Espondiloencondrodisplasia con desregulación inmune relacionada a ACP5. Reporte de cuatro casos / Spondyloenchondrodysplasia with immune dysregulation related to ACP5. A report of 4 cases

La espondiloencondrodisplasia con desregulación inmune relacionada a ACP5 (SPENCDI #607944, por la sigla de spondyloenchondrodysplasia with immune dysregulation y el número que le corresponde en OMIM, Online Mendelian Inheritance in Man) es una displasia inmuno-ósea poco frecuente con manifestaciones heterogéneas y gravedad variable. Presenta lesiones espondilometafisarias, disfunción inmune y compromiso neurológico. Se reportan aspectos clínicos, radiológicos y genéticos de cuatro niñas con SPENCDI en un hospital pediátrico. Todas presentaron manifestaciones esqueléticas y tres de ellas enfermedad inmunológica grave. Se encontró en tres pacientes la variante probablemente patogénica c.791T>A; p.Met264Lys en homocigosis, y en una paciente las variantes c.791T>A; p.Met264Lys y c.632T>C; p.lle211Thr (variante de significado incierto con predicción patogénica según algoritmos bioinformáticos) en heterocigosis compuesta en ACP5. La presencia de la variante repetida c.791T>A sugiere la posibilidad de un ancestro en común en nuestra población. El reconocimiento y diagnóstico de esta entidad es importante para lograr un oportuno abordaje, que deberá ser multidisciplinario, orientado hacia la prevención de posibles complicaciones.

Spondyloenchondrodysplasia with immune dysregulation related to ACP5 (SPENCDI, OMIM number 607944) is an uncommon immune-skeletal dysplasia with heterogeneous manifestations and variable severity. It is characterized by spondylar and metaphyseal lesions, immune dysfunction, and neurological involvement. Here we report the clinical, radiological and genetic aspects of 4 girls with SPENCDI treated at a children's hospital. They all had skeletal manifestations and 3 developed severe immune disease. In 3 patients, the likely pathogenic variant c.791T>A; p.Met264Lys (homozygous mutation) was observed, while 1 patient had variants c.791T>A; p.Met264Lys and c.632T>C; p.lle211Thr (variant of uncertain significance with pathogenic prediction based on bioinformatics algorithms) caused by a compound heterozygous mutation in ACP5. The repeated presence of variant c.791T>A suggests the possibility of a common ancestor in our population. The recognition and diagnosis of this disorder is important to achieve a timely approach, which should be multidisciplinary and aimed at preventing possible complications.

Verma-Naumoff syndrome: a case report / Síndrome de Verma-Naumoff: a propósito de un caso

In skeletal dysplasias, there are short rib polydactyly syndromes, which traditionally differentiate into four lethal types. This report describes a case of Type III, which presented characteristics of Types I and II. A 38-year-old woman presented fetal growth restriction at 17 weeks and 6 days, decreased amniotic fluid, enlarged and hyperechogenic kidneys, and long bones below the 3rd percentile. Three weeks later, she developed anhydramnia. The couple did not consent to the performance of an invasive test for genetic diagnosis and chose to maintain the pregnancy. At 33 weeks, due to premature labor and interactivity, a cesarean section was performed, giving birth to a female baby, who died due to respiratory failure there were no vocal cords and no trachea visible at laryngoscopy. On physical examination, he had the phenotypic characteristics of the syndrome. An X-ray showed short ribs and severe pulmonary hypoplasia. After birth, the parents chose not to carry out a genetic study or an anatomical examination. Researchers have suggested that there is an intersection of the anatomical changes of the types. This case report supports this theory.

En las displasias esqueléticas, existen síndromes de polidactilia de costillas cortas, que tradicionalmente se diferencian en cuatro tipos letales. Este reporte describe un caso del tipo III, que presentó características de los tipos I y II. Mujer de 38 años con restricción del crecimiento fetal a las 17 semanas y 6 días, líquido amniótico disminuido, riñones agrandados e hiperecogénicos y huesos largos por debajo del percentil 3. Tres semanas después, desarrolló anhidramnia. La pareja no consintió en la realización de una prueba invasiva de diagnóstico genético y optó por mantener el embarazo. A las 33 semanas, debido al parto prematuro y la interactividad, se realizó una cesárea, dando a luz a un bebé, que murió debido a una insuficiencia respiratoria: no había cuerdas vocales ni tráquea visible en la laringoscopia. Al examen físico presentaba las características fenotípicas del síndrome. Una radiografía mostró costillas cortas e hipoplasia pulmonar severa. Después del nacimiento, los padres optaron por no realizar un estudio genético ni un examen anatómico. Los investigadores han sugerido que existe una intersección de los cambios anatómicos de los tipos. Este reporte de caso apoya esta teoría.

Cleıdocranıal Dysplasıa: A Rare Skeletal Dysplasıa

ABSTRACT Cleidocranial dysplasia (CCD) is a rare autosomal dominant skeletal dysplasia. Hypoplastic clavicles, delayed closure of the cranial sutures, dental abnormalities, and short stature are main features in this syndrome. RUNX2 is the responsible gene for CCD. Here we reported two cases with CCD; they are admitted to clinic for short stature and dental abnormalities. We report these cases to increase the awareness of clinicians

Achondroplasia: a case report and the review of the basics

The achondroplasia is a variant of short-limbed dwarfism. The word achondroplasia literally means without cartilage formation. However, in achondroplasia the problem is not in formation of cartilage but, in its conversion to bone (i.e. ossification). This deficient ossification is particularly seen in the long bones of arm and leg. The characteristic external appearance of people born with achondroplasia is short stature. The average height of an adult male with achondroplasia is 131 centimetres (4 feet, 4 inches), and the average height for adult females is 124 centimetres (4 feet, 1 inch). The trunk is of average size but the leg and upper arm is of short length. It is because the femur and humerus are relatively shorter in length. The range of movement at elbow is limited. The head is enlarged called macrocephaly and is with a prominent forehead. People with Achondroplasia are generally of normal intelligence. They have bowed legs and abnormal curvature of spine giving rise to lordosis or kyphosis. They may develop spinal stenosis, which is associated with pain, tingling and weakness in leg. This may cause difficulty in walking. The other health problems associated with Achondroplasia are episodes of apnoea, obesity and recurrent ear infection. The purpose of this study is to evaluate the cardinal phenotypic features in patient of Achondroplasia. It is also to assess the body physique, anthropometric measurements and to study the typical radiological signs in such patients as the main tool of diagnosis.

Wolcott-Rallison Syndrome- Endocrinopathy with Recurrent Acute Liver Failure

A 2-yr-old child with early onset diabetes and hypothyroidism,and diagnosed as Wolcott-Rallison Syndrome, developed twoepisodes of acute liver failure and recovered, but he remains athigh risk of developing another episode of acute liver failure.Autoimmune, metabolic or genetic disorders should be evaluatedin children with recurrent acute liver failure and genetic testsneeds to be considered

Novel mutation in Cul7 gene in a family diagnosed with 3M syndrome

This study evaluates a family with two siblings having severe growth retardation and facial dysmorphism, born to consanguineous normal healthy parents. Affymetrix CytoScan 750K microarray showed a 34-Mb pericentric homozygous region on chromosome 6 for both siblings. CUL7 was one of the 141 genes present in this region. Sanger sequencing of CUL7 gene detected a 2-bp novel deletion in the 15th exon (c.2943_2944delCT of the cDNA). This deletion leads to a frameshift and a premature termination signal much upstream of the wild-type termination signal, leading to a nonsense mediated decay of the mRNA. CUL7 protein plays an important role in formation of 3M complex, ubiquitination, microtubule dynamics and cell cycle regulation. Mutations in CUL7 gene is known to cause a rare 3M syndrome. Information about the novel mutation has been accepted in the ClinVar database with rs1064792895.

Diagnosis of atelosteogenesis type I suggested by fetal ultrasonography and atypical paternal phenotype with mosaicism / Diagnóstico de atelosteogênese tipo I sugerido por ultrassonografia fetal e fenótipo paterno atípico com mosaicismo

Abstract Atelosteogenesis type I (AOI) is an autosomal dominant skeletal dysplasia caused by mutations in the filamin B (FLNB) gene with classic and well-recognizable clinical findings. However, parents affected with a mild phenotype, probably with somatic mosaicism, can generate offspring with a much more severe phenotype of AOI. In the present report, we describe a female newborn with classic AOI leading to early neonatal death, whose diagnostic was based on prenatal radiological findings and on the physical examination of the father. Since her father had limb deformities and corporal asymmetry, suggesting somatic mosaicism, his biological samples were analyzed through a gene panel for skeletal dysplasias. A missense mutation not previously described in the literature was detected in the FLNB gene, affecting ~ 20% of the evaluated cells and, therefore, confirming the diagnosis ofmosaic AOI in the father. The molecular analysis of the father was crucial to suggest the diagnosis of AOI in the newborn, since she died early and there were no biological samples available.

Resumo A atelosteogênese tipo I (AOI) é uma displasia esquelética autossômica dominante causada por mutações no gene filamina B (FLNB) comachados clínicos clássicos e bem reconhecíveis. No entanto, pais afetados com um fenótipo mais leve, provavelmente commosaicismo somático, podem gerar uma prole comumfenótipomuito mais grave de AOI. No presente relato, descrevemos um recém-nascido do sexo feminino comAOI clássica, que levou à morte neonatal precoce, e cujo diagnóstico foi baseado em achados radiológicos pré-natais e no exame físico de seu genitor. Como o genitor apresentava deformidades em membros e assimetria corporal, que sugeriam mosaicismo somático, suas amostras biológicas foram analisadas por meio de um painel de genes para displasias esqueléticas. Umamutação missense, não descrita anteriormente na literatura, foi detectada no gene FLNB, afetando ~ 20% das células avaliadas, e, portanto, confirmando o diagnóstico de AOI em mosaico no genitor. A análise molecular realizada no genitor foi fundamental para sugerir o diagnóstico de AOI na recém-nascida, uma vez que esta morreu precocemente, e não havia amostras biológicas disponíveis.

Displasias esqueléticas: Reporte de un caso y revisión de la literatura / Skeletal dysplasias: Report of a case and review of the literature

RESUMEN Las displasias esqueléticas son un grupo heterogéneo de condiciones que afectan primariamente la formación y crecimiento de huesos y cartílagos, se caracterizan por un acortamiento generalizado de huesos largos. Son patologías de baja prevalencia, que se pueden diagnosticar con precisión mediante ultrasonografía del primer y segundo trimestre. La importancia de esta patología radica en que posee una letalidad cercana al 50%. La displasia esqueletica letal más frecuente es la displasia tanatofórica, la cual se caracteriza por macrocefalia con base de cráneo estrecha, tórax estrecho, cuerpos vertebrales planos, micromelia generalizada, ausencia de fracturas, ventriculomegalia, polihidroamnios y mineralización ósea normal. Debido a que la presentación de la displasia tanatoforica se debe a una mutación autosómica dominante de novo no germinal, el riesgo de recurrencia no es mayor que el de la población general. Dado su elevada letalidad no pasa a generaciones futuras.

SUMMARY Skeletal dysplasias are a heterogeneous group of conditions that primarily affect the formation and growth of bones and cartilage, characterized by a generalized shortening of long bones. These are pathologies of low prevalence, which can be accurately diagnosed by first and second trimester ultrasonography. The importance of this pathology lies in that it has a lethality close to 50%. The most common lethal skeletal dysplasia is tanophilic dysplasia, which is characterized by macrocephaly with a narrow cranial base, narrow chest, flat vertebral bodies, generalized micromelia, absence of fractures, ventriculomegaly, polyhydroamnios and normal bone mineralization. Because the presentation of the tanophoretic dysplasia is due to an autosomal dominant mutation of novo non-germinal, the risk of recurrence is not greater than that of the general population. Given its high lethality does not happen to future generations.

Osteogénesis Imperfecta. A propósito de un caso tipo II / Osteogenesis Imperfecta. About a type II case

RESUMEN El síndrome de Osteogénesis Imperfecta (OI) tipo II está dentro del grupo de trastornos del tejido conectivo de origen genético-hereditario que se caracteriza por fragilidad ósea, fracturas múltiples, huesos largos anchos y acortados, además de una pobre mineralización ósea. Su frecuencia de aparición se calcula en aproximadamente 1: 55.000 nacidos vivos y es el resultado de mutaciones de dos genes que codifican las cadenas de colágeno tipo 1. El riesgo de recurrencia es alrededor de 6 % pero si ambos padres fueran heterocigotos, aumentaría a 10-25 %. También se han reportado casos esporádicos por mutación de novo. El diagnóstico se suele realizar por los hallazgos ecográficos en el segundo trimestre o en ecografías previas si los hallazgos son muy evidentes. Las pruebas invasivas son útiles sobretodo en casos de antecedentes familiares con formas leves de OI. En nuestro caso, encontramos durante la ecografía de las 20 semanas una notable hipomineralización de la calota fetal sospechada por hiporrefringencia de la misma, acortamiento de extremidades superiores e inferiores con múltiples fracturas óseas, arcos costales cortos, arqueados y una desproporción toraco-abdominal. En los casos en donde se prosigue con el embarazo más de 60% de los recién nacidos mueren el primer día de vida, el resto lo hace durante el primer mes y la sobrevivencia más allá de un año es rara. La principal causa de muerte postnatal suele ser por falla respiratoria.

SUMMARY Osteogenesis Imperfecta (OI) type II is within the group of connective tissue disorders hereditary genetic-origin characterized by bone fragility, multiple fractures, broad long bones and shortened, and a poor bone mineralization. Their frequency is estimated at approximately 1: 55,000 live births, and is the result of mutations of genes which encoding chains of type 1 collagen. The risk of recurrence is around 6% but if both parents were heterozygous, increase to 10-25%. There has also been reported sporadic cases with de novo mutation. The diagnosis is usually made by ultrasound findings in second trimester or previously if the findings are very obvious. Invasive tests are useful especially in cases of family history with mild forms of OI. In our case, we found during ultrasound 20 weeks a remarkable hypomineralization of fetal calvarial, shortening of upper and lower extremities with multiple bone fractures and short costal arches, arched and thoracoabdominal disproportion. In cases where continued pregnancy more than 60% of newborns die during the first day of life, 80% die in the first month and survival beyond one year is rare. Death can occur prenatally or postnatamente from respiratory failure.

A Case of Platyspondylic Lethal Skeletal Dysplasia Torrance Type

Platyspondylic lethal skeletal dysplasia, Torrance type (PLSD-T), is one of the phenotypes of type II collagenopathy and is characteristic of severe bone growth disorder. This phenotype may limit the growth and expansion of the lungs, which is known to cause death from respiratory failure during or shortly after birth, but in few less severe cases, patients have been reported to have survived to adulthood. We have experienced a case of PLSD-T in a preterm infant who was delivered via cesarean section at the gestational age of 29 weeks 3 days, with a birth weight of 1.15 kg. Physical examination of the infant revealed characteristic findings of short arms and legs, small thorax, distended abdomen, and cleft palate. On the basis of the subsequent genetic testing, the patient had a heterozygous mutation in the encoded c-propeptide region of collagen, type II, alpha 1 (COL2A1), c.4335G>A (p.Trp1445*) in exon 52. This is the first case of PLSD-T diagnosed in Korea, and we hereby report the case.

Fetal Skeletal Lethal Dysplasia: Case Report Displasia Esquelética Letal Fetal: Relato de Caso

Abstract The clinical management and decision-making in pregnancies in which there is suspicion of lethal fetal malformations during the prenatal period, such as lethal skeletal dysplasia (SD), demand a multidisciplinary approach coordinated by an experienced physician. Based on the presentation of a case of osteogenesis imperfecta type IIA, we offer and discuss recommendations with the intention of organizing clinical and laboratory investigations aiming toward the clinical management, prognosis, and etiological diagnosis of these malformations, as well as genetic counselling to patients who wish to become pregnant.

Resumo O manejo clínico e a tomada de decisões médicas em gestantes com suspeita de malformação letal em um feto no período pré-natal, tal qual uma displasia esquelética letal, demandam uma abordagem multidisciplinar coordenada por um médico experiente. Baseado na apresentação de um caso de osteogênese imperfeita tipo IIA, recomendações são apresentadas e discutidas com a intenção de organizar as investigações clínicas e laboratoriais visando o manejo clínico, o prognóstico, e o diagnóstico etiológico dessas malformações, e o aconselhamento genético para as pacientes que desejam engravidar.

Molecular genetic studies of skeletal dysplasia: Research advances / 国际药学研究杂志

Skeletal dysplasia(SD)is a group of genetic disorders resulting from disruption of normal skeletal growth and development, characterized by heterogeneous and overlapping phenotypes. Molecular diagnosis is required to help physicians further identify the type, etiology and prognosis of the disease. A great number of discoveries of pathogenic mutations has been made largely due to extensive use of whole exome sequencing(WES)and the genomic technique. Here we review the most recent molecular genetic studies of SD using WES technique.

Forma letal de distrofia torácica asfixiante (Síndrome de Jeune): a propósito de un caso / Lethal asphyxtiating thoracic dystrophy (Jeune Syndrome): a case report

The asphyxiating thoracic dystrophy (ATD) is an autosomal recessive genetic disease, with wide clinical variability, from minimum to lethal phenotypes. Respiratory failure is due to pulmonary hypoplasia and narrow ribcage. Its frequency is 1/130000 newborns.The aim is to present a clinical case of the lethal form of ATD, emphasizing in pulmonary respiratory failure, poor prognosis and associated diseases.

La Distrofia Torácica Asfixiante (DTA) es una enfermedad genética autosómica recesiva, con amplia variabilidad clínica. La forma letal se debe a insuficiencia respiratoria secundaria a hipoplasia pulmonar y estrechamiento de la caja torácica. Su frecuencia es de 1/130000 recién nacidos vivos. El objetivo es presentar un caso clínico de la forma letal de DTA, enfatizando en el mal pronóstico de la falla respiratoria y la patología asociada.

Valoración ecográfica fetal en displasia esquelética: a propósito de un caso de displasia tanatofórica / Fetal ultrasound evaluation of skeletal dysplasia: apropos of a case of thanatophoric dysplasia

Se presenta el caso de una gestante de 30 semanas con feto afectado por displasia tanatofórica (TD) tipo I, quien fue remitida a la Unidad de Medicina Materno Fetal, Hospital Nacional Daniel Alcides Carrión, Callao, Perú, por sospecha de displasia esquelética. En la ultrasonografía se encontraron signos característicos de TD, con marcadores asociados con alto riesgo de letalidad. A propósito del caso sugerimos algunas recomendaciones para la evaluación ultrasonográfica ante la sospecha de casos de displasia esquelética, como una estrategia de acercamiento al diagnóstico.

The case of a 30 weeks pregnant woman and her fetus affected by thanatophoric dysplasia (TD) type I, referred to our Maternal Fetal Medicine Unit, Hospital Nacional Daniel Alcides Carrión, Callao, Perú, due to suspicion of skeletal dysplasia is reported. On the ultrasound, characteristic signs of TD and markers related to high risk of lethality were found. Recommendations are suggested for ultrasound evaluation of suspected cases of skeletal dysplasia, as a differentiated approach to diagnosis.

Sindrome de Jeune: presentación de un caso clínico / Jeune syndrome: case report

El Síndrome de Jeune fue descrito en 1956 como Displasia Torácica Asfixiante (DTA). Su incidencia es de 1 por cada 100.000 recién nacidos vivos. En Venezuela el primer caso fue descrito por Urdaneta Carruyo en 1986. Forma parte de los síndromes con displasia/hipoplasia costal con/sin polidactilia. Es la insuficiencia respiratoria, por hipoplasia pulmonar, la causa más frecuente de muerte. En vista de ser un síndrome de presentación poco común con una alta mortalidad, se presenta un caso de una escolar de 11 años (diagnosticado desde los 10 meses), con tórax estrecho, braquimelia y rizomelia. Toracoplastia a los 9 años de edad en busca de una expansión torácica. Fallece a los 11 años de edad. Conclusiones: El síndrome de Jeune es una entidad poco frecuente que compromete la vida del paciente; tiene un patrón de herencia autosómica recesiva y requiere consejo genético a los padres y un equipo multidisciplinario para su abordaje y manejo.

Jeune Syndrome was described in 1956 as Thoracic dysplasia Asphyxiant (DTA). Its incidence is 1 per 100,000 live births. In Venezuela the first case was described by Urdaneta Carruyo in 1986. It is a member of the family of the short-rib polydactyly syndromes. Respiratory failure, secondary to pulmonary hypoplasia, it is the most common cause of death. Because DTA is a rare syndrome with a high mortality presentation, we were motivated to report the case of a 11 year old girl (diagnosed at 10 months of age), with a narrow thorax, and variable limb shortness. Thoracoplasty was performed at 9 years of age in order to achieve thoracic expansion. The patient died at 11 years of age. Conclusions: Jeune syndrome is a rare entity, which compromises the life of the patient; it has autosomal recessive inheritance pattern and requires genetic counseling to parents and a multidisciplinary management.

Guidelines for genetic skeletal dysplasias for pediatricians

Skeletal dysplasia (SD) is a kind of heterogeneous genetic disorder characterized by abnormal growth, development, differentiation, and maintenance of the bone and cartilage. The patients with SD most likely to be seen by a pediatrician or orthopedic surgeon are those who present with short stature in childhood. Because each category has so many diseases, classification is important to understand SD better. In order to diagnose a SD accurately, clinical and radiographic findings should be evaluated in detail. In addition, genetic diagnosis of SD is important because there are so various SDs with complex phenotypes. To reach an exact diagnosis of SDs, cooperative approach by a clinician, a radiologist and a geneticist is important. This review aims to provide an outline of the diagnostic approach for children with disproportional short stature.

Condrodisplasia em bovinos no Sul do Rio Grande do Sul / Chondrodysplasia in cattle in Southern Brazil

Descrevem-se 14 casos de condrodisplasia em bovinos. Os dados epidemiológicos e clínicos foram obtidos de protocolos de necropsia e o estudo histológico das lesões foi realizado em fragmentos de ossos longos e ossos da base do crânio dos 14 casos estudados. Onze casos eram de condrodisplasia tipo Telemark e três, tipo bulldog (Dexter). Treze dos 14 bovinos afetados eram da raça Jersey e um era da raça Shorthorn. Concluiu-se que o gene transmissor das condrodisplasias encontra-se presente na população Jersey da região e medidas, como utilização de reprodutores de outras regiões e/ou com teste de progênie ou identificação de genes indesejáveis por meio de técnicas moleculares, devem contribuir para diminuir a ocorrência destes casos na população Jersey da região.

Fourteen cases of chondrodysplasia in cattle are described. Epidemiological and clinical data were obtained from filed necropsy protocols. A histological study of the lesions was performed on long and skull base bones. Eleven cases of chondrodysplasia Telemark type and three Bulldog (Dexter) type were observed. Thirteen out of 14 cases occurred in Jersey cattle and one in Shorthorn. It was concluded that the gene carrier of chondrodysplasia is present in the Jersey population of the region, and breeding measures such as the use of bulls from other regions and/or progeny testing or identification of undesirable genes using molecular techniques should help reduce the occurrence of these cases in the Jersey population of the region.

Bilateral Congenital Cataract Associated with Multiple Epiphyseal Dysplasia: A case Report.

Cataract in children has varied etiology. It may be associated with systemic diseases including skeletal dysplasias. However cataract in Multiple Epiphyseal Dysplasia is a rare association. A child presented with bilateral dense posterior sub capsular cataract and multiple bony abnormalities. Clinical and radiographic findings suggested the disease to be Multiple Epiphyseal Dysplasia. The aim of presenting this case is to report a case of congenital cataract having a rare association with the Multipe Epiphyseal Dyspalsia.

A Case with Spondyloepiphyseal Dysplasia Tarda with TRAPPC2 Mutation

Spondyloepiphyseal dysplasia tarda (SEDT) is an X-linked skeletal dysplasia. Patients show disproportionate short stature with short trunk and barrel-shaped chest, which usually become pronounced in late childhood. The radiologic findings are characterized by narrow intervertebral disc spaces and moderate epiphyseal dysplasia of long bones. Here we report a case of SEDT with a novel frameshift mutation in TRAPPC2, the disease-causing gene of SEDT. This is the first Korean report with SEDT confirmed by genetic testing.

Displasia espóndilo-epifisiaria asociada a cráneo-sinostosis, cataratas, paladar hendido y retardo mental: Reporte de un caso / Spondylo-epiphyseal dysplasia associated with craniosynostosis, cleft palate and mental retardation: A case report

Las displasias esqueléticas son un grupo muy heterogéneo de trastornos que se caracterizan por una alteración en la organización del tejido óseo, lo que causa una distorsión en su patrón de crecimiento y desarrollo. En 1998, se descibió el caso de cuatro hermanos japoneses, tres varones y una hembra que presentaban una displasia espóndilo-epifisiaria, no descrita anteriormente, asociada con cráneo-sinostosis, cataratas, paladar hendido y retardo mental de diferente grado. Se planteó una probable herencia autosómica recesiva, debido a que las alteraciones afectaban a ambos sexos y los padres eran fenotípicamente sanos, aunque con discreto retardo mental; sin embargo, no fue posible descartar un mosaicismo germinal. El caso que se presenta, trata de un paciente con signos clínicos y radiológicos que coinciden con los previamente descritos. Es producto de padres consanguíneos en la segunda generación, lo cual se sumaría a la presunción ya postulada, de una probable mutación de herencia autosómica recesiva. La presente comunicación, representa el segundo reporte en la literatura, del quinto caso descrito y el segundo grupo familiar con la afección mencionada.

Skeletal dysplasias are a heterogeneous group of disorders characterized by an alteration of the organization of osseous tissue causing a distortion on the growth and development pattern of bones. In 1998, four Japanese sibs were described by the first time, three males and one female who presented a previously undescribed spondylo-epiphyseal dysplasia associated with craniosynostosis, cataracts, cleft palate and different grades of mental retardation. A probable autosomic recessive inheritance was suggested, but a germinal mosaicism could not be discarded. This is a case report of a patient with clinical and radiological findings similar to the ones previously described, born to second degree consanguineous parents. This supports the postulated presumption of a mutation with an autosomic recesive inheritance. The present comunication represents the fifth case reported in the literature and the second familiar group affected.