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Rao MS, Sahu D, Kareem H, Devasia T, Shetty KK. Adult Survival in Ellis-van Creveld Syndrome with Common Atrium - A Rare Case Report. J Clin Diagn Res 2017; 11:OD12-OD13. [PMID: 28969186 DOI: 10.7860/jcdr/2017/25126.10454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 05/27/2017] [Indexed: 01/15/2023]
Abstract
Ellis-van Creveld syndrome is a rare genetic disorder, characterized by chondral dysplasia, ectodermal dysplasia, polydactyly and congenital heart defects. Patients with this syndrome rarely survive into adulthood. The syndrome has also been rarely reported in the Indian population. We present the case of a 56 year old female who presented with post-menopausal bleeding, and was diagnosed with Ellis van Creveld syndrome, with a common atrium and common atrioventricular valve.
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Affiliation(s)
- Mugula Sudhakar Rao
- Registrar, Department of Cardiology, KMC, Manipal University, Manipal, Karnataka, India
| | - Devavrata Sahu
- Junior Resident, Department of Medicine, KMC, Manipal University, Manipal, Karnataka, India
| | - Hashir Kareem
- Associate Professor, Department of Cardiology, KMC, Manipal University, Manipal, Karnataka, India
| | - Tom Devasia
- Professor, Department of Cardiology, KMC, Manipal University, Manipal, Karnataka, India
| | - Kishor Kumar Shetty
- Consultant Physician, Department of Medicine, Vinaya Hospital, Kundapur, Karnataka, India
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52
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Nethan ST, Sinha S, Chandra S. Ellis-van Creveld with an Unusual Dental Anomaly: A Case Report. IRANIAN JOURNAL OF MEDICAL SCIENCES 2017; 42:501-504. [PMID: 29234185 PMCID: PMC5722970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The Ellis-van Creveld (EVC) syndrome is a chondroectodermal dysplasia and is characterized by the cardinal features of disproportionate short stature, polydactyly, hidrotic ectodermal dysplasia, and congenital heart malformations, along with other skeletal and dental abnormalities. It is a rare condition, with very few cases reported in the medical literature. It is inherited as an autosomal recessive disorder with variable expressions, due to the mutation of the EVC syndrome 1 and 2 genes, which are located on chromosome 4p16. The present case report describes the EVC syndrome in a 14-year-old girl, who presented with a tetrad of all the cardinal features and other associated features. Additional unusual dental findings such as single-rooted funnel-shaped molars, reduced crown size, enamel hypoplasia, supernumerary teeth, dental fusion, taurodontism, abnormal occlusal anatomy with wide grooves, and atypical cusps have been reported in most previous cases of this syndrome. However, in our patient, surprisingly, the teeth present were relatively non-anomalous, both clinically and radiographically (i.e., with none of the usually found abnormalities mentioned above). The only abnormal dental findings were those of absent maxillary and mandibular incisors (including impacted permanent incisors) and mild malocclusion, a novel point of this case.
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Affiliation(s)
- Suzanne Tanya Nethan
- Department of Oral Medicine and Radiology, Saraswati Dental College, Lucknow, Uttar Pradesh, India,Correspondence: Suzanne Tanya Nethan, MDS; C201 Santushti Apartments, 7A Vivekanand Marg, Lucknow, Uttar Pradesh, 226001, India Tel: +91 94 53013152, +91 80 52005703
| | - Shruti Sinha
- Department of Oral Medicine and Radiology, Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Sunira Chandra
- Department of Oral Medicine and Radiology, Saraswati Dental College, Lucknow, Uttar Pradesh, India
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53
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Wide-spread cone-shaped epiphyses in two Saudi siblings with Ellis-van Creveld syndrome. Int J Surg Case Rep 2017; 39:212-217. [PMID: 28854412 PMCID: PMC5575438 DOI: 10.1016/j.ijscr.2017.08.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/08/2017] [Accepted: 08/08/2017] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Ellis-van Creveld (EVC) syndrome is one of the rarest ciliopathy syndromes. It is caused by mutations of the EVC and EVC2 genes which encode the EVC proteins present in the basal body of the primary cilium. PRESENTATION OF CASES We report on a Saudi family with two affected children. Gene analysis revealed a homozygous c.2T >A in exon 1 of the EVC gene. The most interesting finding in our patients was the wide - spread cone-shaped epiphyses in the hands and feet. DISCUSSION Although cone-shaped epiphyses is a known feature of EVC syndrome, it usually limited to the middle or proximal phalanges. The wide-spread cone-shaped epiphyses seen in our patients have not been previously reported. CONCLUSION EVC syndrome is very rare in the Middle East. We report on the first Saudi family with EVC syndrome confirmed by gene analysis. The most unique finding in our patients was the wide-spread cone-shaped epiphyses in the hands and feet. The abnormality is probably related to abnormal Indian hedgehog signaling in the primary cilium.
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54
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Alapati D, Shaffer TH. Skeletal dysplasia: Respiratory management during infancy. Respir Med 2017; 131:18-26. [PMID: 28947027 DOI: 10.1016/j.rmed.2017.07.063] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 07/30/2017] [Accepted: 07/31/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Skeletal dysplasia encompasses a variety of developmental disorders of the bone and cartilage that manifest as disproportionate shortening of limbs and trunk in the neonate. Many types of skeletal dysplasia are complicated by respiratory failure at or soon after birth and require intensive care and prolonged hospitalization. Respiratory complications in these infants are complex and are characterized by airway anomalies, restrictive lung disease due to a narrow and abnormally compliant chest wall, pulmonary hypoplasia, and central apnea. Appropriate management of these unique patients requires a clear understanding of the pathophysiology and use of pulmonary function tests for early recognition and management of complications. CONCLUSION This review provides an overview of the underlying respiratory pathology and a practical guide to the newborn care provider for the diagnosis and management of respiratory complications in infants with skeletal dysplasia.
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Affiliation(s)
- Deepthi Alapati
- Department of Pediatrics, Nemours, Alfred I. DuPont Hospital for Children, Wilmington, DE, United States; Center for Pediatric Lung Research, Nemours, Alfred I. DuPont Hospital for Children, Wilmington, DE, United States; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States.
| | - Thomas H Shaffer
- Center for Pediatric Lung Research, Nemours, Alfred I. DuPont Hospital for Children, Wilmington, DE, United States; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States; Temple University School of Medicine, Philadelphia, PA, United States
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55
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Toomer KA, Fulmer D, Guo L, Drohan A, Peterson N, Swanson P, Brooks B, Mukherjee R, Body S, Lipschutz JH, Wessels A, Norris RA. A role for primary cilia in aortic valve development and disease. Dev Dyn 2017; 246:625-634. [PMID: 28556366 DOI: 10.1002/dvdy.24524] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 05/17/2017] [Accepted: 05/18/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Bicuspid aortic valve (BAV) disease is the most common congenital heart defect, affecting 0.5-1.2% of the population and causing significant morbidity and mortality. Only a few genes have been identified in pedigrees, and no single gene model explains BAV inheritance, thus supporting a complex genetic network of interacting genes. However, patients with rare syndromic diseases that stem from alterations in the structure and function of primary cilia ("ciliopathies") exhibit BAV as a frequent cardiovascular finding, suggesting primary cilia may factor broadly in disease etiology. RESULTS Our data are the first to demonstrate that primary cilia are expressed on aortic valve mesenchymal cells during embryonic development and are lost as these cells differentiate into collagen-secreting fibroblastic-like cells. The function of primary cilia was tested by genetically ablating the critical ciliogenic gene Ift88. Loss of Ift88 resulted in abrogation of primary cilia and increased fibrogenic extracellular matrix (ECM) production. Consequentially, stratification of ECM boundaries normally present in the aortic valve were lost and a highly penetrant BAV phenotype was evident at birth. CONCLUSIONS Our data support cilia as a novel cellular mechanism for restraining ECM production during aortic valve development and broadly implicate these structures in the etiology of BAV disease in humans. Developmental Dynamics 246:625-634, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Katelynn A Toomer
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, South Carolina
| | - Diana Fulmer
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, South Carolina
| | - Lilong Guo
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, South Carolina
| | - Alex Drohan
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, South Carolina
| | - Neal Peterson
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, South Carolina
| | - Paige Swanson
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, South Carolina
| | - Brittany Brooks
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, South Carolina
| | - Rupak Mukherjee
- Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, South Carolina.,Department of Medicine, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
| | - Simon Body
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Joshua H Lipschutz
- Department of Medicine, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina.,Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Andy Wessels
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, South Carolina
| | - Russell A Norris
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, South Carolina.,Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
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56
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Hampl M, Cela P, Szabo-Rogers HL, Kunova Bosakova M, Dosedelova H, Krejci P, Buchtova M. Role of Primary Cilia in Odontogenesis. J Dent Res 2017; 96:965-974. [PMID: 28605602 DOI: 10.1177/0022034517713688] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Primary cilium is a solitary organelle that emanates from the surface of most postmitotic mammalian cells and serves as a sensory organelle, transmitting the mechanical and chemical cues to the cell. Primary cilia are key coordinators of various signaling pathways during development and maintenance of tissue homeostasis. The emerging evidence implicates primary cilia function in tooth development. Primary cilia are located in the dental epithelium and mesenchyme at early stages of tooth development and later during cell differentiation and production of hard tissues. The cilia are present when interactions between both the epithelium and mesenchyme are required for normal morphogenesis. As the primary cilium coordinates several signaling pathways essential for odontogenesis, ciliary defects can interrupt the latter process. Genetic or experimental alterations of cilia function lead to various developmental defects, including supernumerary or missing teeth, enamel and dentin hypoplasia, or teeth crowding. Moreover, dental phenotypes are observed in ciliopathies, including Bardet-Biedl syndrome, Ellis-van Creveld syndrome, Weyers acrofacial dysostosis, cranioectodermal dysplasia, and oral-facial-digital syndrome, altogether demonstrating that primary cilia play a critical role in regulation of both the early odontogenesis and later differentiation of hard tissue-producing cells. Here, we summarize the current evidence for the localization of primary cilia in dental tissues and the impact of disrupted cilia signaling on tooth development in ciliopathies.
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Affiliation(s)
- M Hampl
- 1 Institute of Animal Physiology and Genetics, v.v.i., Czech Academy of Sciences, Brno, Czech Republic.,2 Department of Experimental Biology, Masaryk University, Brno, Czech Republic
| | - P Cela
- 1 Institute of Animal Physiology and Genetics, v.v.i., Czech Academy of Sciences, Brno, Czech Republic.,3 Department of Physiology, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
| | - H L Szabo-Rogers
- 4 Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,5 Center for Craniofacial Engineering, McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - H Dosedelova
- 1 Institute of Animal Physiology and Genetics, v.v.i., Czech Academy of Sciences, Brno, Czech Republic
| | - P Krejci
- 6 Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,7 International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic
| | - M Buchtova
- 1 Institute of Animal Physiology and Genetics, v.v.i., Czech Academy of Sciences, Brno, Czech Republic.,2 Department of Experimental Biology, Masaryk University, Brno, Czech Republic
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57
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Zhang H, Takeda H, Tsuji T, Kamiya N, Kunieda T, Mochida Y, Mishina Y. Loss of Function of Evc2 in Dental Mesenchyme Leads to Hypomorphic Enamel. J Dent Res 2017; 96:421-429. [PMID: 28081373 DOI: 10.1177/0022034516683674] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Ellis-van Creveld (EvC) syndrome is an autosomal-recessive skeletal dysplasia, characterized by short stature and postaxial polydactyly. A series of dental abnormalities, including hypomorphic enamel formation, has been reported in patients with EvC. Despite previous studies that attempted to uncover the mechanism leading to abnormal tooth development, little is known regarding how hypomorphic enamel is formed in patients with EvC. In the current study, using Evc2/ Limbin mutant mice we recently generated, we analyzed enamel formation in the mouse incisor. Consistent with symptoms in human patients, we observed that Evc2 mutant mice had smaller incisors with enamel hypoplasia. Histologic observations coupled with ameloblast marker analyses suggested that Evc2 mutant preameloblasts were capable of differentiating to secretory ameloblasts; this process, however, was apparently delayed, due to delayed odontoblast differentiation, mediated by a limited number of dental mesenchymal stem cells in Evc2 mutant mice. This concept was further supported by the observation that dental mesenchymal-specific deletion of Evc2 phenocopied the tooth abnormalities in Evc2 mutants. Overall, our findings suggest that mutations in Evc2 affect dental mesenchymal stem cell homeostasis, which further leads to hypomorphic enamel formation.
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Affiliation(s)
- H Zhang
- 1 Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - H Takeda
- 2 Unit of Animal Genomics, GIGA Research Center and Faculty of Veterinary Medicine, University of Liège, 1 Avenue de l'Hôpital, Liège, Belgium
| | - T Tsuji
- 3 Graduate School of Environmental and Life Science, Okayama University, Okayama City, Japan
| | - N Kamiya
- 1 Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
- Faculty of Budo and Sport Studies, Tenri University, Nara, Japan
| | - T Kunieda
- 3 Graduate School of Environmental and Life Science, Okayama University, Okayama City, Japan
| | - Y Mochida
- 4 Department of Molecular and Cell Biology, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA
| | - Y Mishina
- 1 Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
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58
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Velasco HM, Martin ÁM, Galvis J, Buelvas L, Sánchez Y, Umaña LA, Acosta J. [Clinical community genetics: exploring genetic disorders in Boyacá, Colombia]. Rev Salud Publica (Bogota) 2017; 19:32-38. [PMID: 30137152 DOI: 10.15446/rsap.v19n1.55238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 12/11/2016] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To explore the incidence of syndromic genetic pathologies in Boyacá, Colombia, through a community genetics approach. MATERIALS AND METHODS A group made up by different medical specialists (geneticists, a pediatric neurologist, and a biochemical geneticist) developed clinical campaigns, in which patients with clinical suspicion of genetic diseases were involved. Demographic, epidemiological and clinical data were collected, and frequency calculations were made based on the collected data. Several training workshops for health personnel were done in each center visited. RESULTS Two genetic clusters were found: mucopolysaccharidosis type III, and Ellis-Van Creveld Syndrome, both of them with higher incidences than those found in the literature. Also, a high frequency of autosomal recessive diseases was found, as well as microdeletion/microduplication syndromes. CONCLUSIONS Conventional mechanisms of medical attention must be established, in order to facilitate the access to an appropriate diagnosis and treatment. This work intended to provide support to patients, families and health care services personnel through the workshops and clinical campaigns, and to become a starting point to develop primary and secondary prevention processes.
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Affiliation(s)
- Harvy M Velasco
- MD., Esp. Genética Médica, M. Sc. Ciencias Biológicas, M. Sc. Genética Humana, Departamento de Morfología, Universidad Nacional de Colombia.
| | - Ángela M Martin
- MD., M. Sc. Genética Humana. Departamento de Morfología, Universidad Nacional de Colombia.
| | - Johanna Galvis
- MD., M. Sc. Genética Humana., M. Sc. Genética Humana, Departamento de Morfología, Universidad Nacional de Colombia.
| | - Lina Buelvas
- MD., M. Sc. Genética Humana. Departamento de Morfología, Universidad Nacional de Colombia.
| | - Yasmín Sánchez
- MD., Esp. Neuropediatría. Facultad de Medicina, Universidad Pedagógica y Tecnológica de Colombia. Hospital San Rafael. Tunja, Boyacá, Colombia.
| | - Luis A Umaña
- MD., Esp. Pediatría. Esp. Genética Clínica. Esp. Genética Bioquímica Médica. Department of Pediatrics, Division of Genetics and Metabolism, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Johanna Acosta
- MD., Esp. Genética Médica. Instituto de Ortopedia Roosevelt. M. Sc. Genética Humana, Departamento de Morfología, Universidad Nacional de Colombia.
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59
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Lewis ZR, Hanken J. Convergent evolutionary reduction of atrial septation in lungless salamanders. J Anat 2017; 230:16-29. [PMID: 27558020 PMCID: PMC5192874 DOI: 10.1111/joa.12535] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2016] [Indexed: 02/01/2023] Open
Abstract
Nearly two thirds of the approximately 700 species of living salamanders are lungless. These species respire entirely through the skin and buccopharyngeal mucosa. Lung loss dramatically impacts the configuration of the circulatory system but the effects of evolutionary lung loss on cardiac morphology have long been controversial. For example, there is presumably little need for an atrial septum in lungless salamanders due to the absence of pulmonary veins and the presence of a single source of mixed blood flowing into the heart, but whether lungless salamanders possess an atrial septum and whether the sinoatrial aperture is located in the left or right atrium are unresolved; authors have stated opposing claims since the late 1800s. Here, we use micro-computed tomography (μ-CT) imaging, gross dissection and histological reconstruction to compare cardiac morphology among lungless plethodontid salamanders (Plethodontidae), salamanders with lungs, and the convergently lungless species Onychodactylus japonicus (Hynobiidae). Plethodontid salamanders have partial atrial septa and incomplete separation of the atrium into left and right halves. Partial septation is also seen in O. japonicus. Hence, lungless salamanders from two lineages convergently evolved similar morphology of the atrial septum. The partial septum in lungless salamanders can make it appear that the sinoatrial aperture is in the left atrium, but this interpretation is incorrect. Outgroup comparisons demonstrate that the aperture is located in a posterodorsal extension of the right atrium into the left side of the heart. Independent evolutionary losses of the atrial septum may have a similar developmental basis. In mammals, the lungs induce formation of the atrial septum by secreting morphogens to neighboring mesenchyme. We hypothesize that the lungs induce atrial septum development in amphibians in a similar fashion to mammals, and that atrial septum reduction in lungless salamanders is a direct result of lunglessness.
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Affiliation(s)
- Zachary R. Lewis
- Department of Organismic and Evolutionary Biology, and Museum of Comparative ZoologyHarvard UniversityCambridgeMAUSA
| | - James Hanken
- Department of Organismic and Evolutionary Biology, and Museum of Comparative ZoologyHarvard UniversityCambridgeMAUSA
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60
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Pérez-Andreu J, Ray VG, Arribas JM, Sánchez SJ. Ellis-van Creveld syndrome in adulthood: extending the clinical spectrum. Singapore Med J 2016; 56:e110-1. [PMID: 26106249 DOI: 10.11622/smedj.2015097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Ellis-van Creveld (EvC) syndrome is a rare autosomal recessive malformation disorder. Cardiac defects are observed in about 50% of EvC cases. Surgical data is lacking on the prognosis and life expectancy of EvC patients. Herein, we report the case of a 38-year-old man with EvC syndrome who underwent two surgical corrections for cardiac anomalies. This report supplements the available information on the clinical course of EvC syndrome in older patients.
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Affiliation(s)
- Joaquín Pérez-Andreu
- Cardiovascular Surgery Service, Virgen de la Arrixaca University Hospital, Murcia, Spain
| | - Victor Glenn Ray
- Cardiovascular Surgery Service, Virgen de la Arrixaca University Hospital, Murcia, Spain
| | - José María Arribas
- Cardiovascular Surgery Service, Virgen de la Arrixaca University Hospital, Murcia, Spain
| | - Sergio Juan Sánchez
- Cardiovascular Surgery Service, Virgen de la Arrixaca University Hospital, Murcia, Spain
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61
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Bardawil T, Khalil S, Bergqvist C, Abbas O, Kibbi AG, Bitar F, Nemer G, Kurban M. Genetics of inherited cardiocutaneous syndromes: a review. Open Heart 2016; 3:e000442. [PMID: 27933191 PMCID: PMC5133403 DOI: 10.1136/openhrt-2016-000442] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Revised: 07/13/2016] [Accepted: 07/19/2016] [Indexed: 12/17/2022] Open
Abstract
The life of a human being originates as a single cell which, under the influence of certain factors, divides sequentially into multiple cells that subsequently become committed to develop and differentiate into the different structures and organs. Alterations occurring early on in the development process may lead to fetal demise in utero. Conversely, abnormalities at later stages may result in structural and/or functional abnormalities of varying severities. The cardiovascular system and skin share certain developmental and structural factors; therefore, it is not surprising to find several inherited syndromes with both cardiac and skin manifestations. Here, we will review the overlapping pathways in the development of the skin and heart, as well as the resulting syndromes. We will also highlight several cutaneous clues that may help physicians screen and uncover cardiac anomalies that may be otherwise hidden and result in sudden cardiac death.
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Affiliation(s)
| | | | | | - Ossama Abbas
- Department of Dermatology , American University of Beirut , Beirut Lebanon
| | - Abdul Ghani Kibbi
- Department of Dermatology , American University of Beirut , Beirut Lebanon
| | - Fadi Bitar
- Department of Biochemistry and Molecular Genetics, American University of Beirut, BeirutLebanon; Department of Pediatrics, American University of Beirut, BeirutLebanon
| | - Georges Nemer
- Department of Biochemistry and Molecular Genetics , American University of Beirut , Beirut Lebanon
| | - Mazen Kurban
- Department of Dermatology, American University of Beirut, BeirutLebanon; Department of Biochemistry and Molecular Genetics, American University of Beirut, BeirutLebanon; Department of Dermatology, Columbia University Medical Center, New York, New York, USA
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62
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Oud MM, Lamers IJC, Arts HH. Ciliopathies: Genetics in Pediatric Medicine. J Pediatr Genet 2016; 6:18-29. [PMID: 28180024 DOI: 10.1055/s-0036-1593841] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 02/08/2016] [Indexed: 12/15/2022]
Abstract
Ciliary disorders, which are also referred to as ciliopathies, are a group of hereditary disorders that result from dysfunctional cilia. The latter are cellular organelles that stick up from the apical plasma membrane. Cilia have important roles in signal transduction and facilitate communications between cells and their surroundings. Ciliary disruption can result in a wide variety of clinically and genetically heterogeneous disorders with overlapping phenotypes. Because cilia occur widespread in our bodies many organs and sensory systems can be affected when they are dysfunctional. Ciliary disorders may be isolated or syndromic, and common features are cystic liver and/or kidney disease, blindness, neural tube defects, brain anomalies and intellectual disability, skeletal abnormalities ranging from polydactyly to abnormally short ribs and limbs, ectodermal defects, obesity, situs inversus, infertility, and recurrent respiratory tract infections. In this review, we summarize the features, frequency, morbidity, and mortality of each of the different ciliopathies that occur in pediatrics. The importance of genetics and the occurrence of genotype-phenotype correlations are indicated, and advances in gene identification are discussed. The use of next-generation sequencing by which a gene panel or all genes can be screened in a single experiment is highlighted as this technology significantly lowered costs and time of the mutation detection process in the past. We discuss the challenges of this new technology and briefly touch upon the use of whole-exome sequencing as a diagnostic test for ciliary disorders. Finally, a perspective on the future of genetics in the context of ciliary disorders is provided.
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Affiliation(s)
- Machteld M Oud
- Department of Human Genetics, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ideke J C Lamers
- Department of Human Genetics, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Heleen H Arts
- Department of Human Genetics, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Biochemistry, University of Western Ontario, London, Ontario, Canada
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63
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Nguyen TQN, Saitoh M, Trinh HT, Doan NMT, Mizuno Y, Seki M, Sato Y, Ogawa S, Mizuguchi M. Truncation and microdeletion of EVC/EVC2 with missense mutation of EFCAB7 in Ellis-van Creveld syndrome. Congenit Anom (Kyoto) 2016; 56:209-16. [PMID: 26748586 DOI: 10.1111/cga.12155] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 01/04/2016] [Accepted: 01/05/2016] [Indexed: 01/15/2023]
Abstract
Ellis-van Creveld syndrome (EvC) is a ciliopathy with cardiac anomalies, disproportionate short stature, polydactyly, dystrophic nails and oral defects. To obtain further insight into the genetics of EvC, we screened EVC/EVC2 mutations in eight Vietnamese EvC patients. All the patients had a congenital heart defect with atypical oral and/or skeletal abnormalities. One had compound heterozygous EVC2 mutations: a novel mutation c.769G > T-p.E177X in exon 6 inherited from father and another previously reported c.2476C > T-p.R826X mutation in exon 14 inherited from mother. The EVC2 mRNA expression level was significantly lower in the patient and her parents compared to controls. Another case had a novel heterozygous EVC mutation (c.1717C > G-p.S572X) in exon 12, inherited from his father. Of note, the mother without any EVC mutation on Sanger sequencing showed a lower expression level of EVC mRNA compared with controls. SNP array analysis revealed that the patient and mother had a heterozygous 16.4 kb deletion in EVC. This patient also had a heterozygous novel variant in exon 9 of EFCAB7 (c.1171 T > C-p.Y391H), inherited from his father. The atypical cardiac phenotype of this patient and the father suggested that EFCAB7 may modify the phenotype by interacting with EVC. In conclusion, we detected two novel nonsense mutations and a partial deletion of EVC/EVC2 in two Vietnamese families with EvC. Moreover, we found in one family a missense mutation of EFCAB7, a possible modifier gene in EvC and its related disorders.
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Affiliation(s)
- Tran Quynh Nhu Nguyen
- Department of Developmental Medical Sciences, School of International Health, Graduate School of Medicine, The University of Tokyo, Kyoto, Japan.,Children's Hospital 2, Ho Chi Minh City, Vietnam
| | - Makiko Saitoh
- Department of Developmental Medical Sciences, School of International Health, Graduate School of Medicine, The University of Tokyo, Kyoto, Japan.,Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Kyoto, Japan
| | | | - Nguyen Minh Thien Doan
- Department of General Internal Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Yoko Mizuno
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Kyoto, Japan
| | - Masafumi Seki
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Kyoto, Japan
| | - Yusuke Sato
- Department of Pathology and tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Seishi Ogawa
- Department of Pathology and tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masashi Mizuguchi
- Department of Developmental Medical Sciences, School of International Health, Graduate School of Medicine, The University of Tokyo, Kyoto, Japan.,Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Kyoto, Japan
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64
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Tuna EB, Koruyucu M, Kürklü E, Çifter M, Gençay K, Seymen F, Tüysüz B. Oral and craniofacial manifestations of Ellis-van Creveld syndrome: Case series. J Craniomaxillofac Surg 2016; 44:919-24. [PMID: 27325544 DOI: 10.1016/j.jcms.2016.04.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 03/21/2016] [Accepted: 04/15/2016] [Indexed: 01/15/2023] Open
Abstract
PURPOSE The objective of this case series was to determine the oral, dental and craniofacial features of patients with EvC syndrome. MATERIAL AND METHODS Eight patients with EvC syndrome were enrolled. A complete family history, pedigree analysis, detailed medical history were collected. Findings of clinical examination, including craniofacial and orodental manifestations, and radiological investigations were thoroughly studied. RESULTS All eight patients had characteristic face, hypertrophic frenulum, conical and peg-shaped teeth, hypodontia of deciduous and/or permanent teeth and also skeletal dysplasia, small chest, short stature and hypoplastic nails. Additionally dysmorphic filtrum, serrated appearance of gingiva, diastema, enamel hypoplasia, microdontia, taurodontism, single rooted permanent molar, delayed eruption and high caries rate were observed with varying degrees. Cephalometric evaluation revealed skeletal Class III growth pattern in four subjects and Class II growth pattern in one subject. CONCLUSION Evaluation of craniofacial and orodental anomalies of EvC syndrome is required for accurate differential diagnosis from other congenital syndromes.
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Affiliation(s)
- Elif Bahar Tuna
- Istanbul University, Faculty of Dentistry, Department of Pedodontics, Istanbul, Turkey
| | - Mine Koruyucu
- Istanbul University, Faculty of Dentistry, Department of Pedodontics, Istanbul, Turkey
| | - Esma Kürklü
- Istanbul University, Faculty of Dentistry, Department of Oral Surgery, Istanbul, Turkey.
| | - Muhsin Çifter
- Istanbul University, Faculty of Dentistry, Department of Orthodontics, Istanbul, Turkey
| | - Koray Gençay
- Istanbul University, Faculty of Dentistry, Department of Pedodontics, Istanbul, Turkey
| | - Figen Seymen
- Istanbul University, Faculty of Dentistry, Department of Pedodontics, Istanbul, Turkey
| | - Beyhan Tüysüz
- Istanbul University, Cerrahpasa Medical Faculty, Department of Pediatric Genetics, Istanbul, Turkey
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65
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Badri MK, Zhang H, Ohyama Y, Venkitapathi S, Alamoudi A, Kamiya N, Takeda H, Ray M, Scott G, Tsuji T, Kunieda T, Mishina Y, Mochida Y. Expression of Evc2 in craniofacial tissues and craniofacial bone defects in Evc2 knockout mouse. Arch Oral Biol 2016; 68:142-52. [PMID: 27164562 DOI: 10.1016/j.archoralbio.2016.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 04/30/2016] [Accepted: 05/02/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Our objectives were to determine the expression of EVC2 in craniofacial tissues and investigate the effect of Evc2 deficiency on craniofacial bones using Evc2 knockout (KO) mouse model. DESIGN Evc2 KO mice were generated by introducing a premature stop codon followed by the Internal Ribosomal Entry Site fused to β-galactosidase (LacZ). Samples from wild-type (WT), heterozygous (Het) and homozygous Evc2 KO mice were prepared. LacZ staining and immunohistochemistry (IHC) with anti-β-galactosidase, anti-EVC2 and anti-SOX9 antibodies were performed. The craniofacial bones were stained with alcian blue and alizarin red. RESULTS The LacZ activity in KO was mainly observed in the anterior parts of viscerocranium. The Evc2-expressing cells were identified in many cartilageous regions by IHC with anti-β-galactosidase antibody in KO and Het embryos. The endogenous EVC2 protein was observed in these areas in WT embryos. Double labeling with anti-SOX9 antibody showed that these cells were mainly chondrocytes. At adult stages, the expression of EVC2 was found in chondrocytes of nasal bones and spheno-occipital synchondrosis, and osteocytes and endothelial-like cells of the premaxilla and mandible. The skeletal double staining demonstrated that craniofacial bones, where the expression of EVC2 was observed, in KO had the morphological defects as compared to WT. CONCLUSION To our knowledge, our study was the first to identify the types of Evc2-expressing cells in craniofacial tissues. Consistent with the expression pattern, abnormal craniofacial bone morphology was found in the Evc2 KO mice, suggesting that EVC2 may be important during craniofacial growth and development.
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Affiliation(s)
- Mohammed K Badri
- Department of Molecular and Cell Biology, Henry M. Goldman School of Dental Medicine, Boston University, 700 Albany Street, Boston, MA 02118, USA; Department of Pediatric Dentistry and Orthodontics, College of Dentistry, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Honghao Zhang
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, 1011 N. University Ave., Ann Arbor, MI 48109-1078, USA
| | - Yoshio Ohyama
- Department of Molecular and Cell Biology, Henry M. Goldman School of Dental Medicine, Boston University, 700 Albany Street, Boston, MA 02118, USA
| | - Sundharamani Venkitapathi
- Department of Molecular and Cell Biology, Henry M. Goldman School of Dental Medicine, Boston University, 700 Albany Street, Boston, MA 02118, USA
| | - Ahmed Alamoudi
- Department of Molecular and Cell Biology, Henry M. Goldman School of Dental Medicine, Boston University, 700 Albany Street, Boston, MA 02118, USA
| | - Nobuhiro Kamiya
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, 1011 N. University Ave., Ann Arbor, MI 48109-1078, USA; Laboratory of Reproductive and Developmental Toxicology, National Institute of Environmental Health Sciences, 111 TW Alexander Drive, Research Triangle Park, NC 27009, USA
| | - Haruko Takeda
- Unit of Animal Genomics, GIGA-R & Faculty of Veterinary Medicine, University of Liège, 1 Avenue de l'Hôpital, 4000-Liège, Belgium
| | - Manas Ray
- Knock Out Core, National Institute of Environmental Health Sciences, 111 TW Alexander Drive, Research Triangle Park, NC 27009, USA
| | - Greg Scott
- Knock Out Core, National Institute of Environmental Health Sciences, 111 TW Alexander Drive, Research Triangle Park, NC 27009, USA
| | - Takehito Tsuji
- Graduate School of Environmental and Life Science, Okayama University, Okayama City, Japan
| | - Tetsuo Kunieda
- Graduate School of Environmental and Life Science, Okayama University, Okayama City, Japan
| | - Yuji Mishina
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, 1011 N. University Ave., Ann Arbor, MI 48109-1078, USA; Laboratory of Reproductive and Developmental Toxicology, National Institute of Environmental Health Sciences, 111 TW Alexander Drive, Research Triangle Park, NC 27009, USA; Knock Out Core, National Institute of Environmental Health Sciences, 111 TW Alexander Drive, Research Triangle Park, NC 27009, USA
| | - Yoshiyuki Mochida
- Department of Molecular and Cell Biology, Henry M. Goldman School of Dental Medicine, Boston University, 700 Albany Street, Boston, MA 02118, USA.
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66
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Abstract
Skeletal dysplasias are a heterogeneous group of conditions associated with various abnormalities of the skeleton. Some of them are perinatally lethal and can be diagnosed at birth. Lethality is usually due to thoracic underdevelopment and lung hypoplasia. A correct diagnosis and typing of the skeletal disorder is essential for the prognosis as is genetic counseling of the family. A retrospective review of 12 cases of clinico-radiologic diagnosis of skeletal dysplasia, leading to thoracic insufficiency, was conducted.We aimed to make differential diagnosis with special emphasis on radiological findings, and to emphasize the importance of parental counseling.
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Affiliation(s)
- Mehmet Sah İpek
- From the Department of Neonatology (MSİ), Maternity and Children's Hospital; and Department of Radiology (CA), Dicle University School of Medicine, Diyarbakir, Turkey
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67
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Abstract
CHD is frequently associated with a genetic syndrome. These syndromes often present specific cardiovascular and non-cardiovascular co-morbidities that confer significant peri-operative risks affecting multiple organ systems. Although surgical outcomes have improved over time, these co-morbidities continue to contribute substantially to poor peri-operative mortality and morbidity outcomes. Peri-operative morbidity may have long-standing ramifications on neurodevelopment and overall health. Recognising the cardiovascular and non-cardiovascular risks associated with specific syndromic diagnoses will facilitate expectant management, early detection of clinical problems, and improved outcomes--for example, the development of syndrome-based protocols for peri-operative evaluation and prophylactic actions may improve outcomes for the more frequently encountered syndromes such as 22q11 deletion syndrome.
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68
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Iwakura H, Fujii K, Furutani Y, Takatani T, Ebata R, Nakanishi T, Mitsunaga T, Saito T, Kishimoto T, Yoshida H, Shimojo N. Ellis-van Creveld syndrome associated with chronic intestinal pseudo-obstruction. Pediatr Int 2016; 58:64-6. [PMID: 26818569 DOI: 10.1111/ped.12846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 10/10/2015] [Accepted: 10/22/2015] [Indexed: 11/28/2022]
Abstract
Ellis-van Creveld (EVC) syndrome is a rare autosomal recessive disorder characterized by hypoplastic nails, polydactyly, and achondroplasia. Patients usually exhibit normal cognitive function and no remarkable developmental delay. We herein present an unusual case of EVC syndrome. A Japanese 2-year-old boy was born at term, but immediately developed severe respiratory failure due to thorax deformity, postaxial polydactyly and nail hypoplasia. We identified a novel pattern of germinal compound heterozygous nonsense EVC2 mutations of c.1814C > A (p. S605X) and c.2653C > T (p. R885X), leading to the diagnosis of EVC syndrome. Interestingly, he also had severe developmental delay, and suddenly developed excessive abdominal distension at the age of 2. On surgery, extensive necrotic bowel with chronic intestinal pseudo-obstruction was noted. This is, to our knowledge, a most severe phenotype of EVC syndrome, illustrating that the specific pattern of EVC2 compound heterozygous mutations may cause severe developmental delay and intestinal malfunction.
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Affiliation(s)
- Hideo Iwakura
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Katsunori Fujii
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yoshiyuki Furutani
- Department of Pediatric Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Tomozumi Takatani
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Ryota Ebata
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Toshio Nakanishi
- Department of Pediatric Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Tetsuya Mitsunaga
- Department of Pediatric Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Takeshi Saito
- Department of Pediatric Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Takashi Kishimoto
- Department of Molecular Pathology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hideo Yoshida
- Department of Pediatric Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Naoki Shimojo
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
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69
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Smith C, Lamont RE, Wade A, Bernier FP, Parboosingh JS, Innes AM. A relatively mild skeletal ciliopathy phenotype consistent with cranioectodermal dysplasia is associated with a homozygous nonsynonymous mutation in WDR35. Am J Med Genet A 2015; 170:760-5. [PMID: 26691894 DOI: 10.1002/ajmg.a.37514] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 11/17/2015] [Indexed: 11/09/2022]
Abstract
Ciliopathies are a class of clinically and genetically heterogeneous disorders characterized by deficits of the primary cilium, an important organelle for cellular signaling and development. Here we report on a patient from a consanguineous family presenting with renal cysts, short stature, distinctive facial features, missing teeth, brachydactyly, narrow chest, and abnormal ribs. His phenotype resembled a skeletal ciliopathy and the initial clinical differential diagnosis included Jeune thoracic dystrophy and cranioectodermal dysplasia. Due to the presence of parental consanguinity, a homozygous recessive mutation was the suspected cause and homozygosity mapping was used to direct candidate gene sequencing. WDR35, an intraflagellar transport protein previously associated with cranioectodermal dysplasia, the more severe short rib polydactyly syndrome type V and recently Ellis van Creveld syndrome, is present within a region of homozygosity and sequencing of all coding exons identified a novel homozygous nonsynonymous variant, p.Trp1153Cys. This variant affects a highly conserved tryptophan residue, is predicted to be deleterious, and is the most distal mutation yet reported in WDR35. This case expands the spectrum of phenotypes caused by WDR35 mutations, which we review herein.
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Affiliation(s)
- Christopher Smith
- Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ryan E Lamont
- Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Calgary, Albeta, Canada
| | - Andrew Wade
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Francois P Bernier
- Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Calgary, Albeta, Canada
| | - Jillian S Parboosingh
- Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Calgary, Albeta, Canada
| | - A Micheil Innes
- Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Calgary, Albeta, Canada
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70
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Novel mutations in EVC cause aberrant splicing in Ellis-van Creveld syndrome. Mol Genet Genomics 2015; 291:863-72. [PMID: 26621368 DOI: 10.1007/s00438-015-1151-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 11/20/2015] [Indexed: 01/15/2023]
Abstract
Ellis-van Creveld syndrome (EvC) is a rare autosomal recessive disorder characterized by disproportionate chondrodysplasia, postaxial polydactyly, nail dystrophy, dental abnormalities and in a proportion of patients, congenital cardiac malformations. Weyers acrofacial dysostosis (Weyers) is another dominantly inherited disorder allelic to EvC syndrome but with milder phenotypes. Both disorders can result from loss-of-function mutations in either EVC or EVC2 gene, and phenotypes associated with the two gene mutations are clinically indistinguishable. We present here a clinical and molecular analysis of a Chinese family manifested specific features of EvC syndrome. Sequencing of both EVC and EVC2 identified two novel heterozygous splice site mutations c.384+5G>C in intron 3 and c.1465-1G>A in intron 10 in EVC, which were inherited from mother and father, respectively. In vitro minigene expression assay, RT-PCR and sequencing analysis demonstrated that c.384+5G>C mutation abolished normal splice site and created a new cryptic acceptor site within exon 4, whereas c.1465-1G>A mutation affected consensus splice junction site and resulted in full exon 11 skipping. These two aberrant pre-mRNA splicing processes both produced in-frame abnormal transcripts that possibly led to abolishment of important functional domains. To our knowledge, this is the first report of EVC mutations that cause EvC syndrome in Chinese population. Our data revealed that EVC splice site mutations altered splicing pattern and helped elucidate the pathogenesis of EvC syndrome.
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71
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Zhang H, Takeda H, Tsuji T, Kamiya N, Rajderkar S, Louie K, Collier C, Scott G, Ray M, Mochida Y, Kaartinen V, Kunieda T, Mishina Y. Generation of Evc2/Limbin global and conditional KO mice and its roles during mineralized tissue formation. Genesis 2015. [PMID: 26219237 DOI: 10.1002/dvg.22879] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Ellis-van Creveld (EvC) syndrome (OMIM 225500) is an autosomal recessive disease characterized with chondrodysplastic dwarfism in association with abnormalities in oral cavity. Ciliary proteins EVC and EVC2 have been identified as causative genes and they play an important role on Hedgehog signal transduction. We have also identified a causative gene LIMBIN for bovine chondrodysplastic dwarfism (bcd) that is later identified as the bovine ortholog of EVC2. Here, we report generation of conventional and conditional mutant Evc2/Limbin alleles that mimics mutations found in EvC patients and bcd cattle. Resulted homozygous mice showed no ciliary localization of EVC2 and EVC and displayed reduced Hedgehog signaling activity in association with skeletal and oral defects similar to the EvC patients. Cartilage-specific disruption of Evc2/Limbin resulted in similar but milder skeletal defects, whereas osteoblast-specific disruption did not cause overt changes in skeletal system. Neural crest-specific disruption of Evc2/Limbin resulted in defective incisor growth similar to that seen in conventional knockouts; however, differentiation of amelobolasts was relatively normal in the conditional knockouts. These results showcased functions of EVC2/LIMBIN during formation of mineralized tissues. Availability of the conditional allele for this gene should facilitate further detailed analyses of the role of EVC2/LIMBIN in pathogenesis of EvC syndrome. genesis 53:612-626, 2015. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Honghao Zhang
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Michigan
| | - Haruko Takeda
- Reproductive and Developmental Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina.,Unit of Animal Genomics, GIGA-R & Faculty of Veterinary Medicine, University of Liège, 1 Avenue De L'hôpital, Liège, Belgium
| | - Takehito Tsuji
- The Graduate School of Environment and Life Science, Okayama University, Okayama City, Japan
| | - Nobuhiro Kamiya
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Michigan.,Reproductive and Developmental Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina.,Faculty of Budo and Sport Studies, Tenri University, Nara, Japan
| | - Sudha Rajderkar
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Michigan
| | - Ke'Ale Louie
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Michigan
| | - Crystal Collier
- College of Literature, Science and the Arts, University of Michigan, Michigan
| | - Greg Scott
- Knock out Core, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Manas Ray
- Knock out Core, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Yoshiyuki Mochida
- Department of Molecular and Cell Biology, Henry M. Goldman School of Dental Medicine, Boston University, 700 Albany Street, Boston, Massachusetts
| | - Vesa Kaartinen
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Michigan
| | - Tetsuo Kunieda
- The Graduate School of Environment and Life Science, Okayama University, Okayama City, Japan
| | - Yuji Mishina
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Michigan.,Reproductive and Developmental Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina.,Knock out Core, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
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72
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Kowal A, Mostowska A, Mydlak D, Eberdt-Gołąbek B, Misztal M, Jagodziński PP, Hozyasz KK. EVC gene polymorphisms and risks of isolated hypospadias - a preliminary study. Cent European J Urol 2015; 68:257-62. [PMID: 26251756 PMCID: PMC4526603 DOI: 10.5173/ceju.2015.493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 01/22/2015] [Accepted: 03/03/2015] [Indexed: 11/22/2022] Open
Abstract
Introduction Hypospadias has a complex etiology with both genetic and environmental factors contributing to the condition. Urogenital abnormalities including hypospadias, are found in 22% of cases with Ellis van Creveld syndrome (EvC). Mutations in the EVC gene can cause major and minor anomalies, which form phenotypes that partially overlap with those present in EvC. The aim of this study was to evaluate the association between nucleotide variants of the EVC gene and the risk of hypospadias. Material and methods Four single nucleotide polymorphisms (SNPs) of the EVC gene (rs3774856, rs2302075, rs1383180, rs7680768) were taken under investigation in 96 patients with isolated hypospadias and 284 matched controls. Genotyping of all polymorphisms was carried out by PCR and followed by appropriate restriction enzyme digestion (PCR-RFLP). Results Individuals homozygous for the SNP rs2302075 (p.Thr449Lys) showed an elevated risk for hypospadias. Haplotypes containing the rs2302075 variant also revealed modest associations with hypospadias, which did not survive multiple testing corrections. None of the other tested EVC polymorphisms displayed significant association with the risk of hypospadias, either in dominant or recessive inheritance models. Conclusions The results of this study suggest that polymorphic variants of the EVC gene do not substantially contribute to the risk of hypospadias based on our study population. However, further studies should help to clarify the relationship between polymorphisms of EVC and hypospadias.
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Affiliation(s)
- Andrzej Kowal
- Department of Pediatric Surgery, Institute of Mother and Child, Warsaw, Poland
| | - Adrianna Mostowska
- Department of Biochemistry and Molecular Biology, Poznań University of Medical Sciences, Poznań, Poland
| | - Dariusz Mydlak
- Department of Pediatric Surgery, Institute of Mother and Child, Warsaw, Poland
| | | | - Matthew Misztal
- Department of Biochemistry and Molecular Biology, Poznań University of Medical Sciences, Poznań, Poland
| | - Paweł P Jagodziński
- Department of Biochemistry and Molecular Biology, Poznań University of Medical Sciences, Poznań, Poland
| | - Kamil K Hozyasz
- Department of Pediatrics, Institute of Mother and Child, Warsaw, Poland
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73
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Shah S, Ashwath R, Rajiah P. Imaging Cardiovascular Manifestations of Genetic Syndromes. Curr Probl Diagn Radiol 2015; 45:51-60. [PMID: 26163737 DOI: 10.1067/j.cpradiol.2015.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 05/25/2015] [Accepted: 05/26/2015] [Indexed: 11/22/2022]
Abstract
Congenital structural cardiovascular defects are commonly associated and found concurrently with many different types of genetic diseases and syndromes. Understanding these cardiovascular manifestations is essential for diagnosing these genetic syndromes without delay and provides prompt attention and repair of life-threatening defects without complications. Computed tomography and magnetic resonance imaging are increasingly used in the evaluation of cardiovascular abnormalities, and it is imperative for radiologists to be cognizant of the syndromes associated with these abnormalities. In this article, we review the cardiovascular manifestations of the common genetic syndromes and illustrate the role of computed tomography and magnetic resonance imaging in the evaluation of these abnormalities.
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Affiliation(s)
- Soham Shah
- Department of Radiology, University Hospitals Cleveland Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Ravi Ashwath
- Department of Radiology, University Hospitals Cleveland Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Prabhakar Rajiah
- Department of Radiology, University Hospitals Cleveland Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH.
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74
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Kessler K, Wunderlich I, Uebe S, Falk NS, Gießl A, Brandstätter JH, Popp B, Klinger P, Ekici AB, Sticht H, Dörr HG, Reis A, Roepman R, Seemanová E, Thiel CT. DYNC2LI1 mutations broaden the clinical spectrum of dynein-2 defects. Sci Rep 2015; 5:11649. [PMID: 26130459 PMCID: PMC4486972 DOI: 10.1038/srep11649] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 05/27/2015] [Indexed: 12/30/2022] Open
Abstract
Skeletal ciliopathies are a heterogeneous group of autosomal recessive osteochondrodysplasias caused by defects in formation, maintenance and function of the primary cilium. Mutations in the underlying genes affect the molecular motors, intraflagellar transport complexes (IFT), or the basal body. The more severe phenotypes are caused by defects of genes of the dynein-2 complex, where mutations in DYNC2H1, WDR34 and WDR60 have been identified. In a patient with a Jeune-like phenotype we performed exome sequencing and identified compound heterozygous missense and nonsense mutations in DYNC2LI1 segregating with the phenotype. DYNC2LI1 is ubiquitously expressed and interacts with DYNC2H1 to form the dynein-2 complex important for retrograde IFT. Using DYNC2LI1 siRNA knockdown in fibroblasts we identified a significantly reduced cilia length proposed to affect cilia function. In addition, depletion of DYNC2LI1 induced altered cilia morphology with broadened ciliary tips and accumulation of IFT-B complex proteins in accordance with retrograde IFT defects. Our results expand the clinical spectrum of ciliopathies caused by defects of the dynein-2 complex.
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Affiliation(s)
- Kristin Kessler
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Ina Wunderlich
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Steffen Uebe
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Nathalie S Falk
- Animal Physiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Andreas Gießl
- Animal Physiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | | | - Bernt Popp
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Patricia Klinger
- Department of Orthopaedic Rheumatology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Arif B Ekici
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Heinrich Sticht
- Institute of Biochemistry, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Helmuth-Günther Dörr
- Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - André Reis
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Ronald Roepman
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands
| | - Eva Seemanová
- Department of Clinical Genetics, Institute of Biology and Medical Genetics, 2nd Medical School, Charles University, Prague, Czech Republic
| | - Christian T Thiel
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Muscatello LV, Benazzi C, Dittmer KE, Thompson KG, Murgiano L, Drögemüller C, Avallone G, Gentile A, Edwards JF, Piffer C, Bolcato M, Brunetti B. Ellis–van Creveld Syndrome in Grey Alpine Cattle. Vet Pathol 2015; 52:957-66. [DOI: 10.1177/0300985815588610] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Ellis–van Creveld (EvC) syndrome is a human autosomal recessive disorder caused by a mutation in either the EVC or EVC2 gene, and presents with short limbs, polydactyly, and ectodermal and heart defects. The aim of this study was to understand the pathologic basis by which deletions in the EVC2 gene lead to chondrodysplastic dwarfism and to describe the morphologic, immunohistochemical, and molecular hallmarks of EvC syndrome in cattle. Five Grey Alpine calves, with a known mutation in the EVC2 gene, were autopsied. Immunohistochemistry was performed on bone using antibodies to collagen II, collagen X, sonic hedgehog, fibroblast growth factor 2, and Ki67. Reverse transcription polymerase chain reaction was performed to analyze EVC1 and EVC2 gene expression. Autopsy revealed long bones that were severely reduced in length, as well as genital and heart defects. Collagen II was detected in control calves in the resting, proliferative, and hypertrophic zones and in the primary and secondary spongiosa, with a loss of labeling in the resting zone of 2 dwarfs. Collagen X was expressed in hypertrophic zone in the controls but was absent in the EvC cases. In affected calves and controls, sonic hedgehog labeled hypertrophic chondrocytes and primary and secondary spongiosa similarly. FGF2 was expressed in chondrocytes of all growth plate zones in the control calves but was lost in most EvC cases. The Ki67 index was lower in cases compared with controls. EVC and EVC2 transcripts were detected. Our data suggest that EvC syndrome of Grey Alpine cattle is a disorder of chondrocyte differentiation, with accelerated differentiation and premature hypertrophy of chondrocytes, and could be a spontaneous model for the equivalent human disease.
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Affiliation(s)
- L. V. Muscatello
- DIMEVET, University of Bologna, Ozzano dell’Emilia, Bologna, Italy
| | - C. Benazzi
- DIMEVET, University of Bologna, Ozzano dell’Emilia, Bologna, Italy
| | - K. E. Dittmer
- Institute of Veterinary, Animal, and Biomedical Sciences, Massey University, Palmerston North, New Zealand
| | - K. G. Thompson
- Institute of Veterinary, Animal, and Biomedical Sciences, Massey University, Palmerston North, New Zealand
| | - L. Murgiano
- Institute of Genetics, University of Bern, Bern, Switzerland
| | - C. Drögemüller
- Institute of Genetics, University of Bern, Bern, Switzerland
| | - G. Avallone
- DIMEVET, University of Bologna, Ozzano dell’Emilia, Bologna, Italy
| | - A. Gentile
- DIMEVET, University of Bologna, Ozzano dell’Emilia, Bologna, Italy
| | | | - C. Piffer
- Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - M. Bolcato
- DIMEVET, University of Bologna, Ozzano dell’Emilia, Bologna, Italy
| | - B. Brunetti
- DIMEVET, University of Bologna, Ozzano dell’Emilia, Bologna, Italy
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76
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Abstract
The skeletal dysplasias are a group of more than 450 heritable disorders of bone. They frequently present in the newborn period with disproportion, radiographic abnormalities, and occasionally other organ system abnormalities. For improved clinical care, it is important to determine a precise diagnosis to aid in management, familial recurrence, and identify those disorders highly associated with mortality. Long-term management of these disorders is predicated on an understanding of the associated skeletal system abnormalities, and these children are best served by a team approach to health care surveillance.
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Affiliation(s)
- Deborah Krakow
- Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, BSRB/OHRC 615 Charles E. Young Drive South, Room 410, Los Angeles, CA 90095, USA; Department of Human Genetics, David Geffen School of Medicine at UCLA, BSRB/OHRC 615 Charles E. Young Drive South, Room 410, Los Angeles, CA 90095, USA; Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, BSRB/OHRC 615 Charles E. Young Drive South, Room 410, Los Angeles, CA 90095, USA.
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77
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Hassona Y, Hamdan M, Shqaidef A, Abu Karaky A, Scully C. Ellis-Van Creveld syndrome: dental management considerations and description of a new oral finding. SPECIAL CARE IN DENTISTRY 2015; 35:312-5. [PMID: 25939880 DOI: 10.1111/scd.12116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Ellis-Van Creveld is a rare syndrome with characteristic dental and orofacial findings. Dental management of patients with Ellis-Van Creveld syndrome can be complicated by the associated skeletal and cardiac abnormalities. Here, we present the dental and orofacial findings in a patient with Ellis-Van Creveld syndrome, describe a new oral finding, and discuss the dental management considerations.
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Affiliation(s)
- Y Hassona
- Assistant Professor, Department of Oral Surgery, Oral Medicine and Periodontology, Faculty of Dentistry, The University of Jordan, Amman
| | - M Hamdan
- Dental Student, Faculty of Dentistry, The University of Jordan, Amman
| | - A Shqaidef
- Assistant Professor, Department of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, The University of Jordan, Amman
| | - A Abu Karaky
- Associate Professor, Department of Oral Surgery, Oral Medicine and Periodontology, Faculty of Dentistry, The University of Jordan, Amman
| | - C Scully
- Professor Emeritus, University College of London, United Kingdom
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78
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Shetty P, Shetty D, Priyadarshana P, Bhat S. A rare case report of Ellis Van Creveld syndrome in an Indian patient and literature review. J Oral Biol Craniofac Res 2015; 5:98-101. [PMID: 26258022 PMCID: PMC4523583 DOI: 10.1016/j.jobcr.2015.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Accepted: 05/19/2015] [Indexed: 11/20/2022] Open
Abstract
Ellis Van Creveld syndrome (EVC) is a rare genetic disorder having autosomal recessive inheritance affecting the Amish population of Pennsylvania in USA with incidence of 1:244,000 for the general population. This syndrome consists of characteristic features such as bilateral postaxial polydactyly, chondroectodermal dysplasia, congenital heart defects and hypoplastic nails and teeth. There are few case reports of this syndrome reported in dental literature. We report a case of a 17 year old female presenting typical features of this syndrome and the oral findings of this patient which are the key diagnostic features.
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Affiliation(s)
- Prashanth Shetty
- Department of Periodontics, Yogita Dental College & Hospital, Khed, Ratnagiri 415 709, Maharashtra, India
| | - Deepthi Shetty
- Department of Oral and Maxillofacial Surgery, AB Shetty Memorial Institute of Dental Sciences, Derlakatte, Mangalore 575018, Karnataka, India
| | - P.S. Priyadarshana
- Department of Oral and Maxillofacial Surgery, AB Shetty Memorial Institute of Dental Sciences, Derlakatte, Mangalore 575018, Karnataka, India
| | - Smitha Bhat
- Department of Oral and Maxillofacial Surgery, AB Shetty Memorial Institute of Dental Sciences, Derlakatte, Mangalore 575018, Karnataka, India
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79
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Ellis-van Creveld Syndrome: Mutations Uncovered in Lebanese Families. Case Rep Genet 2015; 2015:528481. [PMID: 26064711 PMCID: PMC4430639 DOI: 10.1155/2015/528481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 04/10/2015] [Indexed: 11/19/2022] Open
Abstract
Background. Ellis-van Creveld (EvC) syndrome is a rare, autosomal recessive disorder characterized by short stature, short limbs, growth retardation, polydactyly, and ectodermal defects with cardiac anomalies occurring in around 60% of cases. EVC syndrome has been linked to mutations in EVC and EVC2 genes. Case Presentation. We report EvC syndrome in two unrelated Lebanese families both having homozygous mutations in the EVC2 gene, c.2653C>T (p.(Arg885*)) and c.2012_2015del (p.(Leu671*)) in exons 15 and 13, respectively, with the latter being reported for the first time. Conclusion. Although EvC has been largely described in the medical literature, clinical features of this syndrome vary. While more research is required to explore other genes involved in EvC, early diagnosis and therapeutic care are important to achieve a better quality of life.
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80
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Caparrós-Martín JA, De Luca A, Cartault F, Aglan M, Temtamy S, Otaify GA, Mehrez M, Valencia M, Vázquez L, Alessandri JL, Nevado J, Rueda-Arenas I, Heath KE, Digilio MC, Dallapiccola B, Goodship JA, Mill P, Lapunzina P, Ruiz-Perez VL. Specific variants in WDR35 cause a distinctive form of Ellis-van Creveld syndrome by disrupting the recruitment of the EvC complex and SMO into the cilium. Hum Mol Genet 2015; 24:4126-37. [PMID: 25908617 DOI: 10.1093/hmg/ddv152] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 04/21/2015] [Indexed: 12/13/2022] Open
Abstract
Most patients with Ellis-van Creveld syndrome (EvC) are identified with pathogenic changes in EVC or EVC2, however further genetic heterogeneity has been suggested. In this report we describe pathogenic splicing variants in WDR35, encoding retrograde intraflagellar transport protein 121 (IFT121), in three families with a clinical diagnosis of EvC but having a distinctive phenotype. To understand why WDR35 variants result in EvC, we analysed EVC, EVC2 and Smoothened (SMO) in IFT-A deficient cells. We found that the three proteins failed to localize to Wdr35(-/-) cilia, but not to the cilium of the IFT retrograde motor mutant Dync2h1(-/-), indicating that IFT121 is specifically required for their entry into the ciliary compartment. Furthermore expression of Wdr35 disease cDNAs in Wdr35(-/-) fibroblasts revealed that the newly identified variants lead to Hedgehog signalling defects resembling those of Evc(-/-) and Evc2(-/-) mutants. Together our data indicate that splicing variants in WDR35, and possibly in other IFT-A components, underlie a number of EvC cases by disrupting targeting of both the EvC complex and SMO to cilia.
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Affiliation(s)
- José A Caparrós-Martín
- Instituto de Investigaciones Biomédicas, Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid, Madrid, Spain, CIBER de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Alessandro De Luca
- Casa Sollievo della Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
| | - François Cartault
- CHU de la Réunion Hôpital Félix Guyon, Saint-Denis, Île de la Réunion, France
| | - Mona Aglan
- Human Genetics and Genome Research Division, Centre of Excellence of Human Genetics, National Research Centre, Cairo, Egypt
| | - Samia Temtamy
- Human Genetics and Genome Research Division, Centre of Excellence of Human Genetics, National Research Centre, Cairo, Egypt
| | - Ghada A Otaify
- Human Genetics and Genome Research Division, Centre of Excellence of Human Genetics, National Research Centre, Cairo, Egypt
| | - Mennat Mehrez
- Human Genetics and Genome Research Division, Centre of Excellence of Human Genetics, National Research Centre, Cairo, Egypt
| | - María Valencia
- Instituto de Investigaciones Biomédicas, Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid, Madrid, Spain, CIBER de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Laura Vázquez
- Instituto de Investigaciones Biomédicas, Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid, Madrid, Spain
| | - Jean-Luc Alessandri
- CHU de la Réunion Hôpital Félix Guyon, Saint-Denis, Île de la Réunion, France
| | - Julián Nevado
- CIBER de Enfermedades Raras (CIBERER), Madrid, Spain, Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz-IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain
| | - Inmaculada Rueda-Arenas
- Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz-IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain
| | - Karen E Heath
- CIBER de Enfermedades Raras (CIBERER), Madrid, Spain, Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz-IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain
| | | | | | - Judith A Goodship
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK and
| | - Pleasantine Mill
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, UK
| | - Pablo Lapunzina
- CIBER de Enfermedades Raras (CIBERER), Madrid, Spain, Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz-IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain
| | - Victor L Ruiz-Perez
- Instituto de Investigaciones Biomédicas, Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid, Madrid, Spain, CIBER de Enfermedades Raras (CIBERER), Madrid, Spain,
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81
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Qiao R, He Y, Pan B, Xiao S, Zhang X, Li J, Zhang Z, Hong Y, Xing Y, Ren J. Understanding the molecular mechanisms of human microtia via a pig model of HOXA1 syndrome. Dis Model Mech 2015; 8:611-22. [PMID: 26035869 PMCID: PMC4457031 DOI: 10.1242/dmm.018291] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Accepted: 04/01/2015] [Indexed: 01/27/2023] Open
Abstract
Microtia is a congenital malformation of the outer ears. Although both genetic and environmental components have been implicated in microtia, the genetic causes of this innate disorder are poorly understood. Pigs have naturally occurring diseases comparable to those in humans, providing exceptional opportunity to dissect the molecular mechanism of human inherited diseases. Here we first demonstrated that a truncating mutation in HOXA1 causes a monogenic disorder of microtia in pigs. We further performed RNA sequencing (RNA-Seq) analysis on affected and healthy pig embryos (day 14.25). We identified a list of 337 differentially expressed genes (DEGs) between the normal and mutant samples, shedding light on the transcriptional network involving HOXA1. The DEGs are enriched in biological processes related to cardiovascular system and embryonic development, and neurological, renal and urological diseases. Aberrant expressions of many DEGs have been implicated in human innate deformities corresponding to microtia-associated syndromes. After applying three prioritizing algorithms, we highlighted appealing candidate genes for human microtia from the 337 DEGs. We searched for coding variants of functional significance within six candidate genes in 147 microtia-affected individuals. Of note, we identified one EVC2 non-synonymous mutation (p.Asp1174Asn) as a potential disease-implicating variant for a human microtia-associated syndrome. The findings advance our understanding of the molecular mechanisms underlying human microtia, and provide an interesting example of the characterization of human disease-predisposing variants using pig models. Summary: A pig model of HOXA1 syndrome provides novel insight into the molecular mechanisms of human microtia.
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Affiliation(s)
- Ruimin Qiao
- Key Laboratory for Animal Biotechnology of Jiangxi Province and the Ministry of Agriculture of China, Jiangxi Agricultural University, Nanchang 330045, People's Republic of China College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou 450002, People's Republic of China
| | - Yuyong He
- Key Laboratory for Animal Biotechnology of Jiangxi Province and the Ministry of Agriculture of China, Jiangxi Agricultural University, Nanchang 330045, People's Republic of China
| | - Bo Pan
- Plastic Surgery Hospital, Peking Union Medical College, Beijing 100144, People's Republic of China
| | - Shijun Xiao
- Key Laboratory for Animal Biotechnology of Jiangxi Province and the Ministry of Agriculture of China, Jiangxi Agricultural University, Nanchang 330045, People's Republic of China
| | - Xufei Zhang
- Key Laboratory for Animal Biotechnology of Jiangxi Province and the Ministry of Agriculture of China, Jiangxi Agricultural University, Nanchang 330045, People's Republic of China
| | - Jing Li
- Key Laboratory for Animal Biotechnology of Jiangxi Province and the Ministry of Agriculture of China, Jiangxi Agricultural University, Nanchang 330045, People's Republic of China
| | - Zhiyan Zhang
- Key Laboratory for Animal Biotechnology of Jiangxi Province and the Ministry of Agriculture of China, Jiangxi Agricultural University, Nanchang 330045, People's Republic of China
| | - Yuan Hong
- Key Laboratory for Animal Biotechnology of Jiangxi Province and the Ministry of Agriculture of China, Jiangxi Agricultural University, Nanchang 330045, People's Republic of China
| | - Yuyun Xing
- Key Laboratory for Animal Biotechnology of Jiangxi Province and the Ministry of Agriculture of China, Jiangxi Agricultural University, Nanchang 330045, People's Republic of China
| | - Jun Ren
- Key Laboratory for Animal Biotechnology of Jiangxi Province and the Ministry of Agriculture of China, Jiangxi Agricultural University, Nanchang 330045, People's Republic of China
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82
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Cardiac diagnoses, procedures, and healthcare utilisation in inpatients with Ellis-van Creveld syndrome. Cardiol Young 2015; 25:95-101. [PMID: 24168757 DOI: 10.1017/s1047951113001819] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Ellis-van Creveld syndrome is a rare condition associated with a very high incidence of congenital malformations of the heart. Prior reports have suggested increased morbidity and mortality following surgery for congenital malformations of the heart in patients with Ellis-van Creveld syndrome. MATERIALS AND METHODS The Pediatric Health Information System database, an administrative database containing data from 43 free-standing paediatric hospitals in North America, was queried to search for patients with the diagnostic code for Ellis-van Creveld syndrome between 2004 and 2011. Those patients who underwent cardiac procedures were compared with those who did not with respect to measures of healthcare utilisation. RESULTS A total of 138 admissions occurred in 93 patients with Ellis-van Creveld syndrome during the study period. Of these, 74% had an underlying diagnosis of congenital malformations of the heart. Half of the patients in the sample underwent a cardiac surgical or interventional catheterisation procedure. Patients who underwent a cardiac procedure had a longer hospital length of stay, higher incidence of intensive care unit admission, and higher total and per day hospital charges than patients who did not undergo cardiac surgery during admission. CONCLUSIONS In a large group of inpatients with Ellis-van Creveld syndrome, the prevalence of congenital malformations of the heart was similar to that reported in prior studies. Cardiac surgical and interventional procedures appear to drive a substantial portion of healthcare utilisation in these patients.
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83
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The ciliopathy gene Rpgrip1l is essential for hair follicle development. J Invest Dermatol 2014; 135:701-709. [PMID: 25398052 PMCID: PMC4340706 DOI: 10.1038/jid.2014.483] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 10/27/2014] [Accepted: 10/27/2014] [Indexed: 01/01/2023]
Abstract
The primary cilium is essential for skin morphogenesis through regulating the Notch, Wnt, and hedgehog signaling pathways. Prior studies on the functions of primary cilia in the skin were based on the investigations of genes that are essential for cilium formation. However, none of these ciliogenic genes has been linked to ciliopathy, a group of disorders caused by abnormal formation or function of cilia. To determine whether there is a genetic and molecular link between ciliopathies and skin morphogenesis, we investigated the role of RPGRIP1L, a gene mutated in Joubert (JBTS) and Meckel (MKS) syndromes, two severe forms of ciliopathy, in the context of skin development. We found that RPGRIP1L is essential for hair follicle morphogenesis. Specifically, disrupting the Rpgril1 gene in mice resulted in reduced proliferation and differentiation of follicular keratinocytes, leading to hair follicle developmental defects. These defects were associated with significantly decreased primary cilium formation and attenuated hedgehog signaling. In contrast, we found that hair follicle induction and polarization and the development of interfollicular epidermis were unaffected. This study indicates that RPGRIP1L, a ciliopathy gene, is essential for hair follicle morphogenesis likely through regulating primary cilia formation and the hedgehog signaling pathway.
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84
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Panda A, Gamanagatti S, Jana M, Gupta AK. Skeletal dysplasias: A radiographic approach and review of common non-lethal skeletal dysplasias. World J Radiol 2014; 6:808-825. [PMID: 25349664 PMCID: PMC4209426 DOI: 10.4329/wjr.v6.i10.808] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 07/02/2014] [Accepted: 08/29/2014] [Indexed: 02/06/2023] Open
Abstract
Skeletal dysplasias are not uncommon entities and a radiologist is likely to encounter a suspected case of dysplasia in his practice. The correct and early diagnosis of dysplasia is important for management of complications and for future genetic counselling. While there is an exhaustive classification system on dysplasias, it is important to be familiar with the radiological features of common dysplasias. In this article, we enumerate a radiographic approach to skeletal dysplasias, describe the essential as well as differentiating features of common non-lethal skeletal dysplasias and conclude by presenting working algorithms to either definitively diagnose a particular dysplasia or suggest the most likely differential diagnoses to the referring clinician and thus direct further workup of the patient.
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85
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Fischer AS, Weathers WM, Wolfswinkel EM, Bollo RJ, Hollier LH, Buchanan EP. Ellis-van Creveld Syndrome with Sagittal Craniosynostosis. Craniomaxillofac Trauma Reconstr 2014; 8:132-5. [PMID: 26000085 DOI: 10.1055/s-0034-1393733] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 03/29/2014] [Indexed: 10/24/2022] Open
Abstract
Ellis-van Creveld syndrome (EVC) is a rare disorder (the incidence is estimated at around 7/1,000,000) characterized by the clinical tetrad of chondrodystrophy, polydactyly, ectodermal dysplasia, and cardiac anomalies. Sagittal synostosis is characterized by a dolichocephalic head shape resulting from premature fusion of the sagittal suture. Both are rare disorders, which have never been reported together. We present a case of EVC and sagittal synostosis. We report the clinical features of a Hispanic boy with EVC and sagittal craniosynostosis who underwent cranial vault remodeling. The presentation of this patient is gone over in detail. A never before reported case of EVC and sagittal synostosis is presented in detail.
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Affiliation(s)
- Andrew S Fischer
- Division of Plastic Surgery, Michael E. Debakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - William M Weathers
- Division of Plastic Surgery, Michael E. Debakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Erik M Wolfswinkel
- Division of Plastic Surgery, Michael E. Debakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Robert J Bollo
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
| | - Larry H Hollier
- Division of Plastic Surgery, Michael E. Debakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Edward P Buchanan
- Division of Plastic Surgery, Michael E. Debakey Department of Surgery, Baylor College of Medicine, Houston, Texas
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86
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D'Ambrosio V, Votino C, Cos T, Boulanger S, Dheedene A, Jani J, Keymolen K. Role of CGH array in the diagnosis of autosomal recessive disease: a case of Ellis-van Creveld syndrome. Prenat Diagn 2014; 35:97-9. [PMID: 25174843 DOI: 10.1002/pd.4490] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 08/03/2014] [Accepted: 08/26/2014] [Indexed: 11/07/2022]
Affiliation(s)
- Valentina D'Ambrosio
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Brussels, Belgium; Department of Obstetrics, Gynecology and Urologic Sciences, Sapienza University, Umberto I Hospital, Rome, Italy
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87
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Stoelinga PJW, Berdon WE, Cohen MM. The extraordinary career of Professor Dr. Simon van Creveld. Am J Med Genet A 2014; 164A:2689-700. [PMID: 25269937 DOI: 10.1002/ajmg.a.36334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 10/03/2013] [Indexed: 11/06/2022]
Abstract
Simon van Creveld received both the MD and PhD degrees and had a multifaceted medical and scientific education at many hospitals and research institutes in the Netherlands, Germany, and the UK. He and his wife were the first to develop insulin for the Netherlands. His major interests were in hemophilia and hemorrhagic disorders, which accounted for 87 of his publications. In 1934, van Creveld demonstrated that a dispersed protein fraction obtained from serum could reduce the clotting time of hemophilic blood. His interest in glycogen storage disease resulted in van Creveld-von Gierke disease for which van Creveld contributed four published articles. The Ellis-van Creveld syndrome, also known as chondroectodermal dysplasia, was published in 1940 and became well known to medical geneticists. During the Nazi occupation of the Netherlands, van Creveld's professorship was taken away from him because he was Jewish. His visits to hospitals of concentration camps to treat babies and give pediatric advice while wearing a Jewish Yellow Star and interacting with SS Commandants in charge, and then leaving can only be described as amazing. After the war, his professorship was returned, and in the same year as his retirement, he established a large Hemophila Treatment and Research Center now known as the Van Creveld Clinic, which celebrated its 40th anniversary in 2005.
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Affiliation(s)
- Paul J W Stoelinga
- Department of Oral & Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
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88
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Athar M, Li C, Kim AL, Spiegelman VS, Bickers DR. Sonic hedgehog signaling in Basal cell nevus syndrome. Cancer Res 2014; 74:4967-75. [PMID: 25172843 DOI: 10.1158/0008-5472.can-14-1666] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The hedgehog (Hh) signaling pathway is considered to be a major signal transduction pathway during embryonic development, but it usually shuts down after birth. Aberrant Sonic hedgehog (Shh) activation during adulthood leads to neoplastic growth. Basal cell carcinoma (BCC) of the skin is driven by this pathway. Here, we summarize information related to the pathogenesis of this neoplasm, discuss pathways that crosstalk with Shh signaling, and the importance of the primary cilium in this neoplastic process. The identification of the basic/translational components of Shh signaling has led to the discovery of potential mechanism-driven druggable targets and subsequent clinical trials have confirmed their remarkable efficacy in treating BCCs, particularly in patients with nevoid BCC syndrome (NBCCS), an autosomal dominant disorder in which patients inherit a germline mutation in the tumor-suppressor gene Patched (Ptch). Patients with NBCCS develop dozens to hundreds of BCCs due to derepression of the downstream G-protein-coupled receptor Smoothened (SMO). Ptch mutations permit transposition of SMO to the primary cilium followed by enhanced expression of transcription factors Glis that drive cell proliferation and tumor growth. Clinical trials with the SMO inhibitor, vismodegib, showed remarkable efficacy in patients with NBCCS, which finally led to its FDA approval in 2012.
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Affiliation(s)
- Mohammad Athar
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Changzhao Li
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Arianna L Kim
- Columbia University Medical Center, Irving Cancer Research Center, New York, New York
| | | | - David R Bickers
- Columbia University Medical Center, Irving Cancer Research Center, New York, New York
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89
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Tahririan D, Eshghi A, Givehchian P, Tahririan MA. Chondroectodermal dysplasia: a rare syndrome. JOURNAL OF DENTISTRY (TEHRAN, IRAN) 2014; 11:361-4. [PMID: 25628672 PMCID: PMC4290765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Accepted: 03/20/2014] [Indexed: 11/16/2022]
Abstract
Chondroectodermal dysplasia (Ellis-Van Creveld syndrome) is a rare autosomal recessive congenital abnormality. This syndrome is characterized by a spectrum of clinical findings, among which chondrodystrophy, polydactyly, ectodermal dysplasia, and congenital cardiac anomalies are the most common. It is imperative to not overlook the cardiac complications in patients with this syndrome during dental procedures. The case presented here, although quite rare, was detected under normal conditions and can be alarming for dental care providers. Clinical reports outline the classical and unusual oral and dental manifestations, which help health care providers diagnose chondroectodermal dysplasia, and refer patients with this syndrome to appropriate health care professionals to receive treatment to prevent further cardiac complications and bone deformities.
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Affiliation(s)
- Dana Tahririan
- Resident, Department of Pediatric Dentistry, Faculty of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran,Corresponding author: D. Tahririan Department of Pediatric Dentistry, Faculty of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran,
| | - Alireza Eshghi
- Associate Professor of Pediatric Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Pirooz Givehchian
- Resident, Department of Prosthodontics, Faculty of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Ali Tahririan
- Assistant Professor of Orthopedics, Isfahan University of Medical Science, Isfahan, Iran
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90
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Lalani SR, Belmont JW. Genetic basis of congenital cardiovascular malformations. Eur J Med Genet 2014; 57:402-13. [PMID: 24793338 DOI: 10.1016/j.ejmg.2014.04.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 04/16/2014] [Indexed: 01/14/2023]
Abstract
Cardiovascular malformations are a singularly important class of birth defects and due to dramatic improvements in medical and surgical care, there are now large numbers of adult survivors. The etiologies are complex, but there is strong evidence that genetic factors play a crucial role. Over the last 15 years there has been enormous progress in the discovery of causative genes for syndromic heart malformations and in rare families with Mendelian forms. The rapid characterization of genomic disorders as major contributors to congenital heart defects is also notable. The genes identified encode many transcription factors, chromatin regulators, growth factors and signal transduction proteins- all unified by their required roles in normal cardiac development. Genome-wide sequencing of the coding regions promises to elucidate genetic causation in several disorders affecting cardiac development. Such comprehensive studies evaluating both common and rare variants would be essential in characterizing gene-gene interactions, as well as in understanding the gene-environment interactions that increase susceptibility to congenital heart defects.
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Affiliation(s)
- Seema R Lalani
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.
| | - John W Belmont
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
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91
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Weiner DS, Tank JC, Jonah D, Morscher MA, Krahe A, Kopits S, Schrader WC. An operative approach to address severe genu valgum deformity in the Ellis-van Creveld syndrome. J Child Orthop 2014; 8:61-9. [PMID: 24488845 PMCID: PMC3935021 DOI: 10.1007/s11832-014-0552-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 01/07/2014] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The genu valgum deformity seen in the Ellis-van Creveld syndrome is one of the most severe angular deformities seen in any orthopaedic condition. It is likely a combination of a primary genetic-based dysplasia of the lateral portion of the tibial plateau combined with severe soft-tissue contractures that tether the tibia into valgus deformations. Progressive weight-bearing induces changes, accumulating with growth, acting on the initially distorted and valgus-angulated proximal tibia, worsening the deformity with skeletal maturation. The purpose of this study is to present a relatively large case series of a very rare condition that describes a surgical technique to correct the severe valgus deformity in the Ellis-van Creveld syndrome by combining extensive soft-tissue release with bony realignment. METHODS A retrospective review examined 23 limbs in 13 patients with Ellis-van Creveld syndrome that were surgically corrected by two different surgeons from 1982 to 2011. Seven additional patients were identified, but excluded due to insufficient chart or radiographic data. A successful correction was defined as 10° or less of genu valgum at the time of surgical correction. Although not an outcomes study, maintenance of 20° or less of genu valgum was considered desirable. Average age at surgery was 14.7 years (range 7-25 years). Clinical follow-up is still ongoing, but averages 5.0 years (range 2 months to 18 years). Charts and radiographs were reviewed for complications, radiographic alignment, and surgical technique. The surgical procedure was customized to each patient's deformity, consisting of the following steps: 1. Complete proximal to distal surgical decompression of the peroneal nerve 2. Radical release and mobilization of the severe quadriceps contracture and iliotibial band contracture 3. Distal lateral hamstring lengthening/tenotomy and lateral collateral ligament release 4. Proximal and distal realignment of the subluxed/dislocated patella, medial and lateral retinacular release, vastus medialis advancement, patellar chondroplasty, medial patellofemoral ligament plication, and distal patellar realignment by Roux-Goldthwait technique or patellar tendon transfer with tibial tubercle relocation 5. Proximal tibial varus osteotomy with partial fibulectomy and anterior compartment release 6. Occasionally, distal femoral osteotomy RESULTS In all cases, the combination of radical soft-tissue release, patellar realignment and bony osteotomy resulted in 10° or less of genu valgum at the time of surgical correction. Complications of surgery included three patients (five limbs) with knee stiffness that was successfully manipulated, one peroneal nerve palsy, one wound slough and hematoma requiring a skin graft, and one pseudoarthrosis requiring removal of hardware and repeat fixation. At last follow-up, radiographic correction of no more than 20° of genu valgum was maintained in all but four patients (four limbs). Two patients (three limbs) had or currently require revision surgery due to recurrence of the deformity. CONCLUSION The operative approach presented in this study has resulted in correction of the severe genu valgum deformity in Ellis-van Creveld syndrome to 10° or less of genu valgum at the time of surgery. Although not an outcomes study, a correction of no more than 20° genu valgum has been maintained in many of the cases included in the study. Further clinical follow-up is still warranted. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Dennis S. Weiner
- Department of Pediatric Orthopaedic Surgery, Regional Skeletal Dysplasia Clinic, Akron Children’s Hospital, Northeast Ohio Medical University, 300 Locust Street, Ste. 160, Akron, OH 44302-1821 USA
| | - Jason C. Tank
- Department of Orthopaedic Surgery, Summa Health System, Akron, OH 44310 USA
| | - David Jonah
- Medical Illustrator/Researcher Little People’s Research Fund, Baltimore, MD 21228 USA
| | - Melanie A. Morscher
- Department of Pediatric Orthopaedic Research, Akron Children’s Hospital, Akron, OH 44308 USA
| | - Amy Krahe
- Department of Sports Medicine, Akron Children’s Hospital, Akron, OH 44308 USA
| | - Steven Kopits
- International Center for Skeletal Dysplasia, Saint Joseph Hospital, Towson, MD 21204 USA
| | - William C. Schrader
- Department of Pediatric Orthopaedic Surgery, Regional Skeletal Dysplasia Clinic, Akron Children’s Hospital, Northeast Ohio Medical University, 300 Locust Street, Ste. 160, Akron, OH 44302-1821 USA
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92
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Ellis-van Creveld syndrome: its history. Pediatr Radiol 2013; 43:1030-6. [PMID: 23754541 DOI: 10.1007/s00247-013-2709-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 04/05/2013] [Accepted: 04/08/2013] [Indexed: 10/26/2022]
Abstract
The story of Ellis-van Creveld syndrome is one of serendipity. By chance, Simon van Creveld and Richard Ellis purportedly met on a train and combined their independently encountered patients with short stature, dental anomalies and polydactyly into one landmark publication in 1940. They included a patient used in work published previously by Rustin McIntosh without naming McIntosh as a coauthor. This patient was followed radiologically by Caffey for nearly two decades. In 1964, Victor McKusick felt compelled to investigate a brief report in an obscure pharmaceutical journal on an unusual geographic cluster of short-statured Amish patients in Pennsylvania. This review highlights the lives of the individuals involved in the discovery of Ellis-van Creveld syndrome in their historic context.
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93
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Sasalawad SS, Hugar SM, Poonacha KS, Mallikarjuna R. Ellis-van Creveld syndrome. BMJ Case Rep 2013; 2013:bcr-2013-009463. [PMID: 23843404 DOI: 10.1136/bcr-2013-009463] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Ellis-van Creveld (EvC) syndrome or chondroectodermal dysplasia is an autosomal recessive disorder with characteristic clinical manifestations. The four principal characteristics are chondrodysplasia, polydactyly, ectodermal dysplasia and congenital heart defects. Its incidence in the general population is low. The oral manifestations of EvC syndrome include both soft tissues and teeth, but the dental literature on the subject is scarce. The present case describes the constant and variable oral findings in these patients, which can be diagnosed at any age, even during pregnancy. The presence of a variety of oral manifestations, such as fusion of upper lip to the gingival margin, presence of multiple frenula, abnormally shaped and microdontic teeth and congenitally missing teeth requires multidisciplinary dental treatment, with consideration for the high incidence of cardiac defects in these patients.
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Affiliation(s)
- Shilpa S Sasalawad
- Department of Pedodontics and Preventive Dentistry, KLE VK Institute of Dental Sciences, Belgaum, Karnataka, India
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94
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Kamal R, Dahiya P, Kaur S, Bhardwaj R, Chaudhary K. Ellis-van Creveld syndrome: A rare clinical entity. J Oral Maxillofac Pathol 2013; 17:132-5. [PMID: 23798848 PMCID: PMC3687170 DOI: 10.4103/0973-029x.110716] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Ellis-van Creveld (EVC) syndrome is a genetic disorder with autosomal recessive transmission, which may clinically present as small stature, short limbs, fine sparse hair, hypoplastic fingernails, multiple musculofibrous frenula, conical teeth, hypoplasia of the enamel, hypodontia, and malocclusion. Heart defects, especially abnormalities of atrial septation, have been found in about 60% of cases. The mutation in EVC and EVC2 gene is responsible for this syndrome. The presence of multiple orodental findings makes this syndrome important for dentists. The aim of this article is to present a rare case of EVC syndrome in a 10-year-old girl along with the review of literature.
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Affiliation(s)
- Reet Kamal
- Department of Oral Pathology, HP Government Dental College, (IGMC) Shimla, India
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95
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Tonni G, Panteghini M, Bonasoni M, Pattacini P, Ventura A. Prenatal ultrasound and MRI Diagnosis of Jeune syndrome type I (asphyxiating thoracic dystrophy) with histology and post-mortem three-dimensional CT confirmation. Fetal Pediatr Pathol 2013; 32:123-32. [PMID: 22594482 DOI: 10.3109/15513815.2012.681427] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Asphyxiating thoracic dystrophy (ATD) also known as Jeune syndrome is a rare autosomal recessive multisystem disorder with an incidence estimated in 1:100.000-130.000 live births. Associated findings may include hepatic fibrosis and renal cysts. A prenatal ultrasound and MRI diagnosis performed in the early second-trimester of pregnancy is reported together with DNA analysis. Post-mortem diagnostic investigations such as radiograph and three-dimensional CT scan and histology have been useful in the final diagnosis of this rare skeletal dysplasia.
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Affiliation(s)
- Gabriele Tonni
- Department of Obstetrics and Gyncology, AUSL Reggio Emilia, Guastalla, Italy.
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96
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D'Asdia MC, Torrente I, Consoli F, Ferese R, Magliozzi M, Bernardini L, Guida V, Digilio MC, Marino B, Dallapiccola B, De Luca A. Novel and recurrent EVC and EVC2 mutations in Ellis-van Creveld syndrome and Weyers acrofacial dyostosis. Eur J Med Genet 2013; 56:80-7. [DOI: 10.1016/j.ejmg.2012.11.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 11/10/2012] [Indexed: 01/15/2023]
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97
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Chen CP, Chen CY, Chern SR, Su JW, Wang W. First-trimester prenatal diagnosis of Ellis-van Creveld syndrome. Taiwan J Obstet Gynecol 2013; 51:643-8. [PMID: 23276573 DOI: 10.1016/j.tjog.2012.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2012] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To present the perinatal findings and first-trimester molecular and transabdominal ultrasound diagnosis of a fetus with Ellis-van Creveld (EvC) syndrome. CASE REPORT A 35-year-old woman was referred for genetic counseling at 13 weeks of gestation because of a family history of skeletal dysplasia. She had experienced one spontaneous abortion, and delivered one male fetus and one female fetus with EvC syndrome. During this pregnancy, a prenatal transabdominal ultrasound at 13(+4) weeks of gestation revealed a nuchal translucency (NT) thickness of 2.0 mm, an endocardial cushion defect, postaxial polydactyly of bilateral hands, and mesomelic dysplasia of the long bones. Amniocentesis was performed at 13(+5) weeks of gestation. Results of a cytogenetic analysis revealed a karyotype of 46,XX and that of a molecular analysis revealed compound heterozygous mutations of c.1195C>T and c.871-2_894del26 in the EVC2 gene. Prenatal ultrasound at 16 weeks of gestation showed a fetus with short limbs, an endocardial cushion defect, and postaxial polydactyly of bilateral hands. The parents decided to terminate the pregnancy, and a 116-g female fetus was delivered with a narrow thorax, shortening limbs, and postaxial polydactyly of the hands. CONCLUSION Prenatal diagnosis of an endocardial cushion defect with postaxial polydactyly should include a differential diagnosis of EvC syndrome in addition to short rib-polydactyly syndrome, Bardet-Biedl syndrome, orofaciodigital syndrome, Smith-Lemli-Opitz syndrome, and hydrolethalus syndrome.
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Affiliation(s)
- Chih-Ping Chen
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.
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98
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Jayaraj D, Maheswaran T, Suresh R, Ganapathy N. Ellis-van Creveld. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2012; 4:S153-6. [PMID: 23066239 PMCID: PMC3467917 DOI: 10.4103/0975-7406.100257] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 01/02/2012] [Accepted: 01/26/2012] [Indexed: 11/04/2022] Open
Abstract
Ellis-van Creveld (EVC) syndrome is an autosomal recessive disorder that is also known as chondro-ectodermal dysplasia. The common manifestations of this syndrome are short ribs, postaxial polydactyly, growth retardation, and ectodermal and cardiac defects. The present case report is about an 8-year-old boy who had the features of bilateral hexadactyly, knocked knees, cardiac problems, congenital absence of incisors, fused upper and lower labial frenulum, and mulberry molars.
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Affiliation(s)
- Dhandabani Jayaraj
- Department of Pediatric and Preventive Dentistry, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth University, Pillaiyarkuppam, Puducherry, India
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99
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Identification of one novel mutation in the EVC2 gene in a Chinese family with Ellis-van Creveld syndrome. Gene 2012; 511:380-2. [PMID: 23026208 DOI: 10.1016/j.gene.2012.09.071] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 07/30/2012] [Accepted: 09/12/2012] [Indexed: 11/20/2022]
Abstract
Ellis-van Creveld syndrome (EvC) is a rare autosomal recessive skeletal dysplasia characterized by short limbs, short ribs, postaxial polydactyly, and dysplastic nails and teeth. It is caused by biallelic mutations in the EVC or EVC2 gene. Here, we identified a novel nonsense mutation p.W828X (c.2484G>A) in exon 14 and a recurrent nonsense mutation p. R399X (c.1195C>T) in exon 10 of EVC2 gene in a Chinese boy with EvC. Identification of a novel genotype in EvC will provide clues to the phenotype-genotype relations and may assist not only in the clinical diagnosis of EvC but also in the interpretation of genetic information used for prenatal diagnosis and genetic counseling.
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100
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Karp N, Grosse-Wortmann L, Bowdin S. Severe aortic stenosis, bicuspid aortic valve and atrial septal defect in a child with Joubert Syndrome and Related Disorders (JSRD) - a case report and review of congenital heart defects reported in the human ciliopathies. Eur J Med Genet 2012; 55:605-10. [PMID: 22910529 DOI: 10.1016/j.ejmg.2012.07.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 07/19/2012] [Indexed: 01/04/2023]
Abstract
We report a case of a 2 year-old boy with Joubert Syndrome and Related Disorders (JSRD), severe congenital aortic stenosis, bicuspid aortic valve and an atrial septal defect. JSRD is one of a group of conditions known as 'ciliopathies', whose multi-organ involvement results from primary cilia dysfunction. To date, there have been no other reported cases of aortic stenosis and bicuspid aortic valve associated with JSRD. Cardiac screening is not currently recommended in the management guidelines for individuals suspected of having JSRD. We speculate that while the presence of congenital aortic stenosis in this child could be caused by an unrelated genetic mechanism, it could also represent a phenotypic overlap with another ciliopathy, Bardet Biedl syndrome, in which aortic stenosis is more commonly reported. We also review the range of cardiac malformations reported to be present in all human diseases known to be ciliopathies, in order to assist with the investigation and management of individuals with a suspected or proven ciliopathy.
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Affiliation(s)
- Natalya Karp
- Division of Clinical and Metabolic Genetics, Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON, Canada M5G 1X8
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