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Keeling H, Williams EJ, Itasaki N. Consideration of the thoracic phenotype of cerebro-costo-mandibular syndrome. Clin Anat 2024; 37:254-269. [PMID: 37265362 DOI: 10.1002/ca.24054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 04/01/2023] [Accepted: 04/19/2023] [Indexed: 06/03/2023]
Abstract
Cerebro-costo-mandibular syndrome (CCMS) is a congenital condition with skeletal and orofacial abnormalities that often results in respiratory distress in neonates. The three main phenotypes in the thorax are posterior rib gaps, abnormal costovertebral articulation and absent ribs. Although the condition can be lethal, accurate diagnosis, and subsequent management help improve the survival rate. Mutations in the causative gene SNRPB have been identified, however, the mechanism whereby the skeletal phenotypes affect respiratory function is not well-studied due to the multiple skeletal phenotypes, lack of anatomy-based studies into the condition and rarity of CCMS cases. This review aims to clarify the extent to which the three main skeletal phenotypes in the thorax contribute to respiratory distress in neonates with CCMS. Despite the posterior rib gaps being unique to this condition and visually striking on radiographic images, anatomical consideration, and meta-analyses suggested that they might not be the significant factor in causing respiratory distress in neonates. Rather, the increase in chest wall compliance due to the rib gaps and the decrease in compliance at the costovertebral complex was considered to result in an equilibrium, minimizing the impact of these abnormalities. The absence of floating ribs is likely insignificant as seen in the general population; however, a further absence of ribs or vestigial rib formation is associated with respiratory distress and increased lethality. Based on these, we propose to evaluate the number of absent or vestigial ribs as a priority indicator to develop a personalized treatment plan based on the phenotypes exhibited.
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Affiliation(s)
- Holly Keeling
- Faculty of Health Sciences, University of Bristol, Bristol, UK
| | | | - Nobue Itasaki
- Faculty of Health Sciences, University of Bristol, Bristol, UK
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2
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Fakhouri WD, Metwalli K, Naji A, Bakhiet S, Quispe-Salcedo A, Nitschke L, Kousa YA, Schutte BC. Intercellular Genetic Interaction Between Irf6 and Twist1 during Craniofacial Development. Sci Rep 2017; 7:7129. [PMID: 28769044 PMCID: PMC5540929 DOI: 10.1038/s41598-017-06310-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 06/08/2017] [Indexed: 01/06/2023] Open
Abstract
Interferon Regulatory Factor 6 (IRF6) and TWIST1 are transcription factors necessary for craniofacial development. Human genetic studies showed that mutations in IRF6 lead to cleft lip and palate and mandibular abnormalities. In the mouse, we found that loss of Irf6 causes craniosynostosis and mandibular hypoplasia. Similarly, mutations in TWIST1 cause craniosynostosis, mandibular hypoplasia and cleft palate. Based on this phenotypic overlap, we asked if Irf6 and Twist1 interact genetically during craniofacial formation. While single heterozygous mice are normal, double heterozygous embryos (Irf6+/−; Twist1+/−) can have severe mandibular hypoplasia that leads to agnathia and cleft palate at birth. Analysis of spatiotemporal expression showed that Irf6 and Twist1 are found in different cell types. Consistent with the intercellular interaction, we found reduced expression of Endothelin1 (EDN1) in mandible and transcription factors that are critical for mandibular patterning including DLX5, DLX6 and HAND2, were also reduced in mesenchymal cells. Treatment of mandibular explants with exogenous EDN1 peptides partially rescued abnormalities in Meckel’s cartilage. In addition, partial rescue was observed when double heterozygous embryos also carried a null allele of p53. Considering that variants in IRF6 and TWIST1 contribute to human craniofacial defects, this gene-gene interaction may have implications on craniofacial disorders.
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Affiliation(s)
- Walid D Fakhouri
- Center for Craniofacial Research, Department of Diagnostic and Biomedical Sciences, School of Dentistry, University of Texas Health Science Center at Houston, TX, 77054, USA. .,Department of Pediatrics, Medical School, University of Texas Health Science Center at Houston, TX, 77030, USA. .,Graduate School of Biomedical Sciences, University of Texas Health Science Center and MD Anderson Cancer Center at Houston, TX, 77030, USA.
| | - Kareem Metwalli
- Center for Craniofacial Research, Department of Diagnostic and Biomedical Sciences, School of Dentistry, University of Texas Health Science Center at Houston, TX, 77054, USA
| | - Ali Naji
- Center for Craniofacial Research, Department of Diagnostic and Biomedical Sciences, School of Dentistry, University of Texas Health Science Center at Houston, TX, 77054, USA
| | - Sarah Bakhiet
- Center for Craniofacial Research, Department of Diagnostic and Biomedical Sciences, School of Dentistry, University of Texas Health Science Center at Houston, TX, 77054, USA
| | - Angela Quispe-Salcedo
- Center for Craniofacial Research, Department of Diagnostic and Biomedical Sciences, School of Dentistry, University of Texas Health Science Center at Houston, TX, 77054, USA.,Department of Basic Science, School of Dentistry, National University of San Marcos (UNMSM), Lima, Peru
| | - Larissa Nitschke
- Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI, 48823, USA.,Program in Integrative Molecular and Biomedical Sciences, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Youssef A Kousa
- Department of Biochemistry and Molecular Biology, Michigan State University, East Lansing, MI, 48823, USA.,Pediatric Residency Program, Children's National Health System, Washington, DC, 20010, USA
| | - Brian C Schutte
- Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI, 48823, USA.,Department of Biochemistry and Molecular Biology, Michigan State University, East Lansing, MI, 48823, USA.,Pediatrics and Human Development, Michigan State University, East Lansing, MI, 48823, USA
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3
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Tooley M, Lynch D, Bernier F, Parboosingh J, Bhoj E, Zackai E, Calder A, Itasaki N, Wakeling E, Scott R, Lees M, Clayton-Smith J, Blyth M, Morton J, Shears D, Kini U, Homfray T, Clarke A, Barnicoat A, Wallis C, Hewitson R, Offiah A, Saunders M, Langton-Hewer S, Hilliard T, Davis P, Smithson S. Cerebro-costo-mandibular syndrome: Clinical, radiological, and genetic findings. Am J Med Genet A 2016; 170A:1115-26. [PMID: 26971886 DOI: 10.1002/ajmg.a.37587] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/25/2016] [Indexed: 11/07/2022]
Abstract
Cerebro-Costo-Mandibular syndrome (CCMS) is a rare autosomal dominant condition comprising branchial arch-derivative malformations with striking rib-gaps. Affected patients often have respiratory difficulties, associated with upper airway obstruction, reduced thoracic capacity, and scoliosis. We describe a series of 12 sporadic and 4 familial patients including 13 infants/children and 3 adults. Severe micrognathia and reduced numbers of ribs with gaps are consistent findings. Cleft palate, feeding difficulties, respiratory distress, tracheostomy requirement, and scoliosis are common. Additional malformations such as horseshoe kidney, hypospadias, and septal heart defect may occur. Microcephaly and significant developmental delay are present in a small minority of patients. Key radiological findings are of a narrow thorax, multiple posterior rib gaps and abnormal costo-transverse articulation. A novel finding in 2 patients is bilateral accessory ossicles arising from the hyoid bone. Recently, specific mutations in SNRPB, which encodes components of the major spliceosome, have been found to cause CCMS. These mutations cluster in an alternatively spliced regulatory exon and result in altered SNRPB expression. DNA was available from 14 patients and SNRPB mutations were identified in 12 (4 previously reported). Eleven had recurrent mutations previously described in patients with CCMS and one had a novel mutation in the alternative exon. These results confirm the specificity of SNRPB mutations in CCMS and provide further evidence for the role of spliceosomal proteins in craniofacial and thoracic development.
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Affiliation(s)
- Madeleine Tooley
- Department of Clinical Genetics, St. Michael's Hospital, Bristol, United Kingdom
| | - Danielle Lynch
- Department of Medical Genetics, University of Calgary, Calgary, Canada
| | - Francois Bernier
- Department of Medical Genetics, University of Calgary, Calgary, Canada
| | | | - Elizabeth Bhoj
- Department of Clinical Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Elaine Zackai
- Department of Clinical Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Alistair Calder
- Department of Radiology, Great Ormond Street Children's Hospital, London, United Kingdom
| | - Nobue Itasaki
- Centre for Comparative and Clinical Anatomy, University of Bristol, Bristol, United Kingdom
| | - Emma Wakeling
- North West Thames Regional Genetic Service, North West London Hospitals NHS Trust, London, United Kingdom
| | - Richard Scott
- Department of Clinical Genetics, Great Ormond Street Children's Hospital, London, United Kingdom
| | - Melissa Lees
- Department of Clinical Genetics, Great Ormond Street Children's Hospital, London, United Kingdom
| | - Jill Clayton-Smith
- Department of Clinical Genetics, St. Mary's Hospital, Manchester, United Kingdom
| | - Moira Blyth
- Department of Clinical Genetics, Chapel Allerton Hospital, Leeds, United Kingdom
| | - Jenny Morton
- Department of Clinical Genetics, Birmingham Women's Hospital, United Kingdom
| | - Debbie Shears
- Department of Clinical Genetics, Churchill Hospital, Oxford, United Kingdom
| | - Usha Kini
- Department of Clinical Genetics, Churchill Hospital, Oxford, United Kingdom
| | - Tessa Homfray
- Department of Clinical Genetics, St. George's Hospital, London, United Kingdom
| | - Angus Clarke
- Department of Clinical Genetics, University Hospital Wales, Cardiff, United Kingdom
| | - Angela Barnicoat
- Department of Clinical Genetics, Great Ormond Street Children's Hospital, London, United Kingdom
| | - Colin Wallis
- Department of Paediatric Respiratory Medicine, Great Ormond Street Children's Hospital, London, United Kingdom
| | - Rebecca Hewitson
- Department of Paediatric Respiratory Medicine, Great Ormond Street Children's Hospital, London, United Kingdom
| | - Amaka Offiah
- Academic Unit of Child Health, Sheffield Children's NHS Foundation Trust, Sheffield, United Kingdom
| | - Michael Saunders
- Department of Otolaryngology, St. Michael's Hospital, Bristol, United Kingdom
| | - Simon Langton-Hewer
- Department of Paediatric Respiratory Medicine, Bristol Royal Hospital for Children, London, United Kingdom
| | - Tom Hilliard
- Department of Paediatric Respiratory Medicine, Bristol Royal Hospital for Children, London, United Kingdom
| | - Peter Davis
- Department of Paediatric Intensive Care, Bristol Royal Hospital for Children, Bristol, United Kingdom
| | - Sarah Smithson
- Department of Clinical Genetics, St. Michael's Hospital, Bristol, United Kingdom
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4
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Multi-detector thoracic CT findings in cerebro-costo-mandibular syndrome: rib gaps and failure of costo-vertebral separation. Skeletal Radiol 2014; 43:263-6. [PMID: 24100706 DOI: 10.1007/s00256-013-1732-2] [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] [Received: 07/16/2013] [Revised: 08/28/2013] [Accepted: 08/30/2013] [Indexed: 02/02/2023]
Abstract
Cerebro-costo-mandibular syndrome (CCMS) describes a triad of mandibular hypoplasia, brain dysfunction and posterior rib defects ("rib gaps"). We present the CT imaging for a 2-year-old girl with CCMS that highlights the rib gap defects and shows absent transverse processes with abnormal fusion of the ribs directly to the vertebral bodies. We argue that this is likely to relate to abnormal lateral sclerotome development in embryology, with the failure of normal costo-vertebral junctions compounding impaired thoracic function. The case also highlights the use of CT for specific indications in skeletal dysplasia.
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5
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Shi W, Bain AL, Schwer B, Al-Ejeh F, Smith C, Wong L, Chai H, Miranda MS, Ho U, Kawaguchi M, Miura Y, Finnie JW, Wall M, Heierhorst J, Wicking C, Spring KJ, Alt FW, Khanna KK. Essential developmental, genomic stability, and tumour suppressor functions of the mouse orthologue of hSSB1/NABP2. PLoS Genet 2013; 9:e1003298. [PMID: 23408915 PMCID: PMC3567186 DOI: 10.1371/journal.pgen.1003298] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Accepted: 12/16/2012] [Indexed: 12/15/2022] Open
Abstract
Single-stranded DNA binding proteins (SSBs) regulate multiple DNA transactions, including replication, transcription, and repair. We recently identified SSB1 as a novel protein critical for the initiation of ATM signaling and DNA double-strand break repair by homologous recombination. Here we report that germline Ssb1(-/-) embryos die at birth from respiratory failure due to severe rib cage malformation and impaired alveolar development, coupled with additional skeletal defects. Unexpectedly, Ssb1(-/-) fibroblasts did not exhibit defects in Atm signaling or γ-H2ax focus kinetics in response to ionizing radiation (IR), and B-cell specific deletion of Ssb1 did not affect class-switch recombination in vitro. However, conditional deletion of Ssb1 in adult mice led to increased cancer susceptibility with broad tumour spectrum, impaired male fertility with testicular degeneration, and increased radiosensitivity and IR-induced chromosome breaks in vivo. Collectively, these results demonstrate essential roles of Ssb1 in embryogenesis, spermatogenesis, and genome stability in vivo.
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Affiliation(s)
- Wei Shi
- Queensland Institute of Medical Research, Herston, Australia
| | - Amanda L. Bain
- Queensland Institute of Medical Research, Herston, Australia
- School of Biomolecular and Physical Sciences, Griffith University, Nathan, Australia
| | - Bjoern Schwer
- Howard Hughes Medical Institute, Immune Disease Institute, Program in Cellular and Molecular Medicine, Children's Hospital Boston, Boston, Massachusetts, United States of America
- Department of Genetics and Pediatrics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Fares Al-Ejeh
- Queensland Institute of Medical Research, Herston, Australia
| | - Corey Smith
- Queensland Institute of Medical Research, Herston, Australia
| | - Lee Wong
- Department of Biochemistry and Molecular Biology, School of Biomedical Sciences, Monash University, Melbourne, Australia
| | - Hua Chai
- Howard Hughes Medical Institute, Immune Disease Institute, Program in Cellular and Molecular Medicine, Children's Hospital Boston, Boston, Massachusetts, United States of America
- Department of Genetics and Pediatrics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Mariska S. Miranda
- Queensland Institute of Medical Research, Herston, Australia
- School of Medicine, University of Queensland, Herston, Australia
| | - Uda Ho
- Queensland Institute of Medical Research, Herston, Australia
| | - Makoto Kawaguchi
- Department of Bioregulation and Molecular Neurobiology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | - Yutaka Miura
- Department of Bioregulation and Molecular Neurobiology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | - John W. Finnie
- SA Pathology, Institute of Medical and Veterinary Science, Adelaide, Australia
| | - Meaghan Wall
- Victorian Cancer Cytogenetics Service, St. Vincent's Hospital, Fitzroy, Melbourne, Australia
- Department of Medicine, St. Vincent's Hospital, Fitzroy, Australia
| | - Jörg Heierhorst
- Department of Medicine, St. Vincent's Hospital, Fitzroy, Australia
- St. Vincent's Institute, Fitzroy, Australia
| | - Carol Wicking
- Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Australia
| | - Kevin J. Spring
- Queensland Institute of Medical Research, Herston, Australia
- School of Biomolecular and Physical Sciences, Griffith University, Nathan, Australia
- School of Medicine, University of Queensland, Herston, Australia
| | - Frederick W. Alt
- Howard Hughes Medical Institute, Immune Disease Institute, Program in Cellular and Molecular Medicine, Children's Hospital Boston, Boston, Massachusetts, United States of America
- Department of Genetics and Pediatrics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Kum Kum Khanna
- Queensland Institute of Medical Research, Herston, Australia
- School of Biomolecular and Physical Sciences, Griffith University, Nathan, Australia
- School of Medicine, University of Queensland, Herston, Australia
- * E-mail:
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6
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Lale S, Ardinger H, Mardis N, Changho S, Lancaster T, Singh V. Total absence of ribs in a newborn with cerebrocostomandibular syndrome. Pediatr Dev Pathol 2011; 14:134-7. [PMID: 20658933 DOI: 10.2350/09-11-0745-cr.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Total absence of ribs is a rare finding that has occasionally been documented in patients with cerebrocostomandibular syndrome. Only 2 other reports document complete absence of ribs in 3 individuals, and we tabulate the findings of all the 4 cases of complete absence of ribs in this case report. Our case and the other 3 reported cases represent the extreme form of cerebrocostomandibular syndrome with regard to the costal defects.
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Affiliation(s)
- Seema Lale
- Department of Pathology, Truman Medical Center, Kansas City, MO 64108, USA
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7
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Exclusion of MYF5, GSC, RUNX2, and TCOF1 mutation in a case of cerebro-costo-mandibular syndrome. Clin Dysmorphol 2010; 19:51-55. [PMID: 20177378 DOI: 10.1097/mcd.0b013e328335c133] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Cerebro-costo-mandibular syndrome (CCMS) is an uncommon multiple congenital anomaly syndrome characterized by severe micrognathia, posterior rib-gap defects, and developmental delay. The cause of CCMS is unknown. Genes hypothesized to have a causal role in CCMS, include myogenic factor 5 (MYF5), goosecoid homeobox (GSC) and runt-related transcription factor 2 (RUNX2) [formerly known as core-binding factor (CBFA1)]. We report an infant with typical features of CCMS who, on prenatal ultrasound, was found to have severe micrognathia. We present the first image by three-dimensional computed tomography of posterior rib-defect, and we exclude mutations of the MYF5, GSC, RUNX2, and TCOF1 genes in our patient. Further molecular studies are needed to evaluate the cause of CCMS.
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8
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Recurrence of a severe multiple congenital anomaly syndrome characterized by micrognathia, microtia, cleft palate, and short neck in two siblings. Clin Dysmorphol 2008; 18:45-48. [PMID: 19050404 DOI: 10.1097/mcd.0b013e328317c867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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9
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Zeevaert R, Foulquier F, Dimitrov B, Reynders E, Van Damme-Lombaerts R, Simeonov E, Annaert W, Matthijs G, Jaeken J. Cerebrocostomandibular-like syndrome and a mutation in the conserved oligomeric Golgi complex, subunit 1. Hum Mol Genet 2008; 18:517-24. [PMID: 19008299 DOI: 10.1093/hmg/ddn379] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We describe two patients with a cerebrocostomandibular-like syndrome and a novel mutation in conserved oligomeric Golgi (COG) subunit 1, one of the subunits of the conserved oligomeric Golgi complex. This hetero-octameric protein complex is involved in retrograde vesicular trafficking and glycosylation. We identified in both patients an intronic mutation, c.1070+5G>A, that disrupts a splice donor site and leads to skipping of exon 6, a frameshift and a premature stopcodon in exon 7. Real-time reverse transcriptase polymerase chain reaction showed in the first patient only 3% of normal transcript when compared with control. A delay in retrograde trafficking could be demonstrated by Brefeldin A treatment of this patient's fibroblasts. The costovertebral dysplasia of the two patients has been described in cerebrocostomandibular syndrome (CCMS), but also in cerebrofaciothoracic dysplasia and spondylocostal dysostosis. CCMS itself is heterogeneous because both autosomal dominant and autosomal recessive inheritance has been described. We anticipate further genetic heterogeneity because no mutations in COG1 were found in two additional patients with a CCMS.
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Affiliation(s)
- Renate Zeevaert
- Department of Pediatrics, University Hospitals Leuven, Herestraat 49, BE-3000 Leuven, Belgium
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10
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James PA, Aftimos S. Familial cerebro-costo-mandibular syndrome: a case with unusual prenatal findings and review. Clin Dysmorphol 2003; 12:63-8. [PMID: 12514369 DOI: 10.1097/00019605-200301000-00012] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cerebro-costo-mandibular syndrome is characterized by the Pierre-Robin anomaly, multiple rib defects and the occasional occurrence of intellectual impairment. Over 60 cases have been reported, nearly half of which are familial. We report an infant and her father with typical features of CCMS. The child was diagnosed on prenatal ultrasound and was found to have the previously unreported prenatal finding of an omphalocoele. Twenty-eight cases of familial CCMS are reviewed. Families suggestive of autosomal recessive and autosomal dominant inheritance are not distinguishable on the basis of clinical manifestations.
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Affiliation(s)
- Paul A James
- Northern Regional Genetic Service, Auckland Hospital, Auckland, New Zealand
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Kajantie E, Ammälä P, Salonen R. A fetus suggesting an extension of theXK-aprosencephaly spectrum phenotype. Clin Dysmorphol 2002; 11:299-301. [PMID: 12402000 DOI: 10.1097/00019605-200210000-00015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report a fetus with atelencephaly, bilateral radial aplasia/hypoplasia, ventriculoseptal defect and megacolon, this combination of anomalies being consistent with the diagnosis of XK-aprosencephaly syndrome. The facial dysmorphology of this fetus differs from that previously reported and together with reports on overlapping phenotypes suggests an extension of the XK-aprosencephaly spectrum.
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12
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Thauvin-Robinet C, Rousseau T, Laurent N, Durand C, Maingueneau C, Cormier-Daire V, Sagot P, Faivre L, Nivelon-Chevallier A. Hypomandibular faciocranial dysostosis in consanguineous parents revealed by ultrasound prenatal diagnosis. Prenat Diagn 2002; 22:710-4. [PMID: 12210581 DOI: 10.1002/pd.385] [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: 11/10/2022]
Abstract
We report here the fourth case of hypomandibular faciocranial dysostosis (HFD). The diagnosis was made at birth on the association of severe retrognathia, microstomia, severe hypoglossia with glossoptosis, persistent buccopharyngeal membrane, median cleft palate, bifid uvula, down-slanting palpebral fissures, short nose with anteverted nares, laryngeal hypoplasia, and low-set ears. A severe microstomia and micrognathia were detected by ultrasound at 31 weeks of gestation. Interestingly, even though the present case exhibits many facial dysmorphic features characteristic of HFD, craniosynostosis was absent. This report suggests that craniosynostosis is not mandatory for the diagnosis of this condition. Furthermore, we present a new argument for an autosomal recessive mode of inheritance for HFD.
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Morin G, Gekas J, Naepels P, Gondry J, Devauchelle B, Testelin S, Sevestre H, Thépôt F, Mathieu M. Cerebro-costo-mandibular syndrome in a father and a female fetus: early prenatal ultrasonographic diagnosis and autosomal dominant transmission. Prenat Diagn 2001; 21:890-3. [PMID: 11746136 DOI: 10.1002/pd.175] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Ultrasonography in a female fetus revealed cystic cervical hygroma, severe micrognathia, and vertebral and upper limb anomalies suggestive of cerebro-costo-mandibular syndrome (CCMS) which was diagnosed ultrasonographically at 16 weeks' gestation. The father is affected and presents with a Pierre Robin sequence, short stature and typical costovertebral anomalies. CCMS is a rare and severe disorder. The high frequency of sporadic cases, vertical transmission, and the excess of sibs affected via horizontal transmission suggest dominant autosomal mutation with possible germinal mosaicism. The vertical familial case detailed in the present report is a reminder of the high risk when one parent or one sibling is affected and the extreme variability of phenotype and costal ossification. Early prenatal ultrasound diagnosis is possible in a severely affected fetus.
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Affiliation(s)
- G Morin
- Centre de Diagnostic Prénatal, CHU-80054 Amiens Cedex, France
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