Skip to main content
Journal of Medical Genetics logoLink to Journal of Medical Genetics
. 1988 Feb;25(2):88–95. doi: 10.1136/jmg.25.2.88

Lethal acrodysgenital dwarfism: a severe lethal condition resembling Smith-Lemli-Opitz syndrome.

M L Merrer 1, M L Briard 1, S Girard 1, N Mulliez 1, C Moraine 1, M C Imbert 1
PMCID: PMC1015449  PMID: 2831368

Abstract

We report eight cases of a lethal association of failure to thrive, facial dysmorphism, ambiguous genitalia, syndactyly, postaxial polydactyly, and internal developmental anomalies (Hirschsprung's disease, cardiac and renal malformation). This syndrome is likely to be autosomal recessive and resembles Smith-Lemli-Opitz (SLO) syndrome. However, the lethality, the common occurrence of polydactyly, and the sexual ambiguity distinguishes this condition from SLO syndrome. A review of published reports supports the separate classification of this syndrome for which we propose the name lethal acrodysgenital dwarfism.

Full text

PDF
88

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Akl K. F., Khudr G. S., Der Kaloustian V. M., Najjar S. S. The Smith-Lemli-Opitz syndrome. Report of a consanguineous Arab infant with bilateral focal renal dysplasia. Clin Pediatr (Phila) 1977 Jul;16(7):665–668. doi: 10.1177/000992287701600717. [DOI] [PubMed] [Google Scholar]
  2. Blair H. R., Martin J. K. A syndrome characterized by mental retardation, short stature, craniofacial dysplasia, and genital anomalies occurring in siblings. J Pediatr. 1966 Sep;69(3):457–459. doi: 10.1016/s0022-3476(66)80094-x. [DOI] [PubMed] [Google Scholar]
  3. Cherstvoy E. D., Lazjuk G. I., Lurie I. W., Nedzved M. K., Usoev S. S. The pathological anatomy of the Smith-Lemli-Opitz syndrome. Clin Genet. 1975 May-Jun;7(5):382–387. doi: 10.1111/j.1399-0004.1975.tb00345.x. [DOI] [PubMed] [Google Scholar]
  4. Cherstvoy E. D., Lazjuk G. I., Ostrovskaya T. I., Shved I. A., Kravtzova G. I., Lurie I. W., Gerasimovich A. I. The Smith-Lemli-Opitz syndrome. A detailed pathological study as a clue to a etiological heterogeneity. Virchows Arch A Pathol Anat Histopathol. 1984;404(4):413–425. doi: 10.1007/BF00695225. [DOI] [PubMed] [Google Scholar]
  5. Cruveiller J., Msika S., Lafourcade J. Nanisme de Smith-Lemli-Opitz. A propos de quatre observations. Revue de la littérature. Ann Pediatr (Paris) 1977 Dec;24(12):843–851. [PubMed] [Google Scholar]
  6. Dallaire L. Syndrome of retardation with urogenital and skeletal anomalies (Smith-Lemli-Opitz syndrome): clinical features and mode of inheritance. J Med Genet. 1969 Jun;6(2):113–120. doi: 10.1136/jmg.6.2.113. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Deaton J. G., Mendoza L. O. Smith-Lemli-Optiz syndrome in a 23-year-old man. Arch Intern Med. 1973 Sep;132(3):422–423. [PubMed] [Google Scholar]
  8. Donnai D., Young I. D., Owen W. G., Clark S. A., Miller P. F., Knox W. F. The lethal multiple congenital anomaly syndrome of polydactyly, sex reversal, renal hypoplasia, and unilobular lungs. J Med Genet. 1986 Feb;23(1):64–71. doi: 10.1136/jmg.23.1.64. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Finley S. C., Finley W. H., Monsky D. B. Cataracts in a girl with features of the Smith-Lemli-Opitz syndrome. J Pediatr. 1969 Oct;75(4):706–707. doi: 10.1016/s0022-3476(69)80473-7. [DOI] [PubMed] [Google Scholar]
  10. Greene C., Pitts W., Rosenfeld R., Luzzatti L. Smith-Lemli-Opitz syndrome in two 46,XY infants with female external genitalia. Clin Genet. 1984 Apr;25(4):366–372. doi: 10.1111/j.1399-0004.1984.tb02006.x. [DOI] [PubMed] [Google Scholar]
  11. Hall J. G., Pallister P. D., Clarren S. K., Beckwith J. B., Wiglesworth F. W., Fraser F. C., Cho S., Benke P. J., Reed S. D. Congenital hypothalamic hamartoblastoma, hypopituitarism, imperforate anus and postaxial polydactyly--a new syndrome? Part I: clinical, causal, and pathogenetic considerations. Am J Med Genet. 1980;7(1):47–74. doi: 10.1002/ajmg.1320070110. [DOI] [PubMed] [Google Scholar]
  12. Johnson V. P. Smith-Lemli-Opitz syndrome: review and report of two affected siblings. Z Kinderheilkd. 1975;119(4):221–234. doi: 10.1007/BF00443506. [DOI] [PubMed] [Google Scholar]
  13. Kohler H. G. Brief clinical report: familial neonatally lethal syndrome of hypoplastic left heart, absent pulmonary lobation, polydactyly, and talipes, probably Smith-Lemli-Opitz (RSH) syndrome. Am J Med Genet. 1983 Mar;14(3):423–428. doi: 10.1002/ajmg.1320140304. [DOI] [PubMed] [Google Scholar]
  14. Kretzer F. L., Hittner H. M., Mehta R. S. Ocular manifestations of the Smith-Lemli-Opitz syndrome. Arch Ophthalmol. 1981 Nov;99(11):2000–2006. doi: 10.1001/archopht.1981.03930020876013. [DOI] [PubMed] [Google Scholar]
  15. Le Merrer M., Briard M. L., Chauvet M. L. Une étiologie méconnue de l'ambiguïté sexuelle: syndrome de Smith-Lemli-Opitz ou entité nouvelle? J Genet Hum. 1987 May;35(2-3):187–193. [PubMed] [Google Scholar]
  16. Lipson A., Hayes A. Smith-Lemli-Opitz syndrome and Hirschsprung disease. J Pediatr. 1984 Jul;105(1):177–177. doi: 10.1016/s0022-3476(84)80406-0. [DOI] [PubMed] [Google Scholar]
  17. Lowry R. B. Editorial comment: variability in the Smith-Lemli-Opitz syndrome: overlap with the Meckel syndrome. Am J Med Genet. 1983 Mar;14(3):429–433. doi: 10.1002/ajmg.1320140305. [DOI] [PubMed] [Google Scholar]
  18. Lowry R. B., Miller J. R., MacLean J. R. Micrognathia, polydactyly, and cleft palate. J Pediatr. 1968 Jun;72(6):859–861. doi: 10.1016/s0022-3476(68)80441-x. [DOI] [PubMed] [Google Scholar]
  19. Lowry R. B., Yong S. L. Borderline normal intelligence in the Smith-Lemli-Opitz (RSH) syndrome. Am J Med Genet. 1980;5(2):137–143. doi: 10.1002/ajmg.1320050205. [DOI] [PubMed] [Google Scholar]
  20. PINSKY L., DIGEORGE A. M. A FAMILIAL SYNDROME OF FACIAL AND SKELETAL ANOMALIES ASSOCIATED WITH GENITAL ABNORMALITY IN THE MALE AND NORAML GENITALS IN THE FEMALE: ANOTHER CAUSE OF MALE PSEUDOHERMAPHRODITISM. J Pediatr. 1965 Jun;66:1049–1054. doi: 10.1016/s0022-3476(65)80091-9. [DOI] [PubMed] [Google Scholar]
  21. Patterson K., Toomey K. E., Chandra R. S. Hirschsprung disease in a 46,XY phenotypic infant girl with Smith-Lemli-Opitz syndrome. J Pediatr. 1983 Sep;103(3):425–427. doi: 10.1016/s0022-3476(83)80422-3. [DOI] [PubMed] [Google Scholar]
  22. Pfeiffer R. A., Slavaykoff H. Gibt es ein Syndrom nach Ullrich und Feichtiger? Klin Padiatr. 1975 Mar;187(2):176–180. [PubMed] [Google Scholar]
  23. Rutledge J. C., Friedman J. M., Harrod M. J., Currarino G., Wright C. G., Pinckney L., Chen H. A "new" lethal multiple congenital anomaly syndrome: joint contractures, cerebellar hypoplasia, renal hypoplasia, urogenital anomalies, tongue cysts, shortness of limbs, eye abnormalities, defects of the heart, gallbladder agenesis, and ear malformations. Am J Med Genet. 1984 Oct;19(2):255–264. doi: 10.1002/ajmg.1320190208. [DOI] [PubMed] [Google Scholar]
  24. Ruvalcaba R. H., Reichert A., Smith D. W. Smith-Lemli-Opitz syndrome. Case report. Arch Dis Child. 1968 Oct;43(231):620–623. doi: 10.1136/adc.43.231.620. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. SMITH D. W., LEMLI L., OPITZ J. M. A NEWLY RECOGNIZED SYNDROME OF MULTIPLE CONGENITAL ANOMALIES. J Pediatr. 1964 Feb;64:210–217. doi: 10.1016/s0022-3476(64)80264-x. [DOI] [PubMed] [Google Scholar]
  26. Salonen R., Herva R., Norio R. The hydrolethalus syndrome: delineation of a "new", lethal malformation syndrome based on 28 patients. Clin Genet. 1981 May;19(5):321–330. doi: 10.1111/j.1399-0004.1981.tb00718.x. [DOI] [PubMed] [Google Scholar]
  27. Scarbrough P. R., Huddleston K., Finley S. C. An additional case of Smith-Lemli-Opitz syndrome in a 46,XY infant with female external genitalia. J Med Genet. 1986 Apr;23(2):174–175. doi: 10.1136/jmg.23.2.174. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Townes P. L., Brocks E. R. Hereditary syndrome of imperforate anus with hand, foot, and ear anomalies. J Pediatr. 1972 Aug;81(2):321–326. doi: 10.1016/s0022-3476(72)80302-0. [DOI] [PubMed] [Google Scholar]
  29. Zizka J., Maresová J., Kerekes Z., Nozicka Z., Jüttnerová V., Balícek P. Intestinal aganglionosis in the Smith-Lemli-Opitz syndrome. Acta Paediatr Scand. 1983 Jan;72(1):141–143. doi: 10.1111/j.1651-2227.1983.tb09683.x. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Medical Genetics are provided here courtesy of BMJ Publishing Group

RESOURCES