Familial Pfeiffer Syndrome: Variable Manifestations and Role of Multidisciplinary Team Care

Pfeiffer syndrome is one of the autosomal dominant craniofacial syndromes. Classical clinical manifestations are coronal suture synostosis causing brachycephaly, midface retrusion, airway compromise, broad thumbs, and toes. Pfeiffer syndrome type I (classic type) is associated with FGFR1 mutation. However, wide range of clinical manifestations, with and without craniosynostosis, have been reported. Here, we present a family of Pfeiffer syndrome across 3 generations with identical FGFR1: c.755C>G (p.Pro252Arg) mutation. Where the members of the youngest generation have no cranial involvement. Lastly, we propose a guideline management for familial Pfeiffer syndrome management.

Prenatal diagnosis of Pfeiffer syndrome type 2 with increased nuchal translucency

Pfeiffer syndrome (PS) is a rare autosomal dominant genetic disorder characterized by craniosynostosis, broad thumbs / toes. Here we report a case of PS type 2 with increased nuchal translucency at early trimester.

Deletion of SHANK3 and CREBBP gene in the patients with intellectual disability and mix phenotype

Rubinstein-Taybi Syndrome (RSTS) as a group of congenital anomalies mainly include, short broad thumbs and toes, short stature and intellectual disability are caused by either a micro-deletion in the CREBBP (CBP) or EP300 genes. Generally most RSTS patients have a deletion in the CREBBP gene but some patients have shown deletion in the EP300 gene. Here we introduce an affected case without some typical characteristics of RSTS with deletions in the CREBBP and SHANK3 genes. The patient was a 24 years old man with a history of infantile hypotonia and childhood developmental delay, heavy eyebrows, ptosis, speech difficulty without large thumb and toes. The conventional cytogenetic finding was normal male. Further investigation was performed using Multiplex Ligation Probe Amplification (MLPA) technique to screen micro-deletion syndromes and subtelomeric rearrangements and Micro-deletion was detected in CREBBP and SHANK3 gene and a detected in DECR2 gene. Deletion in the CREBBP or EP300 genes or both in the patients with broad thumb and toes (RSTS) has been detected but there are other patients with deletion in CREBBP gene without this sign of RSTS. However, we report SHANK3 gene deletion in the patient with deletion in CREBBP gene and without broad thumbs and toes. Keywords: Rubinstein-Taybi Syndrome (RSTS); CREBBP; SHANK3; Broad thumb and toes

Broad Thumbs and Toes with Mental Retardation; Syndrome of Rubinstein and Taybi

Seeing the unusual syndrome inan Indonesian baby we consideredpublication worthwhile.The Rubinstein and Taybi syndro-me consists of a large number ofcongenital anomalies. Some of theseare common to all cases, many areseen in some cases only.

RUBINSTEIN TAYBI SYNDROME

Rubinstein Taybi Syndrome (RTS) was first described in 1963 by Rubinsteinand Taybi. The characteristic features of this syndrome include broad thumbs and toes,facial abnormalities like hypertelorism, beaked nose, micrognathia, microcephaly and mentalretardation. Cardiac, renal, ophthalmological and various orthopedic problems can also occur.Prevalence in the general population is approximately 1 case per 300,000 persons and is as highas 1 case per 10,000 live births. There is no definite inheritance pattern so far and recurrenceis very unlikely. In some patients, multiple chromosomal anomalies have been described. Wereport here a case of Rubinstein Taybi syndrome in an 18 months old girl presented with typicalfeatures which is the first case reported in our population.