Mandibulofacial dysostosis-microcephaly syndrome

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Mandibulofacial dysostosis-microcephaly syndrome
Other namesMandibulofacial dysostosis, Guion-Almeida type, MFDM (abbr.) [1]
Autosomal recessive - en.svg
Specialty Medical genetics
Causes Genetic mutation
Differential diagnosis Isolated microcephaly
Preventionnone
Prognosis Medium with treatment, poor without it
Frequencyrare, about 100 cases have been reported
Deaths-

Mandibulofacial dysostosis with microcephaly syndrome, also known as growth delay-intellectual disability-mandibulofacial dysostosis-microcephaly-cleft palate syndrome, mandibulofacial dysostosis, guion-almeida type, or simply as MFDM syndrome is a rare genetic disorder which is characterized by developmental delays, intellectual disabilities, and craniofacial dysmorphisms. [2] [3]

Contents

Signs and symptoms

People with this condition are usually born with congenital microcephaly, the type of microcephaly individuals with this condition exhibit progressive microcephaly, this condition gives the appearance that the head is getting smaller as one ages, this is not true whatsoever; what is actually happening is that the head does not grow at the same rate as the rest of the body. [4]

Other craniofacial dysmorphisms include malar hypoplasia, midface and cheekbone hypoplasia, micrognathia, and small abnormally-shaped ears. [4]

In some individuals with MFDM syndrome, preauricular tags are present. Patients (especially the ones with the difference that was mentioned beforehand) have a higher risk of having anomalies in the ear canal, the auditory ossicles, or semicircular canals. These abnormalities (with the exception of the preauricular tags) end up in hearing loss in some to most cases. [4]

There are also oral and respiratory anomalies present within the condition, cleft palates and choanal atresia aren't uncommon findings. Choanal atresia in particular can end up causing breathing difficulties to the patient. [4]

Occasional findings include short stature, heart and thumb defects, esophageal atresia, and tracheoesophageal fistula. These last two symptoms are highly fatal, and may end up in premature death if left untreated. [4]

Complications

Unilateral choanal atresia can cause neo-natal breathing difficulties and posteriorly mouth breathing, which, although not especially life-threatening, can be deprimental and cause symptoms such as narrow face, tired eyes, etc. [5]

Bilateral choanal atresia can cause respiratory distress and, in most cases, arrest. [5]

Esophageal atresia and tracheoesophageal fistula can be deadly if they are left untreated. The latter causes an abnormal connection between the esophagus and the trachea, which causes esophageal fluids to enter the airways and cause respiratory problems. The combination of both esophageal atresia and tracheoesophageal fistula is especially life-threatening due to feeding difficulties and recurrent esophageal fluid exposure-associated lung damage. [4]

Diagnosis

It can be diagnosed by a thorough examination of the patient's symptoms and genetic testing. [6] [7]

Causes

This condition is caused by inherited autosomal recessive mutations in the EFTUD2 gene. These mutations can either be missense, splice-site, or the result of a microdeletion. [8] This gene is essential for the formation of spliceosomes, which helps in producing and maturing messenger RNA. The mutations involved in MFDM cause EFTUD2 enzymes with little to no function, which likely impairs the process of maturing mRNA. [9]

Treatment

Treatment is done on the symptoms themselves:

Prevalence

Around 100 cases have been described in the medical literature. [10]

History

This disorder was discovered in the year 2000, when Guion-Almeida et al., described 2 Brazilian brothers with growth delays, intellectual disabilities, trigonocephaly, microcephaly, preauricular tags, and cleft palate. They did a follow-up on these patients and 2 new ones: Brazilian siblings of the opposite sex (male and female), they found additional findings they had failed to describe before: zygomatic arc hypoplasia, and micrognathia. They had severe speech/language delay, they found this to be part of a brand new autosomal recessive mandibulofacial dysostosis entity. [3] [11]

See also

The MFDM Foundation

Related Research Articles

<span class="mw-page-title-main">Esophageal atresia</span> Congenital discontinuity of the oesophagus

Esophageal atresia is a congenital medical condition that affects the alimentary tract. It causes the esophagus to end in a blind-ended pouch rather than connecting normally to the stomach. It comprises a variety of congenital anatomic defects that are caused by an abnormal embryological development of the esophagus. It is characterized anatomically by a congenital obstruction of the esophagus with interruption of the continuity of the esophageal wall.

<span class="mw-page-title-main">Treacher Collins syndrome</span> Human genetic disorder

Treacher Collins syndrome (TCS) is a genetic disorder characterized by deformities of the ears, eyes, cheekbones, and chin. The degree to which a person is affected, however, may vary from mild to severe. Complications may include breathing problems, problems seeing, cleft palate, and hearing loss. Those affected generally have normal intelligence.

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

Microtia is a congenital deformity where the auricle is underdeveloped. A completely undeveloped pinna is referred to as anotia. Because microtia and anotia have the same origin, it can be referred to as microtia-anotia. Microtia can be unilateral or bilateral. Microtia occurs in 1 out of about 8,000–10,000 births. In unilateral microtia, the right ear is most commonly affected. It may occur as a complication of taking Accutane (isotretinoin) during pregnancy.

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

The VACTERL association refers to a recognized group of birth defects which tend to co-occur. This pattern is a recognized association, as opposed to a syndrome, because there is no known pathogenetic cause to explain the grouped incidence.

<span class="mw-page-title-main">Goldenhar syndrome</span> Rare birth defect; incomplete development of the face on one side

Goldenhar syndrome is a rare congenital defect characterized by incomplete development of the ear, nose, soft palate, lip and mandible on usually one side of the body. Common clinical manifestations include limbal dermoids, preauricular skin tags and strabismus. It is associated with anomalous development of the first branchial arch and second branchial arch.

Abruzzo–Erickson syndrome is an extremely rare disorder characterized by deafness, protruding ears, coloboma, a cleft palate or palatal rugosity, radial synostosis, and short stature. It was first characterized by Abruzzo and Erickson in 1977 as a CHARGE like syndrome as variably expressed among a family of two brothers, their mother, and their maternal uncle. Members of this family exhibited many of the CHARGE symptoms, but notably did not have choanal atresia and the brothers experienced typical genital development. Due to the recent discovery of this disorder, its etiology is not fully known but it is understood that it arises from mutations on the TBX22 gene on the X-chromosome. The disorder is inherited in an X-linked recessive manner. There is currently no known cure but its symptoms can be treated.

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<span class="mw-page-title-main">Micrognathism</span> Condition in which the jaw is small

Micrognathism is a condition where the jaw is undersized. It is also sometimes called mandibular hypoplasia. It is common in infants, but is usually self-corrected during growth, due to the jaws' increasing in size. It may be a cause of abnormal tooth alignment and in severe cases can hamper feeding. It can also, both in adults and children, make intubation difficult, either during anesthesia or in emergency situations.

<span class="mw-page-title-main">3C syndrome</span> Medical condition

3C syndrome is a rare condition whose symptoms include heart defects, cerebellar hypoplasia, and cranial dysmorphism. It was first described in the medical literature in 1987 by Ritscher and Schinzel, for whom the disorder is sometimes named.

<span class="mw-page-title-main">EFTUD2</span> Protein-coding gene in the species Homo sapiens

116 kDa U5 small nuclear ribonucleoprotein component is a protein that in humans is encoded by the EFTUD2 gene.

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

Frontonasal dysplasia (FND) is a congenital malformation of the midface. For the diagnosis of FND, a patient should present at least two of the following characteristics: hypertelorism, a wide nasal root, vertical midline cleft of the nose and/or upper lip, cleft of the wings of the nose, malformed nasal tip, encephalocele or V-shaped hair pattern on the forehead. The cause of FND remains unknown. FND seems to be sporadic (random) and multiple environmental factors are suggested as possible causes for the syndrome. However, in some families multiple cases of FND were reported, which suggests a genetic cause of FND.

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

Roberts syndrome, or sometimes called pseudothalidomide syndrome, is an extremely rare autosomal recessive genetic disorder that is characterized by mild to severe prenatal retardation or disruption of cell division, leading to malformation of the bones in the skull, face, arms, and legs.

Tracheal agenesis is a rare birth defect with a prevalence of less than 1 in 50,000 in which the trachea fails to develop, resulting in an impaired communication between the larynx and the alveoli of the lungs. Although the defect is normally fatal, occasional cases have been reported of long-term survival following surgical intervention.

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

Acrocraniofacial dysostosis, also known as Kaplan Plauchu Fitch syndrome is a very rare hereditary disorder which is characterized by cranio-facial dysmorphisms, hearing loss, digital clubbing, and osseous anomalies. Only 2 cases have been described in medical literature.

Splenogonadal fusion-limb defects-micrognathia syndrome, also known by its abbreviation, SGFLD syndrome, is a rare genetic disorder characterized by abnormal fusion of the spleen and the gonad alongside limb defects and orofacial anomalies. It is a type of syndromic dysostosis.

<span class="mw-page-title-main">Severe intellectual disability-progressive spastic diplegia syndrome</span> Medical condition

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<span class="mw-page-title-main">Lymphedema-posterior choanal atresia syndrome</span> Medical condition

Lymphedema-posterior choanal atresia syndrome is a rare genetic disorder characterized by the early-onset appearance of lymphedemas and congenital choanal atresia, which might be accompanied by other features such as pectus excavatum, hypoplasia of the nipples, and facial dysmorphisms such as hypertelorism, frontal bossing, etc. Only 7 cases from Yemen and Iran have been described in the medical literature. This condition is caused by homozygous mutations in the PTPN14 gene, located in chromosome 1.

References

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  2. "Mandibulofacial dysostosis with microcephaly - About the Disease - Genetic and Rare Diseases Information Center". rarediseases.info.nih.gov. Retrieved 2022-07-18.
  3. 1 2 "Entry - #610536 - MANDIBULOFACIAL DYSOSTOSIS, GUION-ALMEIDA TYPE; MFDGA - OMIM". www.omim.org. Retrieved 2022-07-18.
  4. 1 2 3 4 5 6 "Mandibulofacial dysostosis with microcephaly: MedlinePlus Genetics". medlineplus.gov. Retrieved 2022-07-18.
  5. 1 2 Philadelphia, The Children's Hospital of (2014-03-15). "Choanal Atresia". www.chop.edu. Retrieved 2022-07-18.
  6. 1 2 3 4 5 Lines, Matthew; Hartley, Taila; MacDonald, Stella K.; Boycott, Kym M. (1993), Adam, Margaret P.; Mirzaa, Ghayda M.; Pagon, Roberta A.; Wallace, Stephanie E. (eds.), "Mandibulofacial Dysostosis with Microcephaly", GeneReviews®, Seattle (WA): University of Washington, Seattle, PMID   24999515 , retrieved 2022-07-18
  7. Ryu, Jae Hui; Kim, Hwa Young; Ko, Jung Min; Kim, Man Jin; Seong, Moon-Woo; Choi, Byung Yoon; Chae, Jong Hee (2022-05-01). "Clinical and molecular delineation of mandibulofacial dysostosis with microcephaly in six Korean patients: When to consider EFTUD2 analysis?". European Journal of Medical Genetics. 65 (5): 104478. doi:10.1016/j.ejmg.2022.104478. ISSN   1769-7212. PMID   35395430. S2CID   247987892.
  8. Jacob, Arthur; Pasquier, Jennifer; Carapito, Raphael; Auradé, Frédéric; Molitor, Anne; Froguel, Philippe; Fakhro, Khalid; Halabi, Najeeb; Viot, Géraldine; Bahram, Seiamak; Rafii, Arash (2020-09-17). "A de novo synonymous variant in EFTUD2 disrupts normal splicing and causes mandibulofacial dysostosis with microcephaly: case report". BMC Medical Genetics. 21 (1): 182. doi: 10.1186/s12881-020-01121-y . ISSN   1471-2350. PMC   7499997 . PMID   32943010.
  9. "EFTUD2 gene: MedlinePlus Genetics". medlineplus.gov. Retrieved 2022-07-18.
  10. RESERVED, INSERM US14-- ALL RIGHTS. "Orphanet: Mandibulofacial dysostosis microcephaly syndrome". www.orpha.net. Retrieved 2022-07-18.{{cite web}}: CS1 maint: numeric names: authors list (link)
  11. Guion-Almeida, Maria Leine; Zechi-Ceide, Roseli Maria; Vendramini, Siulan; Ju Nior, Alfredo Tabith (2006-07-01). "A new syndrome with growth and mental retardation, mandibulofacial dysostosis, microcephaly, and cleft palate". Clinical Dysmorphology. 15 (3): 171–174. doi:10.1097/01.mcd.0000220603.09661.7e. ISSN   0962-8827. PMID   16760738. S2CID   27427214.