A clinical scoring system for congenital contractural arachnodactyly.
Meerschaut ICenter for Medical Genetics, Ghent University Hospital, Ghent, Belgium.
De Coninck SCenter for Medical Genetics, Ghent University Hospital, Ghent, Belgium.
Steyaert WCenter for Medical Genetics, Ghent University Hospital, Ghent, Belgium.
Barnicoat ADepartment of Clinical Genetics, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
Bayat ADepartment of Pediatrics, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.
Benedicenti FClinical Genetics Service and South Tyrol Coordination Center for Rare Diseases, Department of Pediatrics, Regional Hospital of Bolzano, Bolzano, Italy.
Berland SDepartment of Medical Genetics, Haukeland University Hospital, Bergen, Norway.
Blair EMOxford Centre for Genomic Medicine, Oxford, UK.
Breckpot JCenter for Human Genetics, University Hospitals Leuven, Catholic University Leuven, Leuven, Belgium.
de Burca AOxford Centre for Genomic Medicine, Oxford, UK.
Destrée ACenter for Human Genetics, Institute of Pathology and Genetics (IPG), Gosselies, Belgium.
García-Miñaúr SInstitute of Medical and Molecular Genetics (INGEMM), Hospital Universitario La Paz, Madrid, Spain.
Green AJDepartment of Clinical Genetics, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
Hanna BCClinical Genetics Department, Westmead Hospital, Sydney, Australia.
Keymolen KCentre for Medical Genetics, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.
Koopmans MDepartment of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands.
Lederer DCenter for Human Genetics, Institute of Pathology and Genetics (IPG), Gosselies, Belgium.
Lees MDepartment of Clinical Genetics, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
Longman CWest of Scotland Regional Genetics Service, Queen Elizabeth University Hospital, Glasgow, Scotland.
Lynch SADepartment of Clinical Genetics, Temple Street Children's Hospital, Dublin, Ireland.
Male AMDepartment of Clinical Genetics, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
McKenzie FGenetic Services of Western Australia, Perth, WA, Australia.
Migeotte ICentre de Génétique Humaine, Université Libre de Bruxelles, Brussels, Belgium.
Mihci EDepartment of Pediatric Genetics, Akdeniz University Medical School, Akdeniz, Turkey.
Nur BDepartment of Pediatric Genetics, Akdeniz University Medical School, Akdeniz, Turkey.
Petit FClinique de Génétique, CHU Lille, Lille, France.
Piard JCentre de Génétique Humaine, Université de Franche-Comté, CHU Besançon, Besançon, France.
Plasschaert FSDepartment of Pediatric Orthopedics and Traumatology, Ghent University Hospital, Ghent, Belgium.
Rauch AInstitut für Medizinische Genetik, Universität Zürich, Zürich, Switzerland.
Ribaï PCenter for Human Genetics, Institute of Pathology and Genetics (IPG), Gosselies, Belgium.
Stanzial FClinical Genetics Service and South Tyrol Coordination Center for Rare Diseases, Department of Pediatrics, Regional Hospital of Bolzano, Bolzano, Italy.
Stolte-Dijkstra IDepartment of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Valenzuela IDepartment of Clinical and Molecular genetics and Rare disease Unit, University Hospital Vall d'Hebron, Barcelona, Spain.
Varghese VInstitute of Medical Genetics, University Hospital of Wales, Cardiff, UK.
Vasudevan PCMedical Genetics, University of Leicester, University Hospitals of Leicester NHS Trust, Leicester, UK.
Wakeling ENorth West Thames Regional Genetics Service, London North West University Healthcare NHS Trust, Harrow, UK.
Wallgren-Pettersson CThe Folkhaelsan Institute of Genetics and the Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland.
Coucke PCenter for Medical Genetics, Ghent University Hospital, Ghent, Belgium.
De Paepe ACenter for Medical Genetics, Ghent University Hospital, Ghent, Belgium.
De Wolf DDepartment of Pediatric Cardiology, Ghent University Hospital, Ghent, Belgium.
Symoens SCenter for Medical Genetics, Ghent University Hospital, Ghent, Belgium.
Callewaert BCenter for Medical Genetics, Ghent University Hospital, Ghent, Belgium. Bert.Callewaert@UGent.be.
English
PURPOSE Congenital contractural arachnodactyly (CCA) is an autosomal dominant connective tissue disorder manifesting joint contractures, arachnodactyly, crumpled ears, and kyphoscoliosis as main features. Due to its rarity, rather aspecific clinical presentation, and overlap with other conditions including Marfan syndrome, the diagnosis is challenging, but important for prognosis and clinical management. CCA is caused by pathogenic variants in FBN2, encoding fibrillin-2, but locus heterogeneity has been suggested. We designed a clinical scoring system and diagnostic criteria to support the diagnostic process and guide molecular genetic testing.
METHODS In this retrospective study, we assessed 167 probands referred for FBN2 analysis and classified them into a FBN2-positive (n = 44) and FBN2-negative group (n = 123) following molecular analysis. We developed a 20-point weighted clinical scoring system based on the prevalence of ten main clinical characteristics of CCA in both groups.
RESULTS The total score was significantly different between the groups (P < 0.001) and was indicative for classifying patients into unlikely CCA (total score <7) and likely CCA (total score ≥7) groups.
CONCLUSIONS Our clinical score is helpful for clinical guidance for patients suspected to have CCA, and provides a quantitative tool for phenotyping in research settings.