Brancati Francesco, Sarkozy Anna, Dallapiccola Bruno
CSS Hospital, IRCCS, San Giovanni Rotondo and CSS-Mendel Institute, Rome, Italy.
Orphanet J Rare Dis. 2006 Dec 12;1:50. doi: 10.1186/1750-1172-1-50.
KBG syndrome is a rare condition characterised by a typical facial dysmorphism, macrodontia of the upper central incisors, skeletal (mainly costovertebral) anomalies and developmental delay. To date, KBG syndrome has been reported in 45 patients. Clinical features observed in more than half of patients that may support the diagnosis are short stature, electroencephalogram (EEG) anomalies (with or without seizures) and abnormal hair implantation. Cutaneous syndactyly, webbed short neck, cryptorchidism, hearing loss, palatal defects, strabismus and congenital heart defects are less common findings. Autosomal dominant transmission has been observed in some families, and it is predominantly the mother, often showing a milder clinical picture, that transmits the disease. The diagnosis is currently based solely on clinical findings as the aetiology is unknown. The final diagnosis is generally achieved after the eruption of upper permanent central incisors at 7-8 years of age when the management of possible congenital anomalies should have been already planned. A full developmental assessment should be done at diagnosis and, if delays are noted, an infant stimulation program should be initiated. Subsequent management and follow-up should include an EEG, complete orthodontic evaluation, skeletal investigation with particular regard to spine curvatures and limb asymmetry, hearing testing and ophthalmologic assessment.
KBG综合征是一种罕见疾病,其特征为典型的面部畸形、上颌中切牙巨牙症、骨骼(主要是肋椎)异常和发育迟缓。迄今为止,已报道45例KBG综合征患者。半数以上患者中观察到的可能支持诊断的临床特征包括身材矮小、脑电图(EEG)异常(伴或不伴癫痫发作)和毛发植入异常。皮肤并指、蹼状短颈、隐睾、听力丧失、腭裂、斜视和先天性心脏缺陷则为较少见的表现。在一些家族中观察到常染色体显性遗传,且主要是母亲传递该疾病,母亲通常临床表现较轻。由于病因不明,目前诊断仅基于临床发现。最终诊断一般在7 - 8岁上颌恒中切牙萌出后作出,此时应已对可能的先天性异常进行了处理规划。诊断时应进行全面的发育评估,若发现发育迟缓,应启动婴儿刺激计划。后续的处理和随访应包括脑电图检查、全面的正畸评估、骨骼检查(尤其关注脊柱弯曲和肢体不对称情况)、听力测试和眼科评估。