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Cazzolla AP, Testa NF, Spirito F, Di Cosola M, Campobasso A, Crincoli V, Ballini A, Cantore S, Ciavarella D, Lo Muzio L, Dioguardi M. Axenfeld-Rieger syndrome: orthopedic and orthodontic management in a pediatric patient: a case report. Head Face Med 2022; 18:25. [PMID: 35804381 PMCID: PMC9264492 DOI: 10.1186/s13005-022-00329-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 06/30/2022] [Indexed: 11/30/2022] Open
Abstract
Axenfeld–Rieger Syndrome (ARS) is a rare autosomal dominant genetic disease with considerable expressive variability, characterized by ocular and non-ocular manifestations, cardiovascular, mild craniofacial abnormalities and dental malformations. Current data report an incidence of Xenfeld-Rieger syndrome in the population of 1: 200,000. The case described is that of a 14-year-old female patient whose ARS is suspected and investigated following a dental specialist visit for orthodontic reasons, acquired the patient’s family and clinical data following a medical approach multidisciplinary, we proceed to the orthodontic involved the use of the Rapid Palatal Expander (RPE) and a fixed orthodontic treatment. The aim of this study is to report the case of the orthopaedic and orthodontic treatment in a patient affected by ARS and with facial dysmorphism and teeth anomalies associated to ocular anomalies.
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Affiliation(s)
- Angela Pia Cazzolla
- Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, Via Luigi Rovelli, 50, 71100, Foggia, Italy
| | - Nunzio Francesco Testa
- Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, Via Luigi Rovelli, 50, 71100, Foggia, Italy
| | - Francesca Spirito
- Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, Via Luigi Rovelli, 50, 71100, Foggia, Italy
| | - Michele Di Cosola
- Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, Via Luigi Rovelli, 50, 71100, Foggia, Italy
| | - Alessandra Campobasso
- Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, Via Luigi Rovelli, 50, 71100, Foggia, Italy
| | - Vito Crincoli
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, "Aldo Moro" University of Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Andrea Ballini
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, "Aldo Moro" University of Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy.,Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Stefania Cantore
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, "Aldo Moro" University of Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy.,Faculty of Dentistry (Fakulteti i Mjekësisë Dentare-FMD), University of Medicine, 1001, Tirana, Albania
| | - Domenico Ciavarella
- Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, Via Luigi Rovelli, 50, 71100, Foggia, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, Via Luigi Rovelli, 50, 71100, Foggia, Italy
| | - Mario Dioguardi
- Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, Via Luigi Rovelli, 50, 71100, Foggia, Italy.
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Rødahl E, Knappskog PM, Majewski J, Johansson S, Telstad W, Kråkenes J, Boman H. Variants of anterior segment dysgenesis and cerebral involvement in a large family with a novel COL4A1 mutation. Am J Ophthalmol 2013; 155:946-53. [PMID: 23394911 DOI: 10.1016/j.ajo.2012.11.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 11/28/2012] [Accepted: 11/29/2012] [Indexed: 01/12/2023]
Abstract
PURPOSE To investigate the diverse ocular manifestations and identify the causative mutation in a large family with autosomal dominant anterior segment dysgenesis accompanied in some individuals by cerebral vascular disease. DESIGN Retrospective observational case series and laboratory investigation. METHODS Forty-five family members from 4 generations underwent ophthalmic examination. Molecular genetic investigation included analysis with single nucleotide polymorphism (SNP) markers and DNA sequencing. Whole exome sequencing was performed in 1 individual. RESULTS A broad range of ocular manifestations was observed. Typical cases presented with corneal clouding, anterior synechiae, and iris hypoplasia. Posterior embryotoxon, corectopia, and early cataract development were also seen. One obligate carrier and several other family members had minor ocular anomalies, thus confounding the scoring of affected and unaffected individuals. Cerebral hemorrhages had occurred in 4 individuals, in 3 at birth or during the first year of life. Seven patients with corneal clouding were considered "definitely affected" for linkage studies. Haplotype mapping revealed that they shared a 14 cM region in the terminal part of chromosome 13q that included the locus for COL4A1. The affected family members were heterozygous for a novel COL4A1 sequence variant c.4881C>G (p.Asn1627Lys) predicted to be damaging and not found among 185 local blood donors. Exome sequencing showed that this variant was the only one in the candidate region not found in dbSNP. CONCLUSION Among the family members shown to carry the novel COL4A1 mutation, heterogenous presentations of anterior segment dysgenesis was seen. Testing family members for this mutation also made a definite diagnosis possible in patients with a clinical presentation difficult to classify. In families where anterior segment dysgenesis occurs together with cerebral hemorrhages, genetic analysis of COL4A1 should be considered.
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