The Skeletal Dysplasia Alliance is an organization dedicated to advocating for individuals with conditions such as achondroplasia and other skeletal dysplasias with dwarfism (ASDD) across Europe. In the context of global advancements in recognizing the rights of people with disabilities, the alliance emphasizes that the unique needs of the ASDD community that have historically been overlooked. [1]
The alliance collaborates with various organizations to address the common challenges faced by individuals with ASDD in Europe. Despite progress in EU disability policies, there is still an observed gap in acknowledging and addressing the specific needs of this stigmatized community. The consensus declaration presented by the alliance serves as a call to action, urging the European Union to listen to the voices of people with ASDD and implement real, lasting solutions. The alliance envisions a 'social Europe' that establishes common standards, fosters increased cooperation, and brings about tangible change for individuals with ASDD. [2] [3]
In 2020, seven organizations representing individuals with achondroplasia and other skeletal dysplasias from various European countries decided to collaborate on an advocacy project. Their objective is to promote the often overlooked discussion surrounding the needs and challenges of individuals with short stature, both in EU policies and at the national level. They developed a Consensus Paper addressing the situation of ASDD in Europe and proposing political actions for improvement.
The consensus paper served as a cornerstone for advocacy on skeletal dysplasias, analyzing the comprehensive needs of these conditions, including issues related to stigma, health, social protection, and barriers in education and employment. In November 2021, the SD group presented the statement at an institutional event with the support of five representatives from the EU Parliament and the European Commission. The presentation underscored the necessity of political and social dialogue to reduce and overcome the challenges faced by affected individuals. To this end, the alliance believes that coordinated, active efforts of ASDD organizations are essential. [4] [5]
Skeletal dysplasias (SD), or osteochondrodysplasias, encompass over 450 rare conditions linked to cartilage and bone disorders, resulting in varying degrees of short stature. While each specific skeletal dysplasia is individually uncommon, collectively, their incidence is nearly 1 in 5000. [6]
Among these conditions, achondroplasia is the most prevalent, occurring at an approximate rate of 1 in 20,000-30,000 live births. Currently, around 250,000 individuals worldwide are affected by this variant. [7]
While most cases are evident at birth, some receive a diagnosis during early infancy. Newborns with achondroplasia often exhibit distinct limb proportions, including variations in head, thorax, and hand sizes. In adulthood, the average height for males with achondroplasia is 131 cm, while females typically measure 124 cm. [8]
Achondroplasia is a genetic disorder with an autosomal dominant pattern of inheritance whose primary feature is dwarfism. It is the most common cause of dwarfism and affects about 1 in 27,500 people. In those with the condition, the arms and legs are short, while the torso is typically of normal length. Those affected have an average adult height of 131 centimetres for males and 123 centimetres (4 ft) for females. Other features can include an enlarged head with prominent forehead and underdevelopment of the midface. Complications can include sleep apnea or recurrent ear infections. Achondroplasia includes the extremely rare short-limb skeletal dysplasia with severe combined immunodeficiency.
Dwarfism is a condition wherein an organism is exceptionally small, and mostly occurs in the animal kingdom. In humans, it is sometimes defined as an adult height of less than 147 centimetres, regardless of sex; the average adult height among people with dwarfism is 120 centimetres (4 ft). Disproportionate dwarfism is characterized by either short limbs or a short torso. In cases of proportionate dwarfism, both the limbs and torso are unusually small. Intelligence is usually normal, and most have a nearly normal life expectancy. People with dwarfism can usually bear children, though there are additional risks to the mother and child depending upon the underlying condition.
Macrocephaly is a condition in which circumference of the human head is abnormally large. It may be pathological or harmless, and can be a familial genetic characteristic. People diagnosed with macrocephaly will receive further medical tests to determine whether the syndrome is accompanied by particular disorders. Those with benign or familial macrocephaly are considered to have megalencephaly.
Mucopolysaccharidoses are a group of metabolic disorders caused by the absence or malfunctioning of lysosomal enzymes needed to break down molecules called glycosaminoglycans (GAGs). These long chains of sugar carbohydrates occur within the cells that help build bone, cartilage, tendons, corneas, skin and connective tissue. GAGs are also found in the fluids that lubricate joints.
Diastrophic dysplasia is an autosomal recessive dysplasia which affects cartilage and bone development. Diastrophic dysplasia is due to mutations in the SLC26A2 gene.
Thanatophoric dysplasia is a severe skeletal disorder characterized by a disproportionately small ribcage, extremely short limbs and folds of extra skin on the arms and legs.
Short stature refers to a height of a human which is below typical. Whether a person is considered short depends on the context. Because of the lack of preciseness, there is often disagreement about the degree of shortness that should be called short. Dwarfism is the condition of being very short, often caused by a medical condition. In a medical context, short stature is typically defined as an adult height that is more than two standard deviations below a population’s mean for age and sex, which corresponds to the shortest 2.3% of individuals in that population.
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 type II collagenopathies.
Hypochondroplasia (HCH) is a developmental disorder caused by an autosomal dominant genetic defect in the fibroblast growth factor receptor 3 gene (FGFR3) that results in a disproportionately short stature, micromelia and a head that appears large in comparison with the underdeveloped portions of the body. It is classified as short-limbed dwarfism.
Chondrodystrophy refers to a skeletal disorder caused by one of myriad genetic mutations that can affect the development of cartilage. As a very general term, it is only used in the medical literature when a more precise description of the condition is unavailable.
Autosomal recessive multiple epiphyseal dysplasia (ARMED), also called epiphyseal dysplasia, multiple, 4 (EDM4), multiple epiphyseal dysplasia with clubfoot or –with bilayered patellae, is an autosomal recessive congenital disorder affecting cartilage and bone development. The disorder has relatively mild signs and symptoms, including joint pain, scoliosis, and malformations of the hands, feet, and knees.
An osteochondrodysplasia, or skeletal dysplasia, is a disorder of the development of bone and cartilage. Osteochondrodysplasias are rare diseases. About 1 in 5,000 babies are born with some type of skeletal dysplasia. Nonetheless, if taken collectively, genetic skeletal dysplasias or osteochondrodysplasias comprise a recognizable group of genetically determined disorders with generalized skeletal affection. These disorders lead to disproportionate short stature and bone abnormalities, particularly in the arms, legs, and spine. Skeletal dysplasia can result in marked functional limitation and even mortality.
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.
Acrodysostosis is a rare congenital malformation syndrome which involves shortening of the interphalangeal joints of the hands and feet, intellectual disability in approximately 90% of affected children, and peculiar facies. Other common abnormalities include short head, small broad upturned nose with flat nasal bridge, protruding jaw, increased bone age, intrauterine growth retardation, juvenile arthritis and short stature. Further abnormalities of the skin, genitals, teeth, and skeleton may occur.
The Restricted Growth Association (RGA) is a UK charity that supports people with dwarfism.
Severe achondroplasia with developmental delay and acanthosis nigricans (SADDAN) is a very rare genetic disorder. This disorder is one that affects bone growth and is characterized by skeletal, brain, and skin abnormalities. Those affected by the disorder are severely short in height and commonly possess shorter arms and legs. In addition, the bones of the legs are often bowed and the affected have smaller chests with shorter rib bones, along with curved collarbones. Other symptoms of the disorder include broad fingers and extra folds of skin on the arms and legs. Developmentally, many individuals who suffer from the disorder show a higher level in delays and disability. Seizures are also common due to structural abnormalities of the brain. Those affected may also suffer with apnea, the slowing or loss of breath for short periods of time.
Oto-palato-digital syndrome is the generalised term for two conditions, oto-palato-digital syndrome type I (OPD1) and oto-palato-digital syndrome type II (OPD2), that are both X-linked recessive genetic disorders with overlapping phenotypes. The most severe phenotypes of each syndrome occur only in males, with females generally having attenuated forms of the condition, although this does not apply to all individual cases. Some writers conceptualise oto-palato-digital syndrome as a spectrum disorder including two similarly-presenting genetic syndromes, frontometaphyseal dysplasia and Melnick-Needles syndrome.
Spondyloenchondrodysplasia is the medical term for a rare spectrum of symptoms that are inherited following an autosomal recessive inheritance pattern. Skeletal anomalies are the usual symptoms of the disorder, although its phenotypical nature is highly variable among patients with the condition, including symptoms such as muscle spasticity or thrombocytopenia purpura. It is a type of immunoosseous dysplasia.
The Belangenvereniging van Kleine Mensen (BVKM)(English: Interest Association of Little People) is the Dutch Patients' Organization for little people and patients with skeletal dysplasia. The association focuses on individuals with one or more of the two hundred medical conditions falling under the category of dwarfism. Most members have a demonstrable growth disorder and are shorter than 155 cm. Volunteers are responsible for the organization.