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A clinical scoring system for congenital contractural arachnodactyly

2019; Elsevier BV; Volume: 22; Issue: 1 Linguagem: Inglês

10.1038/s41436-019-0609-8

1530-0366

Ilse Meerschaut, Shana De Coninck, Wouter Steyaert, Angela Barnicoat, Allan Bayat, Francesco Benedicenti, Siren Berland, Edward Blair, Jeroen Breckpot, Anna de Burca, Anne Destrėe, Sixto García‐Miñaúr, Andrew Green, Bernadette Hanna, Kathelijn Keymolen, Marion Koopmans, Damien Lederer, Melissa Lees, Cheryl Longman, Sally Ann Lynch, Alison Male, F. Ellis McKenzie, Isabelle Migeotte, Ercan Mıhçı, Banu Nur, Florence Petit, Juliette Piard, Frank Plasschaert, Anita Rauch, Pascale Ribaı̈, Iratxe Salcedo Pacheco, Franco Stanzial, Irene Stolte‐Dijkstra, Irene Valenzuela, Vinod Varghese, Pradeep Vasudevan, Emma Wakeling, Carina Wallgren‐Pettersson, Paul Coucke, Anne De Paepe, Daniël De Wolf, Sofie Symoens, Bert Callewaert,

Congenital limb and hand anomalies

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. 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. 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. Our clinical score is helpful for clinical guidance for patients suspected to have CCA, and provides a quantitative tool for phenotyping in research settings.