Abstract Objective To study the clinical features and fibroblast growth factor receptor 3 (FGFR3) gene mutations of children with achondroplasia (ACH) through an analysis of 17 cases. Methods A retrospective analysis was performed on the clinical data and FGFR3 gene detection results of 17 children with ACH who were diagnosed from January 2009 to October 2021. Results Of the 17 children with ACH, common clinical manifestations included disproportionate short stature (100%, 17/17), macrocephaly (100%, 17/17), trident hand (82%, 14/17), and genu varum (88%, 15/17). The common imaging findings were rhizomelic shortening of the long bones (100%, 17/17) and narrowing of the lumbar intervertebral space (88%, 15/17). Major complications included skeletal dysplasia (100%, 17/17), middle ear dysfunction (82%, 14/17), motor/language developmental delay (88%, 15/17), chronic pain (59%, 10/17), sleep apnea (53%, 9/17), obesity (41%, 7/17), foramen magnum stenosis (35%, 6/17), and hydrocephalus (24%, 4/17). All 17 children (100%) had FGFR3 mutations, among whom 13 had c.1138G>A hotspot mutations of the FGFR3 gene, 2 had c.1138G>C mutations of the FGFR3 gene, and 2 had unreported mutations, with c.1252C>T mutations of the FGFR3 gene in one child and c.445+2_445+5delTAGG mutations of the FGFR3 gene in the other child. Conclusions This study identifies the unreported mutation sites of the FGFR3 gene, which extends the gene mutation spectrum of ACH. ACH is a progressive disease requiring lifelong management through multidisciplinary collaboration.
ZHANG Hui-Qin,TAO Dong-Ying,ZHANG Jing-Jing et al. Clinical features and FGFR3 mutations of children with achondroplasia[J]. CJCP, 2022, 24(4): 405-410.
ZHANG Hui-Qin,TAO Dong-Ying,ZHANG Jing-Jing et al. Clinical features and FGFR3 mutations of children with achondroplasia[J]. CJCP, 2022, 24(4): 405-410.
Le Merrer M, Rousseau F, Legeai-Mallet L, et al. A gene for achondroplasia-hypochondroplasia maps to chromosome 4p[J]. Nat Genet, 1994, 6(3): 318-321. PMID: 8012398. DOI: 10.1038/ng0394-318.
Richards S, Aziz N, Bale S, et al. Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology[J]. Genet Med, 2015, 17(5): 405-424. PMID: 25741868. PMCID: PMC4544753. DOI: 10.1038/gim.2015.30.
Coi A, Santoro M, Garne E, et al. Epidemiology of achondroplasia: a population-based study in Europe[J]. Am J Med Genet A, 2019, 179(9): 1791-1798. PMID: 31294928. DOI: 10.1002/ajmg.a.61289.
Tenconi R, Khirani S, Amaddeo A, et al. Sleep-disordered breathing and its management in children with achondroplasia[J]. Am J Med Genet A, 2017, 173(4): 868-878. PMID: 28239978. DOI: 10.1002/ajmg.a.38130.
Okenfuss E, Moghaddam B, Avins AL. Natural history of achondroplasia: a retrospective review of longitudinal clinical data[J]. Am J Med Genet A, 2020, 182(11): 2540-2551. PMID: 32864841. DOI: 10.1002/ajmg.a.61825.
Hoover-Fong J, Cheung MS, Fano V, et al. Lifetime impact of achondroplasia: current evidence and perspectives on the natural history[J]. Bone, 2021, 146(5): 115872. PMID: 33545406. DOI: 10.1016/j.bone.2021.115872.
Manikkam SA, Chetcuti K, Howell KB, et al. Temporal lobe malformations in achondroplasia: expanding the brain imaging phenotype associated with FGFR3-related skeletal dysplasias[J]. AJNR Am J Neuroradiol, 2018, 39(2): 380-384. PMID: 29170271. PMCID: PMC7410599. DOI: 10.3174/ajnr.A5468.
Ireland PJ, Donaghey S, McGill J, et al. Development in children with achondroplasia: a prospective clinical cohort study[J]. Dev Med Child Neurol, 2012, 54(6): 532-537. PMID: 22409389. DOI: 10.1111/j.1469-8749.2012.04234.x.
Tunkel D, Alade Y, Kerbavaz R, et al. Hearing loss in skeletal dysplasia patients[J]. Am J Med Genet A, 2012, 158A(7): 1551-1555. PMID: 22628261. DOI: 10.1002/ajmg.a.35373.
Hoover-Fong J, Scott CI, Jones MC, et al. Health supervision for people with achondroplasia[J]. Pediatrics, 2020, 145(6): e20201010. PMID: 32457214. DOI: 10.1542/peds.2020-1010.
Dhiman N, Albaghdadi A, Zogg CK, et al. Factors associated with health-related quality of life (HRQOL) in adults with short stature skeletal dysplasias[J]. Qual Life Res, 2017, 26(5): 1337-1348. PMID: 27866314. DOI: 10.1007/s11136-016-1455-7.
Hoover-Fong JE, Schulze KJ, McGready J, et al. Age-appropriate body mass index in children with achondroplasia: interpretation in relation to indexes of height[J]. Am J Clin Nutr, 2008, 88(2): 364-371. PMID: 18689372. DOI: 10.1093/ajcn/88.2.364.
Hoover-Fong J, McGready J, Schulze K, et al. A height-for-age growth reference for children with achondroplasia: expanded applications and comparison with original reference data[J]. Am J Med Genet A, 2017, 173(5): 1226-1230. PMID: 28374958. DOI: 10.1002/ajmg.a.38150.
Miccoli M, Bertelloni S, Massart F. Height outcome of recombinant human growth hormone treatment in achondroplasia children: a meta-analysis[J]. Horm Res Paediatr, 2016, 86(1): 27-34. PMID: 27355624. DOI: 10.1159/000446958.