title: The many faces of aggressive aortic pathology: Loeys-Dietz syndrome.
abstract: BACKGROUND
  Loeys-Dietz syndrome (LDS) is a newly recognised disorder of connective tissue which shares overlapping features with Marfan syndrome (MFS) and the vascular type of Ehlers-Danlos syndrome, including aortic root dilatation and skin abnormalities. It is clinically classified into types 1 and 2. LDS type 1 can be recognised by craniofacial characteristics, e.g. hypertelorism, bifid uvula or cleft palate, whereas these are absent in LDS type 2. It is important to recognise LDS because its vascular pathology is aggressive. We describe nine LDS patients from four families, relate their features to published cases, and discuss important aspects of the diagnosis and management of LDS in order to make clinicians aware of this new syndrome.
  
  
  RESULTS
  Characteristics found in the majority of these LDS patients were aortic root dilatation, cleft palate and/or a bifid/abnormal uvula.
  
  
  CONCLUSIONS
  Because aortic dissection and rupture in LDS tend to occur at a young age or at aortic root diameters not considered at risk in MFS, and because the vascular pathology can be seen throughout the entire arterial tree, patients should be carefully followed up and aggressive surgical treatment is mandatory. Clinicians must therefore be aware of LDS as a cause of aggressive aortic pathology and that its distinguishing features can sometimes be easily recognised. (Neth Heart J 2008;16:299-304.).
authors.affiliation: Department of Cardiothoracic Surgery, Thorax Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
authors.forename: J J J
authors.initials: JJ
authors.lastname: Aalberts
authors.forename: M P
authors.initials: MP
authors.lastname: van den Berg
authors.forename: J E H
authors.initials: JE
authors.lastname: Bergman
authors.forename: G J
authors.initials: GJ
authors.lastname: du Marchie Sarvaas
authors.forename: J G
authors.initials: JG
authors.lastname: Post
authors.forename: H
authors.initials: H
authors.lastname: van Unen
authors.forename: G
authors.initials: G
authors.lastname: Pals
authors.forename: P W
authors.initials: PW
authors.lastname: Boonstra
authors.forename: J P
authors.initials: JP
authors.lastname: van Tintelen