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Myhre syndrome: Clinical features and restrictive cardiopulmonary complications
Author(s) -
Starr Lois J.,
Grange Dorothy K.,
Delaney Jeffrey W.,
Yetman Anji T.,
Hammel James M.,
Sanmann Jennifer N.,
Perry Deborah A.,
Schaefer G. Bradley,
Olney Ann Haskins
Publication year - 2015
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.37273
Subject(s) - medicine , fibrosis , ductus arteriosus , pulmonary hypertension , pericarditis , complication , marfan syndrome , connective tissue disorder , craniofacial , cardiology , surgery , psychiatry
Myhre syndrome, a connective tissue disorder characterized by deafness, restricted joint movement, compact body habitus, and distinctive craniofacial and skeletal features, is caused by heterozygous mutations in SMAD4 . Cardiac manifestations reported to date have included patent ductus arteriosus, septal defects, aortic coarctation and pericarditis. We present five previously unreported patients with Myhre syndrome. Despite varied clinical phenotypes all had significant cardiac and/or pulmonary pathology and abnormal wound healing. Included herein is the first report of cardiac transplantation in patients with Myhre syndrome. A progressive and markedly abnormal fibroproliferative response to surgical intervention is a newly delineated complication that occurred in all patients and contributes to our understanding of the natural history of this disorder. We recommend routine cardiopulmonary surveillance for patients with Myhre syndrome. Surgical intervention should be approached with extreme caution and with as little invasion as possible as the propensity to develop fibrosis/scar tissue is dramatic and can cause significant morbidity and mortality. © 2015 Wiley Periodicals, Inc.