high arched eyebrows

Peroxisomol Fatty Acyl-CoA Reductase 1 Disorder

Clinical Characteristics
Ocular Features: 

At least some patients have cataracts which may be congenital in origin.  Highly arched eyebrows are part of the facial dysmorphism.

Systemic Features: 

Neonatal hypotonia is common while postnatal psychomotor development, somatic growth delay, microcephaly, and seizures become evident later.  The coarse facial dysmorphism includes large ears, a flattened nasal root, thin upper lip, a long philtrum, and a flattening of the nasal root.  Cognitive deficits are often present and some individuals have significant mobility problems. 

Red blood cell plasmalogen may be decreased.

Genetics

This condition results from homozygous or compound heterozygous mutations in FAR1 gene (11p15.2) resulting in complete loss of enzyme activity consistent with a defect in peroxisomes.

There is some clinical resemblance to rhizomelic chondrodysplasia punctata (215100) in which congenital cataracts also occur but lacks the skeletal features and results from a different mutation. 

Pedigree: 
Autosomal recessive
Treatment
Treatment Options: 

No treatment has been reported for the generalized condition but physical therapy and special education could be helpful.  Cataract removal is an option that may be considered.

References
Article Title: 

Baraitser-Winter Syndrome 2

Clinical Characteristics
Ocular Features: 

Hypertelorism, high arched eyebrows, ptosis, and  colobomas occur in the majority of individuals.

Systemic Features: 

Short stature, postnatal microcephaly, lissencephaly, intellectual disability, seizures, and sensorineural hearing loss are common.

Genetics

This syndrome can be considered to be an autosomal dominant disorder secondary to heterozygous mutations in the ACTG1 gene (17q25.3).  However, all patients have been sporadic.

Mutations in ACTG1 are also responsible for autosomal dominant progressive nonsyndromic hearing loss.  

A similar but unique condition known as Baraitser-Winter syndrome 1 (243310) is caused by heterozygous mutations in the ACTB gene. 

Pedigree: 
Autosomal dominant
Treatment
Treatment Options: 

There is no known treatment but special education, hearing devices, and physical therapy may be helpful.

References
Article Title: 

Baraitser-Winter cerebrofrontofacial syndrome: delineation of the spectrum in 42 cases

Verloes A, Di Donato N, Masliah-Planchon J, Jongmans M, Abdul-Raman OA, Albrecht B, Allanson J, Brunner H, Bertola D, Chassaing N, David A, Devriendt K, Eftekhari P, Drouin-Garraud V, Faravelli F, Faivre L, Giuliano F, Guion Almeida L, Juncos J, Kempers M, Eker HK, Lacombe D, Lin A, Mancini G, Melis D, Lourenco CM, Siu VM, Morin G, Nezarati M, Nowaczyk MJ, Ramer JC, Osimani S, Philip N, Pierpont ME, Procaccio V, Roseli ZS, Rossi M, Rusu C, Sznajer Y, Templin L, Uliana V, Klaus M, Van Bon B, Van Ravenswaaij C, Wainer B, Fry AE, Rump A, Hoischen A, Drunat S, Riviere JB, Dobyns WB, Pilz DT. Baraitser-Winter cerebrofrontofacial syndrome: delineation of the spectrum in 42 cases. Eur J Hum Genet. 2014 Jul 23.

PubMed ID: 
25052316

De novo mutations in the actin genes ACTB and ACTG1 cause Baraitser-Winter syndrome

Riviere JB, van Bon BW, Hoischen A, Kholmanskikh SS, O'Roak BJ, Gilissen C, Gijsen S, Sullivan CT, Christian SL, Abdul-Rahman OA, Atkin JF, Chassaing N, Drouin-Garraud V, Fry AE, Fryns JP, Gripp KW, Kempers M, Kleefstra T, Mancini GM, Nowaczyk MJ, van Ravenswaaij-Arts CM, Roscioli T, Marble M, Rosenfeld JA, Siu VM, de Vries BB, Shendure J, Verloes A, Veltman JA, Brunner HG, Ross ME, Pilz DT, Dobyns WB. De novo mutations in the actin genes ACTB and ACTG1 cause Baraitser-Winter syndrome. Nat Genet. 2012 Feb 26;44(4):440-4.

PubMed ID: 
22366783
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