Beine O, Bolland J, Verloes A, Lebrun F R, Khamis J, Muller Ch
Médecin stagiaire, ULg.
Rev Med Liege. 2004 Sep;59(9):513-6.
Spondylocostal dysostoses represent a group of very rare genetic disorders, characterised by vertebral and costal segmentation defects, sometimes accompanied by visceral malformations. The major gene involved is DLL3, on chromosome 19. A mutation may lead to a somitogenesis defect, with segmentation defect of axial skeleton and deformations. Depending on the nature of the mutation of DLL3, spondylocostal dysostosis is transmitted as an autosomal dominant (less severe) or autosomal recessive trait (often more severe, but non lethal). Spondylocostal dysostoses must not to be confused with the Jarcho-Levin spondylothoracic dysostosis, a severe, autosomal recessive syndrome. Its most typical aspect is the crab-like appearance of the rib cage leading to major respiratory disorders. Death, due to respiratory insufficiency, usually occurs before the age of two, most often during the first few months. At this time, guidelines for treatment do not exist. We report a case of spondylocostal dysosotosis in a patient born to consanguineous turkish parents, and review the clinical and genetic data on that group of skeletal disorders.
脊椎肋骨发育不全是一组非常罕见的遗传性疾病,其特征为脊椎和肋骨节段性缺陷,有时伴有内脏畸形。主要相关基因是位于19号染色体上的DLL3。突变可能导致体节发生缺陷,伴有轴向骨骼节段性缺陷和畸形。根据DLL3突变的性质,脊椎肋骨发育不全以常染色体显性(症状较轻)或常染色体隐性性状(通常症状较重,但非致死性)遗传。脊椎肋骨发育不全不应与贾科-莱文脊椎胸廓发育不全相混淆,后者是一种严重的常染色体隐性综合征。其最典型的表现是胸廓呈蟹样外观,导致严重的呼吸障碍。因呼吸功能不全导致的死亡通常发生在两岁之前,最常见于最初几个月。目前尚无治疗指南。我们报告了一例出生于近亲结婚的土耳其父母的患者的脊椎肋骨发育不全病例,并回顾了该组骨骼疾病的临床和遗传数据。