Cerebro-osseous-digital syndrome: four new cases of a lethal skeletal dysplasia--distinct from Neu-Laxova Syndrome.
Neu-Laxova Syndrome (NLS) is a severe disorder with intrauterine growth retardation, edema, and characteristic face (including microcephaly with receding forehead, protuberant eyes, a flattened nose, deformed ears, cleft palate, and micrognathia). Ichthyosis is often present. Limb anomalies include hypoplastic fingers and syndactyly of fingers and toes. Patients are usually stillborn or die shortly after birth. We report five unrelated patients--four with atypical NLS and one with typical NLS. All five patients were stillbirths. Clinically, the atypical NLS patients showed a large skull; rhizo-, meso-, and acromelia; and hypoplasia of the metacarpals and phalanges. The feet were similarly affected. Radiographically, the atypical patients showed interpediculate narrowing and hypoplastic vertebral bodies. The long bones were stick-like, showing diaphyseal widening that spared the metaphyses and was more pronounced in the lower extremities. The ilia had a half-moon configuration with widening of the sacrosciatic notches. The ischia were vertical and the pubic bone was absent. The typical NLS patient showed microcephaly, normal vertebral body, and long bone ossification, but a pelvic configuration similar to that of the atypical NLS patients. The common and distinguishing clinical and radiographic features are reviewed. Scott et al. [1981: Am J Med Genet 9:165-175] described two patients with NLS with radiographic and clinical findings similar to patients 1-4 reported here. Patients 1-4 of this report lack the typical findings of NLS and likely represent a distinct lethal skeletal dysplasia.
Elliott
Alison M
AM
International Skeletal Dysplasia Registry, Cedars Sinai Medical Center, Los Angeles, California 90048, USA.
Gonzales
Marie
M
Hoeffel
Jean-Claude
JC
Le Merrer
Martine
M
Maroteaux
Pierre
P
Encha-Razavi
Ferechte
F
Joye
Nicole
N
Berchel
Colette
C
Fliegel
Christian
C
Aughton
David J
DJ
Beaudry-Rodgers
Kelly
K
Hasteh
Farnez
F
Nerlich
Andreas G
AG
Wilcox
William R
WR
Rimoin
David L
DL
Lachman
Ralph S
RS
Freisinger
Peter
P
D000015:Abnormalities, Multiple / Q000473:pathology*; D001848:Bone Diseases, Developmental / Q000473:pathology*; D019465:Craniofacial Abnormalities / Q000473:pathology*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D005313:Fetal Death; D005317:Fetal Growth Retardation / Q000473:pathology*; D006801:Humans; D008297:Male; D013577:Syndrome