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The Coffin-Siris syndrome.

We present the sixth reported case of the Coffin-Siris syndrome. This disorder is characterized by the absence of the nails of the fifth fingers and toes, severe mental and developmental retardation, and postnatal growth deficiency. Feeding and respiratory problems are prominent features. The Dandy-Walker malformation was found at autopsy in our patient. This malformation was also present in the only other patient with this syndrome whose autopsy has been reported.

Abnormalities, Multiple↗

Ring 19 mosaicism detected during prenatal diagnosis.

A ring chromosome 19 was found in 14 of 20 metaphases (67 per cent) derived from amniotic fluid cell cultures following amniocentesis because of increased maternal age. Elective termination of the pregnancy revealed a hypotrophic female fetus with mild dysmorphic signs, but no congenital malformations. The case is discussed in relation to three reports in the literature of ring chromosome 19 mosaicism in a phenotypically normal girl, a mentally retarded man, and a boy with normal psychomotor development and minor dysmorphic features.

Abnormalities, Multiple↗

The Floating-Harbor syndrome.

We describe the seventh patient with the Floating-Harbor syndrome. Similar to previous cases in the literature this girl presented with proportionate intrauterine and postnatal growth retardation, normocephaly, triangular face with bulbous nose, long eyelashes, short upper lip, small vermilion border of upper lip, dorsally rotated ears, deep nuchal hair line, hirsutism, and clinodactyly of little fingers. She exhibited mental retardation and retarded speech development. Clinical symptoms and differential diagnosis of this rare syndrome are briefly discussed.

Abnormalities, Multiple↗

Oral-facial-digital syndrome type 1 is another dominant polycystic kidney disease: clinical, radiological and histopathological features of a new kindred.

BACKGROUND: Oral-facial-digital syndrome type 1 (OFD1) is a rare disorder comprising malformations of the face, oral cavity, hands, and feet. Polycystic kidney disease (PKD) is a more recently recognized feature of the syndrome. SUBJECTS AND METHODS: We now report on the clinical, radiological and histopathological features of an OFD1 and PKD kindred with five affected members in three subsequent generations. RESULTS: All patients were female and had accompanying PKD as assessed by ultrasound scans. The plasma creatinine was normal in three, but PKD caused end-stage renal failure in two of these individuals in the second and fifth decades. A histochemical analysis of renal tissue from one affected member of this kindred demonstrated a predominantly glomerulocystic kidney disease with a minor population of cysts derived from distal tubules as assessed by staining with Arachis hypogaea lectin. Cyst epithelia had a high level of mitosis as assessed by staining with antisera to proliferating cell nuclear antigen, and distal cysts overexpressed PAX2 protein, a potentially oncogenic transcription factor. We detected multiple pancreatic cysts in one member affected by OFD1 although there were no symptoms of pancreatic disease; this constitutes a novel radiological feature of the syndrome. CONCLUSIONS: This kindred illustrates the inheritance pattern of OFD1 and its accompanying PKD. Although the renal disease superficially resembles ADPKD with macroscopic cysts and a dominant inheritance pattern, histology shows a predominance of glomerular cysts and the syndrome is X-linked, with affected males dying before birth. The recognition of the accompanying dysmorphic features is the key to a diagnosis of OFD1 in a female child or adult who presents with PKD.

Abnormalities, Multiple↗

Isolated and syndromic syngnathism: management, implications, and genetics.

We present 2 contrasting cases of congenital interalveolar synechiae. The first occurred in the setting of Van der Woude syndrome and was associated with a cleft palate. In the second case, it was an isolated abnormality and there was no contributory family history or syndromic associations. We review the literature on interalveolar synechiae and discuss its management, implications, and genetics. Interalveolar synechiae is a condition with an excellent prognosis; its presence necessitates careful examination for associated abnormalities and syndromes.

Abnormalities, Multiple↗

Recessive form of Freeman-Sheldon's syndrome or 'whistling face',.

Freeman-Sheldon's syndrome is a rare genetic disease inherited as an autosomal dominant trait in some families but showing sporadic appearance in the majority of the reported cases. In the present paper we report a family having two affected children from normal consanguineous parents suggesting that Freeman-Sheldon's syndrome may be heterogeneous from the genetic point of view.

Abnormalities, Multiple↗