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Strømme Syndrome

Strømme Syndrome

Patient Information

Characteristics

Background and History

This syndrome has been recognized since 1993 and only a small number of patients have been reported since then.

Clinical Correlations

The cornea (windshield of the eye) has a central scar-like opacity causing vision problems, but the remainder of the eye can be normal.  Others may have smaller than normal eyes and still others have maldevelopment of the iris (colored part) with pupil abnormalities.  The skull is often small (microcephaly) and brain scans may reveal incomplete development of specific structures.  Cleft palate and a small lower jaw are often present.  Some patients exhibit developmental delays with cognitive impairment and learning disabilities.  The small intestines are often abnormal as well with parts of it underdeveloped and malformed, sometimes described as an apple peel deformity.

The heart muscle is sometimes abnormal and weak.  There may be abnormalities of the kidneys as well.

Genetics

Inheritance

This is an autosomal recessive disorder in which the responsible gene is changed (mutated) in both members of the pair.  Usually each clinically normal parent carries a single mutation, in which case their children individually have a 25% risk for this condition.

Pedigree

Autosomal recessive

In order for autosomal recessive disorders to be expressed, offspring generally must inherit two mutations, one from each carrier parent.  Carriers with only one mutation, such as the parents, do not have clinical disease.  Note that carrier parents can expect that 1 in 4 children (25%) will inherit both mutations and have the disorder, 2 in 4 children (50%) will be carriers like their parents, while 1 in 4 children (25%) inherit neither mutation.

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Sample pedigree of autosomal recessive inheritance

In order for autosomal recessive disorders to be expressed, offspring generally must inherit two mutations, one from each carrier parent. Carriers with only one mutation, such as the parents, do not have clinical disease. Note that carrier parents can expect that 1 in 4 children (25%) will inherit both mutations and have the disorder, 2 in 4 children (50%) will be carriers like their parents, while 1 in 4 children (25%) inherit neither mutation.

Diagnosis and Prognosis

Ophthalmologists and pediatricians are helpful in making the diagnosis.  Infants generally do well following intestinal surgery.  The results of eye surgery (corneal transplants) have not been reported.  The prognosis is higly variable.  Some individuals develop and function near normal whereas those with more severe disease may not live beyond infancy or early childhood.

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