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- $Unique_ID{BRK04105}
- $Pretitle{}
- $Title{Phocomelia Syndrome}
- $Subject{Phocomelia Syndrome Roberts SC-Phocomelia Syndrome SC Phocomelia
- Syndrome Roberts Tetraphocomelia Syndrome Roberts SC-Phocomelia Syndrome
- Thalidomide Syndrome Thrombocytopenia-Absent Radius TAR Syndrome}
- $Volume{}
- $Log{}
-
- Copyright (C) 1990, 1992 National Organization for Rare Disorders, Inc.
-
- 780:
- Phocomelia Syndrome
-
- ** IMPORTANT **
- It is possible that the main title of the article (Phocomelia Syndrome)
- is not the name you expected. Please check the SYNONYM listing to find the
- alternate names and disorder subdivisions covered by this article.
-
- Synonyms
-
- Roberts SC-Phocomelia Syndrome
- SC Phocomelia Syndrome
- Roberts Tetraphocomelia Syndrome
-
- Disorder Subdivisions
-
- Roberts SC-Phocomelia Syndrome
- Thalidomide Syndrome
-
- Information on the following disease can be found in the Related
- Disorders section of this report:
-
- Thrombocytopenia-Absent Radius (TAR) 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.
-
- Phocomelia Syndrome is a birth defect that may be occur sporadically or
- be genetically transmitted in some cases. In other cases it may be caused by
- toxins (such as certain drugs) taken by a pregnant woman. Major symptoms may
- include growth and mental deficiencies, defects in the eyes, ears, and nose,
- and characteristic deficient limb development affecting the arms and possibly
- the legs.
-
- Symptoms
-
- The primary symptom of Phocomelia Syndrome is deficient limb development.
- However, the defects of the limbs are variable. Commonly, the upper limbs
- are affected and sections of the hands and arms may be malformed or missing.
- The legs and the feet may also be affected. The hands and/or the feet may be
- attached close to the body or the limbs may be abnormally small.
-
- Individuals with Phocomelia Syndrome usually have growth deficiencies
- before and after birth. In some cases, they also may be mentally retarded.
- The head may be small with sparse hair that may be silvery-blond. A swelling
- or mass of blood vessels (hemangioma) may occur on the face. Prominent
- widely-set eyes (hypertelorism) that have bluish whites, an underdeveloped
- nose with thin nostrils, malformed ears, cleft lip with or without cleft
- palate, and small jaws (micrognathia) may also occur. The testes of males
- may fail to descend (cryptochidism).
-
- Less common symptoms include: a gap in the skull with the brain possibly
- protruding (encephalocele); accumulation of excess spinal fluid under the
- skull (hydrocephalus) which may cause headaches, vomiting, and convulsions;
- and small eyeballs (microphthalmia), corneal clouding, cataracts, and eyelid
- defects. The urethra (the tube leading from the bladder) may open underneath
- the penis or in females may open into the vagina (hypospadias). An
- abnormally shaped uterus (bicornate), an abnormally low level of platelets in
- the blood (thrombocytopenia), kidney and heart abnormalities, a short neck,
- and cranial nerve paralysis may also occur.
-
- Disorder Subdivisions
- When Phocomelia is caused by drugs, it is usually thought of as the
- Thalidomide Syndrome. This type of Phocomelia is characterized by severe
- defects and is caused by the ingestion of the drug Thalidomide (a
- tranquilizer) during early pregnancy. Thalidomide was widely used outside the
- United States in the late 1950's and early 1960's. Symptoms may include:
- limb defects of the arms or all of the limbs, abnormalities of the eyes and
- the ears with possible deafness, paralysis of the face with possible limited
- eye movements, heart defects, abnormal passages (fistulas) between the
- rectum, urethra, and/or vagina, abnormalities of internal organs (such as the
- gallbladder, appendix, small intestine, and uterus), and failure of the
- testes to descend in males (cryptochidism). A small percentage of
- individuals have spinal abnormalities and/or growth deficiencies. This type
- of Phocomelia can also be caused by the acne drug Accutane.
-
- Roberts SC-Phocomelia Syndrome is a birth defect that is genetically
- inherited through recessive genes and may represent Phocomelia in its mildest
- form. There have been a number of patients exhibiting overlap of symptoms
- between the Roberts SC Syndrome and the Thalidomide Syndrome. The two
- disorders may be different expressions of a gene or represent variable
- severity of the same disorder.
-
- Causes
-
- In the cases where Phocomelia Syndrome is inherited, it is transmitted
- by autosomal recessive genes. 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 recessive disorders, the condition
- does not appear unless a person inherits the same defective gene for the same
- trait 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.
-
- In other cases Phocomelia Syndrome can occur as a result of a woman
- taking certain drugs during pregnancy or other unknown reasons. The drug
- Thalidomide caused an unusual surge of babies born with Phocomelia during the
- 1960's, and the drug Accutane (for treatment of acne) can also cause
- Phocomelia.
-
- Affected Population
-
- The hereditary form of Phocomelia is a very rare disorder affecting only a
- dozen or more babies born each year. Males and females are affected in equal
- numbers. An upsurge of the number of Phocomelia cases can signal that
- certain drugs are causing this birth defect. Thalidomide (a tranquilizer)
- and Accutane (for treatment of acne) can cause Phocomelia in a fetus when
- ingested by a pregnant woman.
-
- Related Disorders
-
- Symptoms of the following disorder can be similar to those of Phocomelia
- Syndrome. Comparisons may be useful for a differential diagnosis:
-
- There are many birth defects that can cause malformed or missing limbs.
- One of these is Thrombocytopenia-Absent Radius (TAR) Syndrome. TAR Syndrome
- is a genetic disorder characterized by a very low level of the number of
- platelets in the blood (thrombocytopenia) and the absence or underdevelopment
- of one of the short bones (radius) in the arm. Thrombocytopenia may cause
- excessive bleeding from the skin, mucous membranes (thin moist layer lining
- the body's cavity), or within the skull. Other blood disorders may also
- occur. The underdevelopment of the other short bone (ulna) of the arm, and
- defects of the hands, legs, and/or feet may also occur. (For more
- information on this disorder, choose "TAR" as your search term in the Rare
- Disease Database).
-
- Therapies: Standard
-
- Treatment and rehabilitation of the limb deformities of Phocomelia Syndrome
- should be planned in infancy. Individual prostheses (artificial limbs) and
- orthopedic braces or appliances (ortheses) may be needed. Genetic counseling
- may be of benefit for patients and their families if the child has the
- genetic form of this disorder. Other treatment is symptomatic and
- supportive.
-
- Therapies: Investigational
-
- This disease entry is based upon medical information available through
- November 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 Phocomelia Syndrome, please contact:
-
- National Organization for Rare Disorders
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- NIH/National Institute of Child Health and Human Development (NICHHD)
- 9000 Rockville Pike
- Bethesda, MD 20892
- (301) 496-4236
-
- Association of Children's Prosthetic and Orthotic Clinics (ACPOC)
- 317 E. 34th Street
- New York, NY 10016
-
- National Rehabilitation Information Center (NARIC)
- 8455 Colesville Road, Suite 935
- Silver Spring, MD 20910
- (202) 635-5826
-
- Thalidomide Society
- 19 Upper Hall Park
- Berkhamsted, Herts HP4-2NP
- England
-
- 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, 8th ed.: Victor A. McKusick; Johns Hopkins
- University Press, 1986. Pp. 584, 907.
-
- SMITH'S RECOGNIZABLE PATTERNS OF HUMAN MALFORMATION, 4th ed.: Kenneth L.
- Jones; W.B. Saunders Co., 1988. Pp. 256-7.
-
- ROBERTS-SC PHOCOMELIA SYNDROME: CYTOGENETIC FINDINGS AND CLINICAL
- VARIABILITY IN THREE BROTHERS: G. Antinolo et al.; An Esp Pediatr
- (September, 1988, issue 29(3)). Pp. 239-43.
-
- TREATMENT AND REHABILITATION OF DYSMELIC CHILDREN: L. Kullmann; Magy
- Traumatol Orthop Helyreallito Sebesz (1989, issue 32 (2)). Pp. 99-106.
-
-