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Villarreal O, Comerma Méndez A, Armengol Pérez E, González Giménez X, Farran Ortega L. [Hadju-Cheney syndrome, case report and bibliographic review]. Semergen 2024; 50:102287. [PMID: 38924859 DOI: 10.1016/j.semerg.2024.102287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 02/24/2024] [Indexed: 06/28/2024]
Affiliation(s)
- O Villarreal
- Medicina de Familia, ABS Torroella de Montgrí-SSIBE, Torroella de Montgí, Gerona, España.
| | - A Comerma Méndez
- Medicina de Familia, ABS Torroella de Montgrí-SSIBE, Torroella de Montgí, Gerona, España
| | - E Armengol Pérez
- Reumatología, Hospital de Palamós-SSIBE, Palamós, Gerona, España
| | | | - L Farran Ortega
- Reumatología, Hospital de Palamós-SSIBE, Palamós, Gerona, España
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2
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Tėvelytė I, Bertašius P, Aleknavičienė K, Jonikas R, Klimaitė J, Jašinskienė E, Traberg R. First case of Hajdu-Cheney syndrome in Lithuania caused by novel NOTCH2 gene likely pathogenic variant. Eur J Med Genet 2024; 69:104938. [PMID: 38580081 DOI: 10.1016/j.ejmg.2024.104938] [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: 06/09/2023] [Revised: 12/07/2023] [Accepted: 04/03/2024] [Indexed: 04/07/2024]
Abstract
Hajdu-Cheney syndrome (HCS) is an extremely rare autosomal dominant skeletal disorder. The prevalence rate of less than 1 case per 1,000,000 newborns and only 50 cases were reported in the medical literature. HCS is characterized by progressive bone resorption in the distal phalanges (acro-osteolysis), progressive osteoporosis, distinct craniofacial changes, dental anomalies, and occasional association with renal abnormalities. HCS is caused by pathogenic variants in the NOTCH2 gene, 34th exon. We report first familial case of HCS caused by likely pathogenic variant of NOTCH2 gene c.6449delC, p.(Pro2150LeufsTer5).
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Affiliation(s)
- Ieva Tėvelytė
- Lithuanian University of Health Sciences, Medical Academy, Medical Faculty, Lithuania
| | - Paulius Bertašius
- Lithuanian University of Health Sciences, Medical Academy, Medical Faculty, Lithuania
| | - Kristina Aleknavičienė
- Lithuanian University of Health Sciences, Medical Academy, Medical Faculty, Department of Genetics and Molecular Medicine, Lithuania
| | - Rimvydas Jonikas
- Lithuanian University of Health Sciences, Medical Academy, Department of Genetics and Molecular Medicine, Lithuania
| | - Justina Klimaitė
- Lithuanian University of Health Sciences, Medical Academy, Department of Paediatrics, Lithuania
| | - Edita Jašinskienė
- Lithuanian University of Health Sciences, Medical Academy, Department of Endocrinology, Paediatric Endocrinology Division, Lithuania
| | - Rasa Traberg
- Lithuanian University of Health Sciences, Medical Academy, Department of Genetics and Molecular Medicine, Lithuania.
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3
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Abdelkarim M, Alageel D, Ahsan F, Alhuthil R, Alsarhani H, Alsagheir A. Hajdu-Cheney syndrome with a novel variant in NOTCH2 gene: A case report. Bone Rep 2023; 19:101709. [PMID: 37664144 PMCID: PMC10474580 DOI: 10.1016/j.bonr.2023.101709] [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: 05/30/2023] [Revised: 08/17/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Hajdu-Cheney syndrome is a rare disorder caused by truncation mutations in exon 34 of the NOTCH2 gene. The main presentation includes acro-osteolysis, osteoporosis, and dysmorphism. This syndrome affects the other body systems as well. Case presentation We report a case of a 6-year-old female that initially developed polyhydramnios and short upper limbs as a fetus. In addition, the patient had multiple anomalies as a neonate, including dysmorphism, congenital heart disease, hearing loss, recurrent respiratory tract infections, skeletal abnormalities, renal cysts, and hypertension. She continues to receive multidisciplinary care, and the finding of a C.7021C > T: P.Q2341x mutation in exon 34 of the NOTCH2 gene confirms the diagnosis. To our knowledge, this is the first case to report this variant in the literature. Discussion Because of the rarity of this syndrome and its diverse presentation, a high index of suspicion accompanied by genetic testing is paramount for diagnosing Hajdu-Cheney syndrome. We recommend a multidisciplinary approach for these patients to provide the highest possible quality of care.
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Affiliation(s)
- Mariam Abdelkarim
- College of Medicine, Alfaisal University, P.O. Box 50927, Riyadh 11533, Saudi Arabia
| | - Dalal Alageel
- College of Medicine, Alfaisal University, P.O. Box 50927, Riyadh 11533, Saudi Arabia
| | - Faridul Ahsan
- College of Medicine, Alfaisal University, P.O. Box 50927, Riyadh 11533, Saudi Arabia
| | - Raghad Alhuthil
- Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Haifa Alsarhani
- Department of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Afaf Alsagheir
- Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
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Cutler CB, Li D, Ruge JR. Cranial vault suspension for basilar invagination in patients with open cranial sutures: technique and long-term follow-up. Illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2023; 6:CASE23552. [PMID: 38011698 PMCID: PMC10684056 DOI: 10.3171/case23552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 10/12/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Hajdu-Cheney syndrome (HCS) is an extremely rare genetic disorder characterized by severe osteoporosis, scoliosis, and persistent open cranial sutures (POCSs). Neurological complications include hydrocephalus, Chiari I malformations, and basilar invagination (BI). Surgical intervention in HCS is challenging due to severe osteoporosis, ligamentous laxity, POCSs, and extreme skeletal deformities. Herein, the authors present a case of BI repair in a patient with HCS and POCSs, requiring a novel technique of cranial vault suspension, with long-term follow-up. OBSERVATIONS A 20-year-old female with HCS and progressive symptomatic BI, initially managed with posterior fossa decompression and occipital to cervical fusion, subsequently required cranial vault expansion due to symptomatic shifting of her cranium secondary to POCS. This custom construct provided long-term stabilization and neurological improvement over a follow-up duration of 9.5 years. A literature review performed revealed three other cases of surgical intervention for BI in patients with HCS and clinicopathological characteristics of each case was compared to the present illustrative case. LESSONS POCSs in patients with BI complicate traditional surgical approaches, necessitating more invasive techniques to secure all mobile cranial parts for optimal outcomes. Using this cranial vault suspension and fusion technique results in lasting neurological improvement and construct stability.
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Affiliation(s)
- Christopher B Cutler
- 1Chicago Medical School, Rosalind Franklin University of Medicine and Science, Chicago, Illinois; and
| | - Daphne Li
- 2Department of Neurosurgery, Division of Pediatric Neurosurgery, Advocate Lutheran General Hospital, Chicago, Illinois
| | - John R Ruge
- 2Department of Neurosurgery, Division of Pediatric Neurosurgery, Advocate Lutheran General Hospital, Chicago, Illinois
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Uehara DT, Muramatsu T, Ishii S, Suzuki H, Fukushima K, Arasaki Y, Hayata T, Inazawa J, Ezura Y. Identification of a Biallelic Missense Variant in Gasdermin D (c.823G > C, p.Asp275His) in a Patient of Atypical Gorham-Stout Disease in a Consanguineous Family. JBMR Plus 2023; 7:e10784. [PMID: 37701150 PMCID: PMC10494506 DOI: 10.1002/jbm4.10784] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/08/2023] [Accepted: 05/26/2023] [Indexed: 09/14/2023] Open
Abstract
Gorham-Stout disease (GSD), also called vanishing bone disease, is a rare osteolytic disease, frequently associated with lymphangiomatous tissue proliferation. The causative genetic background has not been noted except for a case with a somatic mutation in KRAS. However, in the present study, we encountered a case of GSD from a consanguineous family member. Whole-exome sequencing (WES) analysis focusing on rare recessive variants with zero homozygotes in population databases identified a homozygous missense variant (c.823G > C, p.Asp275His) in gasdermin D (GSDMD) in the patient and heterozygous in his unaffected brother. Because this variant affects the Asp275 residue that is involved in proteolytic cleavage by caspase-11 (as well as -4 and -5) to generate an activating p30 fragment required for pyroptotic cell death and proinflammation, we confirmed the absence of this cleavage product in peripheral monocytic fractions from the patient. A recent study indicated that a shorter p20 fragment, generated by further cleavage at Asp88, has a cell-autonomous function to suppress the maturation of osteoclasts to resorb bone matrix. Thus, the present study suggests for the first time the existence of hereditary GSD cases or novel GSD-like diseases caused by GSDMD deficiency. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Daniela Tiaki Uehara
- Department of Molecular CytogeneticsMedical Research Institute, Tokyo Medical and Dental University (TMDU)TokyoJapan
| | - Tomoki Muramatsu
- Department of Molecular CytogeneticsMedical Research Institute, Tokyo Medical and Dental University (TMDU)TokyoJapan
| | - Senichi Ishii
- Saku Central Hospital Advanced Care CenterSakuJapan
- Present address:
Ome Municipal General Hospital, OmeTokyoJapan
| | - Hidetsugu Suzuki
- Saku Central Hospital Advanced Care CenterSakuJapan
- Present address:
Department of Orthopedic SurgeryDokkyo Medical UniversitySaitamaJapan
| | | | - Yasuhiro Arasaki
- Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences and Faculty of Pharmaceutical SciencesTokyo University of ScienceChibaJapan
| | - Tadayoshi Hayata
- Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences and Faculty of Pharmaceutical SciencesTokyo University of ScienceChibaJapan
| | - Johji Inazawa
- Department of Molecular CytogeneticsMedical Research Institute, Tokyo Medical and Dental University (TMDU)TokyoJapan
- Research Core, TMDUTokyoJapan
| | - Yoichi Ezura
- Department of Joint Surgery and Sports MedicineTMDUTokyoJapan
- Department of Occupational Therapy, Faculty of Health and Medical ScienceTeikyo Heisei UniversityTokyoJapan
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Daniel EA, Sommer NA, Sharma M. Polycystic kidneys: interaction of notch and renin. Clin Sci (Lond) 2023; 137:1145-1150. [PMID: 37553961 PMCID: PMC11132639 DOI: 10.1042/cs20230023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 08/10/2023]
Abstract
Polycystic kidney disease (PKD) is a developmental disorder, which either manifests in early childhood or later in life, depending on the genetic mutation one harbors. The mechanisms of cyst initiation are not well understood. Increasing literature is now suggesting that Notch signaling may play a critical role in PKD. Activation of Notch signaling is important during nephrogenesis and slows down after development. Deletion of various Notch molecules in the cap mesenchyme leads to formation of cysts and early death in mice. A new study by Belyea et al. has now found that cells of renin lineage may link Notch expression and cystic kidney disease. Here, we use our understanding of Notch signaling and PKD to speculate about the significance of these interactions.
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Affiliation(s)
- Emily A Daniel
- Department of Internal Medicine, The Jared Grantham Kidney Institute, University of Kansas Medical Center, Kansas City, Kansas 66160, U.S.A
| | - Nicole A Sommer
- Department of Internal Medicine, The Jared Grantham Kidney Institute, University of Kansas Medical Center, Kansas City, Kansas 66160, U.S.A
| | - Madhulika Sharma
- Department of Internal Medicine, The Jared Grantham Kidney Institute, University of Kansas Medical Center, Kansas City, Kansas 66160, U.S.A
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Deb W, Joubert M, Cogné B, Vincent M, Ghesh L, Bézieau S, Le Vaillant C, Beneteau C. NOTCH2 related disorders: Description and review of the fetal presentation. Eur J Med Genet 2023; 66:104769. [PMID: 37121269 DOI: 10.1016/j.ejmg.2023.104769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/04/2023] [Accepted: 04/17/2023] [Indexed: 05/02/2023]
Abstract
Signs of skeletal dysplasias are relatively common in fetuses with abnormal ultrasound (US) findings. The diversity of congenital skeletal disorders, the possibility of late-onset severe phenotypes and overlapping syndromes can be a challenge in the way of diagnosis, even if prenatal high-throuput sequencing allows for a better diagnosis, prognosis and genetic counseling. Hajdu-Cheney spectrum pathologies are rarely described in prenatal, and the signs associated remain poorly known, and do not include specific postnatal signs as acro-osteolysis and premature osteoporosis. We hereby report a couple for whom a medical termination of pregnancy was performed because a severe polymalformative syndrome associating severely short limbs with bowed long bones, severe cardiopathy, hyperechogenic kidneys and dysmorphism. After fetopathological and radiological examinations, Exome Sequencing (ES) was performed and revealed a de novo truncating mutation in the last exon of NOTCH2, responsible for Hajdu-Cheney or Serpentine Fibula Polycystic Kidney syndromes.
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Affiliation(s)
- W Deb
- Nantes Université, CHU de Nantes, CNRS, INSERM, l'institut du Thorax, F-44000, Nantes, France; Nantes Université, CHU de Nantes, Service de Génétique Médicale, F-44000, Nantes, France.
| | - M Joubert
- CHU de Nantes, Service d'Anatomie et Cytologie Pathologiques, UF de Fœtopathologie et Génétique, F-44000, Nantes, France
| | - B Cogné
- Nantes Université, CHU de Nantes, CNRS, INSERM, l'institut du Thorax, F-44000, Nantes, France; Nantes Université, CHU de Nantes, Service de Génétique Médicale, F-44000, Nantes, France
| | - M Vincent
- Nantes Université, CHU de Nantes, CNRS, INSERM, l'institut du Thorax, F-44000, Nantes, France; Nantes Université, CHU de Nantes, Service de Génétique Médicale, F-44000, Nantes, France
| | - L Ghesh
- CHU de Nantes, Service de Génétique Médicale, UF de Fœtopathologie et Génétique, F-44000, Nantes, France
| | - S Bézieau
- Nantes Université, CHU de Nantes, CNRS, INSERM, l'institut du Thorax, F-44000, Nantes, France; Nantes Université, CHU de Nantes, Service de Génétique Médicale, F-44000, Nantes, France
| | - C Le Vaillant
- CHU de Nantes, Service de Gynécologie et Obstétrique, F-44000, Nantes, France
| | - C Beneteau
- CHU de Nantes, Service de Génétique Médicale, UF de Fœtopathologie et Génétique, F-44000, Nantes, France; CHU de CHU de Bordeaux, Service de Génétique Médicale, F-33076, Bordeaux, France
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Skweres-Kuchta M, Czerska I, Szaruga E. Literature Review on Health Emigration in Rare Diseases-A Machine Learning Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2483. [PMID: 36767849 PMCID: PMC9915846 DOI: 10.3390/ijerph20032483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/15/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
The article deals with one of the effects of health inequalities and gaps in access to treatments for rare diseases, namely health-driven emigration. The purpose of the paper is to systematize knowledge about the phenomenon of health emigration observed among families affected by rare diseases, for which reimbursed treatment is available, but only in selected countries. The topic proved to be niche; the issue of "health emigration in rare diseases" is an area for exploration. Therefore, the further analysis used text mining and machine learning methods based on a database selected based on keywords related to this issue. The results made it possible to systematize the guesses made by researchers in management and economic fields, to identify the most common keywords and thematic clusters around the perspective of the patient, drug manufacturer and treatment reimbursement decision-maker, and the perspective integrating all the others. Since the topic of health emigration was not directly addressed in the selected sources, the authors attempted to define the related concepts and discussed the importance of this phenomenon in managing the support system in rare diseases. Thus, they indicated directions for further research in this area.
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Affiliation(s)
- Małgorzata Skweres-Kuchta
- Department of Organization and Management, Institute of Management, University of Szczecin, Cukrowa 8 Street, 71-004 Szczecin, Poland
| | - Iwona Czerska
- Department of Marketing Research, Faculty of Management, Wroclaw University of Economics and Business, 118/120 Komandorska Str, 53-345 Wroclaw, Poland
| | - Elżbieta Szaruga
- Department of Transport Management, Institute of Management, University of Szczecin, Cukrowa 8 Street, 71-004 Szczecin, Poland
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Ekure EN, Sokunbi O, Kruszka P, Muenke M, Adeyemo AA. Hajdu-Cheney syndrome with atypical cardiovascular abnormalities. Am J Med Genet A 2023; 191:271-274. [PMID: 36301051 PMCID: PMC9742292 DOI: 10.1002/ajmg.a.63013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 09/27/2022] [Accepted: 10/07/2022] [Indexed: 12/14/2022]
Abstract
Hajdu-Cheney syndrome is an ultra-rare autosomal dominant disorder caused by a heterozygous variant in NOTCH2 gene. Characteristic features include osteolysis, distinct facial appearance, skull deformity, joint laxity, osteoporosis, and short stature. Associated abnormalities are congenital heart disease, congenital defects of the kidney, and neurological problems. Here, we present the first reported case of an African child with a variant in NOTCH2 gene and features of Hajdu-Cheney syndrome in whom we detected a congenital heart defect that has not been previously reported in association with the syndrome. To appropriately characterize this disease and document correct proportion of cardiovascular malformation associations, echocardiography is recommended for all cases of Hajdu Cheney syndrome.
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Affiliation(s)
- Ekanem N. Ekure
- Department of Paediatrics College of Medicine, University of Lagos/ Lagos University Teaching Hospital Idi-Araba, Lagos, Nigeria
| | - Ogochukwu Sokunbi
- Department of Paediatrics College of Medicine, University of Lagos/ Lagos University Teaching Hospital Idi-Araba, Lagos, Nigeria
| | - Paul Kruszka
- Medical Genetics Branch, National Human Genome Research Institute, The National Institutes of Health, Bethesda, Maryland
- Current address: GeneDx, Gaithersburg, Maryland, United Stated States
| | - Maximilian Muenke
- Medical Genetics Branch, National Human Genome Research Institute, The National Institutes of Health, Bethesda, Maryland
- Current address: American College of Medical Genetics and Genomics, 7101 Wisconsin Ave Suite 1101, Bethesda, MD 20814, United States
| | - Adebowale A. Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, The National Institutes of Health, Bethesda, Maryland
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Shrestha S, Regmi B, Pathak R, Kroumpouzos G. Idiopathic Acroosteolysis: A Novel Cutaneous Sign Can Help Identify the Condition Early. Case Rep Dermatol 2023; 15:51-55. [PMID: 36936732 PMCID: PMC10018418 DOI: 10.1159/000529727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 01/31/2023] [Indexed: 03/17/2023] Open
Abstract
Acroosteolysis (AO) is a rare condition characterized by resorption of the distal phalanges of the fingers and/or toes. It can be familial, idiopathic (IAO), occupational, or secondary. Other authors suggest a classification into primary (genetic disorders, lysosomal storage disorders) or secondary AO. Various skin and nail changes have been reported in this condition. However, the cutaneous change on the affected digit(s)/toe(s) during the natural course of AO has been poorly documented. A 5-year-old girl presented with a 3-month history of a distinct transverse boundary between normal skin proximally and affected crusted skin overlying osteolysis distally ("split" sign) on the plantar surface of the third toe. This boundary gradually elongated circumferentially to involve the dorsal surface. The mother gave a similar history of a delimitation line on the 2nd, 4th, and 5th toes of the right foot with durations of 3 months, 1 year, and 2 years, respectively, that disappeared before she noticed a shortening of those toes. X-rays revealed partial resorption of the terminal phalanx of the third toe and several lytic changes in the middle and terminal phalanx of the second, fourth, and fifth toes. The clinical features, radiology findings, and a workup that helped rule out conditions associated with AO (secondary AO) helped establish the diagnosis of IAO in our patient. This case study highlights that the natural course of IAO includes distinct skin findings, such as the "split" sign that we describe. This sign can help identify the condition early.
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Affiliation(s)
- Samir Shrestha
- Department of Dermatology, Rapti Province Hospital, Tulsipur, India
| | - Bashant Regmi
- Department of Radiology, Rapti Province Hospital, Tulsipur, India
| | - Raksha Pathak
- Department of Dermatology, Lumbini Province Hospital, Butwal, India
| | - George Kroumpouzos
- Department of Dermatology, Warren Alpert Medical School at Brown University, Providence, RI, USA
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11
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Progress and Current Status in Hajdu-Cheney Syndrome with Focus on Novel Genetic Research. Int J Mol Sci 2022; 23:ijms231911374. [PMID: 36232677 PMCID: PMC9570194 DOI: 10.3390/ijms231911374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 12/02/2022] Open
Abstract
Hajdu-Cheney syndrome (HCS) is a rare autosomal dominant manifestation of a congenital genetic disorder caused by a mutation in the NOTCH2 gene. NOTCH signaling has variations from NOTCH 1 to 4 and maintains homeostasis by determining and regulating the proliferation and differentiation of various cells. In HCS, the over-accumulated NOTCH2 causes abnormal bone resorption due to its continuous excessive signaling. HCS is characterized by progressive bone destruction, has complex wide-range clinical manifestations, and significantly impacts the patient’s quality of life. However, no effective treatment has been established for HCS to date. There are genetic variants of NOTCH2 that have been reported in the ClinVar database of the U.S. National Institutes of Health. In total, 26 mutant variants were detected based on the American College of Medical Genetics and Genomics (ACMC). To date, there has been no comprehensive compilation of HCS mutations. In this review, we provide the most comprehensive list possible of HCS variants, nucleotide changes, amino acid definitions, and molecular consequences reported to date, following the ACMC guidelines.
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12
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Ndongo Sonfack DJ, Bergeron D, Wang Z, Boubez G, Shedid D, Yuh SJ. Surgical management of high-grade lumbar spondylolisthesis associated with Hajdu-Cheney syndrome: illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2022; 4:CASE22171. [PMID: 36088555 PMCID: PMC9706325 DOI: 10.3171/case22171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Hajdu-Cheney syndrome (HCS) is a rare connective tissue disorder characterized by severe bone demineralization. In the spine, it is associated with the early onset of severe osteoporosis and can cause spondylolisthesis. Spinal instrumentation in the setting of severe osteoporosis is challenging because of poor resistance of vertebrae to biomechanical stress. OBSERVATIONS A 59-year-old woman with known idiopathic HCS presented with a grade 4 L5-S1 spondylolisthesis and right L5 pedicle fracture associated with a left L5 pars fracture, causing a progressive L5 radiculopathy that was worse on the left side than the right side and bilateral foot drop. The authors performed decompressive lumbar surgery, which included a complete L5 laminectomy and resection of the left L5 pedicle. This was followed by multilevel lumbosacral instrumentation using cement-augmented fenestrated pedicle screws as well as transdiscal sacral screws and bilateral alar-iliac fixation. Postoperatively, the radicular pain resolved, and the left foot drop partially recovered. LESSONS Stabilization of high-grade spondylolisthesis in the setting of bone demineralization disorders is challenging. The use of different instrumentation techniques is important because it increases biomechanical stability of the overall instrumentation construct.
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Affiliation(s)
| | | | - Zhi Wang
- Orthopedics, University of Montréal Hospital Center, Montréal, Québec, Canada
| | - Ghassan Boubez
- Orthopedics, University of Montréal Hospital Center, Montréal, Québec, Canada
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Li ZD, Abuduxikuer K, Wang L, Hao CZ, Zhang J, Wang MX, Li LT, Qiu YL, Xie XB, Lu Y, Wang JS. Defining pathogenicity of NOTCH2 variants for diagnosis of Alagille syndrome type 2 using a large cohort of patients. Liver Int 2022; 42:1836-1848. [PMID: 35567760 DOI: 10.1111/liv.15292] [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: 09/22/2021] [Revised: 04/09/2022] [Accepted: 05/09/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS Alagille syndrome (ALGS) type 2 caused by mutations in NOTCH2 has genotypic and phenotypic heterogeneity. Diagnosis in some atypical patients with isolated hepatic presentation could be missed. METHODS Using 2087 patients with paediatric liver manifestations, NOTCH2 allele frequencies, in-silico prediction, protein domains and clinical features were analysed to define the pathogenicity of NOTCH2 variants for diagnosis of ALGS type 2. RESULTS Among 2087 patients with paediatric liver manifestations, significantly more NOTCH2 variants were absent in gnomAD in patients with elevated γ-glutamyltransferase (GGT) (p = .041). Significantly more NOTCH2 variants which were absent in gnomAD were located in protein functional domains (p = .038). When missense variants were absent in gnomAD and predicted to be pathogenic by at least three out of seven in-silico tools, they were found to be significantly associated with liver manifestations with elevated GGT (p = .003). Comparing this to patients with likely benign (LB) variants, the patients with likely-pathogenic (LP) variants have significantly more liver manifestations with elevated GGT (p = .0001). Significantly more patients with LP variants had extra-hepatic phenotypes of ALGS compared with those patients with LB variants (p = .0004). CONCLUSION When NOTCH2 variants are absent in gnomAD, null variants and missense variants which were predicted to be pathogenic by at least three in-silico tools could be considered pathogenic in patients with high GGT chronic liver diseases.
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Affiliation(s)
- Zhong-Die Li
- The Center for Pediatric Liver Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Kuerbanjiang Abuduxikuer
- The Center for Pediatric Liver Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Li Wang
- The Center for Pediatric Liver Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Chen-Zhi Hao
- The Center for Pediatric Liver Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Jing Zhang
- Department of Pediatrics, Jinshan Hospital, Fudan University, Shanghai, China
| | - Meng-Xuan Wang
- Department of Pediatrics, Jinshan Hospital, Fudan University, Shanghai, China
| | - Li-Ting Li
- The Center for Pediatric Liver Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Yi-Ling Qiu
- The Center for Pediatric Liver Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Xin-Bao Xie
- The Center for Pediatric Liver Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Yi Lu
- The Center for Pediatric Liver Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Jian-She Wang
- The Center for Pediatric Liver Diseases, Children's Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Birth Defect, Shanghai, China
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14
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Dąbrowska J, Biedziak B, Szponar-Żurowska A, Budner M, Jagodziński PP, Płoski R, Mostowska A. Identification of novel susceptibility genes for non-syndromic cleft lip with or without cleft palate using NGS-based multigene panel testing. Mol Genet Genomics 2022; 297:1315-1327. [PMID: 35778651 DOI: 10.1007/s00438-022-01919-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 06/12/2022] [Indexed: 01/02/2023]
Abstract
For non-syndromic cleft lip with or without cleft palate (ns-CL/P), the proportion of heritability explained by the known risk loci is estimated to be about 30% and is captured mainly by common variants identified in genome-wide association studies. To contribute to the explanation of the "missing heritability" problem for orofacial clefts, a candidate gene approach was taken to investigate the potential role of rare and private variants in the ns-CL/P risk. Using the next-generation sequencing technology, the coding sequence of a set of 423 candidate genes was analysed in 135 patients from the Polish population. After stringent multistage filtering, 37 rare coding and splicing variants of 28 genes were identified. 35% of these genetic alternations that may play a role of genetic modifiers influencing an individual's risk were detected in genes not previously associated with the ns-CL/P susceptibility, including COL11A1, COL17A1, DLX1, EFTUD2, FGF4, FGF8, FLNB, JAG1, NOTCH2, SHH, WNT5A and WNT9A. Significant enrichment of rare alleles in ns-CL/P patients compared with controls was also demonstrated for ARHGAP29, CHD7, COL17A1, FGF12, GAD1 and SATB2. In addition, analysis of panoramic radiographs of patients with identified predisposing variants may support the hypothesis of a common genetic link between orofacial clefts and dental abnormalities. In conclusion, our study has confirmed that rare coding variants might contribute to the genetic architecture of ns-CL/P. Since only single predisposing variants were identified in novel cleft susceptibility genes, future research will be required to confirm and fully understand their role in the aetiology of ns-CL/P.
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Affiliation(s)
- Justyna Dąbrowska
- Department of Biochemistry and Molecular Biology, Poznan University of Medical Sciences, 6 Swiecickiego Street, 60-781, Poznan, Poland
| | - Barbara Biedziak
- Department of Orthodontics and Craniofacial Anomalies, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Szponar-Żurowska
- Department of Orthodontics and Craniofacial Anomalies, Poznan University of Medical Sciences, Poznan, Poland
| | - Margareta Budner
- Eastern Poland Burn Treatment and Reconstructive Center, Leczna, Poland
| | - Paweł P Jagodziński
- Department of Biochemistry and Molecular Biology, Poznan University of Medical Sciences, 6 Swiecickiego Street, 60-781, Poznan, Poland
| | - Rafał Płoski
- Department of Medical Genetics, Warsaw Medical University, Warsaw, Poland
| | - Adrianna Mostowska
- Department of Biochemistry and Molecular Biology, Poznan University of Medical Sciences, 6 Swiecickiego Street, 60-781, Poznan, Poland.
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15
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Cortés-Martín J, Díaz-Rodríguez L, Piqueras-Sola B, Sánchez-García JC, Menor-Rodríguez MJ, Rodríguez-Blanque R. Nursing Care Plan for Patients with Hajdu-Cheney Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7489. [PMID: 35742738 PMCID: PMC9223558 DOI: 10.3390/ijerph19127489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 02/01/2023]
Abstract
Hajdu-Cheney syndrome is a rare genetic disease. Its main features include phenotypic variability, age-dependent progression and the presence of acroosteolysis of the distal phalanges and generalized osteoporosis, which have significant disabling potential. Currently, there is no effective curative treatment, so nursing care is essential to ensure the maintenance of the quality of life of these patients. The main objective of this study was to establish a specific standardized nursing care plan using the NANDA-NIC-NOC taxonomy. The application of a care plan as such would improve the quality of life of patients affected by this rare disease, will contribute to increasing healthcare professionals' knowledge on this matter and will support future studies on this disease.
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Affiliation(s)
- Jonathan Cortés-Martín
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (J.C.-M.); (L.D.-R.); (B.P.-S.); (R.R.-B.)
- Faculty of Health Sciences, School of Nursing, University of Granada, 18071 Granada, Spain
| | - Lourdes Díaz-Rodríguez
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (J.C.-M.); (L.D.-R.); (B.P.-S.); (R.R.-B.)
- Faculty of Health Sciences, School of Nursing, University of Granada, 18071 Granada, Spain
| | - Beatriz Piqueras-Sola
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (J.C.-M.); (L.D.-R.); (B.P.-S.); (R.R.-B.)
- Hospital University Virgen de las Nieves, 18014 Granada, Spain
| | - Juan Carlos Sánchez-García
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (J.C.-M.); (L.D.-R.); (B.P.-S.); (R.R.-B.)
- Faculty of Health Sciences, School of Nursing, University of Granada, 18071 Granada, Spain
| | - María José Menor-Rodríguez
- Subdirectora de Humanización y Atención al Ciudadano, Área Sanitaria Santiago-Barbanza, 15706 Santiago de Compostela, Spain;
| | - Raquel Rodríguez-Blanque
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (J.C.-M.); (L.D.-R.); (B.P.-S.); (R.R.-B.)
- Faculty of Health Sciences, School of Nursing, University of Granada, 18071 Granada, Spain
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16
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Tan EC, Lai AHM, Brett MSY. Novel phenotypic feature in a patient with a recurrent NOTCH2 nonsense mutation. Am J Med Genet A 2022; 188:2135-2138. [PMID: 35289498 DOI: 10.1002/ajmg.a.62724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 02/15/2022] [Accepted: 03/01/2022] [Indexed: 11/11/2022]
Abstract
Pathogenic variants in NOTCH2 which encodes a single-pass transmembrane protein have been identified as a cause of several autosomal dominant congenital disorders. In particular, truncating mutations in exon 34 have been found in patients with skeletal abnormalities and dysmorphic features. We describe a patient with a de novo variant in NOTCH2 who displayed features of both Hajdu-Cheney syndrome (HJCYS) and serpentine fibula-polycystic kidney syndrome (SFPKS). The recurrent nonsense variant in exon 34 has been reported in seven other patients with syndromic presentations, making it the most common pathogenic variant for NOTCH2 in congenital disorders. In addition to the core features of HJCYS and SFPKS, there was a gastrointestinal tract malformation of an imperforate anus which has not been reported in patients with pathogenic variants in NOTCH2.
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Affiliation(s)
- Ene-Choo Tan
- Research Laboratory, KK Women's and Children's Hospital, Singapore.,SingHealth Duke-NUS Academic Clinical Programme, Singapore
| | - Angeline H M Lai
- SingHealth Duke-NUS Academic Clinical Programme, Singapore.,Genetics Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | - Maggie S Y Brett
- Research Laboratory, KK Women's and Children's Hospital, Singapore
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17
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Hajdu-Cheney Syndrome: Report of a Case in Spain. Diagnostics (Basel) 2022; 12:diagnostics12030566. [PMID: 35328119 PMCID: PMC8947164 DOI: 10.3390/diagnostics12030566] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/12/2022] [Accepted: 02/21/2022] [Indexed: 02/04/2023] Open
Abstract
This paper describes the case of a 54-year-old woman diagnosed with Hajdu–Cheney syndrome, who presents with characteristic craniofacial dysmorphia, short stature, premature loss of teeth, developmental skeletal disorders, fibrocystic mastopathy, bilateral hearing loss and an intermittent mild neutropenia. The patient received treatment with bisphosphonates and was awaiting evaluation for surgical arthroplasty of both hips when she suffered a motor vehicle accident, which led to a rapid progression in her disease by increasing her degree of dependence for most activities of daily living. The clinical presentation and radiologic findings seen in this case confirm the three main features of the syndrome: phenotypic variability, an age-dependent progression and the presence of generalized osteoporosis and acroosteolysis of distal phalanges. The main objective of the manuscript is to describe a new case of a patient diagnosed with Hajdu–Cheney syndrome. Due to the low prevalence of the syndrome and the small number of cases reported in the scientific literature, obtaining a complete description and a global perspective of the disease is complex.
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18
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Ahmad A, Deeb H, Alasmar D. Hajdu Cheney syndrome; A novel NOTCH2 mutation in a Syrian child, and treatment with zolidronic acid: A case report and a literature review of treatments. Ann Med Surg (Lond) 2021; 71:103023. [PMID: 34840770 PMCID: PMC8606845 DOI: 10.1016/j.amsu.2021.103023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/01/2021] [Accepted: 11/01/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Hajdu Cheney Syndrome (HCS) is a rare genetic disorder characterized by skeletal deformities such as acroosteolysis, osteoporosis, unique craniofacial features, and other systemic abnormalities. This syndrome is caused by NOTCH2 gene mutations, which cause an increase of osteoclast and osteoblast activity that leads to the increased bone resorption. Because of how rare the syndrome is and the vague onset of the symptoms, it can be challenging to make an early diagnosis. CASE PRESENTATION We report a case of a female child with HCS who has a new NOTCH2 mutation sequence; (NM_024408.3:c.6463G > T) protein change (Glu2155*), and to our knowledge this is the first reported and diagnosed case in Syria. She presents with short stature, unique craniofacial features, scoliosis, kyphosis, and signs of osteoporosis, in addition to Patent Ductus Arteriosus. The patient was diagnosed with Hajdu Cheney Syndrome, and administered zolidronic acid, and she responded well to the treatment; showing signs of improved bone density and improvement in height, where her bone density improved from 0.23 to 0.31, and she gained 11 cm in height after the treatment. CONCLUSION Due to the rarity of the syndrome, there is no established guideline for treatment yet. Based on the pathophysiology of the syndrome that causes increased bone resorption, treatment with the Bisphosphonates group has yielded positive outcomes. Furthermore, we compare different treatments in the literature with their results.
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Affiliation(s)
- Afaf Ahmad
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Haya Deeb
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Diana Alasmar
- Faculty of Medicine, Damascus University, Damascus, Syria
- Children University Hospital, Damascus, Syria
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19
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Oral Surgery Procedures in a Patient with Hajdu-Cheney Syndrome Treated with Denosumab-A Rare Case Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179099. [PMID: 34501688 PMCID: PMC8431733 DOI: 10.3390/ijerph18179099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 12/20/2022]
Abstract
Background: Hajdu-Cheney syndrome (HCS) is a very rare autosomal-dominant congenital disease associated with mutations in the NOTCH2 gene. This disorder affects the connective tissue and is characterized by severe bone resorption. Hajdu-Cheney syndrome most frequently affects the head and feet bones (acroosteolysis). Case report: We present an extremely rare case of a 34-year-old male with Hajdu-Cheney syndrome. The patient was admitted to the Department of Oral Surgery, Medical University of Gdańsk, in order to perform the extraction of three teeth. These teeth were not eligible for conservative treatment and prosthetic reconstruction. The patient was treated with denosumab (angiogenesis and receptor activator of nuclear factor-κB RANK ligand inhibitor, RANKL). Discussion: Denosumab is a monoclonal antibody against RANKL. This drug works through a suppression of osteoclast activity. In cases of patients in which the pathway of the RANK/RANKL/osteoprotegerin is dysregulated, denosumab has been approved for the treatment off-label. In patients receiving denosumab, a delayed wound healing in the oral cavity and osteonecrosis may occur. Dental procedures involving the alveolar bone process (tooth extractions and bone alveoloplasty) may be a risk factor for medication-related osteonecrosis of the jaw (MRONJ). Spontaneous osteonecrosis is rarely observed. MRONJ consists of the destruction of exposed bone, with the exposure persisting for a minimum of 6–8 weeks. This is the first article about an HCS patient treated with denosumab who underwent invasive oral surgery procedures. This case report highlights the difficulties for professionals occurring during the oral surgery procedures in such patients.
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