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Warnier H, Barrea C, Bethlen S, Schrouff I, Harvengt J. Clinical overview and outcome of the Stuve-Wiedemann syndrome: a systematic review. Orphanet J Rare Dis 2022; 17:174. [PMID: 35461249 PMCID: PMC9034487 DOI: 10.1186/s13023-022-02323-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stuve-Wiedemann syndrome (SWS) is a rare and severe genetic disease characterized by skeletal anomalies and dysautonomic disturbances requiring appropriate care. Peer support is mandatory to fill the lack of clinical recommendations in such rare diseases. We report a new case and provide the first systematic review of all previous published cases. OBJECTIVE To better describe the timeline of SWS and to improve paediatric management. DATA SOURCES SWS English publications available on Pubmed until 31/03/2021. STUDY SELECTION Case description combining typical osteo-articular and dysautonomic involvement (with 2 items by categories required for children < 2 years and 3 items > 2 years). DATA EXTRACTION Demographic, clinical, genetics and outcome data. RESULTS In our cohort of 69 patients, the median age at report was 32 months. Only 46% presented antenatal signs. Mortality rate is higher during the first 2 years (42% < 2 years; 10% > 2 years) mainly due to respiratory failure, pulmonary arterial hypertension appearing to be a poor prognosis factor (mortality rate 63%). After 2 years, orthopaedic symptoms significantly increase including joint mobility restriction (81%), spinal deformations (77%) and fractures (61%). CONCLUSIONS Natural history of SWS is marked by a high mortality rate before 2 years due to dysautonomic disturbances. A specialized multidisciplinary approach is needed to address these early mortality risks and then adapt to the specific, mainly orthopaedic, needs of patients after 2 years of age. Further research is required to provide clinical guidelines and improve pre-natal counselling.
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Affiliation(s)
| | - Christophe Barrea
- Department of Paediatrics, Neuropeadiatrics, CHU of Liège, Liège, Belgium
| | - Sarah Bethlen
- Department of Physical Medicine, CHU of Liège, Liège, Belgium
| | | | - Julie Harvengt
- Department of Human Genetics, CHU of Liège, Avenue de l'Hôpital 1, Sart-Tilman, 4000, Liège, Belgium.
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2
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Siccha SM, Cueto AM, Parrón-Pajares M, González-Morán G, Pacio-Miguez M, Del Pozo Á, Solís M, Rodriguez-Jimenez C, Caino S, Fano V, Heath KE, García-Miñaúr S, Palomares-Bralo M, Santos-Simarro F. Delineation of the clinical and radiological features of Stuve-Wiedemann syndrome childhood survivors, four new cases and review of the literature. Am J Med Genet A 2020; 185:856-865. [PMID: 33305909 DOI: 10.1002/ajmg.a.62010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/08/2020] [Accepted: 11/14/2020] [Indexed: 11/07/2022]
Abstract
Stuve-Wiedemann syndrome (SWS; MIM 601559) is a rare autosomal recessive disease caused by mutations in the leukemia inhibitor factor receptor gene (LIFR). Common clinical and radiological findings are often observed, and high neonatal mortality occurs due to respiratory distress and hyperthermic episodes. Despite initially considered as a lethal disorder during the newborn period, in recent years, several SWS childhood survivors have been reported. We report a detailed clinical and radiological characterization of four unrelated childhood SWS molecularly confirmed patients and review 22 previously reported childhood surviving cases. We contribute to the definition of the childhood survival phenotype of SWS, emphasizing the evolving phenotype, characterized by skeletal abnormalities with typical radiological findings, distinctive dysmorphic features, and dysautonomia. Based on the typical features and clinical course, early diagnosis is possible and crucial to plan appropriate management and prevent potential complications. Genetic confirmation is advisable in order to improve genetic counseling to the patients and their families.
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Affiliation(s)
- Sofía M Siccha
- Institute of Medical & Molecular Genetics (INGEMM), Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ, Madrid, Spain.,Department of Pediatrics, Hospital Universitario la Paz, Madrid, Spain
| | - Anna María Cueto
- Department of Clinical and Molecular Genetics, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,Medical Genetics Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,European Reference Network, ERN CRANIO, Barcelona, Spain
| | - Manuel Parrón-Pajares
- Department of Radiology, Hospital Universitario La Paz, Madrid, Spain.,Skeletal Dysplasia Multidisciplinary Unit (UMDE) and ERN BOND, Hospital Universitario La Paz, Madrid, Spain.,European Reference Network, ERN ITHACA, Madrid, Spain
| | - Gaspar González-Morán
- Skeletal Dysplasia Multidisciplinary Unit (UMDE) and ERN BOND, Hospital Universitario La Paz, Madrid, Spain.,European Reference Network, ERN ITHACA, Madrid, Spain.,Department of Orthopaedic Surgery and Traumatology, Hospital Universitario la Paz, Madrid, Spain
| | - Marta Pacio-Miguez
- Institute of Medical & Molecular Genetics (INGEMM), Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ, Madrid, Spain
| | - Ángela Del Pozo
- Institute of Medical & Molecular Genetics (INGEMM), Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ, Madrid, Spain.,European Reference Network, ERN ITHACA, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U753), Instituto Carlos III, Madrid, Spain
| | - Mario Solís
- Institute of Medical & Molecular Genetics (INGEMM), Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ, Madrid, Spain.,European Reference Network, ERN ITHACA, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U753), Instituto Carlos III, Madrid, Spain
| | - Carmen Rodriguez-Jimenez
- Institute of Medical & Molecular Genetics (INGEMM), Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ, Madrid, Spain
| | - Silvia Caino
- Growth and Developmental Department Hospital de Pediatría Garrahan, Buenos Aires, Argentina
| | - Virginia Fano
- Growth and Developmental Department Hospital de Pediatría Garrahan, Buenos Aires, Argentina
| | - Karen E Heath
- Institute of Medical & Molecular Genetics (INGEMM), Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ, Madrid, Spain.,Skeletal Dysplasia Multidisciplinary Unit (UMDE) and ERN BOND, Hospital Universitario La Paz, Madrid, Spain.,European Reference Network, ERN ITHACA, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U753), Instituto Carlos III, Madrid, Spain
| | - Sixto García-Miñaúr
- Institute of Medical & Molecular Genetics (INGEMM), Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ, Madrid, Spain.,European Reference Network, ERN ITHACA, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U753), Instituto Carlos III, Madrid, Spain
| | - María Palomares-Bralo
- Institute of Medical & Molecular Genetics (INGEMM), Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ, Madrid, Spain.,European Reference Network, ERN ITHACA, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U753), Instituto Carlos III, Madrid, Spain
| | - Fernando Santos-Simarro
- Institute of Medical & Molecular Genetics (INGEMM), Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ, Madrid, Spain.,Skeletal Dysplasia Multidisciplinary Unit (UMDE) and ERN BOND, Hospital Universitario La Paz, Madrid, Spain.,European Reference Network, ERN ITHACA, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U753), Instituto Carlos III, Madrid, Spain
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3
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Developments in the Orthopaedic Management of Children With Stüve-Wiedemann Syndrome: Use of the Fassier-Duval Telescopic Rod to Maintain Correction of Deformity. J Pediatr Orthop 2017; 37:e459-e463. [PMID: 26650577 DOI: 10.1097/bpo.0000000000000711] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Stüve-Wiedemann syndrome is a rare inherited condition, which is frequently fatal in infancy. Those patients who survive into childhood demonstrate a complex progressive deformity of the long bones, with high rates of recurrence after initial successful correction. Because of the rarity of the condition there is, at present, limited evidence on the most appropriate treatment. METHODS We describe our experience in the management of 4 patients, who underwent correction of deformity and fixation with Fassier-Duval telescopic rods. RESULTS In this series we have seen good correction of deformity and maintenance of alignment, with improvement in the walking ability of children treated with this technique. CONCLUSION Fassier-Duval rodding has a role in the prevention of recurrence of deformity and should be considered as a means to reduce the number of operative procedures required. LEVEL OF EVIDENCE Level IV-therapeutic.
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4
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Kosfeld A, Brand F, Weiss AC, Kreuzer M, Goerk M, Martens H, Schubert S, Schäfer AK, Riehmer V, Hennies I, Bräsen JH, Pape L, Amann K, Krogvold L, Bjerre A, Daniel C, Kispert A, Haffner D, Weber RG. Mutations in the leukemia inhibitory factor receptor (LIFR) gene and Lifr deficiency cause urinary tract malformations. Hum Mol Genet 2017; 26:1716-1731. [DOI: 10.1093/hmg/ddx086] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 03/02/2017] [Indexed: 02/01/2023] Open
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5
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Oxford AE, Jorcyk CL, Oxford JT. Neuropathies of Stüve-Wiedemann Syndrome due to mutations in leukemia inhibitory factor receptor (LIFR) gene. ACTA ACUST UNITED AC 2016; 1:37-44. [PMID: 28058407 DOI: 10.29245/2572.942x/2016/7.1068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Stüve-Wiedemann syndrome (STWS; OMIM #610559) is a rare disease that results in dysfunction of the autonomic nervous system, which controls involuntary processes such as breathing rate and body temperature. In infants, this can result in respiratory distress, feeding and swallowing difficulties, and hyperthermic episodes. Individuals may sweat excessively when body temperature is not elevated. Additionally, individuals have reduced ability to feel pain and may lose reflexes such as the corneal reflex that normally causes one to blink, and the patellar reflex resulting in the knee-jerk. STWS usually results in infant mortality, yet some STWS patients survive into early adulthood. STWS is caused by a mutation in the leukemia inhibitory factor receptor (LIFR) gene, which is inherited in an autosomal-recessive pattern. Most LIFR mutations resulting in STWS cause instability of the mRNA due to frameshift mutations leading to premature stop codons, which prevent the formation of LIFR protein. STWS is managed on a symptomatic basis as no treatment is currently available.
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Affiliation(s)
- Alexandra E Oxford
- Boise State University, Department of Biological Sciences, Biomolecular Research Center, 1910 University Drive, Boise State University, Boise, ID 83725
| | - Cheryl L Jorcyk
- Boise State University, Department of Biological Sciences, Biomolecular Research Center, 1910 University Drive, Boise State University, Boise, ID 83725
| | - Julia Thom Oxford
- Boise State University, Department of Biological Sciences, Biomolecular Research Center, 1910 University Drive, Boise State University, Boise, ID 83725
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6
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Romeo Bertola D, Honjo RS, Baratela WAR. Stüve-Wiedemann Syndrome: Update on Clinical and Genetic Aspects. Mol Syndromol 2016; 7:12-8. [PMID: 27194968 DOI: 10.1159/000444729] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2015] [Indexed: 12/20/2022] Open
Abstract
Stüve-Wiedemann syndrome is a rare autosomal recessive disorder characterized by bowed long bones, joint restrictions, dysautonomia, and respiratory and feeding difficulties, leading to death in the neonatal period and infancy in several occasions. Since the first cases in 1971, much has been learned about this condition, including its molecular basis - mutations in the leukemia inhibitory factor receptor gene (LIFR) -, natural history and management possibilities. This review aims to highlight the clinical aspects, radiological features, molecular findings, and management strategies in Stüve-Wiedemann syndrome.
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Affiliation(s)
- Débora Romeo Bertola
- Unidade de Genética, Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | - Rachel S Honjo
- Unidade de Genética, Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | - Wagner A R Baratela
- Unidade de Genética, Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
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7
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Sarafidis K, Piretzi K, Agakidou E, Kohlhase J, Zafeiriou D. Stüve-Wiedemann syndrome in a neonate. Pediatr Int 2015; 57:302-4. [PMID: 25868946 DOI: 10.1111/ped.12431] [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: 04/25/2014] [Revised: 06/06/2014] [Accepted: 06/09/2014] [Indexed: 11/27/2022]
Abstract
We describe a female neonate with Stüve-Wiedemann syndrome. The facial dysmorphism, joint contracture, distinctive skeletal changes, and myotonic discharges on electromyogram raised a suspicion of the rare autosomal recessive syndrome, which was later confirmed on molecular analysis of leukemia inhibitory factor receptor. She developed recurrent attacks of hyperpyrexia and died at age 3 months.
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Affiliation(s)
- Kosmas Sarafidis
- 1st Department of Neonatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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8
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Mikelonis D, Jorcyk CL, Tawara K, Oxford JT. Stüve-Wiedemann syndrome: LIFR and associated cytokines in clinical course and etiology. Orphanet J Rare Dis 2014; 9:34. [PMID: 24618404 PMCID: PMC3995696 DOI: 10.1186/1750-1172-9-34] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Accepted: 03/06/2014] [Indexed: 12/14/2022] Open
Abstract
Stüve-Wiedemann syndrome (STWS; OMIM #610559) is a rare bent-bone dysplasia that includes radiologic bone anomalies, respiratory distress, feeding difficulties, and hyperthermic episodes. STWS usually results in infant mortality, yet some STWS patients survive into and, in some cases, beyond adolescence. STWS is caused by a mutation in the leukemia inhibitory factor receptor (LIFR) gene, which is inherited in an autosomally recessive pattern. Most LIFR mutations resulting in STWS are null mutations which cause instability of the mRNA and prevent the formation of LIFR, impairing the signaling pathway. LIFR signaling usually follows the JAK/STAT3 pathway, and is initiated by several interleukin-6-type cytokines. STWS is managed on a symptomatic basis since there is no treatment currently available.
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Affiliation(s)
| | | | | | - Julia Thom Oxford
- Boise State University, Department of Biological Sciences, Biomolecular Research Center, 1910 University Drive, Boise State University, Boise ID 83725, USA.
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9
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Abstract
Stüve-Wiedemann syndrome (SWS) is a severe congenital skeletal dysplasia associated with life threatening dysautonomic manifestations. Newborns affected with this condition exhibit distinctive shortening and bowing of the long bones with reduced bone volume. The majority of affected newborns die early due to neuromuscular complications namely hyperthermia, apnea, and swallowing difficulties. In this review, we provide an overall picture on the clinical, including long-term management, molecular and cellular aspects of SWS and discuss briefly other related bent bone dysplasias.
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Affiliation(s)
- N A Akawi
- Department of Pathology Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
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10
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Begam MA, Alsafi W, Bekdache GN, Chedid F, Al-Gazali L, Mirghani HM. Stuve-Wiedemann syndrome: a skeletal dysplasia characterized by bowed long bones. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2011; 38:553-558. [PMID: 21337444 DOI: 10.1002/uog.8967] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To describe the prenatal sonographic features of Stuve-Wiedemann syndrome (SWS). METHODS A retrospective review of all cases of confirmed SWS during an 8-year period was conducted. Clinical and historical data and outcome of the pregnancies were noted. Fetal biometry, skeletal survey, amniotic fluid volume and associated anomalies were recorded. A sonographic algorithm was proposed to distinguish SWS from other bent bone disorders. RESULTS In total, there were 10 cases, six of which were diagnosed prenatally. The main prenatal features of SWS were mild-to-moderate micromelia and bowing of the lower limb bones, affecting the tibia more than the femur. There was relative sparing of fibula and upper limb bones, with normal scapulae and clavicles. Camptodactyly was the main associated anomaly. All fetuses developed growth restriction in the late second trimester with oligohydramnios in half of the cases. These features could appear late in pregnancy. Although the thoracic dimensions were normal in the majority of fetuses, respiratory insufficiency, as a result of myotonia, was a leading cause for mortality. CONCLUSIONS It is possible to diagnose SWS prenatally. SWS is associated with high mortality during the first year of life, and those who survive have high morbidity.
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Affiliation(s)
- M A Begam
- OBYGN/Fetal Medicine Unit, Tawam Hospital, Al Ain, Abu Dhabi, United Arab Emirates
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11
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Jung C, Dagoneau N, Baujat G, Le Merrer M, David A, Di Rocco M, Hamel B, Mégarbané A, Superti-Furga A, Unger S, Munnich A, Cormier-Daire V. Stüve-Wiedemann syndrome: long-term follow-up and genetic heterogeneity. Clin Genet 2010; 77:266-72. [PMID: 20447141 DOI: 10.1111/j.1399-0004.2009.01314.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Stüve-Wiedemann syndrome (SWS, OMIM 601559) is a severe autosomal recessive condition caused by mutations in the leukemia inhibitory receptor (LIFR) gene. The main characteristic features are bowing of the long bones, neonatal respiratory distress, swallowing/sucking difficulties and dysautonomia symptoms including temperature instability often leading to death in the first years of life. We report here four patients with SWS who have survived beyond 36 months of age with no LIFR mutation. These patients have been compared with six unreported SWS survivors carrying null LIFR mutations. We provide evidence of clinical homogeneity of the syndrome in spite of the genetic heterogeneity.
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Affiliation(s)
- C Jung
- Department of Genetics, Université Paris Descartes, Paris, France
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12
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Hassan A, Whately C, Letts M. The orthopaedic manifestations and management of children with Stüve-Wiedemann syndrome. ACTA ACUST UNITED AC 2010; 92:880-4. [DOI: 10.1302/0301-620x.92b6.23486] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Stüve-Wiedemann syndrome is an autosomal-recessive disorder characterised by bowing of the long bones, progressive scoliosis, episodic hyperthermia and respiratory distress, usually resulting in death in infancy. We reviewed five children with the condition who had been followed since birth and who survived into childhood with a mean age at operation of 7.8 years (5 to 14). There was marked functional impairment with dysplasia of the long bones and scoliosis. Treatment of the triplanar deformities of the femora involved the use of the Ilizarov technique with the Taylor Spatial Frame. Walking was preserved and improved in three children along with considerable enhancement of the appearance. Early insertion of a growing rod to control the progressive juvenile scoliosis was beneficial. The use of the Taylor Spatial Frame is strongly recommended to address the major complex deformities of the lower limbs which are encountered in this condition and to prevent their progression.
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Affiliation(s)
- A. Hassan
- Division of Orthopaedic Surgery Sheikh Khalifa Medical City, PO 5190 Abu Dhabi, United Arab Emirates
| | - C. Whately
- Division of Orthopaedic Surgery Welcare Hospital, PO 215565 Dubai, United Arab Emirates
| | - M. Letts
- 66 216 Botanica, Ottawa, Ontario L1Y 4P9, Canada
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13
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Abnormal oral-pharyngeal swallowing as cause of morbidity and early death in Stüve-Wiedemann syndrome. Eur J Med Genet 2009; 52:242-6. [PMID: 19371797 DOI: 10.1016/j.ejmg.2009.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2008] [Accepted: 04/02/2009] [Indexed: 11/21/2022]
Abstract
Stüve-Wiedemann syndrome (SWS) is an autosomal recessive bone dysplasia (OMIM #601559) characterized by bowing of long bones, camptodactyly, respiratory insufficiency, hyperthermic episodes, and neonatal death from hyperthermia or apnea. We describe two female siblings with SWS born from consanguineous Gypsy parents. For a further delineation of SWS, we report hypothyroidism and ectopic thyroid as part of its phenotypic spectrum. Molecular study in the leukemia inhibitory factor receptor (LIFR) gene (OMIM *151 443) demonstrated the presence of a mutation. We observed that in one of our patients, oropharyngeal disruption in the swallowing process caused repetitive aspiration pneumonias, life-threatening events, and finally death. We emphasize that these features represent dysautonomic manifestations of SWS, and are probably related to pharyngoesophageal dyskinesia due to abnormal autonomic control of the anterior rami of cervical roots C1-C5.
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14
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Bonthuis D, Morava E, Booij LHDJ, Driessen JJ. Stuve Wiedemann syndrome and related syndromes: case report and possible anesthetic complications. Paediatr Anaesth 2009; 19:212-7. [PMID: 19207241 DOI: 10.1111/j.1460-9592.2008.02891.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Stuve Wiedemann syndrome (SWS) is an autosomal recessively inherited syndrome which is characterized by bowing of the long bones, camptodactyly, facial dysmorphism, hypotonia, feeding and swallowing difficulties, and respiratory distress. In most cases episodes of unexplained hyperthermia are present. Patients with SWS can develop hyperthermia in conjunction with anesthesia and surgery, and a relationship has been suggested between the syndrome and malignant hyperthermia. We describe a 3-year-old child diagnosed with SWS to whom we administered general anesthesia during the removal of a corneal ulcer and dilatation of the lacrimal duct. Our patient had received, uncomplicated, inhalational anesthesia five times previously for different operations. There were no anesthesia-related complications in the present or previous perioperative periods. On one occasion the patient developed mild postoperative hyperthermia. We believe that this hyperthermia is different from the specific disorder of malignant hyperthermia and that sevoflurane can be safely used in patients with SWS. We also describe symptomatically related syndromes and their theoretical risks for anesthesia.
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Affiliation(s)
- Dominique Bonthuis
- Department of Anesthesiology, Pain and Palliative Care, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
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15
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Al Kaissi A, Rumpler M, Csepan R, Grill F, Klaushofer K. Congenital contractures and distinctive phenotypic features consistent with Stuve-Wiedmann syndrome in a male infant. CASES JOURNAL 2008; 1:121. [PMID: 18718019 PMCID: PMC2533000 DOI: 10.1186/1757-1626-1-121] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2008] [Accepted: 08/21/2008] [Indexed: 12/03/2022]
Abstract
Introduction Expressionless face associated with multiple contractures has been encountered in an infant. There is a wide range of misconception regarding the categorization of children with multiple contractures among different pediatric disciplines. The fundamental element in categorizing children with multiple contractures is "the etiological understanding". In the absence of concomitant neuromuscular disease, however, the search for other reasons is mandatory. Our present paper signifies the necessity of proper interpretations of unusual clinical and radiographic features. Case presentation We describe a 3-months-old-infant presented with the phenotypic and the radiographic features consistent with the diagnosis of Stüve-Wiedemann syndrome. We report what might be the first clinical report of Stüve-Wiedemann syndrome from a consanguineous family in Austria. Conclusion Congenital limitations of the hips in a newborn infant raise the possibility of " Congenital Hip Dislocation". As congenital hip dislocation is a dysplastic process. Here further knowledge by the pediatrician and the orthopaedic surgeon is needed. Our present patient appears to constitute a distinct pathological entity consistent with Stüve-Wiedemann syndrome (SWS). Superti-Furga et al, and Cormier-Daire et al, also suggest that Stüve-Wiedemann syndrome and Schwartz-Jampel syndrome type 2 are allelic conditions. We wish to stress that, given the rarity of syndromic malformation complex, our impression is that it is more common than it is reported.
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Affiliation(s)
- Ali Al Kaissi
- Ludwig Boltzmann Institute of Osteology, at the Hanusch Hospital of WGKK and, AUVA Trauma Centre Meidling, 4th Medical Department, Hanusch Hospital, Vienna, Austria.
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Gaspar IM, Saldanha T, Cabral P, Vilhena MM, Tuna M, Costa C, Dagoneau N, Daire VC, Hennekam RCM. Long-term follow-up in Stuve-Wiedemann syndrome: a clinical report. Am J Med Genet A 2008; 146A:1748-53. [PMID: 18546280 DOI: 10.1002/ajmg.a.32325] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Stuve-Wiedemann syndrome (SWS) is an autosomal recessively inherited disorder that is usually associated with high mortality in the neonatal period. Eleven cases have been published with prolonged survival, the oldest being 16 years. This phenotype is characterized by progressive skeletal anomalies including short stature, severe spinal deformities, bowing of the long bones, contractures and spontaneous fractures, and by neurological features that resemble dysautonomia. Here we report on the natural history of a Portuguese girl from birth till 12 years. The diagnosis was molecularly confirmed by the detection of a homozygous 4 bp deletion (167_170 del TAAC) in exon 3 of LIFR. We compare the findings in this patient to other patients with prolonged survival from the literature.
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17
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Langer R, Al-Gazali L, Raupp P, Varady E. Radiological manifestations of the skeleton, lungs and brain in Stueve-Wiedemann syndrome. AUSTRALASIAN RADIOLOGY 2007; 51:203-10. [PMID: 17504309 DOI: 10.1111/j.1440-1673.2007.01714.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A total of 25 patients with the rare skeletal dysplasia Stueve-Wiedemann syndrome (SWS) have been evaluated during the last 11 years. Of all patients with clinical suspicion of SWS, skeletal and chest radiographs were obtained for classification of the underlying skeletal dysplasia. In one case, CT was carried out for the first time for further investigation of the midface hypoplasia. Typical conventional radiological findings and CT features were analysed and compared with published data. Early diagnosis of SWS was made by correlating radiological and clinical findings. Follow-up radiological examinations of the skeleton and of the chest were carried out in six children surviving infancy for evaluation of progression. Clinically, they suffered from progressive orthopaedic problems, recurrent aspiration pneumonia and recurrent episodes of hyperthermia, as well as cutaneous infections. Radiologically progressive bowing of the long tubular bones and progressive metaphyseal decalcification were present on follow-up skeletal radiographs. Skeletal abnormalities in SWS are so characteristic that an early post-partum diagnosis can be made by correlation of typical clinical and radiological findings. Few cases survive infancy. First, these patients face progressive orthopaedic problems and respiratory infections.
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Affiliation(s)
- R Langer
- Department of Radiology, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
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Lachman RS. S. TAYBI AND LACHMAN'S RADIOLOGY OF SYNDROMES, METABOLIC DISORDERS AND SKELETAL DYSPLASIAS 2007. [PMCID: PMC7315357 DOI: 10.1016/b978-0-323-01931-6.50027-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dagoneau N, Scheffer D, Huber C, Al-Gazali LI, Di Rocco M, Godard A, Martinovic J, Raas-Rothschild A, Sigaudy S, Unger S, Nicole S, Fontaine B, Taupin JL, Moreau JF, Superti-Furga A, Le Merrer M, Bonaventure J, Munnich A, Legeai-Mallet L, Cormier-Daire V. Null leukemia inhibitory factor receptor (LIFR) mutations in Stuve-Wiedemann/Schwartz-Jampel type 2 syndrome. Am J Hum Genet 2004; 74:298-305. [PMID: 14740318 PMCID: PMC1181927 DOI: 10.1086/381715] [Citation(s) in RCA: 128] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2003] [Accepted: 11/11/2003] [Indexed: 11/03/2022] Open
Abstract
Stuve-Wiedemann syndrome (SWS) is a severe autosomal recessive condition characterized by bowing of the long bones, with cortical thickening, flared metaphyses with coarsened trabecular pattern, camptodactyly, respiratory distress, feeding difficulties, and hyperthermic episodes responsible for early lethality. Clinical overlap with Schwartz-Jampel type 2 syndrome (SJS2) has suggested that SWS and SJS2 could be allelic disorders. Through studying a series of 19 families with SWS/SJS2, we have mapped the disease gene to chromosome 5p13.1 at locus D5S418 (Zmax=10.66 at theta =0) and have identified null mutations in the leukemia inhibitory factor receptor (LIFR or gp190 chain) gene. A total of 14 distinct mutations were identified in the 19 families. An identical frameshift insertion (653_654insT) was identified in families from the United Arab Emirates, suggesting a founder effect in that region. It is interesting that 12/14 mutations predicted premature termination of translation. Functional studies indicated that these mutations alter the stability of LIFR messenger RNA transcripts, resulting in the absence of the LIFR protein and in the impairment of the JAK/STAT3 signaling pathway in patient cells. We conclude, therefore, that SWS and SJS2 represent a single clinically and genetically homogeneous condition due to null mutations in the LIFR gene on chromosome 5p13.
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Affiliation(s)
- Nathalie Dagoneau
- Department of Medical Genetics and INSERM U393, Hôpital Necker-Enfants Malades, and INSERM U546, Faculté de Médecine Pitié-Salpêtrière, Paris; Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain; Second Unit of Pediatrics, Istituto G. Gaslini, Genoa; INSERM U463, Institut de Biologie, Nantes, France; Department of Genetics, Hadassah University Medical Center, Jerusalem; Hôpital d’Enfants de La Timone, Marseille; Division of Clinical and Genetic Metabolics, University of Toronto, Toronto; CNRS UMR 5540, Université Bordeaux 2, Bordeaux; and Department of Pediatrics, University of Lausanne, Lausanne
| | - Deborah Scheffer
- Department of Medical Genetics and INSERM U393, Hôpital Necker-Enfants Malades, and INSERM U546, Faculté de Médecine Pitié-Salpêtrière, Paris; Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain; Second Unit of Pediatrics, Istituto G. Gaslini, Genoa; INSERM U463, Institut de Biologie, Nantes, France; Department of Genetics, Hadassah University Medical Center, Jerusalem; Hôpital d’Enfants de La Timone, Marseille; Division of Clinical and Genetic Metabolics, University of Toronto, Toronto; CNRS UMR 5540, Université Bordeaux 2, Bordeaux; and Department of Pediatrics, University of Lausanne, Lausanne
| | - Céline Huber
- Department of Medical Genetics and INSERM U393, Hôpital Necker-Enfants Malades, and INSERM U546, Faculté de Médecine Pitié-Salpêtrière, Paris; Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain; Second Unit of Pediatrics, Istituto G. Gaslini, Genoa; INSERM U463, Institut de Biologie, Nantes, France; Department of Genetics, Hadassah University Medical Center, Jerusalem; Hôpital d’Enfants de La Timone, Marseille; Division of Clinical and Genetic Metabolics, University of Toronto, Toronto; CNRS UMR 5540, Université Bordeaux 2, Bordeaux; and Department of Pediatrics, University of Lausanne, Lausanne
| | - Lihadh I. Al-Gazali
- Department of Medical Genetics and INSERM U393, Hôpital Necker-Enfants Malades, and INSERM U546, Faculté de Médecine Pitié-Salpêtrière, Paris; Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain; Second Unit of Pediatrics, Istituto G. Gaslini, Genoa; INSERM U463, Institut de Biologie, Nantes, France; Department of Genetics, Hadassah University Medical Center, Jerusalem; Hôpital d’Enfants de La Timone, Marseille; Division of Clinical and Genetic Metabolics, University of Toronto, Toronto; CNRS UMR 5540, Université Bordeaux 2, Bordeaux; and Department of Pediatrics, University of Lausanne, Lausanne
| | - Maja Di Rocco
- Department of Medical Genetics and INSERM U393, Hôpital Necker-Enfants Malades, and INSERM U546, Faculté de Médecine Pitié-Salpêtrière, Paris; Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain; Second Unit of Pediatrics, Istituto G. Gaslini, Genoa; INSERM U463, Institut de Biologie, Nantes, France; Department of Genetics, Hadassah University Medical Center, Jerusalem; Hôpital d’Enfants de La Timone, Marseille; Division of Clinical and Genetic Metabolics, University of Toronto, Toronto; CNRS UMR 5540, Université Bordeaux 2, Bordeaux; and Department of Pediatrics, University of Lausanne, Lausanne
| | - Anne Godard
- Department of Medical Genetics and INSERM U393, Hôpital Necker-Enfants Malades, and INSERM U546, Faculté de Médecine Pitié-Salpêtrière, Paris; Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain; Second Unit of Pediatrics, Istituto G. Gaslini, Genoa; INSERM U463, Institut de Biologie, Nantes, France; Department of Genetics, Hadassah University Medical Center, Jerusalem; Hôpital d’Enfants de La Timone, Marseille; Division of Clinical and Genetic Metabolics, University of Toronto, Toronto; CNRS UMR 5540, Université Bordeaux 2, Bordeaux; and Department of Pediatrics, University of Lausanne, Lausanne
| | - Jelena Martinovic
- Department of Medical Genetics and INSERM U393, Hôpital Necker-Enfants Malades, and INSERM U546, Faculté de Médecine Pitié-Salpêtrière, Paris; Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain; Second Unit of Pediatrics, Istituto G. Gaslini, Genoa; INSERM U463, Institut de Biologie, Nantes, France; Department of Genetics, Hadassah University Medical Center, Jerusalem; Hôpital d’Enfants de La Timone, Marseille; Division of Clinical and Genetic Metabolics, University of Toronto, Toronto; CNRS UMR 5540, Université Bordeaux 2, Bordeaux; and Department of Pediatrics, University of Lausanne, Lausanne
| | - Annick Raas-Rothschild
- Department of Medical Genetics and INSERM U393, Hôpital Necker-Enfants Malades, and INSERM U546, Faculté de Médecine Pitié-Salpêtrière, Paris; Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain; Second Unit of Pediatrics, Istituto G. Gaslini, Genoa; INSERM U463, Institut de Biologie, Nantes, France; Department of Genetics, Hadassah University Medical Center, Jerusalem; Hôpital d’Enfants de La Timone, Marseille; Division of Clinical and Genetic Metabolics, University of Toronto, Toronto; CNRS UMR 5540, Université Bordeaux 2, Bordeaux; and Department of Pediatrics, University of Lausanne, Lausanne
| | - Sabine Sigaudy
- Department of Medical Genetics and INSERM U393, Hôpital Necker-Enfants Malades, and INSERM U546, Faculté de Médecine Pitié-Salpêtrière, Paris; Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain; Second Unit of Pediatrics, Istituto G. Gaslini, Genoa; INSERM U463, Institut de Biologie, Nantes, France; Department of Genetics, Hadassah University Medical Center, Jerusalem; Hôpital d’Enfants de La Timone, Marseille; Division of Clinical and Genetic Metabolics, University of Toronto, Toronto; CNRS UMR 5540, Université Bordeaux 2, Bordeaux; and Department of Pediatrics, University of Lausanne, Lausanne
| | - Sheila Unger
- Department of Medical Genetics and INSERM U393, Hôpital Necker-Enfants Malades, and INSERM U546, Faculté de Médecine Pitié-Salpêtrière, Paris; Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain; Second Unit of Pediatrics, Istituto G. Gaslini, Genoa; INSERM U463, Institut de Biologie, Nantes, France; Department of Genetics, Hadassah University Medical Center, Jerusalem; Hôpital d’Enfants de La Timone, Marseille; Division of Clinical and Genetic Metabolics, University of Toronto, Toronto; CNRS UMR 5540, Université Bordeaux 2, Bordeaux; and Department of Pediatrics, University of Lausanne, Lausanne
| | - Sophie Nicole
- Department of Medical Genetics and INSERM U393, Hôpital Necker-Enfants Malades, and INSERM U546, Faculté de Médecine Pitié-Salpêtrière, Paris; Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain; Second Unit of Pediatrics, Istituto G. Gaslini, Genoa; INSERM U463, Institut de Biologie, Nantes, France; Department of Genetics, Hadassah University Medical Center, Jerusalem; Hôpital d’Enfants de La Timone, Marseille; Division of Clinical and Genetic Metabolics, University of Toronto, Toronto; CNRS UMR 5540, Université Bordeaux 2, Bordeaux; and Department of Pediatrics, University of Lausanne, Lausanne
| | - Bertrand Fontaine
- Department of Medical Genetics and INSERM U393, Hôpital Necker-Enfants Malades, and INSERM U546, Faculté de Médecine Pitié-Salpêtrière, Paris; Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain; Second Unit of Pediatrics, Istituto G. Gaslini, Genoa; INSERM U463, Institut de Biologie, Nantes, France; Department of Genetics, Hadassah University Medical Center, Jerusalem; Hôpital d’Enfants de La Timone, Marseille; Division of Clinical and Genetic Metabolics, University of Toronto, Toronto; CNRS UMR 5540, Université Bordeaux 2, Bordeaux; and Department of Pediatrics, University of Lausanne, Lausanne
| | - Jean-Luc Taupin
- Department of Medical Genetics and INSERM U393, Hôpital Necker-Enfants Malades, and INSERM U546, Faculté de Médecine Pitié-Salpêtrière, Paris; Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain; Second Unit of Pediatrics, Istituto G. Gaslini, Genoa; INSERM U463, Institut de Biologie, Nantes, France; Department of Genetics, Hadassah University Medical Center, Jerusalem; Hôpital d’Enfants de La Timone, Marseille; Division of Clinical and Genetic Metabolics, University of Toronto, Toronto; CNRS UMR 5540, Université Bordeaux 2, Bordeaux; and Department of Pediatrics, University of Lausanne, Lausanne
| | - Jean-François Moreau
- Department of Medical Genetics and INSERM U393, Hôpital Necker-Enfants Malades, and INSERM U546, Faculté de Médecine Pitié-Salpêtrière, Paris; Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain; Second Unit of Pediatrics, Istituto G. Gaslini, Genoa; INSERM U463, Institut de Biologie, Nantes, France; Department of Genetics, Hadassah University Medical Center, Jerusalem; Hôpital d’Enfants de La Timone, Marseille; Division of Clinical and Genetic Metabolics, University of Toronto, Toronto; CNRS UMR 5540, Université Bordeaux 2, Bordeaux; and Department of Pediatrics, University of Lausanne, Lausanne
| | - Andrea Superti-Furga
- Department of Medical Genetics and INSERM U393, Hôpital Necker-Enfants Malades, and INSERM U546, Faculté de Médecine Pitié-Salpêtrière, Paris; Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain; Second Unit of Pediatrics, Istituto G. Gaslini, Genoa; INSERM U463, Institut de Biologie, Nantes, France; Department of Genetics, Hadassah University Medical Center, Jerusalem; Hôpital d’Enfants de La Timone, Marseille; Division of Clinical and Genetic Metabolics, University of Toronto, Toronto; CNRS UMR 5540, Université Bordeaux 2, Bordeaux; and Department of Pediatrics, University of Lausanne, Lausanne
| | - Martine Le Merrer
- Department of Medical Genetics and INSERM U393, Hôpital Necker-Enfants Malades, and INSERM U546, Faculté de Médecine Pitié-Salpêtrière, Paris; Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain; Second Unit of Pediatrics, Istituto G. Gaslini, Genoa; INSERM U463, Institut de Biologie, Nantes, France; Department of Genetics, Hadassah University Medical Center, Jerusalem; Hôpital d’Enfants de La Timone, Marseille; Division of Clinical and Genetic Metabolics, University of Toronto, Toronto; CNRS UMR 5540, Université Bordeaux 2, Bordeaux; and Department of Pediatrics, University of Lausanne, Lausanne
| | - Jacky Bonaventure
- Department of Medical Genetics and INSERM U393, Hôpital Necker-Enfants Malades, and INSERM U546, Faculté de Médecine Pitié-Salpêtrière, Paris; Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain; Second Unit of Pediatrics, Istituto G. Gaslini, Genoa; INSERM U463, Institut de Biologie, Nantes, France; Department of Genetics, Hadassah University Medical Center, Jerusalem; Hôpital d’Enfants de La Timone, Marseille; Division of Clinical and Genetic Metabolics, University of Toronto, Toronto; CNRS UMR 5540, Université Bordeaux 2, Bordeaux; and Department of Pediatrics, University of Lausanne, Lausanne
| | - Arnold Munnich
- Department of Medical Genetics and INSERM U393, Hôpital Necker-Enfants Malades, and INSERM U546, Faculté de Médecine Pitié-Salpêtrière, Paris; Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain; Second Unit of Pediatrics, Istituto G. Gaslini, Genoa; INSERM U463, Institut de Biologie, Nantes, France; Department of Genetics, Hadassah University Medical Center, Jerusalem; Hôpital d’Enfants de La Timone, Marseille; Division of Clinical and Genetic Metabolics, University of Toronto, Toronto; CNRS UMR 5540, Université Bordeaux 2, Bordeaux; and Department of Pediatrics, University of Lausanne, Lausanne
| | - Laurence Legeai-Mallet
- Department of Medical Genetics and INSERM U393, Hôpital Necker-Enfants Malades, and INSERM U546, Faculté de Médecine Pitié-Salpêtrière, Paris; Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain; Second Unit of Pediatrics, Istituto G. Gaslini, Genoa; INSERM U463, Institut de Biologie, Nantes, France; Department of Genetics, Hadassah University Medical Center, Jerusalem; Hôpital d’Enfants de La Timone, Marseille; Division of Clinical and Genetic Metabolics, University of Toronto, Toronto; CNRS UMR 5540, Université Bordeaux 2, Bordeaux; and Department of Pediatrics, University of Lausanne, Lausanne
| | - Valérie Cormier-Daire
- Department of Medical Genetics and INSERM U393, Hôpital Necker-Enfants Malades, and INSERM U546, Faculté de Médecine Pitié-Salpêtrière, Paris; Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain; Second Unit of Pediatrics, Istituto G. Gaslini, Genoa; INSERM U463, Institut de Biologie, Nantes, France; Department of Genetics, Hadassah University Medical Center, Jerusalem; Hôpital d’Enfants de La Timone, Marseille; Division of Clinical and Genetic Metabolics, University of Toronto, Toronto; CNRS UMR 5540, Université Bordeaux 2, Bordeaux; and Department of Pediatrics, University of Lausanne, Lausanne
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Abstract
Crisponi syndrome was described in the original paper in 17 patients form 12 families [Crisponi, 1996: Am J Med Genet 62:365-371]. It is characterised by episodes of muscle contraction in response to external stimuli and intermittent hypethermia with neonatal onset. The disease is often lethal in the first infancy. We describe a patient with the same unusual phenotype.
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Affiliation(s)
- P Accorsi
- Divisione di Neuropsichiatria Infantile, A.O. Spedali Civili di Brescia, Piazzale Spedali Civili, 25123 Brescia, Italy.
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Raas-Rothschild A, Ergaz-Schaltiel Z, Bar-Ziv J, Rein AJJT. Cardiovascular abnormalities associated with the Stuve-Wiedemann syndrome. Am J Med Genet A 2003; 121A:156-8. [PMID: 12910496 DOI: 10.1002/ajmg.a.20066] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The Stuve-Wiedemann syndrome (SWS) is a congenital bone dysplasia characterized by camptodactyly with ulnar deviation and congenital bowing of the long bones. Affected patients present with respiratory difficulties in the neonatal period or later and recurrent episodes of hyperthermia. The typical radiological findings are bowing of the long bones of the lower limbs, wide metaphyses with decreased density, and abnormal trabecular pattern. Generally, respiratory insufficiency and hyperthermia are reported to be the cause of death. We report on two sibs with SWS, who died from severe pulmonary hypertension with pulmonary artery wall abnormality. We suggest a common pathophysiological process, which could explain the cardiovascular findings that we observed immediately after birth in the two affected sibs. We hypothesize that the severe pulmonary hypertension due to the arterial wall abnormality could explain the neonatal death of these two children.
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Le Merrer M, Cormier Daire V, Maroteaux P. Re-evaluation of kyphomelic dysplasia. Am J Med Genet A 2003; 120A:289-91. [PMID: 12833417 DOI: 10.1002/ajmg.a.20035] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Di Rocco M, Dodero P. Concerning "Five additional Costello syndrome patients with rhabdomyosarcoma: proposal for a tumor screening protocol". Am J Med Genet A 2003; 118A:199. [PMID: 12698963 DOI: 10.1002/ajmg.a.10879] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Al-Gazali LI, Ravenscroft A, Feng A, Shubbar A, Al-Saggaf A, Haas D. Stüve-Wiedemann syndrome in children surviving infancy: clinical and radiological features. Clin Dysmorphol 2003; 12:1-8. [PMID: 12514358 DOI: 10.1097/00019605-200301000-00001] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We report three children from two inbred Arab families with Stüve-Wiedemann syndrome who have survived the first year of life (ages are 6 years, 2.8 years and 2 years). All exhibited a characteristic phenotype resembling that described by Chen et al.[(2001). Am J Med Genet 101:240-245]. In all three children the skeletal abnormalities progressed to severe bowing of the long bones with prominent joints and severe spinal deformity. Neurological symptoms were present in all of them. These included temperature instability with excessive sweating, reduced pain sensation with repeated injury to the tongue and limbs, absent corneal reflexes and a smooth tongue. Mentality was normal in all of them. Radiological changes included under tubulation of the diaphyses, rarefaction and striation of metaphyses, destruction of the femoral heads and spinal deformity. We confirm that survival in this syndrome is possible and that the prognosis improves after the first year of life. This should be taken into consideration when counselling parents of affected children. This report further supports the existence of a characteristic phenotype in Stüve-Wiedemann syndrome survivors which include, in addition to the skeletal abnormalities and distinctive radiological features, neurological symptoms reminiscent of dysautonomia.
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Affiliation(s)
- L I Al-Gazali
- Paediatrics Department, Faculty of Medicine and Health Sciences, UAE University, PO Box 17666, Al Ain, United Arab Emirates.
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Reed UC, Reimão R, Espíndola AÁ, Kok F, Ferreira LG, Resende MBD, Messias TC, Carvalho MS, Diament A, Scaff M, Marie SKN. Schwartz-jampel syndrome: report of five cases. ARQUIVOS DE NEURO-PSIQUIATRIA 2002. [DOI: 10.1590/s0004-282x2002000500010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We describe five patients with Schwartz-Jampel syndrome (SJS) examined at the outpatient service for neuromuscular disorders at our Institution from 1996 to 1999 with the objective of emphasizing the characteristic dysmorphic phenotype of SJS and its different clinical forms. Two cases presented SJS-type 1A, two had SJS-type 1B and one manifested SJS-type 2. Two boys with 3 and 13 years of age had generalized stiffness and the characteristic facial as well as osteoarticular changes from birth. Other two boys with 11 and 7 years had less marked dysmorphic changes at birth and manifested myotonia, as a limiting factor, during the second year of age. A girl with two months of age had severe myotonia from birth leading to feeding diffuculties. In all cases the diagnosis was based on dysmorphic features, and on electromyographic changes showing continuous electrical activity of muscle fibers. All were treated with carbamazepine, 20-30 mg/Kg since diagnosis. The four boys (all with normal intelligence) improved of myotonia in daily activities, markedly in three, and moderately in one. The girl did not improve and showed global development delay: by the last follow-up (at 20 months of age) she did not sit unsupported, and had mental retardation. Carbamazepine in SJS-type 1 improves general daily performance and psychological status of the patients.
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Schefels J, Wenzl TG, Merz U, Ramaekers V, Holzki J, Rudnik-Schoeneborn S, Hermanns B, Hörnchen H. Functional upper airway obstruction in a child with Freeman-Sheldon syndrome. ORL J Otorhinolaryngol Relat Spec 2002; 64:53-6. [PMID: 11891401 DOI: 10.1159/000049271] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Freeman-Sheldon syndrome is defined as a combination of microstomia, deep set eyes, small palpebral fissures, arthrogryposis with ulnar deviation of the hand, talipes equinovarus and generalized muscular hypertension. Respiratory and swallowing problems are frequently encountered in these patients due to small orifices of mouth and nose. Obstruction of the upper airway tract resulting in tracheostomy has only been described twice. The described child manifested the typical dysmorphic features of Freeman-Sheldon syndrome and suffered from serious respiratory distress and swallowing difficulties from birth. The boy died at the age of 7 months after accidental decannulation of the tracheostoma during sleep. He did not show anatomical or histopathological abnormalities in the pharyngeal, laryngeal or tracheal regions. We assume that the only explanation of the repeated obstructive episodes is a functional muscular obstruction.
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Affiliation(s)
- Joerg Schefels
- Neonatologische Intensivmedizin, Kinderklinik, Aachen, Deutschland
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28
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Chen E, Cotter PD, Cohen RA, Lachman RS. Characterization of a long-term survivor with Stüve-Wiedemann syndrome and mosaicism of a supernumerary marker chromosome. AMERICAN JOURNAL OF MEDICAL GENETICS 2001; 101:240-5. [PMID: 11424139 DOI: 10.1002/ajmg.1382] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Stüve-Wiedemann syndrome (SWS) is typically lethal in the neonatal period; only two patients have been reported with a longer survival. We report a new patient with SWS, who at 9 years of age is one of the longest survivors with this disorder. In addition to the characteristic features of SWS, she has a number of unique clinical signs, including lack of corneal and patellar reflexes, a smooth tongue with no fungiform papillae, chronic gingival abscesses, mottled, poor dentition, blotchy pigmentation of the skin, unusual infections, multiple fractures, and progressive scoliosis. Cytogenetic analysis identified mosaicism for a supernumerary marker chromosome (SMC), seen in the majority of amniocytes, blood, and skin fibroblasts. The SMC was shown to be derived from chromosome 5 and contains euchromatin. The significance of the SMC to the etiology of SWS is unknown. This patient further demonstrates that SWS is not universally lethal.
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Affiliation(s)
- E Chen
- Division of Medical Genetics, Children's Hospital Oakland, Oakland, California 94609, USA.
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29
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Spranger J, Hall BD, Häne B, Srivastava A, Stevenson RE. Spectrum of Schwartz-Jampel syndrome includes micromelic chondrodysplasia, kyphomelic dysplasia, and Burton disease. AMERICAN JOURNAL OF MEDICAL GENETICS 2000; 94:287-95. [PMID: 11038441 DOI: 10.1002/1096-8628(20001002)94:4<287::aid-ajmg5>3.0.co;2-g] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Follow-up and re-evaluation of four patients originally described as examples of severe infantile "micromelic chondrodysplasia" resembling Kniest disease, "kyphomelic dysplasia," and "Burton skeletal dysplasia" revealed the diagnosis of Schwartz-Jampel syndrome (SJS, myotonic chondrodysplasia) in all of them. SJS may be suspected in neonates with Kniest-like chondrodysplasia, congenital bowing of shortened femora and tibiae, and facial manifestations consisting of a small mouth, micrognathia, and possibly pursed lips. The disorder must be differentiated from the Stüve-Wiedemann syndrome, a genetically distinct myotonic chondrodysplasia with similar clinical but different skeletal changes and an unfavorable early prognosis. The demise of "kyphomelic dysplasia" as a nosological entity reemphasizes the symptomatic nature of congenital bowing of the long bones.
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Affiliation(s)
- J Spranger
- Greenwood Genetic Center, Greenwood, South Carolina 29646, USA
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