Thanatophoric dysplasia

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Thanatophoric dysplasia
Thanatophoric-dwarf-102.jpg
Radiogram of a baby born with thanatophoric dwarfism
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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.

Contents

Symptoms and signs

Infant with cloverleaf skull and shortened limbs (likely thanatophoric dysplasia), 1849 ABNORMALITIES; Tabulae ad illustrandam embry Wellcome L0032358.jpg
Infant with cloverleaf skull and shortened limbs (likely thanatophoric dysplasia), 1849

Infants with this condition have disproportionately short arms and legs with extra folds of skin. Other signs of the disorder include a narrow chest, small ribs, underdeveloped lungs, and an enlarged head with a large forehead and prominent, wide-spaced eyes. Thanatophoric dysplasia is a lethal skeletal dysplasia divided into two subtypes. Type I is characterized by extreme rhizomelia, bowed long bones, narrow thorax, a relatively large head, normal trunk length and absent cloverleaf skull. The spine shows platyspondyly, the cranium has a short base, and, frequently, the foramen magnum is decreased in size. The forehead is prominent, and hypertelorism and a saddle nose may be present. Hands and feet are normal, but fingers are short. Type II is characterized by short, straight long bones and cloverleaf skull. [1] It presents with typical telephone-handle shaped long bones and H-shaped vertebrae.[ citation needed ]

Causes

It can be associated with missense mutations in fibroblast growth factor receptor-3. It is inherited in an autosomal dominant manner. [2] [3]

While the condition can be inherited, most cases of thanatophoric dysplasia are caused by new mutations in people with no family history of the disorder. No individual with thanatophoric dysplasia is known to have had children, so the disorder has not been observed to have been passed down to the next generation. Thanatophoric dysplasia occurs in 1 in 20,000 to 50,000 newborns, and type I thanatophoric dysplasia is more common than type II thanatophoric dysplasia. [4]

Diagnosis

Classification

Infants with type 1 thanatophoric dysplasia also have curved thigh bones, flattened bones of the spine (platyspondyly) and shortened thoracic ribs. Note: Prenatal ultra-sound images of the ribs sometimes appear asymmetrical when in fact they are not. In certain cases, this has caused a misdiagnosis of osteogenesis imperfecta (OI) type II.[ citation needed ]

An unusual head shape called kleeblattschaedel ("cloverleaf skull") can be seen with type 2 thanatophoric dysplasia. [5]

Prognosis

The term thanatophoric is Greek for "death bearing". Children with this condition are usually stillborn or die shortly after birth from respiratory failure. A small number have survived into childhood, and a very few beyond. Survivors have difficulty breathing on their own and require respiratory support such as high flow oxygen through a canula or ventilator support via tracheostomy. There may also be evidence of spinal stenosis and seizures. The oldest known living TD survivor as of 2013 was a 29-year-old woman. [6] One man lived to be 26 years old. Another man lived to age 20. It was reported in 1998 that a 21 year old man with the condition lives in the United States, while two children with TD aged 10 and 12, a boy and a girl, were known in Germany. There was also a 6-year-old boy living with TD and two 1-year old boys. [7] As of 2023 Christopher Álvarez, 26, is a Colombian living with TD in New York City. [8]

Incidence

This condition affects about 1 in 60,000 births. [9] [ failed verification ]

Related Research Articles

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.

<span class="mw-page-title-main">Dwarfism</span> Small size of an organism, caused by growth deficiency or genetic mutations

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.

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

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Kniest dysplasia is a rare form of dwarfism caused by a mutation in the COL2A1 gene on chromosome 12. 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.

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<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 type II collagenopathies.

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

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<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">Fibroblast growth factor receptor 3</span> Gene involved in the most common form of dwarfism

Fibroblast growth factor receptor 3 is a protein that in humans is encoded by the FGFR3 gene. FGFR3 has also been designated as CD333. The gene, which is located on chromosome 4, location p16.3, is expressed in tissues such as the cartilage, brain, intestine, and kidneys.

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<span class="mw-page-title-main">Severe achondroplasia with developmental delay and acanthosis nigricans</span> Medical condition

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<span class="mw-page-title-main">Spondyloepimetaphyseal dysplasia-short limb-abnormal calcification syndrome</span> Medical condition

Spondyloepimetaphyseal dysplasia-short limb-abnormal calcification syndrome is a rare genetic disorder which is characterized by osseous anomalies resulting in short stature and other afflictions.

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

Czech dysplasia metatarsal type is a rare type of Czech dysplasia which is characterized primarily by bone anomalies.

<span class="mw-page-title-main">Calvarial doughnut lesions-bone fragility syndrome</span> Medical condition

Calvarial doughnut lesions-bone fragility syndrome, also known as familial calvarial doughnut lesions, is a rare autosomal dominant genetic disorder characterized by mild to moderate fragility of the bones accompanied with calvarial doughnut lesions.

References

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  2. Bonaventure J, Gibbs L, Horne WC, Baron R (2007). "The localization of FGFR3 mutations causing thanatophoric dysplasia type I differentially affects phosphorylation, processing and ubiquitylation of the receptor". FEBS J. 274 (12): 3078–93. doi: 10.1111/j.1742-4658.2007.05835.x . PMID   17509076.
  3. Lievens PM, Liboi E (2003). "The thanatophoric dysplasia type II mutation hampers complete maturation of fibroblast growth factor receptor 3 (FGFR3), which activates signal transducer and activator of transcription 1 (STAT1) from the endoplasmic reticulum". J. Biol. Chem. 278 (19): 17344–9. doi: 10.1074/jbc.M212710200 . PMID   12624096.
  4. "Thanatophoric dysplasia". MedlinePlus. Retrieved 26 February 2023.
  5. Norman AM, Rimmer S, Landy S, Donnai D (1992). "Thanatophoric dysplasia of the straight-bone type (type 2)". Clin. Dysmorphol. 1 (2): 115–20. doi:10.1097/00019605-199204000-00008. PMID   1345514.
  6. Nikkel, Sarah M.; Major, Nathalie; King, W. James (2013-12-01). "Growth and development in thanatophoric dysplasia – an update 25 years later". Clinical Case Reports. 1 (2): 75–78. doi:10.1002/ccr3.29. ISSN   2050-0904. PMC   4184754 . PMID   25356217.
  7. Baker, K. M.; Olson, D. S.; Harding, C. O.; Pauli, R. M. (1997). "Long-term survival in typical thanatophoric dysplasia type 1". American Journal of Medical Genetics. 70 (4): 427–436. doi:10.1002/(SICI)1096-8628(19970627)70:4<427::AID-AJMG18>3.0.CO;2-J. PMID   9182787.
  8. "New Scholarship Helps Adelphi Students Who Face the Biggest Challenges". Adelphi University. 6 August 2019. Retrieved 1 February 2021.
  9. Vajo, Zoltan; Francomano CA; Wilkin DJ (2000). "The molecular and genetic basis of fibroblast growth factor receptor 3 disorders: the achondroplasia family of skeletal dysplasias, Muenke craniosynostosis, and Crouzon syndrome with acanthosis nigricans". Endocr. Rev. 21 (1): 23–39. doi: 10.1210/edrv.21.1.0387 . PMID   10696568. S2CID   43581040.