Related Experiment Videos
Mild autosomal dominant hypophosphatasia: in utero presentation in two families
C A Moore1, C J Curry, P S Henthorn
1Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Insights
Mild hypophosphatasia can present in utero with severe long bone bowing, but often improves spontaneously after birth. Early recognition through family studies and prenatal ultrasound is key for better prognosis.
Area of Science:
- Genetics
- Perinatology
- Pediatric Orthopedics
Background:
- Hypophosphatasia is a rare genetic disorder affecting bone mineralization.
- Severe forms of hypophosphatasia have a poor prognosis.
- Prenatal diagnosis of skeletal abnormalities is crucial for management.
Purpose of the Study:
- To describe a unique in utero presentation of mild hypophosphatasia.
- To highlight the importance of recognizing this specific phenotype for improved patient outcomes.
- To emphasize the role of family history and prenatal ultrasonography.
Main Methods:
- Case series describing four pregnancies across two families.
- Autosomal dominant inheritance pattern analysis.
- Prenatal ultrasonographic assessment of fetal skeletal ossification and chest size.
Main Results:
- Mild hypophosphatasia presented in utero with severe long bone bowing.
- Postnatal spontaneous improvement of skeletal defects was observed.
- Autosomal dominant transmission was suggested.
Conclusions:
- Prenatal diagnosis of this mild hypophosphatasia variant is possible through ultrasonography.
- Early identification allows for a better prognosis compared to severe forms.
- Family investigation is essential for understanding inheritance patterns and genetic counseling.
Abstract:
We describe four pregnancies in two families in which mild hypophosphatasia, apparently transmitted as an autosomal dominant trait, manifested in utero as severe long bone bowing. Postnatally, there was spontaneous improvement of the skeletal defects. Recognition of this presentation for hypophosphatasia by family investigation and assessment of the fetal skeleton for degree of ossification and chest size using ultrasonography is important. The prognosis for this condition is considerably better than for more severe forms of hypophosphatasia and for many other disorders that cause skeletal defects with long bone bowing in utero.