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Deftereou TE, Karapepera VR, Alexiadi CA, Tologkos S, Papadatou V, Alexiadis G, Karamanidis D, Maria L. A Case of Fibular Aplasia-Tibial Campomelia-Oligosyndactyly (FATCO) Syndrome Associated With Split Hand/Foot Syndrome With Long Bone Deficiency (SHFLD) and Review of the Literature. Cureus 2024; 16:e65162. [PMID: 39176338 PMCID: PMC11339580 DOI: 10.7759/cureus.65162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2024] [Indexed: 08/24/2024] Open
Abstract
Split hand/foot malformation is a heterogeneous congenital disorder mainly presented with a median cleft of hands or/and feet. It can be associated with long bone aplasia, a syndrome also known as split hand/foot syndrome with long bone deficiency (SHFLD), which is a very rare condition. We report a very rare case of a male fetus with SHFLD syndrome combined with fibular aplasia, tibial campomelia, and oligosyndactyly (FATCO) syndrome. FATCO syndrome is also an extremely infrequent congenital limb defect by itself. Based on our review of the literature, there appears to be no other FATCO case reported in Greece.
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Affiliation(s)
| | - Vaya R Karapepera
- ENT Clinic, General Hospital of Ioannina "G. Hatzikosta", Ioannnina, GRC
| | | | - Stylianos Tologkos
- Laboratory of Histology-Embryology, Democritus University of Thrace, Alexandroupolis, GRC
| | - Vasiliki Papadatou
- Laboratory of Histology-Embryology, Democritus University of Thrace, Alexandroupolis, GRC
| | - Georgios Alexiadis
- Department of Radiology, Private Radiodiagnostic Center, Alexandroupolis, GRC
| | - Dimitrios Karamanidis
- Department of Obstetrics and Gynecology, University General Hospital of Alexandroupolis, Alexandroupolis, GRC
| | - Lambropoulou Maria
- Laboratory of Histology-Embryology, Democritus University of Thrace, Alexandroupolis, GRC
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Sifre-Ruiz A, Sagasta A, Santos E, Perez de Nanclares G, Heath KE. New pathogenic variant in DLX5: New clues for a clinical spectrum from split-hand-foot malformation to fibular aplasia, tibial campomelia and oligosyndactyly. Front Genet 2023; 14:1165780. [PMID: 37124614 PMCID: PMC10133553 DOI: 10.3389/fgene.2023.1165780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/05/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction: FATCO (Fibular Aplasia, Tibial Campomelia and Oligosyndactyly) is a very infrequent skeletal dysplasia classified within the limb hypoplasia-reduction defects group whose genetic cause has not yet been identified. The advent of next-generation sequencing is enabling the diagnosis of diseases with no previously known genetic cause. Methods: We performed a thorough autopsy on a fetus whose pregnancy was legally terminated due to severe malformations detected by ultrasound. A trio exome was run to identify the genetic cause and risk of recurrence. Previous literature of similar cases was systematically searched. Results: Anatomopathological analyses revealed complete fibular aplasia, shortened and campomelic tibia, absent ankle joint, club right foot and a split foot malformation, leading to the diagnosis of FATCO. Exome sequencing showed that the female fetus carried a de novo nonsense variant in DLX5. The literature search permitted the collection of information on 43 patients with FATCO, the majority of whom were males diagnosed postnatally. In most cases, lower limbs were affected exclusively, but in 39.5% of cases the upper limbs were also affected. Conclusion: The pathologies associated with DLX5 variants encompass a wide spectrum of manifestations ranging from abnormalities exclusively in the hands and feet to long bones such as the tibia and fibula.
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Affiliation(s)
- Anna Sifre-Ruiz
- Pathology Service, Bioaraba Research Health Institute, Araba University Hospital, Vitoria-Gasteiz, Spain
| | - Amaia Sagasta
- Pathology Service, Bioaraba Research Health Institute, Araba University Hospital, Vitoria-Gasteiz, Spain
| | - Erika Santos
- Radiodiagnostic Service, Araba University Hospital, Vitoria-Gasteiz, Spain
| | - Guiomar Perez de Nanclares
- Rare Diseases Research Group, Molecular (Epi)Genetics Laboratory, Bioaraba Research Health Institute, Araba University Hospital-Txagorritxu, Vitoria-Gasteiz, Araba, Spain
| | - Karen E. Heath
- Institute of Medical and Molecular Genetics (INGEMM), IdiPAZ, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain
- Skeletal Dysplasia Multidisciplinary Unit (UMDE), ERN-BOND, Hospital Universitario La Paz, Madrid, Spain
- CIBERER, ISCIII, Madrid, Spain
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Matalon DR, Bhoj EJ, Li D, McDougall C, Schindewolf E, Khalek N, Wilkens A, McManus M, Deardorff MA, Zackai EH. Genomic sequencing in a cohort of individuals with fibular aplasia, tibial campomelia, and oligosyndactyly (FATCO) syndrome. Am J Med Genet A 2023; 191:977-982. [PMID: 36610046 DOI: 10.1002/ajmg.a.63105] [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: 06/10/2022] [Revised: 11/19/2022] [Accepted: 12/16/2022] [Indexed: 01/09/2023]
Abstract
Fibular aplasia, tibial campomelia, and oligosyndactyly (FATCO) syndrome (MIM 246570) is a rare disorder characterized by specific skeletal findings (fibular aplasia, shortened or bowed tibia, and oligosyndactyly of the foot and/or hand). Typically, no other anomalies, craniofacial dysmorphism, or developmental delays are associated. Here we report three unrelated individuals with limb anomalies consistent with FATCO syndrome who have been followed clinically for 5 years. Genetic testing of previously reported individuals with FATCO syndrome has not revealed a genetic diagnosis. However, no broader sequencing approaches have been reported. We describe the results of the three individuals with FATCO syndrome from exome and genome sequencing, all of which was nondiagnostic. Our study suggests that FATCO syndrome is not the result of a simple monogenic etiology.
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Affiliation(s)
- Dena R Matalon
- Division of Medical Genetics, Stanford University, Stanford, California, USA
| | - Elizabeth J Bhoj
- Division of Human Genetics and Molecular Biology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Dong Li
- Division of Human Genetics and Molecular Biology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Carey McDougall
- Division of Human Genetics and Molecular Biology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Erica Schindewolf
- Center for Fetal Diagnosis and Therapy, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Nahla Khalek
- Center for Fetal Diagnosis and Therapy, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Alisha Wilkens
- Division of Human Genetics and Molecular Biology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Morgan McManus
- Division of Human Genetics and Molecular Biology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Matthew A Deardorff
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Elaine H Zackai
- Division of Human Genetics and Molecular Biology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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