hypoplastic alae nasi

Fraser Syndrome 2

Clinical Characteristics
Ocular Features: 

Cryptophthalmos, both unilateral and bilateral, is the ocular hallmark.  The lid margins may be fused.

Systemic Features: 

Multiple systemic malformations are usually present.  A small mouth, nasal dysplasia with hypoplastic alae nasi, and syndactyly may be seen.  Urogenital malformations such as renal dysgenesis or dysplasia, ambiguous genitalia, streak ovaries may be present.  Pulmonary hypoplasia and imperforate anus have been reported.

Genetics

Homozygous mutations in the FREM2 gene (13q13.3) have been identified in Fraser syndrome 2.  

See Fraser syndrome 1 (219000) for additional features that may be present in Fraser syndrome.

Fraser syndrome 3 (617667) results from homozygous mutations in GRIP1.

Pedigree: 
Autosomal recessive
Treatment
Treatment Options: 

No treatment has been reported.

References
Article Title: 

Waardenburg Syndrome, Type 3

Clinical Characteristics
Ocular Features: 

Type 3 Waardenburg syndrome has many of the features of other types but with the addition of upper limb anomalies.  Dystopia canthorum and a broad nasal root are characteristic.  Iris heterochromia is present in some patients.  Hypopigmentation may be seen in lashes and eyebrows.

Systemic Features: 

The upper limbs may appear underdeveloped with flexion contractures, fusion of the carpal bones and sometimes syndactyly.  A white forelock may or may not be present.  The cranial bones may be anomalous and rare patients can have microcephaly with significant mental retardation.  Mental function is usually normal though. Occasional patients have cleft palate and/or lip. Hearing loss is of the sensorineural type.  Hypopigmented skin patches are sometimes present but not all patients have them.

Genetics

The uniqueness of Waardenburg syndrome types 1 and 3 remains to be established.  Mutations in the PAX3 gene are responsible for both types and both have been found in the same family.  The phenotype is transmitted in an autosomal dominant pattern in either case but several families have been reported with type 1 WS in parents heterozygous for PAX3 mutations who had a homozygous child with the type 3 phenotype.  However, heterozygous individuals with type 3 have also been reported and the relationship of the two types remains unknown.

Craniofacial-deafness-hand syndrome(122880) with mutations in PAX3 has many features similar to those found in Waardenburg syndrome type 3 and may or may not be a unique disorder.

Pedigree: 
Autosomal dominant
Autosomal recessive
Treatment
Treatment Options: 

There is no treatment for the syndrome but cochlear implants might be helpful.

References
Article Title: 
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