Kniest dysplasia

Last updated
Kniest dysplasia
Specialty Medical genetics   OOjs UI icon edit-ltr-progressive.svg

Kniest dysplasia is a rare form of dwarfism caused by a mutation in the COL2A1 gene on chromosome 12. [1] The COL2A1 gene is responsible for producing type II collagen. The mutation of COL2A1 gene leads to abnormal skeletal growth and problems with hearing and vision. What characterizes Kniest dysplasia from other type II osteochondrodysplasia is the level of severity and the dumb-bell shape of shortened long tubular bones. [2]

Contents

This condition was first described by Dr. Wilhelm Kniest in 1952, publishing the case history of a 3 1⁄2 year-old girl. Dr. Kniest noticed that his patient had bone deformities and restricted joint mobility. The patient also had short stature and later developed blindness, resulting from retinal detachment and glaucoma. [3] Upon analysis of the patient's DNA in 1992, sequencing revealed deletion of a 28 base pair sequence encompassing a splice site in exon 12 and a G to A transition in exon 50 of the COL2A1 gene. [4]

This condition is very rare and occurs less than 1 in 1,000,000 people. Males and females have equal chances of having this condition. [5] Currently, there is no cure for Kniest dysplasia. Alternative names for Kniest Dysplasia can include Kniest syndrome, swiss cheese cartilage syndrome, Kniest chondrodystrophy, or metatrophic dwarfism type II.

Signs and symptoms

Because collagen plays an important role in the development of the body, people with Kniest Dysplasia will typically have their first symptoms at birth. These symptoms can include: [6]

Most symptoms are chronic and will continue to worsen as the individual ages. It is essential to have regular checkups with general doctors, orthopedist, ophthalmologists, and/or otorhinolaryngologists. This will help to detect whether there are any changes that could cause concern. [7]

Genetics

PhenotypeLocationGene/LocusGene/Locus MIM NumberInheritancePhenotype MIM NumberPhenotype Mapping Key
Kniest Dysplasia12q13.11COL2A1120141Autosomal Dominant1565503

Mechanism

Studies have shown that a mutated COL2A1 gene is responsible for all type II chondroldysplasias, including Kniest dysplasia. It is believed that point mutations or the alteration of splice sites in COL2A1 domains will result in Kniest Dysplasia. The COL2A1 domain typically spans between exon 12 and 24. Mutations that occur at a splice donor site results in the loss of function at that site. This leads to the skipping of the exon and deletion of amino acids. The loss of these amino acids result in an abnormal procollagen II structure. The structure is not stable like the normal procollagen II structure and is normally degraded at a faster rate. [8]

Diagnosis

Family/medical history

An autosomal dominant pattern Autosomal dominant - en.svg
An autosomal dominant pattern

Kniest dysplasia is an autosomal dominant condition. [9] This means that the person only needs to have one copy of the mutated gene in order to have the condition. People with a family history are at a higher risk of having the disease than people with no family history. A random mutation in the gene can cause a person with no family history to also have the condition.[ citation needed ]

Diagnostic techniques

A combination of medical tests are used to diagnosis Kniest dysplasia. These tests can include: [10]

The images taken will help to identify any bone anomalies. Two key features to look for in a patient with Kniest dysplasia is the presence of dumb-bell shaped femur bones and coronal clefts in the vertebrae. Other features to look for include:[ citation needed ]

Genetic Testing - A genetic sample may be taken in order to closely look at the patient's DNA. Finding an error in the COL2A1 gene will help identify the condition as a type II chondroldysplasia.[ citation needed ]

Treatment

Because Kniest dysplasia can affect various body systems, treatments can vary between non-surgical and surgical treatment. Patients will be monitored over time, and treatments will be provided based on the complications that arise. [11]

Surgical

Non-surgical

Like treatment options, the prognosis is dependent on the severity of the symptoms. Despite the various symptoms and limitations, most individuals have normal intelligence and can lead a normal life.[ citation needed ]

Recent research

A recent article in 2015 reported a persistent notochord in a fetus at 23 weeks of gestation. The fetus had an abnormal spine, shortened long bones and a left clubfoot. After running postmortem tests and ultrasound, the researchers believed that the fetus suffered from hypochondrogenesis. Hypochondrogenesis is caused when type II collagen is abnormally formed due to a mutation in the COL2A1 gene. Normally, the cartilaginous notochord develops into the bony vertebrae in a human body. The COL2A1 gene results in malformed type II collagen, which is essential in the transition from collagen to bone. This is the first time that researchers found a persistent notochord in a human body due to a COL2A1 mutation. [12]

Eponym

It is named for Wilhelm Kniest. [13]

Related Research Articles

<span class="mw-page-title-main">Weissenbacher–Zweymüller syndrome</span> Medical condition

Weissenbacher–Zweymuller syndrome (WZS), also called Pierre-Robin syndrome with fetal chondrodysplasia, is an autosomal recessive congenital disorder, linked to mutations in the COL11A2 gene, which codes for the α2 strand of collagen type XI. It is a collagenopathy, types II and XI disorder. The condition was first characterized in 1964 by G. Weissenbacher and Ernst Zweymüller.

<span class="mw-page-title-main">Osteogenesis imperfecta</span> Group of genetic disorders that mainly affect the bones

Osteogenesis imperfecta, colloquially known as brittle bone disease, is a group of genetic disorders that all result in bones that break easily. The range of symptoms—on the skeleton as well as on the body's other organs—may be mild to severe. Symptoms found in various types of OI include whites of the eye (sclerae) that are blue instead, short stature, loose joints, hearing loss, breathing problems and problems with the teeth. Potentially life-threatening complications, all of which become more common in more severe OI, include: tearing (dissection) of the major arteries, such as the aorta; pulmonary valve insufficiency secondary to distortion of the ribcage; and basilar invagination.

<span class="mw-page-title-main">Stickler syndrome</span> Medical condition

Stickler syndrome is a group of rare genetic disorders affecting connective tissue, specifically collagen. Stickler syndrome is a subtype of collagenopathy, types II and XI. Stickler syndrome is characterized by distinctive facial abnormalities, ocular problems, hearing loss, and joint and skeletal problems. It was first studied and characterized by Gunnar B. Stickler in 1965.

<span class="mw-page-title-main">Spondyloperipheral dysplasia</span> Medical condition

Spondyloperipheral dysplasia is an autosomal dominant disorder of bone growth. The condition is characterized by flattened bones of the spine (platyspondyly) and unusually short fingers and toes (brachydactyly). Some affected individuals also have other skeletal abnormalities, short stature, nearsightedness (myopia), hearing loss, and mental retardation. Spondyloperipheral dysplasia is a subtype of collagenopathy, types II and XI.

The type II and XI collagenopathies are a group of disorders that affect connective tissue, the tissue that supports the body's joints and organs. These disorders are caused by defects in type II or type XI collagen. Collagens are complex molecules that provide structure, strength, and elasticity to connective tissue. Type II and type XI collagen disorders are grouped together because both types of collagen are components of the cartilage found in joints and the spinal column, the inner ear, and the jelly-like substance that fills the eyeball. The type II and XI collagenopathies result in similar clinical features.

Hypochondrogenesis is a severe genetic disorder causing malformations of bone growth. The condition is characterized by a short body and limbs and abnormal bone formation in the spine and pelvis.

<span class="mw-page-title-main">Otospondylomegaepiphyseal dysplasia</span> Medical condition

Otospondylomegaepiphyseal dysplasia (OSMED) is an autosomal recessive disorder of bone growth that results in skeletal abnormalities, severe hearing loss, and distinctive facial features. The name of the condition indicates that it affects hearing (oto-) and the bones of the spine (spondylo-), and enlarges the ends of bones (megaepiphyses).

Spondyloepiphyseal dysplasia congenita is a rare disorder of bone growth that results in dwarfism, characteristic skeletal abnormalities, and occasionally problems with vision and hearing. The name of the condition indicates that it affects the bones of the spine (spondylo-) and the ends of bones (epiphyses), and that it is present from birth (congenital). The signs and symptoms of spondyloepiphyseal dysplasia congenita are similar to, but milder than, the related skeletal disorders achondrogenesis type 2 and hypochondrogenesis. Spondyloepiphyseal dysplasia congenita is a subtype of collagenopathy, types II and XI.

<span class="mw-page-title-main">Spondyloepimetaphyseal dysplasia, Strudwick type</span> Medical condition

Spondyloepimetaphyseal dysplasia, Strudwick type is an inherited disorder of bone growth that results in dwarfism, characteristic skeletal abnormalities, and problems with vision. The name of the condition indicates that it affects the bones of the spine (spondylo-) and two regions near the ends of bones. This type was named after the first reported patient with the disorder. Spondyloepimetaphyseal dysplasia, Strudwick type is a subtype of collagenopathy, types II and XI.

<span class="mw-page-title-main">Cherubism</span> Medical condition

Cherubism is a rare genetic disorder that causes prominence in the lower portion in the face. The name is derived from the temporary chubby-cheeked resemblance to putti, the chubby-faced infants featured in Renaissance paintings, which were often mistakenly described as cherubs.

<span class="mw-page-title-main">Collagen, type II, alpha 1</span>

Collagen, type II, alpha 1 , also known as COL2A1, is a human gene that provides instructions for the production of the pro-alpha1(II) chain of type II collagen.

<span class="mw-page-title-main">Collagen, type I, alpha 1</span> Mammalian protein found in Homo sapiens

Collagen, type I, alpha 1, also known as alpha-1 type I collagen, is a protein that in humans is encoded by the COL1A1 gene. COL1A1 encodes the major component of type I collagen, the fibrillar collagen found in most connective tissues, including cartilage.

<span class="mw-page-title-main">Collagen, type XI, alpha 2</span>

Collagen alpha-2(XI) chain is a protein that in humans is encoded by the COL11A2 gene.

<span class="mw-page-title-main">Platyspondylic lethal skeletal dysplasia, Torrance type</span> Medical condition

Platyspondylic lethal skeletal dysplasia, Torrance type is a severe disorder of bone growth. People with this condition have very short arms and legs, a small chest with short ribs, underdeveloped pelvic bones, and unusually short fingers and toes (brachydactyly). This disorder is also characterized by flattened spinal bones (platyspondyly) and abnormal curvature of the spine (lordosis).

<span class="mw-page-title-main">Larsen syndrome</span> Medical condition

Larsen syndrome (LS) is a congenital disorder discovered in 1950 by Larsen and associates when they observed dislocation of the large joints and face anomalies in six of their patients. Patients with Larsen syndrome normally present with a variety of symptoms, including congenital anterior dislocation of the knees, dislocation of the hips and elbows, flattened facial appearance, prominent foreheads, and depressed nasal bridges. Larsen syndrome can also cause a variety of cardiovascular and orthopedic abnormalities. This rare disorder is caused by a genetic defect in the gene encoding filamin B, a cytoplasmic protein that is important in regulating the structure and activity of the cytoskeleton. The gene that influences the emergence of Larsen syndrome is found in chromosome region, 3p21.1-14.1, a region containing human type VII collagen gene. Larsen syndrome has recently been described as a mesenchyme disorder that affects the connective tissue of an individual. Autosomal dominant and recessive forms of the disorder have been reported, although most cases are autosomal dominant. Reports have found that in Western societies, Larsen syndrome can be found in one in every 100,000 births, but this is most likely an underestimate because the disorder is frequently unrecognized or misdiagnosed.

<span class="mw-page-title-main">Kyphoscoliosis</span> Medical condition

Kyphoscoliosis describes an abnormal curvature of the spine in both a coronal and sagittal plane. It is a combination of kyphosis and scoliosis. This musculoskeletal disorder often leads to other issues in patients, such as under-ventilation of lungs, pulmonary hypertension, difficulty in performing day-to-day activities, psychological issues emanating from anxiety about acceptance among peers, especially in young patients. It can also be seen in syringomyelia, Friedreich's ataxia, spina bifida, kyphoscoliotic Ehlers–Danlos syndrome (kEDS), and Duchenne muscular dystrophy due to asymmetric weakening of the paraspinal muscles.

<span class="mw-page-title-main">Multiple epiphyseal dysplasia</span> Rare genetic disorder

Fairbank's disease or multiple epiphyseal dysplasia (MED) is a rare genetic disorder that affects the growing ends of bones. Long bones normally elongate by expansion of cartilage in the growth plate near their ends. As it expands outward from the growth plate, the cartilage mineralizes and hardens to become bone (ossification). In MED, this process is defective.

<span class="mw-page-title-main">Pseudoachondroplasia</span> Inherited disorder of bone growth

Pseudoachondroplasia is an inherited disorder of bone growth. It is a genetic autosomal dominant disorder. It is generally not discovered until 2–3 years of age, since growth is normal at first. Pseudoachondroplasia is usually first detected by a drop of linear growth in contrast to peers, a waddling gait or arising lower limb deformities.

<span class="mw-page-title-main">Spondyloepimetaphyseal dysplasia, Pakistani type</span> Medical condition

Spondyloepimetaphyseal dysplasia, Pakistani type is a form of spondyloepimetaphyseal dysplasia involving PAPSS2. The condition is rare.

Acromesomelic dysplasia is a rare skeletal disorder that causes abnormal bone and cartilage development, leading to shortening of the forearms, lower legs, hands, feet, fingers, and toes. Five different genetic mutations have been implicated in the disorder. Treatment is individualized but is generally aimed at palliating symptoms, for example, treatment of kyphosis and lumbar hyperlordosis.

References

  1. Hirsch, Larissa. "Kniest Dysplasia". Nemours Children Health System. The Nemours Foundation. Archived from the original on 11 December 2015. Retrieved 21 November 2015.
  2. Chen, Harold (2012). Chen, Harold (ed.). Atlas of Genetic Diagnosis and Counseling. New York: Springer US. pp. 1259–1263. doi:10.1007/978-1-4614-1037-9. ISBN   978-1-4614-1036-2. S2CID   42921995.
  3. Spranger, Jürgen; Winterpacht, Andreas; Zabel, Bernhard (3 March 1997). "Kniest Dysplasia: Dr. W. Kniest, His Patient, the Molecular Defect". American Journal of Medical Genetics. 69 (1): 79–84. doi:10.1002/(SICI)1096-8628(19970303)69:1<79::AID-AJMG15>3.0.CO;2-L. PMID   9066888 . Retrieved 18 January 2021.
  4. Winterpacht, Andreas; Hilbert, Matthias; Schwarze, Ulrike; Mundlos, Stefan; Spranger, Jürgen; Zabel, Bernhard (1 April 1993). "Kniest and Stickler dysplasia phenotypes caused by collagen type II gene (COL2A1) defect". Nature Genetics. 3 (4): 323–326. doi:10.1038/ng0493-323. PMID   7981752. S2CID   21982098 . Retrieved 18 January 2021.
  5. "Kniest Dysplasia". National Organization for Rare Disorders. National Organization for Rare Disorders. Retrieved 20 November 2015.
  6. Hirsch, Larissa. "Kniest Dysplasia". Nemours Children Health System. The Nemours Foundation. Archived from the original on 11 December 2015. Retrieved 21 November 2015.
  7. John, Dormans (2014-02-23). "Kniest Dysplasia". Children’s Hospital of Philadelphia. Children’s Hospital of Philadelphia. Retrieved 21 November 2015.
  8. McKusick, Victor. "Kniest Dysplasia". omim.org/. Johns Hopkins University. Retrieved 21 November 2015.
  9. Jenkin, Henry J. (2010). "Hand and foot abnormalities associated with genetic diseases". Hand (New York, N.Y.). Springer Link. 6 (1): 18–26. doi:10.1007/s11552-010-9302-8. PMC   3041879 . PMID   22379434.
  10. John, Dormans (2014-02-23). "Kniest Dysplasia". Children’s Hospital of Philadelphia. Children’s Hospital of Philadelphia. Retrieved 21 November 2015.
  11. Pauli, Richard. "Kniest Dysplasia Natural History" (PDF). lpaonline.org/. Little People of America. Retrieved 21 November 2015.
  12. Codsi, Elisabeth et al. “Persistent Notochord in a Fetus with COL2A1 Mutation.” Case Reports in Obstetrics and Gynecology 2015 (2015): 935204. PMC. Web. 21 Nov. 2015.
  13. synd/2170 at Who Named It?