[Holt-Oram syndrome and portal extrahepatic hypertension. A case report].
BACKGROUND
The Holt-Oram syndrome (HOS) is characterized by skeletal abnormalities, frequently accompanied by congenital cardiac defects. It was first described by Holt and Oram in 1960. It has a prevalence of 0.95/10,000 live newborns. The syndrome shows a dominant autosomic heritance with high penetrance. A mutation in the transcription gene factor TBX5 has been identified. This factor has been shown to be important in the heart and upper extremities development.


METHODS
A 17 year-old boy with muscle-skeletal abnormalities in forearms and hands, with implantation defects of thumbs and narrow shoulders as well as wide atrial septal defect type osteum secundum. He also showed portal cavernomatosus degeneration which conditioned portal extrahepatic hypertension and esophageal varicose veins. The diagnosis was established by clinical, radiological and auxiliary studies. His parents were also studied, and they did not show abnormalities.


CONCLUSIONS
Two previous cases have been reported in the Mexican medical literature, both due to de novo genetic mutation. However, none has been associated with portal cavernomatosus degeneration and portal hypertension.
Loya-García
Blanca Esthela
BE
Unidad de Medicina Familiar 51, Delegación Guanajuato, Instituto Mexicano del Seguro Social, Guanajuato, Jalisco, Mexico. blanca.loya@imss.gob.mx
Montesano-Delfín
Jesús Rafael
JR
Guízar-Mendoza
Juan Manuel
JM
Gallegos-Rivas
Mayra Celina
MC
Hernández-González
Martha Alicia
MA
Venegas-Loya
Paulina
P
D000015:Abnormalities, Multiple; D000293:Adolescent; D006344:Heart Septal Defects, Atrial / Q000150:complications*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D008297:Male; D009139:Musculoskeletal Abnormalities / Q000150:complications*; D013577:Syndrome