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$Unique_ID{BRK04105}
$Pretitle{}
$Title{Phocomelia Syndrome}
$Subject{Phocomelia Syndrome Roberts SC-Phocomelia Syndrome SC Phocomelia
Syndrome Roberts Tetraphocomelia Syndrome Roberts SC-Phocomelia Syndrome
Thalidomide Syndrome Thrombocytopenia-Absent Radius TAR Syndrome}
$Volume{}
$Log{}
Copyright (C) 1990, 1992 National Organization for Rare Disorders, Inc.
780:
Phocomelia Syndrome
** IMPORTANT **
It is possible that the main title of the article (Phocomelia Syndrome)
is not the name you expected. Please check the SYNONYM listing to find the
alternate names and disorder subdivisions covered by this article.
Synonyms
Roberts SC-Phocomelia Syndrome
SC Phocomelia Syndrome
Roberts Tetraphocomelia Syndrome
Disorder Subdivisions
Roberts SC-Phocomelia Syndrome
Thalidomide Syndrome
Information on the following disease can be found in the Related
Disorders section of this report:
Thrombocytopenia-Absent Radius (TAR) Syndrome
General Discussion
** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only. It should not be used for diagnostic or treatment
purposes. If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.
Phocomelia Syndrome is a birth defect that may be occur sporadically or
be genetically transmitted in some cases. In other cases it may be caused by
toxins (such as certain drugs) taken by a pregnant woman. Major symptoms may
include growth and mental deficiencies, defects in the eyes, ears, and nose,
and characteristic deficient limb development affecting the arms and possibly
the legs.
Symptoms
The primary symptom of Phocomelia Syndrome is deficient limb development.
However, the defects of the limbs are variable. Commonly, the upper limbs
are affected and sections of the hands and arms may be malformed or missing.
The legs and the feet may also be affected. The hands and/or the feet may be
attached close to the body or the limbs may be abnormally small.
Individuals with Phocomelia Syndrome usually have growth deficiencies
before and after birth. In some cases, they also may be mentally retarded.
The head may be small with sparse hair that may be silvery-blond. A swelling
or mass of blood vessels (hemangioma) may occur on the face. Prominent
widely-set eyes (hypertelorism) that have bluish whites, an underdeveloped
nose with thin nostrils, malformed ears, cleft lip with or without cleft
palate, and small jaws (micrognathia) may also occur. The testes of males
may fail to descend (cryptochidism).
Less common symptoms include: a gap in the skull with the brain possibly
protruding (encephalocele); accumulation of excess spinal fluid under the
skull (hydrocephalus) which may cause headaches, vomiting, and convulsions;
and small eyeballs (microphthalmia), corneal clouding, cataracts, and eyelid
defects. The urethra (the tube leading from the bladder) may open underneath
the penis or in females may open into the vagina (hypospadias). An
abnormally shaped uterus (bicornate), an abnormally low level of platelets in
the blood (thrombocytopenia), kidney and heart abnormalities, a short neck,
and cranial nerve paralysis may also occur.
Disorder Subdivisions
When Phocomelia is caused by drugs, it is usually thought of as the
Thalidomide Syndrome. This type of Phocomelia is characterized by severe
defects and is caused by the ingestion of the drug Thalidomide (a
tranquilizer) during early pregnancy. Thalidomide was widely used outside the
United States in the late 1950's and early 1960's. Symptoms may include:
limb defects of the arms or all of the limbs, abnormalities of the eyes and
the ears with possible deafness, paralysis of the face with possible limited
eye movements, heart defects, abnormal passages (fistulas) between the
rectum, urethra, and/or vagina, abnormalities of internal organs (such as the
gallbladder, appendix, small intestine, and uterus), and failure of the
testes to descend in males (cryptochidism). A small percentage of
individuals have spinal abnormalities and/or growth deficiencies. This type
of Phocomelia can also be caused by the acne drug Accutane.
Roberts SC-Phocomelia Syndrome is a birth defect that is genetically
inherited through recessive genes and may represent Phocomelia in its mildest
form. There have been a number of patients exhibiting overlap of symptoms
between the Roberts SC Syndrome and the Thalidomide Syndrome. The two
disorders may be different expressions of a gene or represent variable
severity of the same disorder.
Causes
In the cases where Phocomelia Syndrome is inherited, it is transmitted
by autosomal recessive genes. Human traits, including the classic genetic
diseases, are the product of the interaction of two genes, one received from
the father and one from the mother. In recessive disorders, the condition
does not appear unless a person inherits the same defective gene for the same
trait from each parent. If one receives one normal gene and one gene for the
disease, the person will be a carrier for the disease, but usually will show
no symptoms. The risk of transmitting the disease to the children of a
couple, both of whom are carriers for a recessive disorder, is twenty-five
percent. Fifty percent of their children will be carriers, but healthy as
described above. Twenty-five percent of their children will receive both
normal genes, one from each parent, and will be genetically normal.
In other cases Phocomelia Syndrome can occur as a result of a woman
taking certain drugs during pregnancy or other unknown reasons. The drug
Thalidomide caused an unusual surge of babies born with Phocomelia during the
1960's, and the drug Accutane (for treatment of acne) can also cause
Phocomelia.
Affected Population
The hereditary form of Phocomelia is a very rare disorder affecting only a
dozen or more babies born each year. Males and females are affected in equal
numbers. An upsurge of the number of Phocomelia cases can signal that
certain drugs are causing this birth defect. Thalidomide (a tranquilizer)
and Accutane (for treatment of acne) can cause Phocomelia in a fetus when
ingested by a pregnant woman.
Related Disorders
Symptoms of the following disorder can be similar to those of Phocomelia
Syndrome. Comparisons may be useful for a differential diagnosis:
There are many birth defects that can cause malformed or missing limbs.
One of these is Thrombocytopenia-Absent Radius (TAR) Syndrome. TAR Syndrome
is a genetic disorder characterized by a very low level of the number of
platelets in the blood (thrombocytopenia) and the absence or underdevelopment
of one of the short bones (radius) in the arm. Thrombocytopenia may cause
excessive bleeding from the skin, mucous membranes (thin moist layer lining
the body's cavity), or within the skull. Other blood disorders may also
occur. The underdevelopment of the other short bone (ulna) of the arm, and
defects of the hands, legs, and/or feet may also occur. (For more
information on this disorder, choose "TAR" as your search term in the Rare
Disease Database).
Therapies: Standard
Treatment and rehabilitation of the limb deformities of Phocomelia Syndrome
should be planned in infancy. Individual prostheses (artificial limbs) and
orthopedic braces or appliances (ortheses) may be needed. Genetic counseling
may be of benefit for patients and their families if the child has the
genetic form of this disorder. Other treatment is symptomatic and
supportive.
Therapies: Investigational
This disease entry is based upon medical information available through
November 1990. Since NORD's resources are limited, it is not possible to
keep every entry in the Rare Disease Database completely current and
accurate. Please check with the agencies listed in the Resources section for
the most current information about this disorder.
Resources
For more information on Phocomelia Syndrome, please contact:
National Organization for Rare Disorders
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
NIH/National Institute of Child Health and Human Development (NICHHD)
9000 Rockville Pike
Bethesda, MD 20892
(301) 496-4236
Association of Children's Prosthetic and Orthotic Clinics (ACPOC)
317 E. 34th Street
New York, NY 10016
National Rehabilitation Information Center (NARIC)
8455 Colesville Road, Suite 935
Silver Spring, MD 20910
(202) 635-5826
Thalidomide Society
19 Upper Hall Park
Berkhamsted, Herts HP4-2NP
England
For Genetic Information and genetic counseling referrals:
March of Dimes Birth Defects Foundation
1275 Mamaroneck Avenue
White Plains, NY 10605
(914) 428-7100
Alliance of Genetic Support Groups
35 Wisconsin Circle, Suite 440
Chevy Chase, MD 20815
(800) 336-GENE
(301) 652-5553
References
MENDELIAN INHERITANCE IN MAN, 8th ed.: Victor A. McKusick; Johns Hopkins
University Press, 1986. Pp. 584, 907.
SMITH'S RECOGNIZABLE PATTERNS OF HUMAN MALFORMATION, 4th ed.: Kenneth L.
Jones; W.B. Saunders Co., 1988. Pp. 256-7.
ROBERTS-SC PHOCOMELIA SYNDROME: CYTOGENETIC FINDINGS AND CLINICAL
VARIABILITY IN THREE BROTHERS: G. Antinolo et al.; An Esp Pediatr
(September, 1988, issue 29(3)). Pp. 239-43.
TREATMENT AND REHABILITATION OF DYSMELIC CHILDREN: L. Kullmann; Magy
Traumatol Orthop Helyreallito Sebesz (1989, issue 32 (2)). Pp. 99-106.