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$Unique_ID{BRK04096}
$Pretitle{}
$Title{Pentalogy of Cantrell}
$Subject{Pentalogy of Cantrell Cantrell Syndrome Cantrell-Haller-Ravich
Syndrome Cantrell Pentalogy Pentalogy Syndrome Peritoneopericardial
Diaphragmatic Hernia Thoracoabdominal Ectopia Cordis Thoracoabdominal Syndrome
TAS Midline Defect TAS Midline Defects Included Omphalocele}
$Volume{}
$Log{}
Copyright (C) 1993 National Organization for Rare Disorders, Inc.
939:
Pentalogy of Cantrell
** IMPORTANT **
It is possible that the main title of the article (Pentalogy of Cantrell)
is not the name you expected. Please check the SYNONYM listing to find the
alternate names and disorder subdivisions covered by this article.
Synonyms
Cantrell Syndrome
Cantrell-Haller-Ravich Syndrome
Cantrell Pentalogy
Pentalogy Syndrome
Peritoneopericardial Diaphragmatic Hernia
Thoracoabdominal Ectopia Cordis
Thoracoabdominal Syndrome
TAS Midline Defect
TAS, Midline Defects, Included
Information on the following diseases can be found in the Related
Disorders section of this report:
Omphalocele
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.
Pentalogy of Cantrell is a very rare disorder characterized by a
combination of severe defects of the middle of the chest, sternum, diaphragm,
heart, and abdominal wall. This defect can affect males or females and is
apparent at birth or shortly after.
Symptoms
Pentalogy of Cantrell is characterized by chest wall defects that may include
a clefting of the chest area. The protrusion of the intestines through the
child's navel into a sac (omphalocele) is also present. Muscles of the
diaphragm are often missing allowing the heart to be apparent under the skin.
An opening between the area of the body that contains the bowels, liver, and
heart may exist. Often the above defects affect the infant's ability to
breathe, for the heart to function, and may even cause widespread internal
infection of the patient's abdominal cavity. Symptoms may occur due to an
abnormality in the development of midline embryonic tissue fourteen to
eighteen days after conception. The infant usually has normal intelligence.
Causes
Pentalogy of Cantrell can be a sporadic condition or be transmitted by an X-
linked gene. 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. X-linked disorders are conditions which result from a
defective gene on the X chromosome. Females have two X chromosomes, but
males have one X chromosome and one Y chromosome. Therefore, in females,
disease traits on the X chromosome can be corrected by the normal gene on the
other X chromosome causing the female to be asymptomatic or making symptoms
less serious than in males. Since males only have one X chromosome, if they
inherit a gene for a disease present on the X, it will be expressed. Men
with X-linked disorders transmit the gene to all their daughters, who are
carriers, but never to their sons. Women who are carriers of an X-linked
disorder have a fifty percent risk of transmitting the carrier condition to
their daughters, and a fifty percent risk of transmitting the disease to
their sons.
Affected Population
Pentalogy of Cantrell is a very rare disorder it effects 5.5 infants per one
million live births. Males are effected more frequently than females.
Females tend to have less severe symptoms than males. Approximately fifty
cases have been identified in the medical literature.
Related Disorders
Symptoms of the following disorders can be similar to those of Pentalogy of
Cantrell. Comparisons may be useful for a differential diagnosis:
Omphalocele is the protrusion of the internal abdominal tissue through
the navel into a clear sac outside of the body. If the size is less than 4
cm it is considered a hernia of the navel. If more than 4 cm it is an
omphalocele.
Therapies: Standard
Pentalogy of Cantrell usually requires a series of surgeries over a period of
years. Abdominal and heart defects both require very involved surgical
procedures. The abdominal defect is usually closed first. Heart defects are
repaired when the child is older.
The disorder is usually apparent at birth or shortly after. Ultrasound
testing can determine if the condition is present even before birth.
Genetic counseling will be of benefit for patients and their families.
Other treatment is symptomatic and supportive.
Therapies: Investigational
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 birth defects in the future.
This disease entry is based upon medical information available through
May 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 Pentalogy of Cantrell, please contact:
National Organization for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812
(203) 746-6518
NIH/National Institute of Child Health and Human Development (NICHD)
9000 Rockville Pike
Bethesda, MD 20892
(301) 496-5133
For Genetic Information and Genetic Counseling Referrals:
March of Dimes Birth Defects Foundation
1275 Mamaroneck Ave.
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, 1992. P. 1971.
NELSON TEXTBOOK OF PEDIATRICS, 14th ed., Ed.: Richard E. Behrman, W.B.
Saunders Company, 1992. Pp. 1032-1033.
BIRTH DEFECTS ENCYCLOPEDIA, Mary Louise Buyse, M.D., Editor-In-Chief;
Blackwell Scientific Publications, 1990. Pp. 1375-1376.
GASTROINTESTINAL DISEASE, PATHOPHYSIOLOGY, DIAGNOSIS, AND MANAGEMENT, 4th
ed., Ed.: Marvin H. Sleisenger, M.D., W.B. Saunders, Co., 1989. Pp. 1015-
1017.
PRENATAL DIAGNOSIS OF PENTALOGY OF CANTRELL., A. Ghidini, et al.; J
Ultrasound Med, October, 1988, (issue 7 (10)). Pp. 567-572.
PENTALOGY OF CANTRELL AND ECTOPIA CORDIS, A FAMILIAL DEVELOPMENTAL FIELD
COMPLEX., R.A. Martin, Am J Med Genet, April, 1992, (issue 42 (6)). Pp. 839,
841.