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$Unique_ID{BRK03694}
$Pretitle{}
$Title{Ectrodactyly-Ectodermal Dysplasia-Cleft Lip/Palate}
$Subject{Ectrodactyly-Ectodermal Dysplasia-Cleft Lip/Palate
Ectrodactyly-Ectodermal Dysplasia-Clefting Syndrome EEC Syndrome Ectodermal
Dysplasias Rapp-Hodgkins Syndrome Growth Hormone Deficiency}
$Volume{}
$Log{}
Copyright (C) 1993 National Organization for Rare Disorders, Inc.
935:
Ectrodactyly-Ectodermal Dysplasia-Cleft Lip/Palate
** IMPORTANT **
It is possible that the main title of the article (Ectrodactyly-
Ectodermal Dysplasia-Cleft Lip/Palate) is not the name you expected. Please
check the SYNONYMS listing to find the alternate name and disorder
subdivisions covered by this article.
Synonyms
Ectrodactyly-Ectodermal Dysplasia-Clefting Syndrome
EEC Syndrome
Information on the following diseases can be found in the Related
Disorders section of this report:
Ectodermal Dysplasias
Rapp-Hodgkins Syndrome
Growth Hormone Deficiency
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.
Ectrodactyly-Ectodermal Dysplasia-Cleft Lip/Palate (EEC Syndrome) is a
rare form of ectodermal dysplasia inherited as an autosomal dominant genetic
trait. It can vary from mild symptoms to severe. The most common symptoms
found in patients with EEC Syndrome are: missing or irregular fingers and/or
toes (ectrodactyly), abnormalities of the hair and glands, cleft lip and/or
palate, or unusual facial features, as well as abnormalities of the eyes and
urinary tract.
Symptoms
The most common symptoms of Ectrodactyly-Ectodermal Dysplasia-Cleft
Lip/Palate are: absent or irregular fingers and/or toes (ectrodactyly);
and/or abnormalities of the eyes, glands, skin, teeth and urinary tract. Any
combination of the following symptoms may be present in affected patients.
Missing or irregular fingers and/or toes (ectrodactyly) may be present
with abnormalities of the third digit being the most common. This is
sometimes referred to as split hand and/or split foot deformity. The
affected digits may not be the same on each side. If ectrodactyly is not
present, there may be fusion or webbing of the digits (syndactyly).
Ectodermal Dysplasias are a group of hereditary, nonprogressive syndromes
in which the affected tissue derives primarily from the ectodermal germ
layer. The skin, its derivatives, and some other organs are involved. EEC
Syndrome patients are typically affected with symptoms of ectodermal
dysplasia. The hair may be dry, light colored, fine, and sparse with absent
eyebrows and eyelashes. The skin may be dry and teeth may be missing,
abnormally small or lacking enamel. (For more information on this disorder
choose "Ectodermal Dysplasia" as your search term in the Rare Disease
Database).
Patients with EEC Syndrome may also have abnormalities of the eyes. The
gland of the eye that allows tears to escape (lacrimal gland) may be missing.
This gland is needed to moisten the underlining of the eyelids (conjunctiva).
The opening of the glands that secrete fluid onto the back of the eyelid
(meibomian gland orifice) may also be absent. An abnormally narrow passage
of the channel that carries tears from the eye to the nasal cavity
(nasolacrimalduct) is another condition found in some patients with EEC
Syndrome. These conditions may make the patient susceptible to eye
infections as well as scarring of the eye. Vision may also be affected.
An opening or fissure on the roof of the mouth or lip (cleft palate
and/or cleft lip) may also be present in patients with EEC Syndrome. When
cleft palate and/or cleft lip are not present, the patient may have an
underdeveloped jaw, a short groove in the center of the upper lip and a broad
nasal tip. Widely spaced eyes (hypertelorism) and/or slanted eyes are also
sometimes present. (For more information on this disorder choose "Cleft Lip"
or "Cleft Palate" as your search term in the Rare disease database).
Kidney abnormalities may also be a part of EEC Syndrome in some patients.
The tube that carries urine from the kidney into the bladder (ureter) may be
obstructed causing the pelvis and kidney duct to become swollen with an
accumulation of urine (hydronephrosis). Kidney and pelvis inflammation and
infection causing fever, chills, pain, nausea and frequent urination
(pyelonephritis) may also occur. An absent kidney as well as duplication of
a kidney has been reported in a few cases of EEC Syndrome.
Brown pigmented areas on the body (macules), slowed voluntary movement,
an abnormally small brain and absent long bones of the arms and legs have
been found in association with EEC Syndrome in a few cases.
Causes
Ectrodactyly-Ectodermal Dysplasia-Cleft Lip/Palate is a rare disorder thought
to be inherited as an Autosomal Dominant genetic trait varying in the degree
to which the symptoms appear. 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 dominant disorders a single copy of
the disease gene (received from either the mother or father) will be
expressed "dominating" the other normal gene and resulting in the appearance
of the disease. The risk of transmitting the disorder from affected parent
to offspring is fifty percent for each pregnancy regardless of the sex of the
resulting child.
Affected Population
Ectrodactyly-Ectodermal Dysplasia-Cleft Lip/Palate is a very rare disorder
that affects males and females in equal numbers. Well over seventy affected
families have been reported in the medical literature. There has been a high
number of EEC patients located in the country of Denmark.
Related Disorders
Symptoms of the following disorders can be similar to those of Ectrodactyly-
Ectodermal Dysplasia-Cleft Lip/Palate. Comparisons may be useful for a
differential diagnosis:
Ectodermal Dysplasias are a group of hereditary, nonprogressive syndromes
in which the affected tissue derives primarily from the ectodermal germ
layer. The skin, its derivatives, and some other organs are involved.
Symptoms may include: eczema, poorly functioning sweat glands, sparse or
absent hair follicles, absent or abnormal teeth, disfigured nails, and
difficulties with the nasal passages and ears. (For more information on this
disorder, choose " Ectodermal Dysplasia" as your search term in the Rare
Disease Database).
Rapp-Hodgkins Syndrome is a rare form of ectodermal dysplasia inherited
as an autosomal dominant genetic trait. Major symptoms of this disorder
include inability to sweat in combination with cleft lip and palate, dental
abnormalities and lack of hair. (For more information on this disorder,
choose "Rapp Hodgkins Syndrome" as your search term in the Rare Disease
Database).
The following disorders may be associated with Ectrodactyly-Ectodermal
Dysplasia-Cleft Lip/Palate as secondary characteristics. They are not
necessary for a differential diagnosis:
Growth Hormone Deficiency has been reported in a few cases of EEC
Syndrome. Growth Hormone is manufactured in the pituitary gland. If it is
missing or reduced in quantity during infancy or childhood, it results in
growth retardation, short stature and other maturation delays. (For more
information on this disorder choose "Growth Hormone Deficiency" as your
search term in the Rare Disease Database).
Therapies: Standard
When hydronephrosis is present, temporary drainage of the urine may be
necessary. Surgery may be indicated when pain, infection and/or kidney
function is compromised.
Surgery may be performed on fingers and/or toes to correct webbing and
malformations in some cases. Special skin care techniques may be warranted
under the direction of a dermatologist, and dental treatment may be required.
Treatment of a person with cleft lip and/or palate requires the
coordination efforts of a team of specialists. Pediatricians, dental
specialists, surgeons, speech pathologists, and psychologists must work
together in planning the child's treatment and rehabilitation. Cleft palate
may be repaired by surgery or covered by an artificial device (prosthesis)
that closes or blocks the opening. Surgical repair can be carried out in
stages or in a single operation, according to the nature and severity of the
defect.
Genetic counseling may be of benefit for patients and their families.
Other treatment is symptomatic and supportive.
Therapies: Investigational
Orphan Products: The palate of cleft palate patients is closed during early
childhood but difficulties may persist if the palate is excessively short in
relation to the pharynx. Researchers are studying a teflon-glycerine paste
that is applied to the rear of the pharynx in a minor surgical procedure. A
rounder bump or ledge is formed, bringing the pharynx and palate into the
proper relationship with each other. The hardened paste remains in place
indefinitely; no side affects have been observed. Children as young as eight
years old have been treated with this procedure.
For further information on this procedure contact:
William N. Williams, D.D.S.
University of Florida
College of Dentistry
Box J-424
Gainesville, FL 32610
(904) 392-4370
Research on birth defects and their causes is ongoing. The National
Institutes of Health (NIH) is sponsoring the Human Genome Project which is
aimed at mapping every gene in the human body and learning why they sometimes
malfunction. It is hoped that this new knowledge will lead to prevention and
treatment of genetic disorders in the future.
This disease entry is based upon medical information available through
January 1993. 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 Ectrodactyly-Ectodermal Dysplasia-Clefting Syndrome,
please contact:
National Organization for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
National Foundation for Ectodermal Dysplasias
219 E. Main Street
Mascoutah, IL 62258
(618) 566-2020
NIH/National Arthritis and Musculoskeletal and Skin Disease Information
Clearinghouse
Box AMS
Bethesda, MD 20892
(301) 496-4484
American Cleft Palate Cranial Facial Association
1218 Granview Ave.
Pittsburgh, PA 15211
(412) 681-1376
(800) 24CLEFT
National Cleft Palate Association
2950 Hearne Ave
Shreveport, LA 71103
(318) 635-8191
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, 10th Ed.: Victor A. McKusick, Editor: Johns
Hopkins University Press, 1990. Pp. 335.
SMITH'S RECOGNIZABLE PATTERNS OF HUMAN MALFORMATION, 4th Ed.: Kenneth L.
Jones, M.D., Editor; W.B. Saunders Co., 1988. P .252.
BIRTH DEFECTS ENCYCLOPEDIA, Mary Louise Buyse, M.D., Editor-In-Chief;
Blackwell Scientific Publications, 1990. Pp. 607-8.
NELSON TEXTBOOK OF PEDIATRICS, 14th. Ed.; Richard E. Behrman, M.D.,
Editor: W.B. Saunders Company, 1992. Pp. 1629.
GROWTH HORMONE DEFICIENCY ASSOCIATED WITH THE ECTRODACTYLY-ECTODERMAL
DYSPLASIA-CLEFTING SYNDROME: J. Knudtzon, et al.; Pediatrics (March, 1987,
issue 79(3)). Pp. 410-2.
EEC SYNDROME: REPORT ON 20 NEW PATIENTS, CLINICAL AND GENETIC
CONSIDERATIONS: E.S. Rodini, et al.; Am J Genet (September, 1990, issue
37(1)). Pp. 42-53.
GENITOURINARY ANOMALIES ARE A COMPONENT MANIFESTATION IN THE ECTODERMAL
DYSPLASIA, ECTRODACTYLY, CLEFT LIP/PALATE (EEC) SYNDROME: B.R. Rollnick, et
al.; Am J Med Genet (January, 1988, issue 29(1)). Pp. 131-6.