Conradi–Hünermann syndrome

Conradi–Hünermann syndrome is a rare type of chondrodysplasia punctata. It is associated with the EBP gene[3][4] and affects between one in 100,000 and one in 200,000 babies.

Conradi–Hünermann syndrome
Other names"Conradi–Hünermann–Happle syndrome",[1]:500 "Happle syndrome,"[2] and "X-linked dominant chondrodysplasia punctata"[2]
SpecialtyMedical genetics 

Signs and symptoms

Possible signs and symptoms may include [5]

  • Transient linear ichthyosiform erythroderma presenting with thick feathery scales along the blaschko lines with abnormal redness of the skin right after the birth to early infancy [6]
  • The scales are replaced with small skin depressions known as follicular atrophoderma [7]
  • alopecia and coarse sparse hair
  • Growth deficiency
  • Low nasal bridge
  • Flat face
  • Down-slanting space between eyelids
  • Cataracts
  • Asymmetric limb shortness
  • Joint shortening or spasms
  • Frequent scoliosis
  • Frequent kyphosis
  • Syndactyly [8]
  • Polydactyly [9]
  • Rhizomelic shortening of the limbs [10]

Genetics

Conradi–Hünermann syndrome is a form of chondrodysplasia punctata, a group of rare genetic disorders of skeletal development involving abnormal accumulations of calcium salts within the growing ends of long bones. Conradi–Hünermann syndrome is commonly associated with mild to moderate growth deficiency, disproportionate shortening of long bones, particularly those of the upper arms and the thigh bones, short stature, and/or curvature of the spine. In rare cases, intellectual disability may also be present. While evidence suggests that Conradi–Hünermann syndrome predominantly occurs in females and is usually inherited as an X-linked dominant trait, rare cases in which males were affected have also been reported.

The genetics of Conradi–Hünermann syndrome have perplexed medical geneticists, pediatricians and dermatologists for some time, but a number of perplexing features of the genetics of the syndrome have now been resolved, including the fact that the disease is caused by mutations in a gene, and these mutations are simple substitutions, deletions or insertions and are therefore not "unstable". Scientists are still trying to understand exactly where the mutation occurs so that they can correct it.

Diagnosis

An important test to confirm a diagnosis of Conradi-Hünermann syndrome is evaluating the plasma for elevated levels of a substance known as sterols. Mutations of the EBP gene result in the accumulation of sterols in the plasma and certain tissues of the body. Sterol levels are measured by gas chromatography-mass spectrometry. [11]

Screening

Genetic screening for Conradi-Hünermann syndrome via the EBP Gene is offered by multiple providers.[12][13]

Treatment

Treatment can involve operations to lengthen the leg bones, which involves many visits to the hospital. Other symptoms can be treated with medicine or surgery. Most female patients with the syndrome can live a long and normal life, while males have only survived in rare cases.

History

It is also known as Happle's syndrome, after the German Physician, Rudolf Happle (b. 1938), who wrote a series of papers about the disease in 1976. The name Conradi-Hünermann Syndrome is named for Erich Conradi (1882–1968), and Carl (Karl) Hünermann (1904–1978), both are German Physicians.

See also

References
  1. Thomas Bernard Fitzpatrick; Irwin M. Freedberg (2003). Fitzpatrick's Dermatology in General Medicine. ISBN 978-0-07-138076-8.
  2. Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L.; Joseph L. Jorizzo; Ronald P. Rapini (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
  3. Ausavarat S, Tanpaiboon P, Tongkobpetch S, Suphapeetiporn K, Shotelersuk V (2008). "Two novel EBP mutations in Conradi–Hünermann–Happle syndrome". Eur J Dermatol. 18 (4): 391–3. doi:10.1684/ejd.2008.0433 (inactive 2021-01-16). PMID 18573709.CS1 maint: DOI inactive as of January 2021 (link)
  4. Steijlen PM, van Geel M, Vreeburg M, et al. (December 2007). "Novel EBP gene mutations in Conradi–Hünermann–Happle syndrome". Br. J. Dermatol. 157 (6): 1225–9. doi:10.1111/j.1365-2133.2007.08254.x. PMID 17949453. S2CID 25890696.
  5. Rajabi, Fateme (2021/1/29). "A neonate with feathery scales". The Journal of Pediatrics. doi:10.1016/j.jpeds.2021.01.049. PMID 33516679. Check date values in: |date= (help)
  6. Rajabi, Fateme (2021/1/29). "A neonate with feathery scales". The Journal of Pediatrics. doi:10.1016/j.jpeds.2021.01.049. PMID 33516679. Check date values in: |date= (help)
  7. Rajabi, Fateme (2021/1/29). "A neonate with feathery scales". The Journal of Pediatrics. doi:10.1016/j.jpeds.2021.01.049. PMID 33516679. Check date values in: |date= (help)
  8. Rajabi, Fateme (2021/1/29). "A neonate with feathery scales". The Journal of Pediatrics. doi:10.1016/j.jpeds.2021.01.049. PMID 33516679. Check date values in: |date= (help)
  9. Rajabi, Fateme (2021/1/29). "A neonate with feathery scales". The Journal of Pediatrics. doi:10.1016/j.jpeds.2021.01.049. PMID 33516679. Check date values in: |date= (help)
  10. Rajabi, Fateme (2021/1/29). "A neonate with feathery scales". The Journal of Pediatrics. doi:10.1016/j.jpeds.2021.01.049. PMID 33516679. Check date values in: |date= (help)
  11. National Organization for Rare Disorders. "Conradi Hünermann Syndrome - NORD (National Organization for Rare Disorders)". National Organization for Rare Disorders. National Organization for Rare Disorders. Retrieved 2018-03-01.
  12. National Center for Biotechnology Information (2016-08-17). "Clinical test for Chondrodysplasia punctata 2 X-linked dominant Offered by Laboratory Genetic Metabolic Diseases". National Center for Biotechnology Information. National Center for Biotechnology Information. Retrieved 2018-03-01.
  13. National Center for Biotechnology Information (2017-12-04). "Clinical test for Chondrodysplasia punctata 2 X-linked dominant offered by PreventionGenetics". National Center for Biotechnology Information. National Center for Biotechnology Information. Retrieved 2018-03-01.
Classification
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