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2.1
Rhizomelic Chondrodysplasia Punctata Type 2
Chondrodysplasia Punctata Rhizomelic due to Dihydroxyacetonephosphate Acyltransferase Deficiency

Presentation

We present two cases of CRCP type I with two different forms of presentation, one severe and another one mild or bening, in relation with the residual enzyme activity and we revise the main clinical aspects(AU) [pesquisa.bvsalud.org]

Infants who survivebeyond the first year usually present normal life expectancy andmental development. [rb.org.br]

Clinical Characteristics Ocular Features: Congenital cataracts are the outstanding ocular feature of this syndrome and are present in over 70% of patients. [disorders.eyes.arizona.edu]

Life expectancy is considerably reduced. [1] [2] Prevalence Estimated 1 in 100,000; RCDP 1 is most common subtype. [1] Characteristics/Clinical Presentation These patients present with severe and symmetrical shortening of the proximal long bones (rhizomelia [physio-pedia.com]

Entire Body System

  • Disability

    It is unclear how these alterations cause the shortening of the long bones, or intellectual disability and other characteristics of the RCDP3. [ivami.com]

    This disease is characterized by congenital cataracts, proximal limb shortening, seizures, growth delay and intellectual disability. Due to respiratory complications, this condition is usually fatal within the first decade of life. [sema4genomics.com]

    […] stippling Flexion contracture Generalized hypotonia Hypotonia Irregular vertebral endplates Large fontanelles Microcephaly Micrognathia Osteopenia Scoliosis Stippled calcification proximal humeral epiphyses Abnormality of the nervous system Intellectual disability [ncbi.nlm.nih.gov]

    Rhizomelic chondrodysplasia punctata (RCDP) is an autosomal recessive peroxisomal disorder characterized by disproportionate short stature with rhizomelic limb shortening, congenital cataracts, distinct facial features, severe intellectual disability, [ctgt.net]

    […] pelvic girdle bone morphology ; Anteverted nares ; Autosomal recessive inheritance ; Calcific stippling ; Cataract ; Depressed nasal bridge ; Failure to thrive ; Flexion contracture ; Generalized hypotonia ; High forehead ; High palate ; Intellectual disability [mousephenotype.org]

  • Disproportionate Short Stature

    Rhizomelic chondrodysplasia punctata (RCDP) is a peroxisomal disorder characterized by disproportionately short stature primarily affecting the proximal parts of the extremities, a typical facial appearance including a broad nasal bridge, epicanthus, [ncbi.nlm.nih.gov]

    Rhizomelic chondrodysplasia punctata (RCDP) is an autosomal recessive peroxisomal disorder characterized by disproportionate short stature with rhizomelic limb shortening, congenital cataracts, distinct facial features, severe intellectual disability, [ctgt.net]

    Familial osteochondritis dissecans Orphanet_251262 [Familial osteochondritis dissecans is a rare genetic skeletal disorder characterized clinically by abnormal chondro-skeletal development, disproportionate short stature and skeletal deformation mainly [ebi.ac.uk]

  • Trisomy 21

    The differential diagnosis includes other causes for CDP,Keutel syndrome, Zellweger syndrome, Smith-Lemn-Opitz syndrome,classical and neonatal Refsum disease, neonataladrenoleucodystrophy, neonatal lupus, trisomy 21 or 18, fetalalcoholic syndrome, congenital [rb.org.br]

    Google Scholar Tolksdorf, M., Goll, H., Spranger, J.: Trisomie 21 und punktförmige epiphysäre Verkalkungen. (In Vorbereitung.) Google Scholar Valdmanis, A., Wilson, J. R., Mann, J. D., Pearson, G., Shaw, M. [link.springer.com]

  • Poor Feeding

    After ten days, the baby was seen by the primary-care physician (PCP) for a new-onset fever and poor feeding. The patient was put on amoxicillin for otitis media but no clinical improvement ensued. [file.scirp.org]

    Prevention of Secondary Complications Poor feeding and recurrent aspiration necessitate the placement of a gastrostomy tube. Note: Improved nutrition does not enhance linear growth. [ncbi.nlm.nih.gov]

  • Feeding Difficulties

    Moreover, this patient showed signs of pain to any stimulation and had feeding difficulties that necessitated gastric drip-feeding. At echography, images of his brain showed mild ventricular dilatation. [ajnr.org]

Respiratoric

  • Saddle Nose

    The patient presented ichthyosis, irregular foci of alopecia,feeble skin, shortened neck, flattened facies with saddle nose,permanently flexed knee and elbow joints, besides limbsshortening, microcephaly and micrognathia and history ofdeglutition difficulty [rb.org.br]

Gastrointestinal

  • Failure to Thrive

    She had rhizomelic chondrodysplasia punctata, microcephaly, failure to thrive, delayed motor and mental development, and spastic quadriplegia. [ncbi.nlm.nih.gov]

    […] to thrive ; Flexion contracture ; Generalized hypotonia ; High forehead ; High palate ; Intellectual disability ; Irregular vertebral endplates ; Large fontanelles ; Microcephaly ; Micrognathia ; Muscular hypotonia ; Osteopenia ; Rhizomelia ; Scoliosis [mousephenotype.org]

    Affected infants may fail to grow and gain weight at the rate expected for age and gender (failure to thrive). Growth deficiencies may ultimately result in a final adult height that is below normal (short stature). [rarediseases.org]

Eyes

  • Strabismus

    […] cysts 614561 616663 Autosomal recessive SNRPB 20p13 Cerebrocostomandibular syndrome 117650 182282 Autosomal dominant SNTA1 20q11.21 Long QT syndrome 12 612955 601017 Autosomal dominant SOBP 6q21 Mental retardation, anterior maxillary protrusion, and strabismus [mnglabs.com]

Skin

  • Skin Lesion

    The skin lesions typically present at birth and often persist, but can develop at any age, often at a site of skin damage. [ncbi.nlm.nih.gov]

    The clinical picturemay range from mild disease to an extremely severe condition,with cataracts, asymmetrical shortening of long bones, scoliosis,ichthyotic-type skin lesions, and flattened facies with broadnasal bridge (6). [rb.org.br]

  • Dry Skin

    Once a child has been diagnosed with RCDP a skin sample is taken to determine which type of RCDP a child has (see below). An RCDP infant will often, but not always, be born with cataracts in both eyes. They might suffer stiff joints and dry skin. [geneticdisordersuk.org]

Musculoskeletal

  • Short Humerus

    Keywords: Rhizomelic Chondrodysplasia Punctata Type I, Seizure, Short Humerus ABSTRACT Rhizomelic Chondrodysplasia Punctata Type I is one of the rare peroxisome disorders. [file.scirp.org]

    [from OMIM] Show allHide all Abnormality of head or neck Anteverted nares Depressed nasal bridge High forehead High palate Wide nasal bridge Abnormality of limbs Rhizomelia Short humerus Abnormality of the eye Cataract Abnormality of the musculoskeletal [ncbi.nlm.nih.gov]

    […] thrive ; Flexion contracture ; Generalized hypotonia ; High forehead ; High palate ; Intellectual disability ; Irregular vertebral endplates ; Large fontanelles ; Microcephaly ; Micrognathia ; Muscular hypotonia ; Osteopenia ; Rhizomelia ; Scoliosis ; Short [mousephenotype.org]

    The baby had short humerus bones with stippled epiphy-ses, consistent with the disease. He had also delay in myelinization on brain MRI with bilateral subependymal cysts over the atria and frontal horns of the lateral ventricles. [scirp.org]

    Figure3: Infantogram of the patient with red arrows showing both short humerus and blue arrows show bilateral short femur bones Click here to view Abdominal and cranial ultrasonography was normal. Two-dimensional echocardiography was normal. [jcnonweb.com]

Face, Head & Neck

  • Hypertelorism

    These include a prominent forehead, widely set eyes ( hypertelorism ), a sunken appearance of the middle of the face ( midface hypoplasia ), a small nose with upturned nostrils, and full cheeks. [ghr.nlm.nih.gov]

    In reference to the distinctive facial features include: prominent forehead, hypertelorism, midface hypoplasia, a small nose pointing upwards and prominent cheeks. [ivami.com]

    Other distinctive features include downslanting palpebral fissures, ocular hypertelorism, low-set ears, and high-arched palate [ Happle 1979, Herman 2000 ]. Skeletal. [ncbi.nlm.nih.gov]

  • Large Fontanel

    fontanelles Microcephaly Micrognathia Osteopenia Scoliosis Stippled calcification proximal humeral epiphyses Abnormality of the nervous system Intellectual disability Growth abnormality Disproportionate short stature Failure to thrive IMPORTANT NOTE: [ncbi.nlm.nih.gov]

    fontanelles ; Microcephaly ; Micrognathia ; Muscular hypotonia ; Osteopenia ; Rhizomelia ; Scoliosis ; Short humerus ; Stippled calcification proximal humeral epiphyses ; Wide nasal bridge Associated Genes GNPAT (Withdrawn symbols: DAP-AT, DAPAT, DHAPAT [mousephenotype.org]

Neurologic

  • Nystagmus

    In rare cases, additional eye (ocular) abnormalities include abnormally small eyes (microphthalmos), abnormally small corneas (microcornea), down-slanting eyelid folds (palpebral fissures), rapid, involuntary eye movements (nystagmus), and degeneration [rarediseases.org]

    602723 607211 Autosomal dominant CARD14 17q25.3 Pityriasis rubra pilaris 173200 607211 Autosomal dominant CARS2 13q34 Combined oxidative phosphorylation deficiency 27 616672 612800 Autosomal recessive CASK Xp11.4 Mental retardation, with or without nystagmus [mnglabs.com]

Treatment

Management and treatment There is no specific treatment for the enzyme defect. Prognosis Rhizomelic chondrodysplasia has a severe prognosis with death generally occurring during the first decade of life, mainly due to respiratory complications. [orpha.net]

TREATMENT Treatment for Rhizomelic Chondrodysplasia Punctata Type 1 is symptomatic depending on the features of an individual. [evolvegene.com]

Treatment Treatment Options: No treatment is available beyond supportive measures. Cataract removal may improve vision but the poor prognosis for longevity requires caution be used. [disorders.eyes.arizona.edu]

TREATMENT There is no current cure for RCDP. Treatment is supportive and many include physical therapy, anti-seizure medication, hearing amplification, and cataract removal. [secure.ssa.gov]

Treatment - Rhizomelic chondrodysplasia punctata- type 2 Not supplied. Resources - Rhizomelic chondrodysplasia punctata- type 2 Not supplied. [checkorphan.org]

Prognosis

Prognosis Rhizomelic chondrodysplasia has a severe prognosis with death generally occurring during the first decade of life, mainly due to respiratory complications. [orpha.net]

Treatment and prognosis While prognosis is variable, the rhizomelic forms can be lethal 3. [radiopaedia.org]

Prognosis - Rhizomelic chondrodysplasia punctata- type 2 Not supplied. Treatment - Rhizomelic chondrodysplasia punctata- type 2 Not supplied. Resources - Rhizomelic chondrodysplasia punctata- type 2 Not supplied. [checkorphan.org]

The rhizomelic condrodisplasia has a grave prognosis, usually with death during first decade of life (mainly because of respiratory complications). [tellmegen.com]

Cataract removal may improve vision but the poor prognosis for longevity requires caution be used. References Motley AM, Brites P, Gerez L, Hogenhout E, Haasjes J, Benne R, Tabak HF, Wanders RJ, Waterham HR. [disorders.eyes.arizona.edu]

Etiology

Etiology The disease is caused by defective peroxisome metabolism. [orpha.net]

Disorder of glycolysis Orphanet_308459 Disorder of carbohydrate metabolism Orphanet_79161 Rhizomelic chondrodysplasia punctata type 1 Orphanet_309789 etiological subtype Orphanet_377795 [Subdivision of a disease, malformation syndrome, morphological anomaly [ebi.ac.uk]

Etiology germline mutation in the gene encoding delta(8)-delta(7) sterol isomerase emopamil-binding protein (EBP) (MIM.300205) Physiopathology Because chondrodysplasia punctata has been described in SLOS, Kelley et al. investigated the possibility that [humpath.com]

These findings, in combination with the specific clinical presentation, leads to the diagnosis of rhizomelic chondrodysplasia punctata. [3] Etiology/Causes Genetic mutations of three genes mentioned above, which leads to peroxisome biogenesis disorders [physio-pedia.com]

This article uses diagnostician as any of these person categories, a diagnostic procedure does not necessarily involve elucidation of the etiology of the diseases or conditions of interest, that is, what caused the disease or condition. [wikivisually.com]

Epidemiology

[…] syndrome Hypocalcemic vitamin D-resistant rickets Synonym(s): (no synonyms) Classification (Orphanet): - Inborn errors of metabolism - Rare genetic disease Classification (ICD10): - Congenital malformations, deformations and chromosomal abnormalities - Epidemiological [csbg.cnb.csic.es]

Summary Epidemiology Prevalence of the rhizomelic type is estimated at 1 in 100,000. [orpha.net]

It gives compreensive coverage of the epidemiology, aetiology, and mechanism of disease, as well as clear, unambiguous coverage of the diagnosis, practical management and prevention of the entire spectrum of medical disorders. [books.google.com]

Pathophysiology

The condition is acquired in an autosomal recessive manner. [1] Pathophysiology [ edit ] The mechanism of rhizomelic chondrodysplasia punctata in the case of type 1 of this condition one finds that peroxisome objective is PEX7, in peroxisome assembly. [en.wikipedia.org]

There are major introductory sections on the scientific basis of disease; and in the system-based clinical sections genetic predisposition, pathophysiology, pathogenesis, molecular mechanisms, and cell biology are covered in depth for all significant [books.google.com]

Rhizomelic chondrodysplasia punctata type 1 and fulminant neonatal respiratory failure, a case report and discussion of pathophysiology. American Journal Of Medical Genetics. Part A [serial online]. December 2011;155A(12):3160-3163. [physio-pedia.com]

Rhizomelic chondrodysplasia punctata type 1 and fulminant neonatal respiratory failure, a case report and discussion of pathophysiology. Am J Med Genet A. 2011; 155A :3160–3. [ PubMed : 22052861 ] Powers JM, Kenjarski TP, Moser AB, Moser HW. [ncbi.nlm.nih.gov]

Prevention

Prevention - Rhizomelic chondrodysplasia punctata- type 2 Not supplied. Diagnosis - Rhizomelic chondrodysplasia punctata- type 2 Not supplied. Prognosis - Rhizomelic chondrodysplasia punctata- type 2 Not supplied. [checkorphan.org]

The main goals for physical therapy are to prevent secondary impairments of RCDP. [3] Improve contractures related to RCDP Prevention of respiratory complications Management of spasticity Provide cognitive stimulation Can also be a referral source for [physio-pedia.com]

Genetic mutations responsible PEX7 RCDP1 prevent the peroxisomal biogenesis factor 7 enzymes the transport critical, particularly alkylglycerol phosphate synthase, peroxisomes. [ivami.com]

It gives compreensive coverage of the epidemiology, aetiology, and mechanism of disease, as well as clear, unambiguous coverage of the diagnosis, practical management and prevention of the entire spectrum of medical disorders. [books.google.com]

Mutations in the PEX7 gene prevent plasmalogen production and disrupt peroxisome functions. The condition is inherited in an autosomal recessive pattern. [evolvegene.com]

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