TY - JOUR
T1 - A clinical scoring system for congenital contractural arachnodactyly
AU - Meerschaut, Ilse
AU - De Coninck, Shana
AU - Steyaert, Wouter
AU - Barnicoat, Angela
AU - Bayat, Allan
AU - Benedicenti, Francesco
AU - Berland, Siren
AU - Blair, Edward M
AU - Breckpot, Jeroen
AU - de Burca, Anna
AU - Destrée, Anne
AU - García-Miñaúr, Sixto
AU - Green, Andrew J
AU - Hanna, Bernadette C
AU - Keymolen, Kathelijn
AU - Koopmans, Marije
AU - Lederer, Damien
AU - Lees, Melissa
AU - Longman, Cheryl
AU - Lynch, Sally Ann
AU - Male, Alison M
AU - McKenzie, Fiona
AU - Migeotte, Isabelle
AU - Mihci, Ercan
AU - Nur, Banu
AU - Petit, Florence
AU - Piard, Juliette
AU - Plasschaert, Frank S
AU - Rauch, Anita
AU - Ribaï, Pascale
AU - Pacheco, Iratxe Salcedo
AU - Stanzial, Franco
AU - Stolte-Dijkstra, Irene
AU - Valenzuela, Irene
AU - Varghese, Vinod
AU - Vasudevan, Pradeep C
AU - Wakeling, Emma
AU - Wallgren-Pettersson, Carina
AU - Coucke, Paul
AU - De Paepe, Anne
AU - De Wolf, Daniël
AU - Symoens, Sofie
AU - Callewaert, Bert
PY - 2020/1
Y1 - 2020/1
N2 - 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.
AB - 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.
KW - Arachnodactyly/diagnosis
KW - Child
KW - Contracture/diagnosis
KW - Diagnosis, Differential
KW - Early Diagnosis
KW - Female
KW - Fibrillin-2/genetics
KW - Genetic Testing
KW - Humans
KW - Male
KW - Marfan Syndrome/diagnosis
KW - Phenotype
KW - Retrospective Studies
KW - Sensitivity and Specificity
KW - Sequence Analysis, DNA/methods
U2 - 10.1038/s41436-019-0609-8
DO - 10.1038/s41436-019-0609-8
M3 - Article
C2 - 31316167
SN - 1098-3600
VL - 22
SP - 124
EP - 131
JO - Genetics in Medicine
JF - Genetics in Medicine
IS - 1
ER -