Valdés-Flores Margarita, Casas-Avila Leonora, Hernández-Zamora Edgar, Kofman Susana, Hidalgo-Bravo Alberto
Genetics Department, Instituto Nacional de Rehabilitación (INR), Mexico City, Mexico.
Genetics Department, Instituto Nacional de Rehabilitación (INR), Mexico City, Mexico.
J Pediatr (Rio J). 2016 Jan-Feb;92(1):58-64. doi: 10.1016/j.jped.2015.04.008. Epub 2015 Oct 9.
Arthrogryposis multiplex congenita is a relatively rare neuromuscular syndrome, with a prevalence of 1:3000-5000 newborns. In this study, the authors describe the clinical features of a group of 50 unrelated Mexican patients with arthrogryposis multiplex congenita.
Patients were diagnosed by physical and radiographic examination and the family history was evaluated.
Of the 50 cases, nine presented other features (pectum excavatum, cleft palate, mental retardation, ulnar agenesis, etc.). Environmental factors, as well as prenatal and family history, were analyzed. The chromosomal anomalies and clinical entities associated with arthrogryposis multiplex congenita were reported. No chromosomal aberrations were present in the cases with mental retardation. Three unrelated familial cases with arthrogryposis multiplex congenita were observed in which autosomal recessive, autosomal dominant and X-linked inheritance patterns are possible. A literature review regarding arthrogryposis multiplex congenita was also conducted.
It is important to establish patient-specific physical therapy and rehabilitation programs. A multidisciplinary approach is necessary, with medical, surgical, rehabilitation, social and psychological care, including genetic counseling.
先天性多发性关节挛缩症是一种相对罕见的神经肌肉综合征,在新生儿中的患病率为1:3000 - 5000。在本研究中,作者描述了一组50名无亲缘关系的墨西哥先天性多发性关节挛缩症患者的临床特征。
通过体格检查和影像学检查对患者进行诊断,并评估家族史。
在这50例病例中,9例呈现出其他特征(漏斗胸、腭裂、智力发育迟缓、尺骨发育不全等)。分析了环境因素以及产前和家族史。报告了与先天性多发性关节挛缩症相关的染色体异常和临床实体。智力发育迟缓的病例中未发现染色体畸变。观察到3例无亲缘关系的先天性多发性关节挛缩症家族病例,可能存在常染色体隐性、常染色体显性和X连锁遗传模式。还对先天性多发性关节挛缩症进行了文献综述。
制定针对患者的物理治疗和康复计划很重要。多学科方法是必要的,包括医疗、手术、康复、社会和心理护理,包括遗传咨询。