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Discriminative Features in Three Autosomal Recessive Cutis Laxa Syndromes: Cutis Laxa IIA, Cutis Laxa IIB, and Geroderma Osteoplastica

Authors: Hamid Reza Khorram Khorshid; Abigail Loh; Ariana Kariminejad; Bruno Reversade; Faezeh Mojahedi; Fariba Afroozan; Yu Xuan Tan; +9 Authors

Discriminative Features in Three Autosomal Recessive Cutis Laxa Syndromes: Cutis Laxa IIA, Cutis Laxa IIB, and Geroderma Osteoplastica

Abstract

Cutis laxa is a heterogeneous condition characterized by redundant, sagging, inelastic, and wrinkled skin. The inherited forms of this disease are rare and can have autosomal dominant, autosomal recessive, or X-linked inheritance. Three of the autosomal recessive cutis laxa syndromes, namely cutis laxa IIA (ARCL2A), cutis laxa IIB (ARCL2B), and geroderma osteodysplastica (GO), have very similar clinical features, complicating accurate diagnosis. Individuals with these conditions often present with cutis laxa, progeroid features, and hyperextensible joints. These conditions also share additional features, such as short stature, hypotonia, and congenital hip dislocation, but the severity and frequency of these findings are variable in each of these cutis laxa syndromes. The characteristic features for ARCL2A are abnormal isoelectric focusing and facial features, including downslanting palpebral fissures and a long philtrum. Rather, the clinical phenotype of ARCL2B includes severe wrinkling of the dorsum of the hands and feet, wormian bones, athetoid movements, lipodystrophy, cataract and corneal clouding, a thin triangular face, and a pinched nose. Normal cognition and osteopenia leading to pathological fractures, maxillary hypoplasia, and oblique furrowing from the outer canthus to the lateral border of the supraorbital ridge are discriminative features for GO. Here we present 10 Iranian patients who were initially diagnosed clinically using the respective features of each cutis laxa syndrome. Each patient’s clinical diagnosis was then confirmed with molecular investigation of the responsible gene. Review of the clinical features from the cases reported from the literature also supports our conclusions.

Keywords

cognition, Male, dwarfism, Chemistry, Multidisciplinary, cutis laxa, Review, PHENOTYPE, preschool child, FAMILIES, Cutis Laxa, BRAIN DYSGENESIS, palpebral fissure, differential diagnosis, Diagnosis, Medicine and Health Sciences, RAB6-INTERACTING (GORAB), GOLGIN, RAB6-INTERACTING (GORAB), microcephaly, ALTERED GLYCOSYLATION, BRAIN, Child, wrinkle, child, adult, Skin Diseases, Genetic, 600, Syndrome, DEBRE TYPE, syndrome, Chemistry, female, Phenotype, Pyrroline-5-carboxylate reductase 1 (PYCR1), cataract, Child, Preschool, Physical Sciences, OSTEODYSPLASTICA, Female, Bone Diseases, congenital hip dislocation, Life Sciences & Biomedicine, ATP6V0A2, Adult, Biochemistry & Molecular Biology, 3101 Biochemistry and cell biology, lipodystrophy, H plus transporting lysosomal V0 subunit A2 (ATP6V0A2), phenotype, 0699 Other Biological Sciences, 610, WRINKLY SKIN SYNDROME, Dwarfism, Skin Diseases, Diagnosis, Differential, male, Genetic, autosomal recessive cutis laxa 2a, 0399 Other Chemical Sciences, autosomal recessive cutis laxa 2b, case report, ATPase, Humans, human, Preschool, 3404 Medicinal and biomolecular chemistry, long philtrum, 0604 Genetics, Science & Technology, Chemical Physics, muscle hypotonia, Radboudumc 7: Neurodevelopmental disorders DCMN: Donders Center for Medical Neuroscience, MUTATIONS, Biology and Life Sciences, Infant, infant, GOLGIN, short stature, CONNECTIVE-TISSUE, 3107 Microbiology, osteopenia, Laboratory Medicine - Radboud University Medical Center, geroderma osteodysplastica, Differential, autosomal recessive cutis laxa 2A, ATPase, H+ transporting lysosomal V0 subunit A2 (ATP6V0A2), autosomal recessive cutis laxa 2B, DYSGENESIS

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
24
Top 10%
Top 10%
Top 10%
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gold