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Cartilage–hair hypoplasia

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Cartilage-hair hypoplasia
Other namesMcKusick type metaphyseal chondrodysplasia
Cartilage-hair hypoplasia has an autosomal recessive pattern of inheritance
Pronunciation
SymptomsShort limb dwarfism
Very fine thin light hairs and eyebrows
Hyperextensible joints of hand and feet
Abnormalities of spine
Neutropenia
Defective antibody and cell mediated immunity

Cartilage–hair hypoplasia (CHH), also known as McKusick type metaphyseal chondrodysplasia,[1]: 578  is a rare genetic disorder. Symptoms may include short-limbed dwarfism due to skeletal dysplasia, variable level of immunodeficiency, and predisposition to cancer. It was first reported in 1965 by McKusick.

Signs and symptoms

  • Short limb dwarfism
  • very fine thin light hairs and eyebrows
  • hyperextensible joints of hand and feet
  • abnormalities of spine
  • neutropenia
  • defective antibody and cell mediated immunity

Genetics

Phytohemagglutinin

CHH is an autosomal recessive[2] inherited disorder. It is a highly pleiotropic disorder. A rarely encountered genetic phenomenon, known as uniparental disomy (a genetic circumstance where a child inherits two copies of a chromosome from one parent, as opposed to one copy from each parent) has also been observed with the disorder.[2]

An association between mutations near or within the ncRNA component of RNase MRP, RMRP, has been identified.[3][4][5][6] The endoribonuclease RNase MRP is a complex of RNA molecule and several proteins and it participates in cleavage of mitochondrial primers responsible for DNA replication and in pre-rRNA processing in the nucleolus.[7][8] The locus of the gene has been mapped to the short arm of chromosome 9.[9]

Immunodeficiency

Patients with CHH usually suffer from cellular immunodeficiency. In the study of 108 Finnish patients with CHH, there was detected mild to moderate form of lymphopenia, decreased delayed type of hypersensitivity and impaired responses to phytohaemagglutinin.[10] This leads to susceptibility to and, in some more severe cases, mortality from infections early in childhood. There has also been detected combined immunodeficiency in some patients [11][11] Patients with CHH often have increased predispositions to malignancies.[11]

Diagnosis

Treatment

A verified treatment for this disease is yet to be discovered. Over the years, a number of treatments have been claimed to have been discovered in the east. Chinese medicines have claimed to be able to cure dwarfism for many years, but as of yet, not one verified case has been demonstrated of someone who is a dwarf or suffering from any other similar disability growing to a "normal" height.

See also

References

  1. ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
  2. ^ a b Sulisalo T, Makitie O, Sistonen P, Ridanpaa M, el Rifai W, Ruuskanen O, de la Chapelle A, Kaitila L (1997). "Uniparental disomy in cartilage-hair hypoplasia". European Journal of Human Genetics. 5 (1): 35–42. PMID 9156319.
  3. ^ Bonafé L, Schmitt K, Eich G, Giedion A, Superti-Furga A (February 2002). "RMRP gene sequence analysis confirms a cartilage-hair hypoplasia variant with only skeletal manifestations and reveals a high density of single-nucleotide polymorphisms". Clinical genetics. 61 (2): 146–51. doi:10.1034/j.1399-0004.2002.610210.x. PMID 11940090.
  4. ^ Ridanpää M, van Eenennaam H, Pelin K, Chadwick R, Johnson C, Yuan B, vanVenrooij W, Pruijn G, Salmela R, Rockas S, Mäkitie O, Kaitila I, de la Chapelle A (2001). "Mutations in the RNA component of RNase MRP cause a pleiotropic human disease, cartilage-hair hypoplasia". Cell. 104 (2): 195–203. doi:10.1016/S0092-8674(01)00205-7. PMID 11207361.
  5. ^ Martin AN, Li Y (2007). "RNase MRP RNA and human genetic diseases". Cell research. 17 (3): 219–26. doi:10.1038/sj.cr.7310120. PMID 17189938.
  6. ^ Kavadas FD, Giliani S, Gu Y, Mazzolari E, Bates A, Pegoiani E, Roifman CM, Notarangelo LD (2008). "Variability of clinical and laboratory features among patients with ribonuclease mitochondrial RNA processing endoribonuclease gene mutations". The Journal of Allergy and Clinical Immunology. 122 (6): 1178–84. doi:10.1016/j.jaci.2008.07.036. PMID 18804272.
  7. ^ Hsieh, C. L.; Donlon, T. A.; Darras, B. T.; Chang, D. D.; Topper, J. N.; Clayton, D. A.; Francke, U (1990). "The gene for the RNA component of the mitochondrial RNA-processing endoribonuclease is located on human chromosome 9p and on mouse chromosome 4". Genomics. 6 (3): 540–544. doi:10.1016/0888-7543(90)90483-b. PMID 2328993.
  8. ^ Topper, J. N.; Clayton, D. A. (1990). "Characterization of human MRP/Th RNA and its nuclear gene: Full length MRP/Th RNA is an active endoribonuclease when assembled as an RNP". Nucleic Acids Research. 18 (4): 793–799. doi:10.1093/nar/18.4.793. PMC 330329. PMID 1690392.
  9. ^ Sulisalo, T; Sistonen, P; Hästbacka, J; Wadelius, C; Mäkitie, O; de la Chapelle, A; Kaitila, I (1993). "Cartilage-hair hypoplasia gene assigned to chromosome 9 by linkage analysis". Nature Genetics. 3 (4): 338–341. doi:10.1038/ng0493-338. PMID 7981754.
  10. ^ Mäkitie, O; Kaitila, I (1993). "Cartilage-hair hypoplasia--clinical manifestations in 108 Finnish patients". European journal of pediatrics. 152 (3): 211–7. doi:10.1007/bf01956147. PMID 8444246.
  11. ^ a b c Saulsbury, F. T.; Winkelstein, J. A.; Davis, L. E.; Hsu, S. H.; d'Souza, B. J.; Gutcher, G. R.; Butler, I. J. (1975). "Combined immunodeficiency and vaccine-related poliomyelitis in a child with cartilage-hair hypoplasia". The Journal of Pediatrics. 86 (6): 868–72. doi:10.1016/s0022-3476(75)80216-2. PMID 165279.

Further reading

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