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- $Unique_ID{BRK03828}
- $Pretitle{}
- $Title{Holt-Oram Syndrome}
- $Subject{Holt-Oram Syndrome HOS Heart-Hand Syndrome Atriodigital Dysplasia
- Upper Limb-Cardiovascular Syndrome Thrombocytopenia Absent Radius Syndrome
- (TAR) }
- $Volume{}
- $Log{}
-
- Copyright (C) 1988, 1989 National Organization for Rare Disorders, Inc.
-
- 523:
- Holt-Oram Syndrome
-
- ** IMPORTANT **
- It is possible the main title of the article (Holt-Oram Syndrome) is not
- the name you expected. Please check the SYNONYMS listing on the next page to
- find alternate names and disorder subdivisions covered by this article.
-
- Synonyms
-
- HOS
- Heart-Hand Syndrome
- Atriodigital Dysplasia
- Upper Limb-Cardiovascular Syndrome
-
- Information on the following diseases can be found in the Related
- Disorders section of this report:
-
- Thrombocytopenia Absent Radius Syndrome (TAR)
-
- 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.
-
- Holt-Oram Syndrome is a genetic disorder consisting of congenital heart
- disease and upper limb abnormalities. Often, the forearm, fingers and wrists
- are deformed. Although some affected individuals may have limb defects
- only, they may pass the more severe syndrome to their offspring. Some
- skeletal defects occur, but may be so slight they are not noticed.
-
- Symptoms
-
- Holt-Oram Syndrome is characterized by a particular group of structural
- abnormalities of veins, and more frequently, arteries of the heart (e.g.,
- defects of the wall between the chambers of the right and left side of the
- heart), and skeletal malformations. The bones of the shoulder are not
- proportioned, and the arms are abnormally shortened so that the hands are
- attached close to the body. The thumbs may be underdeveloped, fingers may be
- webbed and/or permanently bent, and bones of the forearm and hand are often
- shorter than normal. The fleshy prominence on the palm of the hand between
- the thumb and wrist (thenar eminence) may also be abnormally flat.
- Occasionally, bone abnormalities may be so slight as to escape notice. The
- skeletal defects often occur on both sides of the body, but may be somewhat
- more severe on the left side. Abnormalities of the wrist (carpal bones)
- appear to occur more often than those of the thumb.
-
- No exact correlation in degree of severity between affected parents and
- children with Holt-Oram Syndrome has been identified. Persons with mild
- skeletal defects only may pass on a more severe form of the disorder to their
- offspring. This condition has been observed to occur in more than one person
- in a family.
-
- Causes
-
- Holt-Oram Syndrome is inherited as an autosomal dominant trait. (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 dominant disorders, a single copy of the disease
- gene (received from either the mother or father) will be expressed
- "dominating" the normal gene and resulting in appearance of the disease. The
- risk of transmitting the disorder from affected parent to offspring is 50%
- for each pregnancy regardless of the sex of the resulting child.) The exact
- mechanism whereby the malformations occur is not well understood, although it
- is thought to be a biochemical abnormality occurring during the fourth to
- fifth week of pregnancy when the upper limb buds and the heart tube undergo
- major changes in the embryo.
-
- Affected Population
-
- Approximately two hundred cases of Holt-Oram Syndrome have been identified
- worldwide since it was first described in 1960. This disorder can affect all
- ethnic groups and races. Males and females are affected in equal numbers.
-
- Related Disorders
-
- Symptoms of the following disorders can be similar to those of Holt-Oram
- Syndrome. Comparisons may be useful for a differential diagnosis:
-
- Thrombocytopenia Absent Radius Syndrome (TAR) is a rare genetic disorder
- characterized by congenital absence of the forearm bone (radius) associated
- with an unusually low number of platelets in circulating blood
- (thrombocytopenia). The disorder begins during infancy but later improves.
- Congenital heart disease and kidney abnormalities may occur in some cases.
- (For more information on this disorder, choose "TAR" as your search term in
- the Rare Disease Database.)
-
- Therapies: Standard
-
- Holt-Oram Syndrome is treated by surgical correction where necessary, both of
- the heart and skeletal problems. Pregnant women at risk of having an
- affected child may undergo ultrasound imaging procedures prenatally to
- evaluate fetal development as early as fourteen weeks into pregnancy.
- Genetic counseling is recommended for patients and their families. Services
- which benefit the physically handicapped may be of benefit in some cases.
- Other treatment is symptomatic and supportive.
-
- Therapies: Investigational
-
- This disease entry is based upon medical information available through June
- 1988. 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 Holt-Oram Syndrome, please contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- American Heart Association
- 7320 Greenville Ave.
- Dallas, TX 75231
- (214) 750-5300
-
- For Heart Symptom Information:
-
- NIH/National Heart, Blood and Lung Institute (NHLBI)
- Office of Public Inquiries
- 9000 Rockville Pike
- Bethesda, MD 20892
- (301) 496-4236
-
- For Bone Symptom Information:
-
- The National Arthritis and Musculoskeletal and Skin Diseases Information
- Clearinghouse
- Box AMS
- Bethesda, MD 20892
- (301) 495-4484
-
- International Center for Skeletal Dysplasia
- 2t. Joseph Hospital
- 7620 York Road
- Towson, MD 21204
- (301)337-1250
-
- 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
-
- This Rare Disease Database Entry is based upon outlines prepared by
- medical and dental students (1984-1986) at the Medical College of Virginia
- for their course in human genetics, and the following articles:
-
- MENDELIAN INHERITANCE IN MAN, 7th ed.: Victor A. McKusick; Johns Hopkins
- University Press, 1986. P. 380.
-
- CROSS-SECTIONAL ECHOCARDIOGRAPHIC IMAGING OF SUPRACARDIAC TOTAL ANOMALOUS
- PULMONARY VENOUS DRAINAGE TO A VERTICAL VEIN IN A PATIENT WITH HOLT-ORAM
- SYNDROME: K.Z. Zhang, et al.; Chest (January 1981, issue 79(1)). Pp. 113-
- 115.
-
-