent with facial hypotonia[mendelian.co]

Treatment

  • Treatment guide A clinical trial of pyridoxine (vitamin B6) treatment for IGD is on going in Japan.[igd.biken.osaka-u.ac.jp]
  • CLOSE Medical Disclaimer The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes.[diseaseinfosearch.org]
  • It is not in any way intended to be used as a substitute for professional medical advice, diagnosis, treatment or care. Our staff consists of biologists and biochemists that are not trained to give medical advice .[uniprot.org]
  • In the area of metabolic disease, he is developing new treatments for maple syrup urine disease and urea cycle disorders. Fernando Scaglia, MD, is a Professor in the Department of Molecular and Human Genetics at Baylor College of Medicine.[books.google.com]
  • Teddy's parents also learned there is no treatment, and that most affected children have an average life span of three years.[theledger.com]

Prognosis

  • Prognosis was poor. Eight cases died, while survived cased suffered from refractory epilepsy, profound mental retardation, muscle weakness, etc.[ncbi.nlm.nih.gov]
  • Prognosis Frequently results in stillbirth or death within the first year. If patients survive beyond infancy, they have slow but constant progress in terms of development.[patient.info]
  • Identification of the molecular basis of EIEE in an affected individual may confirm diagnosis, determine prognosis, inform treatment options, and encourage testing of additional family members to inform reproductive risk.[invitae.com]

Etiology

  • Prenatal testing is possible where one parent is known to be a carrier of the condition. [ 6 ] Bergemann AD, Cole F, Hirschhorn K ; The etiology of Wolf-Hirschhorn syndrome. Trends Genet. 2005 Mar21(3):188-95.[patient.info]
  • Karyotype assessment is important to consider in all epilepsies where the etiology is uncertain as dysmorphic features may be subtle or not apparent. Karyotype examination should be extended to 50-100 mitoses to exclude mosaicism.[epilepsydiagnosis.org]
  • Finding new etiologies of mental retardation and hypotonia: X marks the spot. Dev Med Child Neurol 2008; 50 : 104–111. 17. Schwartz CE, Tarpey PS, Lubs HA, et al.[nature.com]

Epidemiology

  • Relevant External Links for PIGN Genetic Association Database (GAD) PIGN Human Genome Epidemiology (HuGE) Navigator PIGN Atlas of Genetics and Cytogenetics in Oncology and Haematology: PIGN No data available for Genatlas for PIGN Gene MCD4 encodes a conserved[genecards.org]
  • Epidemiology of pyridoxine dependent and pyridoxine responsive seizures in the UK. Arch. Dis. Child. 1999; 81(5):431-3. PMID: 10519720 Trevathan, E, et al. The descriptive epidemiology of infantile spasms among Atlanta children.[invitae.com]
  • Synonyms: chromosome 4p deletion syndrome, 4p- syndrome, monosomy 4p syndrome Wolf-Hirschhorn syndrome (WHS) is characterised by learning difficulties, epilepsy, growth delay and craniofacial dysgenesis. [ 1 ] Epidemiology The incidence is estimated at[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology Decreased expression of certain GPI-APs and associated symptoms Decreased expression of ALP and seizures Tissue non-specific ALP (an isozyme of ALP) is expressed on neurons and dephosphorylates pyridoxal phosphate (PLP) into pyridoxal[igd.biken.osaka-u.ac.jp]
  • Any hypotheisis must also account for the close pathophysiologic relationship between PNH and acquired aplastic anemia, a T cell-mediated autoimmune disease characterized by depletion of hematopoietic stem cells.[bloodjournal.org]

Prevention

  • For long term storage store at -20 C in small aliquots to prevent freeze-thaw cycles. Expiry Date 6 months Supplier Images PIGT Antibody (C-term) western blot analysis in NCI-H292 cell line lysates (35ug/lan...[antibodies-online.com]
  • Prevention Genetic counselling will assess the risk to family members, based on the mechanism of origin of the deletion.[patient.info]
  • The hypomorph protein, in this patients, prevents the lethality but not the MCAHS-2 like phenotype. PIGA PIGA 1 1 Philippe Campeau 00028960 - PubMed: Kato et al 2014 Two brothers with early infantile epileptic encephalopathy.[databases.lovd.nl]
  • Eculizumab inhibits terminal complement activation by binding to C5 and preventing generation of C5a and C5b.[bloodjournal.org]

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