Al Kaissi Ali, Ganger Rudolf, Rötzer Katharina M, Klaushofer Klaus, Grill Franz
Ludwig Boltzmann Institute of Osteology, Hanusch Hospital of WGKK, Vienna, Austria; AUVA Trauma Centre Meidling, First Medical Department, Hanusch Hospital, Vienna, Austria; Paediatric Department, Orthopaedic Hospital of Speising, Vienna, Austria.
Am J Med Genet A. 2014 Sep;164A(9):2338-43. doi: 10.1002/ajmg.a.36614. Epub 2014 May 16.
We describe a-2-year-old boy who presented with a neonatal history of thrombocytopenia associated with a constellation of limb malformations mimicking split hand/foot malformation with long bone deficiency (SHFLD) syndrome. Limb malformations consisted of unilateral monodactyly with radial aplasia, unilateral split foot and bilateral club foot. Tibial aplasia of one limb and tibial hypoplasia of the other limb were notable. Partial agenesis of the sacrum was additional skeletal malformation. Craniofacial features included dense thick scalp hair, narrow frontal area, thick eye-brows, deep-set eyes, depressed nasal bridge, and small overhanging nasal tip, full-cheeks, and large ears. Array-CGH showed duplication of the short arm of chromosome 17p13.3 in the boy and his father, respectively. The father was free from any skeletal abnormalities, though he shares similar craniofacial dysmorphic features like his son. In addition, a paternal sib (uncle of the proband) manifested a phenotype similar to that of the proband. To the best of our knowledge the overall phenotypic and genotypic characterizations were consistent but not completely compatible with the traditional type of TAR syndrome or with SHFLD syndrome. We report on what might be a novel variant of SHFLD associated with transient thrombocytopenia, dysmorphic facial features, and a constellation of bone malformations.
我们描述了一名2岁男孩,他有新生儿期血小板减少症病史,并伴有一系列肢体畸形,类似于伴有长骨缺损的裂手/裂足畸形(SHFLD)综合征。肢体畸形包括单侧单指畸形伴桡骨发育不全、单侧裂足和双侧马蹄内翻足。一侧肢体胫骨发育不全,另一侧肢体胫骨发育不良较为明显。骶骨部分发育不全是另外的骨骼畸形。颅面部特征包括头皮浓密厚发、额部狭窄、眉毛浓密、眼窝深陷、鼻梁凹陷、鼻尖低垂、脸颊丰满和耳朵较大。阵列比较基因组杂交(Array-CGH)显示该男孩及其父亲的17号染色体短臂p13.3重复。父亲没有任何骨骼异常,不过他和儿子有相似的颅面部畸形特征。此外,先证者的一位父系亲属(先证者的叔叔)表现出与先证者相似的表型。据我们所知,总体表型和基因型特征是一致的,但并不完全符合传统类型的血小板减少桡骨缺失(TAR)综合征或SHFLD综合征。我们报告了一种可能与短暂性血小板减少、面部畸形特征以及一系列骨骼畸形相关的SHFLD新变异型。