Raine syndrome
Raine syndrome is a rare autosomal recessive congenital disorder characterized by distinctive craniofacial abnormalities, osteosclerosis, and hypophosphatemia. It is caused by mutations in the FAM20C gene, which plays a crucial role in bone mineralization and phosphate metabolism.
Presentation
Individuals with Raine syndrome typically present with a range of clinical features, including:
- Craniofacial dysmorphism: This includes midface hypoplasia, microcephaly, exophthalmos, and depressed nasal bridge.
- Osteosclerosis: Increased bone density, particularly in the skull and long bones.
- Hypophosphatemia: Low levels of phosphate in the blood, which can lead to rickets and osteomalacia.
- Growth retardation: Affected individuals often exhibit failure to thrive and short stature.
- Neurological abnormalities: These may include seizures, developmental delay, and intellectual disability.
Genetics
Raine syndrome is inherited in an autosomal recessive manner. This means that an individual must inherit two copies of the mutated FAM20C gene, one from each parent, to be affected by the disorder. Carriers of a single mutated gene typically do not show symptoms.
Diagnosis
The diagnosis of Raine syndrome is based on clinical evaluation, characteristic radiographic findings, and genetic testing to identify mutations in the FAM20C gene. Prenatal diagnosis may be possible through amniocentesis or chorionic villus sampling if there is a known family history of the disorder.
Management
There is currently no cure for Raine syndrome, and treatment is primarily supportive and symptomatic. Management strategies may include:
- Nutritional support to address failure to thrive.
- Physical therapy and occupational therapy to improve motor skills and functional abilities.
- Seizure management with appropriate anticonvulsant medications.
- Orthopedic interventions for skeletal abnormalities.
Prognosis
The prognosis for individuals with Raine syndrome varies depending on the severity of the condition. Severe cases may result in early infant mortality, while milder cases may allow for longer survival with significant medical and developmental challenges.
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