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- $Unique_ID{BRK04226}
- $Pretitle{}
- $Title{Smith-Lemli-Opitz Syndrome}
- $Subject{Smith-Lemli-Opitz Syndrome RSH Syndrome Smith-Opitz-Inborn syndrome }
- $Volume{}
- $Log{}
-
- Copyright (C) 1986, 1988, 1990 National Organization for Rare Disorders, Inc.
-
- 292:
- Smith-Lemli-Opitz Syndrome
-
- ** IMPORTANT **
- It is possible the main title of the article (Smith-Lemli-Opitz Syndrome)
- is not the name you expected. Please check the SYNONYMS listing to find the
- alternate names and disorder subdivisions covered by this article.
-
- Synonyms
-
- RSH Syndrome
- Smith-Opitz-Inborn 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.
-
-
- Smith-Lemli-Opitz syndrome is a hereditary developmental disorder. It is
- characterized by nostrils that are turned forward, drooping eyelids, webbing
- between the second and third toes, and male genital abnormalities in mentally
- retarded persons of small stature.
-
- Symptoms
-
- Onset of Smith-Lemli-Opitz syndrome occurs before birth. Symptoms of the
- disorder include:
-
- 1. Low birth weight and subsequent growth deficiency.
- 2. Moderate to severe mental retardation with variable alteration of
- muscle tone.
- 3. Vomiting in early infancy and tendency toward a shrill cry.
- 4. A small head that is abnormally long and narrow.
- 5. Drooping eyelids, folds in the inner corners of the eyelids, and
- crossing of the eyes.
- 6. A broad nasal tip and nostrils that are turned forward.
- 7. Broad lateral ridges in the palate and a moderately small jaw.
- 8. The palms and soles frequently show a single transverse crease.
- Often, webbing appears between the second and third toes. Fingertips often
- show whorl dermatoglyphic patterns.
- 9. Genitals in males reveal failure of the testes to descend into the
- scrotum (cryptorchidism), opening of the urethra on the underside of the
- penis (hypospadias) and a small penis.
- 10. An abnormal electro-encephalogram (EEG) is frequently reported.
-
- Occasional features of Smith-Lemli-Opitz syndrome may include a broad
- nasal bridge, cleft palate, a clenched hand with the index finger overlying
- the third finger, an asymmetric short thumb, and abnormal ridges in the palm
- (distal palmar axial triradius). The fore part of the foot may deviate
- toward the midline (metatarsus adductus), and a hip may be dislocated. The
- child may also have a deep sacral dimple, a pit anterior to the anus, wide-
- spread nipples, heart defect, hernia in the groin, a narrowing in the distal
- opening of the stomach (pyloric stenosis), and dilated kidney cavities
- (calices).
-
- Rarely, dysplasia epiphysialis punctata occurs, which consists of multiple
- punctate stippling of the ends of the long bones appearing in x-rays,
- dwarfism, flexion contraction, cataracts, a dulled intellect, short blunt
- fingers and general weakness. An underdeveloped thymus gland occurs rarely.
-
- Causes
-
- Smith-Lemli-Opitz syndrome is an autosomal recessive inherited disorder.
- (Human traits including the classic genetic diseases, are the product of the
- interaction of two genes for that condition, 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 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.)
-
- Affected Population
-
- Smith-Lemli-Opitz may be more easily diagnosed in males because of the
- noticeable genital abnormalities. However, the disorder occurs equally in
- males and females.
-
- Therapies: Standard
-
- Medical treatment of Smith-Lemli-Opitz syndrome is symptomatic and
- supportive. A common complication of the syndrome is pneumonia, which should
- be treated with antibiotics according to the causative agent.
-
- Special education services and physical therapy may also be recommended.
- Genetic counseling with the parents of patients with this syndrome is
- recommended for further family planning. Prenatal diagnosis (e.g. by
- amniocentesis) is not yet available for this disorder.
-
- Therapies: Investigational
-
- This disease entry is based upon medical information available through
- January 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 Smith-Lemli-Opitz Syndrome, please contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- Dr. Opitz
- Shodar Children's Hospital
- P.O. Box 5539
- Helena, MT 59604
-
- NIH/National Institute of Child Health and Human Development (NCHHD)
- 9000 Rockville Pike
- Bethesda, MD 20892
- (301) 496-5133
-
- For genetic information and genetic counseling referrals, please contact:
-
- 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
-
- BIRTH DEFECTS COMPENDIUM, 2nd ed: Daniel Bergsma, ed; March of Dimes, 1979.
- Pp. 963.
-
-