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Soğukpınar M, Demir GÜ, Utine GE, Gönç EN, Özön ZA, Şimşek-Kiper PÖ. Review of patients with achondroplasia: a single-center's experience with follow-up and associated morbidities. Eur J Pediatr 2024; 183:3819-3829. [PMID: 38879704 PMCID: PMC11322371 DOI: 10.1007/s00431-024-05643-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/30/2024] [Accepted: 06/03/2024] [Indexed: 07/19/2024]
Abstract
Achondroplasia (ACH; MIM #100,800), caused by a heterozygous gain of function pathogenic variant in the fibroblast growth factor receptor 3 gene (FGFR3; MIM*134,934), is the most prevalent and most readily identifiable cause of disproportionate short stature that is compatible with life. In addition, individuals with achondroplasia face significant medical, functional, and psychosocial challenges throughout their lives. This study assessed associated morbidities in patients with achondroplasia at a single center in Turkey. In this study, the clinical findings and associated morbidities of a group of patients with achondroplasia (n = 68) with clinical multidisciplinary follow-up at a single center between the years 2005-2023 are evaluated retrospectively. A total of 68 patients, 30 male (44.1%) and 38 female (55.9%), were evaluated. In the majority (84.2%) of patients, shortness of extremities was detected in the prenatal period at an average of 28.7 gestational weeks (± 3.6 SDS) with the aid of ultrasonography. More than half (n = 34/63, 54%) of the patients had a father of advanced paternal age (≥ 35 years). Among the complications, respiratory system manifestations, including obstructive sleep apnea (70%), ear-nose-throat manifestations including adenoid hypertrophy (56.6%) and otitis media (54.7%), neurological manifestations due to foramen magnum stenosis (53.2%), and skeletal manifestations including scoliosis (28.8%), are represented among the most common. The mortality rate was 7.3% (n = 5/68).Conclusion: This study not only represents the first retrospective analysis of the associated morbidities of patients with achondroplasia from a single center in Turkey but also will provide a reference point for future studies.
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Affiliation(s)
- Merve Soğukpınar
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
| | - Gizem Ürel Demir
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Gülen Eda Utine
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Elmas Nazlı Gönç
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Zeynep Alev Özön
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Pelin Özlem Şimşek-Kiper
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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2
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Tofts LJ, Armstrong JA, Broley S, Carroll T, Ireland PJ, Koo M, Langdon K, McGregor L, McKenzie F, Mehta D, Savarirayan R, Tate T, Wesley A, Zankl A, Jenner M, Eyles M, Pacey V. Australian guidelines for the management of children with achondroplasia. J Paediatr Child Health 2023; 59:229-241. [PMID: 36628540 PMCID: PMC10107108 DOI: 10.1111/jpc.16290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/14/2022] [Accepted: 10/23/2022] [Indexed: 01/12/2023]
Abstract
Achondroplasia is the most common form of skeletal dysplasia. In addition to altered growth, children and young people with achondroplasia may experience medical complications, develop and function differently to others and require psychosocial support. International, European and American consensus guidelines have been developed for the management of achondroplasia. The Australian focused guidelines presented here are designed to complement those existing guidelines. They aim to provide core care recommendations for families and clinicians, consolidate key resources for the management of children with achondroplasia, facilitate communication between specialist, local teams and families and support delivery of high-quality care regardless of setting and geographical location. The guidelines include a series of consensus statements, developed using a modified Delphi process. These statements are supported by the best available evidence assessed using the National Health and Medicine Research Council's criteria for Level of Evidence and their Grading of Recommendations Assessment, Development and Evaluation (GRADE). Additionally, age specific guides are presented that focus on the key domains of growth, medical, development, psychosocial and community. The guidelines are intended for use by health professionals and children and young people with achondroplasia and their families living in Australia.
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Affiliation(s)
- Louise J Tofts
- Department of Health Sciences, Macquarie University, Sydney, New South Wales, Australia.,Kids Rehab, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Jennifer A Armstrong
- Department of Health Sciences, Macquarie University, Sydney, New South Wales, Australia.,Department of Orthopaedics, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Stephanie Broley
- Genetic Services of Western Australia, King Edward Memorial Hospital, Perth, Western Australia, Australia.,Undiagnosed Diseases Program, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Theresa Carroll
- Queensland Paediatric Rehabilitation Service, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Penelope J Ireland
- Queensland Paediatric Rehabilitation Service, Queensland Children's Hospital, Brisbane, Queensland, Australia.,School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Minna Koo
- Kids Rehab, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Katherine Langdon
- Kids Rehab WA, Perth Children's Hospital, Perth, Western Australia, Australia.,Telethon Kids Institute, Perth, Western Australia, Australia
| | - Lesley McGregor
- Paediatric and Reproductive Genetics Unit, Women's and Children's Hospital, Adelaide, Australia
| | - Fiona McKenzie
- Genetic Services of Western Australia, King Edward Memorial Hospital, Perth, Western Australia, Australia.,School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia
| | - Divyesh Mehta
- Curtin University, Perth, Western Australia, Australia.,Child and Adolescent Health Services, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Ravi Savarirayan
- Skeletal Therapies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,University of Melbourne, Melbourne, Victoria, Australia
| | - Tracy Tate
- Kids Rehab, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Alison Wesley
- Kids Rehab, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Andreas Zankl
- The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia.,Department of Clinical Genetics, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Maree Jenner
- Medical Advisory Board, Short Statured People of Australia, Melbourne, Victoria, Australia
| | - Marta Eyles
- Medical Advisory Board, Short Statured People of Australia, Melbourne, Victoria, Australia
| | - Verity Pacey
- Department of Health Sciences, Macquarie University, Sydney, New South Wales, Australia.,The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
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3
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What to Expect of Feeding Abilities and Nutritional Aspects in Achondroplasia Patients: A Narrative Review. Genes (Basel) 2023; 14:genes14010199. [PMID: 36672940 PMCID: PMC9858955 DOI: 10.3390/genes14010199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/05/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
Achondroplasia is an autosomal dominant genetic disease representing the most common form of human skeletal dysplasia: almost all individuals with achondroplasia have identifiable mutations in the fibroblast growth factor receptor type 3 (FGFR3) gene. The cardinal features of this condition and its inheritance have been well-established, but the occurrence of feeding and nutritional complications has received little prominence. In infancy, the presence of floppiness and neurological injury due to foramen magnum stenosis may impair the feeding function of a newborn with achondroplasia. Along with growth, the optimal development of feeding skills may be affected by variable interactions between midface hypoplasia, sleep apnea disturbance, and structural anomalies. Anterior open bite, prognathic mandible, retrognathic maxilla, and relative macroglossia may adversely impact masticatory and respiratory functions. Independence during mealtimes in achondroplasia is usually achieved later than peers. Early supervision of nutritional intake should proceed into adolescence and adulthood because of the increased risk of obesity and respiratory problems and their resulting sequelae. Due to the multisystem involvement, oral motor dysfunction, nutrition, and gastrointestinal issues require special attention and personalized management to facilitate optimal outcomes, especially because of the novel therapeutic options in achondroplasia, which could alter the progression of this rare disease.
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4
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Shediac R, Moshkovich O, Gerould H, Ballinger R, Williams A, Bellenger MA, Quinn J, Hoover‐Fong J, Mohnike K, Savarirayan R, Kelly D. Experiences of children and adolescents living with achondroplasia and their caregivers. Mol Genet Genomic Med 2022; 10:e1891. [PMID: 35138050 PMCID: PMC9000943 DOI: 10.1002/mgg3.1891] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 12/23/2021] [Accepted: 01/13/2022] [Indexed: 12/13/2022] Open
Abstract
Background Achondroplasia, caused by a pathogenic variant in the fibroblast growth factor receptor 3 gene (FGFR3), leads to significant multisystem complications across the lifespan that may affect the health‐related quality of life (HRQoL) of individuals and families living with the condition. Methods The objective of this qualitative study was to describe the HRQoL of children and adolescents with achondroplasia and their caregivers. Thirty‐four caregivers and 12 adolescents from the United States and Spain participated in one of eight focus groups or completed an individual interview, which was audio‐recorded and transcribed. Thematic analysis of qualitative data was performed to identify commonly occurring themes pertaining to HRQoL. Results Caregivers and adolescents described challenges with physical functioning and medical complications due to achondroplasia. Key challenges included difficulties performing activities of daily living, issues of accessibility, bullying, or unwanted attention in public, and negative effects on self‐esteem. Caregivers were concerned about accessing appropriate medical care for their child, and also reported experiencing financial, relational, and emotional challenges in their families. Achondroplasia also affected individuals and their families in positive ways, including increasing empathy, receiving positive attention, and feeling supported by the achondroplasia community. Conclusions These findings underscore the importance of regular assessments of HRQoL and the provision of psychosocial support to affected children and families.
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Affiliation(s)
| | | | | | | | | | | | | | - Julie Hoover‐Fong
- McKusick‐Nathans Department of Genetic MedicineJohns Hopkins UniversityBaltimoreMarylandUSA
| | | | - Ravi Savarirayan
- Murdoch Children's Research InstituteRoyal Children's Hospital, and University of MelbourneParkvilleVictoriaAustralia
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5
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Ahmadi M, Herting A, Mueffelmann B, Woermann FG, Abou Jamra R, Bien CG, Polster T, Brandt C. Hypochondroplasia and temporal lobe epilepsy - A series of 4 cases. Epilepsy Behav 2022; 126:108479. [PMID: 34922328 DOI: 10.1016/j.yebeh.2021.108479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/26/2021] [Accepted: 11/27/2021] [Indexed: 11/03/2022]
Abstract
Hypochondroplasia is a skeletal dysplasia syndrome with an autosomal dominant inheritance. It may be associated with temporal lobe epilepsy. We present a series of four patients (two female, two male) with hypochondroplasia who presented at our center with drug refractory epilepsy. Clinical details and EEG and MRI findings led to a diagnosis of temporal lobe epilepsy in all four cases. The MRI findings indicate the epilepsy in hypochondroplasia may be associated with bilateral temporal lobe dysgenesis.
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Affiliation(s)
- Mehdi Ahmadi
- Dept. of Epileptology (Krankenhaus Mara), Bielefeld University, Medical School, Campus Bielefeld-Bethel, Maraweg 21, 33617 Bielefeld, Germany.
| | - Arne Herting
- Dept. of Epileptology (Krankenhaus Mara), Bielefeld University, Medical School, Campus Bielefeld-Bethel, Maraweg 21, 33617 Bielefeld, Germany.
| | - Birgitt Mueffelmann
- Dept. of Epileptology (Krankenhaus Mara), Bielefeld University, Medical School, Campus Bielefeld-Bethel, Maraweg 21, 33617 Bielefeld, Germany.
| | | | - Rami Abou Jamra
- Institute of Human Genetics, University Medical Center Leipzig, Leipzig, Germany.
| | - Christian G Bien
- Dept. of Epileptology (Krankenhaus Mara), Bielefeld University, Medical School, Campus Bielefeld-Bethel, Maraweg 21, 33617 Bielefeld, Germany.
| | - Tilman Polster
- Dept. of Epileptology (Krankenhaus Mara), Bielefeld University, Medical School, Campus Bielefeld-Bethel, Maraweg 21, 33617 Bielefeld, Germany.
| | - Christian Brandt
- Dept. of Epileptology (Krankenhaus Mara), Bielefeld University, Medical School, Campus Bielefeld-Bethel, Maraweg 21, 33617 Bielefeld, Germany.
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6
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Constantinides C, Landis SH, Jarrett J, Quinn J, Ireland PJ. Quality of life, physical functioning, and psychosocial function among patients with achondroplasia : a targeted literature review. Disabil Rehabil 2021; 44:6166-6178. [PMID: 34403286 DOI: 10.1080/09638288.2021.1963853] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE Achondroplasia (ACH) is the most common form of skeletal dysplasia, resulting in disproportionate short stature and medical complications. We review the literature on physical functioning, psychosocial function, and quality of life (QoL) in ACH individuals compared to average stature individuals or other short stature conditions. Studies that assess the association between these outcomes and height, limb length/lengthening surgery in ACH patients are also summarized. MATERIALS AND METHODS PubMed/MEDLINE and Embase were searched through April 2021. Study inclusion criteria were: (1) quantitative design; (2) study population consisting solely/mainly of ACH patients; (3) reports of physical functioning, psychosocial functioning, and/or QoL. Included studies were summarized separately for pediatric and adult populations. RESULTS Of 1664 records identified, 23 primary studies (sample size 8-437 participants) were included. Multiple tools were used across studies, including the generic PedsQL and SF-36 and height-specific QoLISSY. CONCLUSIONS The literature demonstrates that ACH patients experience limitations in physical functioning and poorer QoL outcomes compared to average stature people across the life span. This appeared to be at least in part due to disproportionate short stature. Future research to better characterize QoL in ACH patients will assist clinicians to better evaluate the effectiveness of management programs including novel interventions.IMPLICATIONS FOR REHABILITATIONPatients with achondroplasia experience limitations in physical functioning and poorer quality of life throughout their life course when compared to average statured individuals.Psychosocial issues are also heightened in adults with achondroplasia compared to average statured peers but are observed less frequently in children and adolescents with achondroplasia.The overall impact that limb lengthening has on physical functioning and QoL remains unclear, although there is some evidence that greater height or upper limb length may lead to an improvement in these parameters.Rehabilitation professionals should regularly assess physical functioning, psychosocial wellbeing, and quality of life in individuals with achondroplasia using condition-specific tools.
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Affiliation(s)
| | | | | | | | - Penelope J Ireland
- Children's Health Queensland Hospital & Health Service, Brisbane, Australia
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7
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Hoover-Fong J, Cheung MS, Fano V, Hagenas L, Hecht JT, Ireland P, Irving M, Mohnike K, Offiah AC, Okenfuss E, Ozono K, Raggio C, Tofts L, Kelly D, Shediac R, Pan W, Savarirayan R. Lifetime impact of achondroplasia: Current evidence and perspectives on the natural history. Bone 2021; 146:115872. [PMID: 33545406 DOI: 10.1016/j.bone.2021.115872] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 01/24/2021] [Accepted: 01/30/2021] [Indexed: 11/18/2022]
Abstract
Achondroplasia, the most common form of disproportionate short stature, is caused by a variant in the fibroblast growth factor receptor 3 (FGFR3) gene. Advances in drug treatment for achondroplasia have underscored the need to better understand the natural history of this condition. This article provides a critical review and discussion of the natural history of achondroplasia based on current literature evidence and the perspectives of clinicians with extensive knowledge and practical experience in managing individuals with this diagnosis. This review draws evidence from recent and ongoing longitudinal natural history studies, supplemented with relevant cross-sectional studies where longitudinal research is lacking, to summarize the current knowledge on the nature, incidence, chronology, and interrelationships of achondroplasia-related comorbidities across the lifespan. When possible, data related to adults are presented separately from data specific to children and adolescents. Gaps in knowledge regarding clinical care are identified and areas for future research are recommended and discussed.
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Affiliation(s)
- Julie Hoover-Fong
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University, Baltimore, MD, USA.
| | - Moira S Cheung
- Guy's and St. Thomas' NHS Foundation Trust, Evelina Children's Hospital, London, UK
| | - Virginia Fano
- Department of Growth and Development, Hospital Garrahan, Buenos Aires, Argentina
| | - Lars Hagenas
- Karolinska Institute, Division of Pediatric Endocrinology, Department of Women's and Children's Health, Stockholm, Sweden
| | - Jacqueline T Hecht
- University of Texas, Houston, McGovern Medical School, Department of Pediatrics, Houston, TX, USA
| | - Penny Ireland
- Queensland Paediatric Rehabilitation Service, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Melita Irving
- Guy's and St. Thomas' NHS Foundation Trust, Evelina Children's Hospital, London, UK
| | - Klaus Mohnike
- Otto-von-Guericke-University Magdeburg, Department of Pediatrics, Magdeburg, Germany
| | - Amaka C Offiah
- Department of Oncology & Metabolism, University of Sheffield, Sheffield, UK
| | - Ericka Okenfuss
- Kaiser Permanente - Sacramento Medical Center, Department of Genetics, Sacramento, CA, USA
| | - Keiichi Ozono
- Osaka University Graduate School of Medicine, Department of Pediatrics, Osaka, Japan
| | - Cathleen Raggio
- Hospital for Special Surgery, Pediatric Orthopedic Surgery Service, New York, NY, USA
| | - Louise Tofts
- Kids Rehab, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Dominique Kelly
- BioMarin Pharmaceutical Inc., Global Medical Affairs, Novato, CA, USA
| | - Renée Shediac
- BioMarin Pharmaceutical Inc., Global Medical Affairs, Novato, CA, USA
| | - Wayne Pan
- BioMarin Pharmaceutical Inc., Global Medical Affairs, Novato, CA, USA
| | - Ravi Savarirayan
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia
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8
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Coi A, Santoro M, Garne E, Pierini A, Addor MC, Alessandri JL, Bergman JEH, Bianchi F, Boban L, Braz P, Cavero-Carbonell C, Gatt M, Haeusler M, Klungsøyr K, Kurinczuk JJ, Lanzoni M, Lelong N, Luyt K, Mokoroa O, Mullaney C, Nelen V, Neville AJ, O'Mahony MT, Perthus I, Rankin J, Rissmann A, Rouget F, Schaub B, Tucker D, Wellesley D, Wisniewska K, Zymak-Zakutnia N, Barišić I. Epidemiology of achondroplasia: A population-based study in Europe. Am J Med Genet A 2019; 179:1791-1798. [PMID: 31294928 DOI: 10.1002/ajmg.a.61289] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 06/20/2019] [Accepted: 06/23/2019] [Indexed: 01/06/2023]
Abstract
Achondroplasia is a rare genetic disorder resulting in short-limb skeletal dysplasia. We present the largest European population-based epidemiological study to date using data provided by the European Surveillance of Congenital Anomalies (EUROCAT) network. All cases of achondroplasia notified to 28 EUROCAT registries (1991-2015) were included in the study. Prevalence, birth outcomes, prenatal diagnosis, associated anomalies, and the impact of paternal and maternal age on de novo achondroplasia were presented. The study population consisted of 434 achondroplasia cases with a prevalence of 3.72 per 100,000 births (95%CIs: 3.14-4.39). There were 350 live births, 82 terminations of pregnancy after prenatal diagnosis, and two fetal deaths. The prenatal detection rate was significantly higher in recent years (71% in 2011-2015 vs. 36% in 1991-1995). Major associated congenital anomalies were present in 10% of cases. About 20% of cases were familial. After adjusting for maternal age, fathers >34 years had a significantly higher risk of having infants with de novo achondroplasia than younger fathers. Prevalence was stable over time, but regional differences were observed. All pregnancy outcomes were included in the prevalence estimate with 80.6% being live born. The study confirmed the increased risk for older fathers of having infants with de novo achondroplasia.
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Affiliation(s)
- Alessio Coi
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Michele Santoro
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Ester Garne
- Paediatric Department, Hospital Lillebaelt, Kolding, Denmark
| | - Anna Pierini
- Institute of Clinical Physiology, National Research Council, Pisa, Italy.,Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Marie-Claude Addor
- Department of Woman-Mother-Child, University Medical Center CHUV, Lausanne, Switzerland
| | - Jean-Luc Alessandri
- Pole Femme-Mère-Enfants, CHR Felix Guyon, CHU La Réunion, Saint-Denis, La Réunion, France
| | - Jorieke E H Bergman
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Fabrizio Bianchi
- Institute of Clinical Physiology, National Research Council, Pisa, Italy.,Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Ljubica Boban
- Children's Hospital Zagreb, Centre of Excellence for Reproductive and Regenerative Medicine, Medical School University of Zagreb, Zagreb, Croatia
| | - Paula Braz
- Epidemiology Department, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Miriam Gatt
- Malta Congenital Anomalies Register, Directorate for Health Information and Research, Guardamangia, Malta
| | | | - Kari Klungsøyr
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
| | - Jennifer J Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Monica Lanzoni
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Nathalie Lelong
- Paris Registry of Congenital Malformations, Inserm UMR 1153-Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Paris, France
| | - Karen Luyt
- South West Congenital Anomaly Register (SWCAR), Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Olatz Mokoroa
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, Donostia-San Sebastian, Spain
| | - Carmel Mullaney
- HSE South East Area, Department of Public Health, Kilkenny, Ireland
| | - Vera Nelen
- Provinciaal Instituut voor Hygiene (PIH), Antwerp, Belgium
| | - Amanda J Neville
- IMER Registry (Emilia Romagna Registry of Birth Defects), Center for Clinical and Epidemiological Research, University of Ferrara Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
| | - Mary T O'Mahony
- HSE South (Cork & Kerry), Department of Public Health, Cork, Ireland
| | - Isabelle Perthus
- Auvergne Registry of Congenital Anomalies (CEMC-Auvergne), Department of Clinical Genetics, Centre de Référence des Maladies Rares, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Judith Rankin
- Institute of Health & Society, Newcastle University/National Congenital Anomaly and Rare Disease Registration Service (NCARDRS), Public Health England, Newcastle upon Tyne, United Kingdom
| | - Anke Rissmann
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University, Magdeburg, Germany
| | - Florence Rouget
- Brittany Registry of Congenital Malformations, CHU Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, Rennes, France
| | - Bruno Schaub
- French West Indies Registry, Registre des Malformations des Antilles (REMALAN), Maison de la Femme de la Mère et de l'Enfant, University Hospital of Martinique, Fort-de-France, France
| | - David Tucker
- Congenital Anomaly Register & Information Service for Wales (CARIS), Public Health Wales, Swansea, United Kingdom
| | - Diana Wellesley
- Wessex Clinical Genetics Service, University Hospitals Southampton, Southampton, United Kingdom
| | - Katarzyna Wisniewska
- Department of Preventive Medicine, Epidemiology Unit, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Ingeborg Barišić
- Children's Hospital Zagreb, Centre of Excellence for Reproductive and Regenerative Medicine, Medical School University of Zagreb, Zagreb, Croatia
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9
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Abstract
Achondroplasia is the most common of the skeletal dysplasias that result in marked short stature (dwarfism). Although its clinical and radiologic phenotype has been described for more than 50 years, there is still a great deal to be learned about the medical issues that arise secondary to this diagnosis, the manner in which these are best diagnosed and addressed, and whether preventive strategies can ameliorate the problems that can compromise the health and well being of affected individuals. This review provides both an updated discussion of the care needs of those with achondroplasia and an exploration of the limits of evidence that is available regarding care recommendations, controversies that are currently present, and the many areas of ignorance that remain.
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Affiliation(s)
- Richard M Pauli
- Midwest Regional Bone Dysplasia Clinic, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, 1500 Highland Ave., Madison, WI, 53705, USA.
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10
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Shazeeb MS, Cox MK, Gupta A, Tang W, Singh K, Pryce CT, Fogle R, Mu Y, Weber WD, Bangari DS, Ying X, Sabbagh Y. Skeletal Characterization of the Fgfr3 Mouse Model of Achondroplasia Using Micro-CT and MRI Volumetric Imaging. Sci Rep 2018; 8:469. [PMID: 29323153 PMCID: PMC5765052 DOI: 10.1038/s41598-017-18801-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 12/18/2017] [Indexed: 01/16/2023] Open
Abstract
Achondroplasia, the most common form of dwarfism, affects more than a quarter million people worldwide and remains an unmet medical need. Achondroplasia is caused by mutations in the fibroblast growth factor receptor 3 (FGFR3) gene which results in over-activation of the receptor, interfering with normal skeletal development leading to disproportional short stature. Multiple mouse models have been generated to study achondroplasia. The characterization of these preclinical models has been primarily done with 2D measurements. In this study, we explored the transgenic model expressing mouse Fgfr3 containing the achondroplasia mutation G380R under the Col2 promoter (Ach). Survival and growth rate of the Ach mice were reduced compared to wild-type (WT) littermates. Axial skeletal defects and abnormalities of the sternebrae and vertebrae were observed in the Ach mice. Further evaluation of the Ach mouse model was performed by developing 3D parameters from micro-computed tomography (micro-CT) and magnetic resonance imaging (MRI). The 3-week-old mice showed greater differences between the Ach and WT groups compared to the 6-week-old mice for all parameters. Deeper understanding of skeletal abnormalities of this model will help guide future studies for evaluating novel and effective therapeutic approaches for the treatment of achondroplasia.
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Affiliation(s)
- Mohammed Salman Shazeeb
- Global Bioimaging Department, Translational In-vivo Models, Sanofi R&D Global Research Platform, 49 New York Avenue, Framingham, MA, 01701, United States
| | - Megan K Cox
- Rare Diseases, Sanofi, 49 New York Avenue, Framingham, MA, 01701, USA
| | - Anurag Gupta
- Global Bioimaging Department, Translational In-vivo Models, Sanofi R&D Global Research Platform, 49 New York Avenue, Framingham, MA, 01701, United States
| | - Wen Tang
- Rare Diseases, Sanofi, 49 New York Avenue, Framingham, MA, 01701, USA
| | - Kuldeep Singh
- Global Discovery Pathology, Translational In-vivo Models, Sanofi R&D Global Research Platform, 5 The Mountain Road, Framingham, MA, 01701, USA
| | - Cynthia T Pryce
- Translational Sciences, Sanofi R&D Global Research Platform, 49 New York avenue, Framingham, MA, 01701, United States
| | - Robert Fogle
- Global Bioimaging Department, Translational In-vivo Models, Sanofi R&D Global Research Platform, 49 New York Avenue, Framingham, MA, 01701, United States
| | - Ying Mu
- Global Bioimaging Department, Translational In-vivo Models, Sanofi R&D Global Research Platform, 49 New York Avenue, Framingham, MA, 01701, United States
| | - William D Weber
- Translational Sciences, Sanofi R&D Global Research Platform, 49 New York avenue, Framingham, MA, 01701, United States
| | - Dinesh S Bangari
- Global Discovery Pathology, Translational In-vivo Models, Sanofi R&D Global Research Platform, 5 The Mountain Road, Framingham, MA, 01701, USA
| | - Xiaoyou Ying
- Global Bioimaging Department, Translational In-vivo Models, Sanofi R&D Global Research Platform, 49 New York Avenue, Framingham, MA, 01701, United States.
| | - Yves Sabbagh
- Rare Diseases, Sanofi, 49 New York Avenue, Framingham, MA, 01701, USA.
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