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Mandibuloacral dysplasia type A in childhood
Author(s) -
Garavelli L.,
D'Apice M.R.,
Rivieri F.,
Bertoli M.,
Wischmeijer A.,
Gelmini C.,
De Nigris V.,
Albertini E.,
Rosato S.,
Virdis R.,
Bacchini E.,
Dal Zotto R.,
Banchini G.,
Iughetti L.,
Bernasconi S.,
SupertiFurga A.,
Novelli G.
Publication year - 2009
Publication title -
american journal of medical genetics part a
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.064
H-Index - 112
eISSN - 1552-4833
pISSN - 1552-4825
DOI - 10.1002/ajmg.a.33005
Subject(s) - medicine , lipodystrophy , anatomy , dermatology , hypoplasia , atrophy , pathology , family medicine , human immunodeficiency virus (hiv) , viral load , antiretroviral therapy
Mandibuloacral dysplasia type A (MADA) is characterized by growth retardation, postnatal onset of craniofacial anomalies with mandibular hypoplasia, progressive acral osteolysis, and skin changes including mottled pigmentation, skin atrophy, and lipodystrophy. Owing to its slowly progressive course, the syndrome has been recognized in adults, and pediatric case reports are scarce. We present the clinical case of two children in whom the diagnosis of MADA was made at an unusually early age. A 5‐year‐old boy presented with ocular proptosis, thin nose, and short and bulbous distal phalanges of fingers. A 4‐year‐old girl presented with round face and chubby cheeks, thin nose, bulbous fingertips, and type A lipodystrophy. In both, a skeletal survey showed wormian bones, thin clavicles, short distal phalanges of fingers and toes with acro‐osteolysis. Both children were found to be homozygous for the recurrent missense mutation, c.1580G>A, (p.R527H) in exon 9 of the LMNA gene. Thus, the phenotype of MADA can be manifest in preschool age; diagnosis may be suggested by short and bulbous fingertips, facial features, and lipodystrophy, supported by the finding of acral osteolysis, and confirmed by mutation analysis. © 2009 Wiley‐Liss, Inc.