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At a glance

It is a medical condition characterized by dwarfism with disproportionately short legs. Reduced joint mobility (or stiffness) and ocular anomalies (hyperopia, glaucoma, cataract, and retinal detachment).

Synonym

Dwarfism Stiff Joints Ocular Abnormalities Syndrome.

Incidence

There are only few families described in the medical literature.

Genetic inheritance

It is believed inherited as an autosomal dominant pattern. Genetic disorder transmitted from male to male. Acromicric dysplasia, geleophysic dysplasia, and Moore-Federman Syndrome may be allelic forms of the same disorder or different disturbances of the same metabolic pathway.

Clinical aspects

Disproportionate dwarfism, with short legs and fingers, delayed carpal bone age, stiff joints, and thickened forearm skin. Abnormalities of the eyes may include hyperopia, glaucoma, cataract, and retinal detachment. A comparison of these different related entities is difficult because of the small number of patients reported, and not all descriptions are of the same quality with regard to details of clinical features or radiography.

Anesthetic considerations

The true syndrome has no descriptions of association with any storage or metabolic disease, and no problems with tracheal stenosis have been reported. However, because of the small number of cases and the possible overlapping of several syndromes, pay special attention to the airway, and check cardiac and hepatic functions.

Other conditions to be considered

  • Acromicric Dysplasia: Mild facial anomalies, markedly shortened hands and feet, and severe growth retardation. Radiologic examination reveals short, stubby metacarpals and phalanges with notching of the second metacarpal.

  • Geleophysic Dysplasia: Characterized by the designation of the happy face of the affected child (gelios = happy, physis = nature). This disorder is often considered a “focal” mucopolysaccharidosis. The clinical features include dysostosis multiplex-like changes, predominantly in the hands and feet, and the consequences of focal accumulation of acid mucopolysaccharides in the liver and possibly the cardiovascular system. Joint contractures, hepatomegaly, and cardiomegaly can be present. Aortic and mitral valves regurgitation have been reported.

  • Leri Pleonosteosis: Characterized by laryngotracheal stenoses, short stature, mongoloid facies, short spadelike hands, broad thumbs in valgus position, genu recurvatum and generalized limitation of joint mobility, thickening of the palmar and forearm fasciae, enlargement of the posterior neural arches of the cervical vertebrae, and shuffling short-stepped gait. It is inherited as an autosomal dominant pattern.

  • Weill-Marchesani Syndrome: Rare, genetic disorder characterized by short stature, brachycephaly, hand defects, including brachydactyly, and unusually small, round lenses of the eyes (spherophakia) prone to ectopia lentis. Affected individuals may have varying degrees of visual impairment, ranging from myopia to blindness. Autosomal recessive or autosomal dominant inheritance.

References

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Faivre  L, Le Merrer  M, Baumann  C,  et al: Acromicric dysplasia: Longterm outcome and evidence of autosomal dominant inheritance. J Med Genet...

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