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Schwartz DD, Fein RH, Carvalho CMB, Sutton VR, Mazzeu JF, Axelrad ME. Neurocognitive, adaptive, and psychosocial functioning in individuals with Robinow syndrome. Am J Med Genet A 2020; 185:3576-3583. [PMID: 32954672 DOI: 10.1002/ajmg.a.61854] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/10/2020] [Accepted: 08/14/2020] [Indexed: 11/12/2022]
Abstract
It has been estimated that 10-15% of people with Robinow syndrome (RS) show delayed development, but no studies have formally assessed developmental domains. The objective of this study is to provide the first description of cognitive, adaptive, and psychological functioning in RS. Thirteen participants (10 males) aged 4-51 years were seen for neuropsychological screening. Eight had autosomal-dominant RS (DVL1, n = 5; WNT5A, n = 3), four had autosomal-recessive RS (NXN, n = 2; ROR2, n = 2), and one had a mutation on an RS candidate gene (GPC4). Participants completed measures of intellectual, fine-motor, adaptive, executive, and psychological functioning. Findings indicated generally average intellectual functioning and low-average visuomotor skills. Adaptive functioning was average in autosomal-recessive RS (RRS) but low average in autosomal-dominant RS (DRS). Parent-report indicated executive dysfunction and attention problems in 4/8 children, 3/4 of whom had a DVL1 variant; adult self-report did not indicate similar difficulties. Learning disabilities were also reported in 4/8 individuals with DRS, 3/4 of whom had a DVL1 variant. Peer problems were reported for a majority of participants, many of whom also reported emotional concerns. Altogether, the findings indicate average neurocognitive functioning in RRS. In contrast, DRS, especially DVL1 pathogenic alleles, may confer specific risk for neurodevelopmental disability.
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Affiliation(s)
- David D Schwartz
- Section of Psychology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Rachel H Fein
- Section of Psychology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Claudia M B Carvalho
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - V Reid Sutton
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | | | - Marni E Axelrad
- Section of Psychology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
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2
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Kaissi AA, Kenis V, Shboul M, Grill F, Ganger R, Kircher SG. Tomographic Study of the Malformation Complex in Correlation With the Genotype in Patients With Robinow Syndrome: Review Article. J Investig Med High Impact Case Rep 2020; 8:2324709620911771. [PMID: 32172608 PMCID: PMC7074505 DOI: 10.1177/2324709620911771] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/11/2020] [Accepted: 01/26/2020] [Indexed: 11/17/2022] Open
Abstract
We aimed to understand the etiology behind the abnormal craniofacial contour and other clinical presentations in a number of children with Robinow syndrome. Seven children with Robinow syndrome were enrolled in this study (autosomal recessive caused by homozygous mutations in the ROR2 gene on chromosome 9q22, and the autosomal dominant caused by heterozygous mutation in the WNT5A gene on chromosome 3p14). In the autosomal recessive (AR) group, the main clinical presentations were intellectual, disability, poor schooling achievement, episodes of headache/migraine, and poor fine motor coordinative skills, in addition to massive restrictions of the spine biomechanics causing effectively the development of kyposcoliosis and frequent bouts of respiratory infections. Three-dimensional reconstruction computed tomography scan revealed early closure of the metopic and the squamosal sutures of skull bones. Massive spinal malsegmentation and unsegmented spinal bar were noted in the AR group. In addition to severe mesomelia and camptodactyly, in the autosomal dominant (AD) group, no craniosynostosis but few Wormian bones and the spine showed limited malsegemetation, and no mesomelia or camptodactyly have been noted. We wish to stress that little information is available in the literature regarding the exact pathology of the cranial bones, axial, and appendicular malformations in correlation with the variable clinical presentations in patients with the 2 types of Robinow syndrome.
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Affiliation(s)
- Ali Al Kaissi
- Hanusch Hospital, Vienna, Austria
- Orthopedic Hospital of Speising, Vienna, Austria
| | - Vladimir Kenis
- Pediatric Orthopedic Institute n.a. H. Turner, Saint-Petersburg, Russia
| | | | - Franz Grill
- Orthopedic Hospital of Speising, Vienna, Austria
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Abstract
Managing patients with rare genetic disorders is a challenge that dentists face often. Robinow syndrome (RS) is one such rare genetic disorder with <200 cases reported worldwide. RS demonstrates multiple craniofacial abnormalities and orodental disorders, which need to be taken into consideration by a dental practitioner while rendering dental care.
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Affiliation(s)
- Priti Sushil Jain
- Department of Pediatric and Preventive Dentistry, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Tejashri Shreyas Gupte
- Department of Pediatric and Preventive Dentistry, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Abdulkadeer M Jetpurwala
- Department of Pediatric and Preventive Dentistry, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Shely Pratik Dedhia
- Department of Pediatric and Preventive Dentistry, Nair Hospital Dental College, Mumbai, Maharashtra, India
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Basman A, Akay G, Peker I, Gungor K, Akarslan Z, Ozcan S, Ucok CO. Dental management and orofacial manifestations of a patient with Robinow Syndrome. J Istanb Univ Fac Dent 2017; 51:43-48. [PMID: 28955595 PMCID: PMC5573473 DOI: 10.17096/jiufd.86251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 04/25/2016] [Indexed: 11/15/2022] Open
Abstract
Robinow syndrome (RS) is an extremely rare condition. Characteristic craniofacial findings of RS include a fetal facial appearance, ear abnormalities and oral
findings. The aim of this case report was to evaluate the oral findings of a 26-year-old man with RS and to describe the dental treatments performed. The patient had
short stature, vertebral anomalies, short and broad fingers, a fetal facial appearance, gingival hyperplasia, fissured tongue, caries and multiple impacted teeth.
Periodontal and restorative dental treatments were performed under aseptic conditions with due precautions. No surgical treatment was performed to the impacted teeth
because of the lack of symptoms.
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Affiliation(s)
- Adil Basman
- Department of Periodontology Faculty of Dentistry Gazi University Turkey
| | - Gulsun Akay
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Gazi University Turkey
| | - Ilkay Peker
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Gazi University Turkey
| | - Kahraman Gungor
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Gazi University Turkey
| | - Zuhre Akarslan
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Gazi University Turkey
| | - Suat Ozcan
- Department of Restorative Dentistry Faculty of Dentistry Gazi University Turkey
| | - Cemile Ozlem Ucok
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Gazi University Turkey
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Mali S, Bansal N, Dhokar A, Yadav M. Orofacial Manifestations of Autosomal Recessive Robinow's Syndrome: A Rare Case Report. J Clin Diagn Res 2016; 10:ZD09-10. [PMID: 27135013 DOI: 10.7860/jcdr/2016/16318.7469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 11/17/2015] [Indexed: 11/24/2022]
Abstract
Robinow's syndrome is a very rare genetic disorder which bears a resemblance to a foetal face. It is characterized by short-limbed dwarfism, defects in vertebral segmentation and abnormalities in the head, face and external genitalia. It has a genetic heterogeneity with autosomal dominant and recessive forms which relates to the severity of phenotype presentation. A rare case of an autosomal recessive form of Robinow's syndrome is presented with emphasis on, characteristic craniofacial and intraoral manifestations to aid in diagnosis and dental management of this patient.
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Affiliation(s)
- Santosh Mali
- Lecturer, Department of Oral Medicine and Radiology, Terna Dental College and Hospital , Navi Mumbai, Maharashtra, India
| | - Neha Bansal
- Assistant Professor, Department of Oral Medicine and Radiology, Government Dental College , Aurangabad, Maharashtra, India
| | - Amol Dhokar
- Professor and Head of Department, Department of Oral Medicine and Radiology, Terna Dental College and Hospital , Navi Mumbai, Maharashtra, India
| | - Monica Yadav
- Professor and Head of Department, Department of Oral Pathology, Terna Dental College and Hospital , Navi Mumbai, Maharashtra, India
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Altunkas A, Sarikaya B, Aktas F, Ozmen Z, Sonmezgoz F, Acu B, Pinarbasili T, Firat MM. Vertebral anomalies accompanying Robinow syndrome. Spine J 2016; 16:e341-2. [PMID: 26674440 DOI: 10.1016/j.spinee.2015.11.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 11/10/2015] [Accepted: 11/19/2015] [Indexed: 02/03/2023]
Affiliation(s)
- Aysegul Altunkas
- School of Medicine, Department of Radiology, Gaziosmanpasa University, Tokat, Turkey
| | - Basar Sarikaya
- Department of Radiology, Camlica Medicana Hospital, Istanbul, Turkey
| | - Fatma Aktas
- School of Medicine, Department of Radiology, Gaziosmanpasa University, Tokat, Turkey
| | - Zafer Ozmen
- School of Medicine, Department of Radiology, Gaziosmanpasa University, Tokat, Turkey
| | - Fitnet Sonmezgoz
- School of Medicine, Department of Radiology, Gaziosmanpasa University, Tokat, Turkey
| | - Berat Acu
- School of Medicine, Department of Radiology, Osmangazi University, Eskisehir, Turkey
| | - Tansu Pinarbasili
- Department of Radiology, Mersin Tarsus Government Hospital, Tarsus, Mersin, Turkey
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Cerqueira DF, de Souza IPR. Orofacial manifestations of Robinow's syndrome: a case report in a pediatric patient. ACTA ACUST UNITED AC 2007; 105:353-7. [PMID: 18061493 DOI: 10.1016/j.tripleo.2007.05.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2006] [Revised: 05/23/2007] [Accepted: 05/28/2007] [Indexed: 10/22/2022]
Abstract
Robinow's syndrome (Online Mendelian Inheritance in Man [OMIM] 268310), or fetal facies syndrome, is a rare genetic disorder causing autosomal dominant and recessive forms. This syndrome includes a series of anomalies such as short stature, characteristic facial dysmorphism (fetal facies), genital hypoplasia, and mesomelic brachymelia. The purpose of the present case is to describe the orofacial manifestations of the syndrome in a pediatric patient: craniofacial features, triangular mouth and a long upper lip philtrum, ankyloglossia, a shortened tongue devoid of tongue tip, a geographic tongue, arched palate, gingival hyperplasia, dental abnormalities (misaligned and crowded teeth), and delayed tooth eruption.
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Affiliation(s)
- Daniella Ferraz Cerqueira
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Mazzeu JF, Pardono E, Vianna-Morgante AM, Richieri-Costa A, Ae Kim C, Brunoni D, Martelli L, de Andrade CEF, Colin G, Otto PA. Clinical characterization of autosomal dominant and recessive variants of Robinow syndrome. Am J Med Genet A 2007; 143:320-5. [PMID: 17256787 DOI: 10.1002/ajmg.a.31592] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Robinow syndrome is a genetically heterogeneous condition characterized by mesomelic limb shortening associated with facial and genital anomalies that can be inherited in an autosomal dominant or recessive mode. We characterized these two variants clinically, with the aim of establishing clinical criteria to enhance the differential diagnosis between them or other similar conditions. The frequencies of clinical signs considered important for the discrimination of the dominant or recessive variants were estimated in a sample consisting of 38 patients personally examined by the authors and of 50 affected subjects from the literature. Using the presence of rib fusions as diagnostic of the recessive variant, and also based on the inheritance pattern in familial cases, we classified 37 patients as having the recessive form and other 51 as having the dominant form. The clinical signs present in more than 75% of patients with either form, and therefore the most important for the characterization of this syndrome were hypertelorism, nasal features (large nasal bridge, short upturned nose, and anteverted nares), midface hypoplasia, mesomelic limb shortening, brachydactyly, clinodactyly, micropenis, and short stature. Hemivertebrae and scoliosis were present in more than 75% of patients with the recessive form, but in less than 25% of patients with the dominant form. Umbilical hernia (32.3%) and supernumerary teeth (10.3%) were found exclusively in patients with the dominant form.
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Affiliation(s)
- Juliana Forte Mazzeu
- Departamento de Genética e Biologia Evolutiva, Instituto de Biociências, Universidade de São Paulo, Brazil
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Al Kaissi A, Bieganski T, Baranska D, Chehida FB, Gharbi H, Ghachem MB, Hendaoui L, Safi H, Kozlowski K. Robinow syndrome: report of two cases and review of the literature. ACTA ACUST UNITED AC 2007; 51:83-6. [PMID: 17217496 DOI: 10.1111/j.1440-1673.2006.01668.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We report two patients with Robinow syndrome, review the published literature and stress the importance and limitations of radiographic examination in the diagnosis of this disorder, which shows extreme clinical and radiographic variability. The radiographic differential diagnosis of Robinow syndrome is discussed.
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Affiliation(s)
- A Al Kaissi
- Department of Paediatric Orthopaedics, Children's Hospital Tunis, Tunsia
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Leung AKC, McLeod DR. Autosomal dominant flat umbilicus. Am J Med Genet A 2004; 131:307-9. [PMID: 15523632 DOI: 10.1002/ajmg.a.30395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
We describe a Chinese family among whom five members in three generations had a flat umbilicus with vertical and male to male transmission indicative of autosomal dominant inheritance. Except the proband, who also had Tetralogy of Fallot, other affected members had a flat umbilicus as an isolated anomaly. Autosomal dominant transmission of isolated flat umbilicus has not been reported previously.
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Affiliation(s)
- Alexander K C Leung
- Department of Pediatrics, the University of Calgary, Alberta Children's Hospital, Calgary, Alberta T2M 0H5, Canada.
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Afzal AR, Jeffery S. One gene, two phenotypes: ROR2 mutations in autosomal recessive Robinow syndrome and autosomal dominant brachydactyly type B. Hum Mutat 2003; 22:1-11. [PMID: 12815588 DOI: 10.1002/humu.10233] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Autosomal recessive Robinow syndrome (RRS) is a severe skeletal dysplasia with short stature, generalized limb shortening, segmental defects of the spine, brachydactyly, and a dysmorphic facial appearance. The gene encoding receptor orphan receptor tyrosine kinase 2 (ROR2) is located on chromosome 9q22 and homozygous loss-of-function mutations in this gene are responsible for RRS. Moreover, knocking out the mouse Ror2 gene causes mesomelic dwarfism in the homozygous state, with almost identical features to recessive Robinow syndrome. The protein product of this gene is a cell membrane receptor, containing distinct motifs including an immunoglobulin-like (Ig) domain, a Frizzled-like cysteine-rich domain (FRZ or CRD), and a kringle domain (KD) in the extracellular region; and an intracellular region with tyrosine kinase (TK), serine/threonine-rich, and proline-rich structures. The extracellular motifs of the ROR2 protein are known to be involved in protein-protein interactions. The tyrosine kinase domain is involved in an as yet uncharacterized signaling pathway. Interestingly, heterozygous mutations in ROR2 have recently been shown to give rise to autosomal dominant brachydactyly type B1 (BDB1). This condition is characterized by terminal deficiency of fingers and toes. A variety of mutations have been reported in ROR2. Here, these genetic defects are compiled and possible genotype-phenotype correlations are discussed.
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Affiliation(s)
- Ali R Afzal
- Medical Genetics Unit, St George's Hospital Medical School, London, UK.
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Afzal AR, Rajab A, Fenske CD, Oldridge M, Elanko N, Ternes-Pereira E, Tüysüz B, Murday VA, Patton MA, Wilkie AO, Jeffery S. Recessive Robinow syndrome, allelic to dominant brachydactyly type B, is caused by mutation of ROR2. Nat Genet 2000; 25:419-22. [PMID: 10932186 DOI: 10.1038/78107] [Citation(s) in RCA: 209] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The autosomal recessive form of Robinow syndrome (RRS; MIM 268310) is a severe skeletal dysplasia with generalized limb bone shortening, segmental defects of the spine, brachydactyly and a dysmorphic facial appearance. We previously mapped the gene mutated in RRS to chromosome 9q22 (ref. 4), a region that overlaps the locus for autosomal dominant brachydactyly type B (refs 5,6). The recent identification of ROR2, encoding an orphan receptor tyrosine kinase, as the gene mutated in brachydactyly type B (BDB1; ref. 7) and the mesomelic dwarfing in mice homozygous for a lacZ and/or a neo insertion into Ror2 (refs 8,9) made this gene a candidate for RRS. Here we report homozygous missense mutations in both intracellular and extracellular domains of ROR2 in affected individuals from 3 unrelated consanguineous families, and a nonsense mutation that removes the tyrosine kinase domain and all subsequent 3' regions of the gene in 14 patients from 7 families from Oman. The nature of these mutations suggests that RRS is caused by loss of ROR2 activity. The identification of mutations in three distinct domains (containing Frizzled-like, kringle and tyrosine kinase motifs) indicates that these are all essential for ROR2 function.
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Affiliation(s)
- A R Afzal
- Medical Genetics Unit, St George's Hospital Medical School, London, UK
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