Dermato-sparaxis ehlers-danlos syndromeQ79.6

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 24.09.2022

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Synonym(s)

Dermatosparaxis EDS; EDS type VIIc; EDS type VIIC; Ehlers-Danlos syndrome, dermatosparaxis type; Ehlers-Danlos syndrome, dermatosparax type

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DefinitionThis section has been translated automatically.

Ehlers-Danlos Syndrome (EDS) is a heterogeneous group of hereditary connective tissue diseases whose main clinical features are overstretchability of the skin and hyperreflexia of the joints. Depending on the type of disease and the underlying gene mutations, vessels, muscles, ligaments, tendons and internal organs are also affected (Brady A et al. 2017).

So far, 19 gene mutations are known to trigger EDS. The various mutations lead to changes in the structure, production or processing of collagen or of proteins that interact with collagen. The frequency of occurrence in the population is assumed to be 1:5,000 to 1:10,000, making EDS a rare disease (orphan disease).

The very rare Dermatosparaxis EDS is an autosomal recessive inherited, rare disease variant of the Ehlers-Danlos Syndrome (Malfait F et al. 2004)

EtiopathogenesisThis section has been translated automatically.

Mutations in the ADAMTS2 gene can be detected. The ADAMTS2 gene (procollagen I N-proteinase gene) is located on chromosome 5q35.3 and codes for a procollagen I N-proteinase.

This enzyme cuts off a short chain of amino acids at one end of the procollagen. This "clipping step" is essential for the collagen molecules to be processed normally and to be able to assemble into fibrils outside the cells.

Clinical featuresThis section has been translated automatically.

Clinical symptoms are classified according to major and minor criteria (Brinckmann J 2018).

Major symptoms are:

  • Skin: Pronounced fragility with congenital or postpartum skin tears.
  • Cutis laxa-likesymptomatology with severe wrinkling of wrists and ankles, increased skin wrinkling palmar
  • Severe hematoma formation with risk of subcutaneous hematomas and hemorrhages
  • Other: Characteristic facial physiognomy
  • Umbilical hernias
  • Growth retardation
  • Perinatal complications due to tissue fragility
  • Shortened hand and foot limbs

Minor criteria:

  • Skin: soft doughy skin
  • hyperelasticity, tissue fragility with atrophic scars
  • Skeletal system: generalized hypermobility of joints
  • Osteopenia
  • Neuromuscular system: muscular hypotonia

Other:

  • Visceral fragility (bladder and/or diaphragmatic ruptures, rectal prolapse, delayed motor development, hirsutism, dental anomalies, defective vision, strabismus.

DiagnosisThis section has been translated automatically.

Detection of the genetic defect

Clinical symptoms with extreme skin fragility + dysmorphia of the face.

LiteratureThis section has been translated automatically.

  1. Ayoub S et al (2020) Clinical features, molecular results, and management of 12 individuals with the rare arthrochalasia Ehlers-Danlos syndrome. At J Med Genet A doi: 10,1002/ajmg.a.61523.
  2. Bowen et al(2017): Ehlers-Danlos syndrome, classical type. American Journal of Medical Genetics 175C:17-39
  3. Brady A et al (2017): Ehlers-Danlos Syndomes, rarer types. In: Ehlers-Danlos Society. American Journal of Medical Genetics 175C:70-115
  4. Brinckmann J (2018) Hereditary connective tissue diseases. In. Plewig et al. (Ed.) Braun-Falco`s Dermatology, Venerology and Allergology, Springer Reference Medizin S 883-890
  5. Byers PH et al (2019): Diagnosis, natural history and management in vascular Ehlers-Danlos syndrome. American Jourrnal of Medical Genetics 175C:40-47
  6. Guarnieri V et al (2019) Cardiac valvular Ehlers-Danlos syndrome is a well-defined condition due to recessive null variants in COL1A2. On J Med Genet A 179:846-851.
  7. Malfait F et al (2006) Total absence of the alpha2(I) chain of collagen type I causes a rare form of Ehlers-Danlos syndrome with hypermobility and propensity to cardiac valvular problems.J Med Genet 43:e36.
  8. Malfait F et al (2004) The natural history, including orofacial features of three patients with Ehlers-Danlos syndrome, dermatosparaxis type (EDS type VIIC). On J Med Genet A 131:18-28.
  9. Melis D et al (2012) Cardiac valve disease: an unreported feature in Ehlers-Danlos syndrome arthrocalasia type? Ital J Pediatr 38:65.
  10. Micale L et al (2019) Novel TNXB Variants in Two Italian Patients with Classical-Like Ehlers-Danlos Syndrome.Genes (Basel) 10: doi: 10.3390/genes10120967.
  11. Solomons J et al (2013) Dermatosparaxis (Ehlers-Danlos type VIIC): prenatal diagnosis following a previous pregnancy with unexpected skull fractures at delivery. Am J Med Genet A 161A:1122-1125.
  12. Van Damme T et al (2016) Expanding the clinical and mutational spectrum of the Ehlers-Danlos syndrome, dermatosparaxis type. Genet Med 18:882-891.

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Last updated on: 24.09.2022