RESUMO
Rothmund-Thomson syndrome (RTS) is a rare autosomal recessive disorder characterized by a range of clinical symptoms, including poikiloderma, juvenile cataracts, short stature, sparse hair, eyebrows/eyelashes, nail dysplasia, and skeletal abnormalities. While classically associated with mutations in the RECQL4 gene, which encodes a DNA helicase involved in DNA replication and repair, three additional genes have been recently identified in RTS: ANAPC1, encoding a subunit of the APC/C complex; DNA2, which encodes a nuclease/helicase involved in DNA repair; and CRIPT, encoding a poorly characterized protein implicated in excitatory synapse formation and splicing. Here, we review the clinical spectrum of RTS patients, analyze the genetic basis of the disease, and discuss molecular functions of the affected genes, drawing some novel genotype-phenotype correlations and proposing avenues for future studies into this enigmatic disorder.
RESUMO
The purpose of this study was to report the clinical findings, dental treatment, and improvement in quality of life for a child with Rothmund-Thomson syndrome. The patient had alopecia, delayed speech, low weight and height, cholestasis, and iron deficiency anemia. Furthermore, there were carious lesions and darkened spots on all primary molars. Microdontia of a premolar was observed at the radiographic examination. The patient and family had no commitment to her oral health and dental treatment at first appointments. Oral hygiene instructions, composite restorations, endodontic treatments, teeth extractions, and stainless steel crown installations were performed. The patient was followed up for 7 years through the present due to other possible future clinical findings associated with the syndrome. An improvement in social aspects was observed after removal of toothache and improved esthetics. Such patients need continuous periodic services, which contributes to improving the quality of life in both buccal and general aspects.
RESUMO
ABSTRACT Rothmund-Thomson syndrome (RTS) is a rare dermatosis with about 300 cases reported to date. The authors describe two siblings with RTS and inflammatory conjunctival disease featuring fornix shortening and symblepharon as well as palpebral disease with sparse eyelashes. These cases demonstrate RTS ocular surface findings different to those usually described.
RESUMO A síndrome de Rothmund-Thomson (SRT) é uma dermatose rara com cerca de 300 casos reportados. Os autores descrevem dois irmãos com síndrome de Rothmund-Thomson e doença inflamatória conjuntival com encurtamento do fundo de saco e simbléfaro, assim como doença palpebral com escassez de cilíos. Ambos os casos demonstram achados da superfície ocular diferentes dos habitualmente descritos.
Assuntos
Humanos , Masculino , Feminino , Adulto , Síndrome de Rothmund-Thomson/patologia , Conjuntivite/patologia , Doenças Palpebrais/patologia , Aderências Teciduais , Túnica Conjuntiva/patologia , Pestanas/patologiaRESUMO
RESUMO A síndrome de Rothmund (RTS) é uma rara genodermatose, de herança autossômica recessiva. Sua incidência é desconhecida, com aproximadamente 300 casos descritos na literatura. A síndrome é determinada por eritema facial (poiquilodermia), seu marco diagnóstico, além de alterações esqueléticas, alopecia, catarata juvenil e predisposição a osteossarcoma. Neste relato, descrevemos uma paciente com esta síndrome, que foi referida ao serviço de oftalmologia por baixa visão e hiperemia ocular.
ABSTRACT Rothmund-Thomson syndrome (RTS) is a rare autosomal recessive genodermatosis. While its incidence is unknown, approximately 300 cases have been reported in the literature. The syndrome typically presents with a characteristic facial rash (poikiloderma), its diagnostic hallmark, and heterogeneous clinical features including congenital skeletal abnormalities, sparse hair distribution, juvenile cataracts, and a predisposition to osteosarcoma. This is a report describing a patient diagnosed with RTS referred to us because of low vision and red eyes.
Assuntos
Humanos , Feminino , Síndrome de Rothmund-Thomson/complicações , Síndrome de Rothmund-Thomson/diagnóstico , Síndrome de Rothmund-Thomson/patologia , Acuidade Visual , Entrópio/cirurgia , Entrópio/etiologia , Síndrome de Rothmund-Thomson/genética , Transplante de Córnea , Limbo da Córnea , Opacidade da Córnea/diagnóstico , Opacidade da Córnea/etiologia , Opacidade da Córnea/patologia , Predisposição Genética para Doença , HiperemiaRESUMO
Rothmund-Thomson syndrome (RTS) is a rare autosomal recessive disorder presenting with poikiloderma and other clinical features, affecting the bones and eyes and, in type II RTS, presenting an increased risk for malignancy. With about 300 cases reported so far, we present a 13-year follow-up including clinical images, X-rays and genetic analysis. A 13-month-old female started with a facial rash with blisters on her cheeks and limbs at the age of 3 months along with congenital hypoplastic thumbs, frontal bossing and fine hair, eyebrows and eyelashes. The patient was lost to follow-up and returned 12 years later with palmoplantar hyperkeratotic lesions, short stature, disseminated poikiloderma and sparse scalp hair, with absence of eyelashes and eyebrows. Radiographic analysis showed radial ray defect, absence of the thumb and three wrist carpal bones, and reduced bone density. Gene sequencing for the RECQL4 helicase gene revealed a mutation on each allele. RTS is a rare disease, and in this patient we observed the evolution of her skin lesions and other clinical features, which were important for the classification of type II RTS. The next years will provide even more information on this rare disease.
RESUMO
El síndrome de Rothmund-Thomson (SRT) es una genodermatosis autosómica recesiva, que se presenta con poiquilodermia congénita, causada por mutaciones en el gen RECQL4. La poiquilodermia congénita se caracteriza por erupción cutánea, atrofia de la piel y lesiones telangiectásicas con áreas de hiperpigmentación o despigmentación. El SRT se asocia a baja talla, pestañas, cejas y pelo del cuero cabelludo escasos, anormalidades esqueléticas, envejecimiento prematuro, fotosensibilidad, distrofia ungueal y predisposición a cánceres de piel y hueso. Se describe el caso de un paciente con síndrome de Rothmund-Thomson tipo I.(AU)
Rothmund-Thomson syndrome (RTS) is an autosomal recessive genodermatosis presenting with congenital poikiloderma, caused by mutations in the RECQL4 gene. Congenital poikiloderma, is characterized by: cutaneous rash, skin atrophy and telangiectasic lesions with areas of hyperpigmentation or depigmentation. RTS is associated with short stature, sparse eyelashes, sparse eyebrows and sparse scalp hair, skeletal abnormalities, premature aging, photosensitivity, ungueal dystrophy and predisposition to skin and bone cancers. Here we report the case of a patient with Rothmund-Thomson syndrome type I.(AU)
RESUMO
El síndrome de Rothmund-Thomson (SRT) es una genodermatosis autosómica recesiva, que se presenta con poiquilodermia congénita, causada por mutaciones en el gen RECQL4. La poiquilodermia congénita se caracteriza por erupción cutánea, atrofia de la piel y lesiones telangiectásicas con áreas de hiperpigmentación o despigmentación. El SRT se asocia a baja talla, pestañas, cejas y pelo del cuero cabelludo escasos, anormalidades esqueléticas, envejecimiento prematuro, fotosensibilidad, distrofia ungueal y predisposición a cánceres de piel y hueso. Se describe el caso de un paciente con síndrome de Rothmund-Thomson tipo I.
Rothmund-Thomson syndrome (RTS) is an autosomal recessive genodermatosis presenting with congenital poikiloderma, caused by mutations in the RECQL4 gene. Congenital poikiloderma, is characterized by: cutaneous rash, skin atrophy and telangiectasic lesions with areas of hyperpigmentation or depigmentation. RTS is associated with short stature, sparse eyelashes, sparse eyebrows and sparse scalp hair, skeletal abnormalities, premature aging, photosensitivity, ungueal dystrophy and predisposition to skin and bone cancers. Here we report the case of a patient with Rothmund-Thomson syndrome type I.
RESUMO
Objetivos: Presentar el caso de un síndrome muy raro, el Síndrome de Rothmund-Thomson, de herencia autosómica recesiva, atribuible a una mutación en el gen RECQL4 helicase, 8q24. Se caracteriza por la presencia de placas cutáneas reticuladas, atróficas, hiperpigmentadas, telangiectásicas, que a menudo se acompañan de catarata juvenil, nariz en silla de montar, defectos óseos congénitos, trastornos en el crecimiento del cabello, uñas, dientes, hipotiroidismo, talla baja e hipogonadismo. Caso clínico: Paciente femenina de 12 años que consulta por talla baja. Antecedentes personales y familiares sin importancia. La familia ha notado cambios cutáneos en la piel desde poco después del nacimiento. La niña tiene un retraso escolar importante. Al examen físico presenta talla 124 cm, peso 21 kg, ambos muy por debajo del percentil 3 para su edad y sexo. Facies de cara de pájaro, piel pálida con telangiectasias rojas en telaraña en cara, brazos y abdomen, alopecia difusa, paladar ojival, atrofia cutánea en manos y atrofia de uñas, dientes irregulares y malformados, incisivos proyectados hacia delante. Presenta bocio difuso grado Ib, telarquia estadío II de Tanner (botón mamario) y no hay pubarquia. Edad ósea de 10 años. Con los exámenes de laboratorio se diagnostica hipotiroidismo primario y se indica tratamiento con 50 μg de levotiroxina sódica. En el seguimiento a los 3 meses se nota crecimiento de 2 cms y normalización de TSH. Evaluación oftalmológica sin alteraciones. Dada la presentación clínica y la evolución de la paciente, se establece el diagnóstico de Síndrome de Rothmund Thomson. Conclusiones: El síndrome de Rothmund Thompson es una entidad clínica poco frecuente, asociada con una amplia gama de alteraciones endocrinas, por lo cual consideramos importante reportar este caso.
Objectives: To present the case of a rare syndrome, the Rothmund-Thomson syndrome, autosomal recessive, attributable to a mutation in the RECQL4 helicase gene, 8q24. It is characterized by reticulate skin plaques, atrophic, hyperpigmented, telangiectatic, often accompanied by juvenile cataracts, saddle nose, congenital bone defects, disturbances in the growth of hair, nails, teeth, hypothyroidism, short stature and hypogonadism. Clinical case: A twelve year old girl came to the clinic because of short stature. Her personal and family history was unremarkable. Her parents noticed skin changes few days after birth. She has a delay in her school performance. Physical exam: height: 124cm, weight: 21kg, both below the third percentile for her age and sex; a bird face appearance. Skin pale with red spider thelangiectasias in the face, arms and abdomen. Generalized alopecia. Arched palate. There was skin and nail atrophy in both hands, irregular and malformed teeth and incisors projected forward. Goiter grade Ib, breasts with budding tanner stage II, there was no pubic hair. Bone age of 10 years. Laboratory tests: a diagnosis of primary hypothyroidism was made. She was started on L-Thyroxine 50 micrograms daily with an increase of 2cm when she came back three months later. An ophthalmological evaluation was normal. With the above clinical findings and clinical course we conclude that she has the Rothmund-Thomson Syndrome. Conclusions: The Rothmund Thompson syndrome is a rare clinical entity associated with a wide range of endocrine disruption, so we consider it is important to report this case.
RESUMO
A síndrome de Rothmund-Thomson é distúrbio autossômico recessivo de expressividade variável associado a mutações do gene RecQL4. Caracteriza-se por poiquilodermia, alopecia, defeitos de crescimento e desenvolvimento, catarata juvenil, alterações dentárias e esqueléticas e predisposição ao câncer cutâneo e ao osteossarcoma. Relata-se caso de paciente de 29 anos de idade com lesões cutâneas desde a infância, catarata bilateral antes dos 20 anos e carcinoma espinocelular aos 26 anos de idade.
Rothmund-Thomson syndrome is an autosomal recessive disorder of variable expression associated to mutations in the RECQL4 gene. Poikilodermatous rash, alopecia, growth and development defects, juvenile cataracts, dental abnormalities and predisposition to skin cancer and osteosarcoma are the main characteristics of this syndrome. The case of a 29-year-old woman with specific cutaneous lesions since childhood, bilateral cataracts before 20 years of age and squamous cell carcinoma at the age of 26 is reported.