Craniossinostose é definida como a fusão prematura de uma ou mais suturas cranianas, levando à distorção secundária da forma do crânio, resultando em deformidades do crânio com apresentação variável. A craniossinostose pode ocorrer isoladamente ou como parte de uma síndrome.
Introdução
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Craniossinostose é definida como a fusão prematura de uma ou mais suturas cranianas, levando à distorção secundária da forma do crânio, resultando em deformidades do crânio com apresentação variável. A craniossinostose pode ocorrer isoladamente ou como parte de uma síndrome.
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Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Partes do corpo afetadas
+ 361 sintomas em outras categorias
Características mais comuns
Os sintomas variam de pessoa para pessoa. Abaixo estão as 897 características clínicas mais associadas, ordenadas por frequência.
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Genética e causas
O que está alterado no DNA e como passa nas famílias
Genes associados
30 genes identificados com associação a esta condição. Padrão de herança: Autosomal dominant, Autosomal recessive, Not applicable, Unknown, X-linked recessive.
Acts as a transcriptional activator. Involved in neurogenesis. Plays important roles in the early stage of organogenesis of the CNS, as well as during dorsal spinal cord development and maturation of the cerebellum. Involved in the spatial distribution of mossy fiber (MF) neurons within the pontine gray nucleus (PGN). Plays a role in the regulation of MF axon pathway choice. Promotes MF migration towards ipsilaterally-located cerebellar territories. May have a role in shear flow mechanotransduct
NucleusCytoplasm
Craniosynostosis 6
A form of craniosynostosis, a primary abnormality of skull growth involving premature fusion of one or more cranial sutures. The growth velocity of the skull often cannot match that of the developing brain resulting in an abnormal head shape and, in some cases, increased intracranial pressure, which must be treated promptly to avoid permanent neurodevelopmental disability.
As a component of the IFT complex A (IFT-A), a complex required for retrograde ciliary transport and entry into cilia of G protein-coupled receptors (GPCRs), it is involved in ciliogenesis and ciliary protein trafficking (PubMed:21473986, PubMed:28400947, PubMed:29220510). May promote CASP3 activation and TNF-stimulated apoptosis
Cytoplasm, cytoskeleton, microtubule organizing center, centrosomeCytoplasm, cytoskeleton, cilium axonemeCytoplasm, cytoskeleton, cilium basal body
Cranioectodermal dysplasia 2
A disorder characterized by craniofacial, skeletal and ectodermal abnormalities. Clinical features include short stature, dolichocephaly, craniosynostosis, narrow thorax with pectus excavatum, short limbs, brachydactyly, joint laxity, narrow palpebral fissures, telecanthus with hypertelorism, low-set simple ears, everted lower lip, and short neck. Teeth abnormalities include widely spaced, hypoplastic and fused teeth.
Zinc finger nuclear factor involved in transcription by regulating chromatin structure and organization (PubMed:20219459, PubMed:21570965). Involved in the pluripotency and differentiation of embryonic stem cells by regulating SOX2, POU5F1/OCT4, and NANOG (PubMed:21570965). By binding PBX1, prevents the heterodimerization of PBX1 and HOXA9 and their binding to DNA (By similarity). Regulates neuronal development and neural cell differentiation (PubMed:21570965)
Nucleus
Weiss-Kruszka syndrome
An autosomal dominant, multiple congenital anomaly syndrome with variable expressivity and complete penetrance. Patients manifest developmental delay, hypotonia, feeding difficulties, craniofacial abnormalities including ptosis, abnormal head shape, downslanting palpebral fissures, metopic ridging, and craniosynostosis. Variable congenital heart defects can be observed in some patients. A few patients show agenesis of the corpus callosum on brain imaging.
As a component of IFT complex A (IFT-A), a complex required for retrograde ciliary transport and entry into cilia of G protein-coupled receptors (GPCRs), it is involved in ciliogenesis (PubMed:28400947, PubMed:28973684). Involved in retrograde ciliary transport along microtubules from the ciliary tip to the base (PubMed:21378380)
Cytoplasm, cytoskeletonCell projection, cilium
Cranioectodermal dysplasia 3
A disorder primarily characterized by craniofacial, skeletal and ectodermal abnormalities. Clinical features include craniosynostosis, narrow rib cage, short limbs, brachydactyly, hypoplastic and widely spaced teeth, sparse hair, skin laxity and abnormal nails. Nephronophthisis leading to progressive renal failure, hepatic fibrosis, heart defects, and retinitis pigmentosa have also been described.
Transcriptional regulator. Involved in the initiation of neuronal differentiation. Activates transcription by binding to the E box (5'-CANNTG-3') (By similarity). May be involved in the functional network that regulates the development of the GnRH axis (PubMed:32620954)
Nucleus
Craniosynostosis 3
A primary abnormality of skull growth involving premature fusion of one or more cranial sutures. The growth velocity of the skull often cannot match that of the developing brain resulting in an abnormal head shape and, in some cases, increased intracranial pressure, which must be treated promptly to avoid permanent neurodevelopmental disability.
Component of the IFT complex A (IFT-A), a complex required for retrograde ciliary transport and entry into cilia of G protein-coupled receptors (GPCRs) (PubMed:20889716, PubMed:22503633). Plays a pivotal role in proper development and function of ciliated cells through its role in ciliogenesis and/or cilium maintenance (PubMed:22503633). Required for the development and maintenance of the outer segments of rod and cone photoreceptor cells. Plays a role in maintenance and the delivery of opsin to
Cytoplasm, cytoskeleton, cilium basal bodyCytoplasm, cytoskeleton, microtubule organizing center, centrosomeCell projection, cilium
Short-rib thoracic dysplasia 9 with or without polydactyly
A form of short-rib thoracic dysplasia, a group of autosomal recessive ciliopathies that are characterized by a constricted thoracic cage, short ribs, shortened tubular bones, and a 'trident' appearance of the acetabular roof. Polydactyly is variably present. Non-skeletal involvement can include cleft lip/palate as well as anomalies of major organs such as the brain, eye, heart, kidneys, liver, pancreas, intestines, and genitalia. Some forms of the disease are lethal in the neonatal period due to respiratory insufficiency secondary to a severely restricted thoracic cage, whereas others are compatible with life. Disease spectrum encompasses Ellis-van Creveld syndrome, asphyxiating thoracic dystrophy (Jeune syndrome), Mainzer-Saldino syndrome, and short rib-polydactyly syndrome. SRTD9 is characterized by phalangeal cone-shaped epiphyses, chronic renal disease, nearly constant retinal dystrophy, and mild radiographic abnormality of the proximal femur. Occasional features include short stature, cerebellar ataxia, and hepatic fibrosis.
Potent transcriptional repressor that binds to the H1 element of the Ets2 promoter. May regulate other genes involved in cellular proliferation. Required for extraembryonic ectoderm differentiation, ectoplacental cone cavity closure, and chorioallantoic attachment (By similarity). May be important for regulating trophoblast stem cell differentiation (By similarity)
Nucleus
Craniosynostosis 4
A primary abnormality of skull growth involving premature fusion of one or more cranial sutures. The growth velocity of the skull often cannot match that of the developing brain resulting in an abnormal head shape and, in some cases, increased intracranial pressure, which must be treated promptly to avoid permanent neurodevelopmental disability.
Acts as a coreceptor with members of the frizzled family of seven-transmembrane spanning receptors to transduce signal by Wnt proteins (PubMed:11336703, PubMed:11448771, PubMed:11719191, PubMed:15778503, PubMed:15908424, PubMed:16252235). Activates the canonical Wnt signaling pathway that controls cell fate determination and self-renewal during embryonic development and adult tissue regeneration (PubMed:11336703, PubMed:11719191). In particular, may play an important role in the development of t
MembraneEndoplasmic reticulum
Vitreoretinopathy, exudative 1
An autosomal dominant disorder of the retinal vasculature characterized by an abrupt cessation of growth of peripheral capillaries, leading to an avascular peripheral retina. This may lead to compensatory retinal neovascularization, which is thought to be induced by hypoxia from the initial avascular insult. New vessels are prone to leakage and rupture causing exudates and bleeding, followed by scarring, retinal detachment and blindness. Clinical features can be highly variable, even within the same family. Patients with mild forms of the disease are asymptomatic, and their only disease related abnormality is an arc of avascular retina in the extreme temporal periphery. In many ways the disease resembles retinopathy of prematurity but there is no evidence of prematurity or small birth weight in the patient history.
Receptor for interleukin-11 (IL11). The receptor systems for IL6, LIF, OSM, CNTF, IL11 and CT1 can utilize IL6ST for initiating signal transmission. The IL11/IL11RA/IL6ST complex may be involved in the control of proliferation and/or differentiation of skeletogenic progenitor or other mesenchymal cells (Probable). Essential for the normal development of craniofacial bones and teeth. Restricts suture fusion and tooth number Soluble form of IL11 receptor (sIL11RA) that acts as an agonist of IL11 a
MembraneSecreted
Craniosynostosis and dental anomalies
A disorder characterized by craniosynostosis, maxillary hypoplasia, and dental anomalies, including malocclusion, delayed and ectopic tooth eruption, and/or supernumerary teeth. Some patients also display minor digit anomalies, such as syndactyly and/or clinodactyly.
Extracellular matrix protein that plays a role in epidermal differentiation and is required for epidermal adhesion during embryonic development
Secreted, extracellular space, extracellular matrix, basement membrane
Bifid nose, with or without anorectal and renal anomalies
A disease characterized by the presence of a bifid nose usually associated with renal agenesis and anorectal malformations. A bifid nose is a congenital deformity due to failure of the paired nasal processes to fuse to a single midline organ during early gestation.
May play a role in terminal differentiation of skeletal muscle cells but not in the determination of cells to the myogenic lineage. Functions as a repressor of TGF-beta signaling
Nucleus
Shprintzen-Goldberg craniosynostosis syndrome
A very rare syndrome characterized by a marfanoid habitus, craniosynostosis, characteristic dysmorphic facial features, skeletal and cardiovascular abnormalities, intellectual disability, developmental delay and learning disabilities.
Tyrosine-protein kinase that acts as a cell-surface receptor for fibroblast growth factors and plays an essential role in the regulation of cell proliferation, differentiation, migration and apoptosis, and in the regulation of embryonic development. Required for normal embryonic patterning, trophoblast function, limb bud development, lung morphogenesis, osteogenesis and skin development. Plays an essential role in the regulation of osteoblast differentiation, proliferation and apoptosis, and is
Cell membraneGolgi apparatusCytoplasmic vesicleSecreted
Crouzon syndrome
An autosomal dominant syndrome characterized by craniosynostosis, hypertelorism, exophthalmos and external strabismus, parrot-beaked nose, short upper lip, hypoplastic maxilla, and a relative mandibular prognathism.
Tyrosine-protein kinase that acts as a cell-surface receptor for fibroblast growth factors and plays an essential role in the regulation of embryonic development, cell proliferation, differentiation and migration. Required for normal mesoderm patterning and correct axial organization during embryonic development, normal skeletogenesis and normal development of the gonadotropin-releasing hormone (GnRH) neuronal system. Phosphorylates PLCG1, FRS2, GAB1 and SHB. Ligand binding leads to the activati
Cell membraneNucleusCytoplasm, cytosolCytoplasmic vesicle
Pfeiffer syndrome
A syndrome characterized by the association of craniosynostosis, broad and deviated thumbs and big toes, and partial syndactyly of the fingers and toes. Three subtypes are known: mild autosomal dominant form (type 1); cloverleaf skull, elbow ankylosis, early death, sporadic (type 2); craniosynostosis, early demise, sporadic (type 3).
Flavoenzyme which catalyzes the oxidation of spermine to spermidine. Can also use N(1)-acetylspermine and spermidine as substrates, with different affinity depending on the isoform (isozyme) and on the experimental conditions. Plays an important role in the regulation of polyamine intracellular concentration and has the potential to act as a determinant of cellular sensitivity to the antitumor polyamine analogs. May contribute to beta-alanine production via aldehyde dehydrogenase conversion of 3
CytoplasmNucleus
Histone acetyltransferase that acetylates lysine residues in histone H3 and histone H4 (in vitro) (PubMed:11742995, PubMed:11965546). Component of the MOZ/MORF complex which has a histone H3 acetyltransferase activity (PubMed:11965546). May act as a transcriptional coactivator for RUNX1 and RUNX2 (PubMed:12771199). Acetylates p53/TP53 at 'Lys-120' and 'Lys-382' and controls its transcriptional activity via association with PML (PubMed:23431171). May play a role in leukemogenic gene transcription
NucleusNucleus, nucleolusNucleus, nucleoplasmNucleus, PML body
Acts as a transcriptional regulator. Inhibits myogenesis by sequestrating E proteins, inhibiting trans-activation by MEF2, and inhibiting DNA-binding by MYOD1 through physical interaction. This interaction probably involves the basic domains of both proteins. Also represses expression of pro-inflammatory cytokines such as TNFA and IL1B. Regulates cranial suture patterning and fusion. Activates transcription as a heterodimer with E proteins. Regulates gene expression differentially, depending on
Nucleus
Saethre-Chotzen syndrome
A craniosynostosis syndrome characterized by coronal synostosis, brachycephaly, low frontal hairline, facial asymmetry, hypertelorism, broad halluces, and clinodactyly.
Structural component of the 10-12 nm diameter microfibrils of the extracellular matrix, which conveys both structural and regulatory properties to load-bearing connective tissues (PubMed:15062093, PubMed:1860873). Fibrillin-1-containing microfibrils provide long-term force bearing structural support (PubMed:27026396). In tissues such as the lung, blood vessels and skin, microfibrils form the periphery of the elastic fiber, acting as a scaffold for the deposition of elastin (PubMed:27026396). In
SecretedSecreted, extracellular space, extracellular matrix
Marfan syndrome
A hereditary disorder of connective tissue that affects the skeletal, ocular, and cardiovascular systems. A wide variety of skeletal abnormalities occurs with Marfan syndrome, including scoliosis, chest wall deformity, tall stature, abnormal joint mobility. Ectopia lentis occurs in most of the patients and is almost always bilateral. The leading cause of premature death is progressive dilation of the aortic root and ascending aorta, causing aortic incompetence and dissection. Neonatal Marfan syndrome is the most severe form resulting in death from cardiorespiratory failure in the first few years of life.
Acts as a negative regulator of hedgehog signaling
Membrane
Carpenter syndrome 2
An autosomal recessive multiple congenital malformation disorder characterized by multisuture craniosynostosis and polysyndactyly of the hands and feet, in association with abnormal left-right patterning and other features, most commonly obesity, umbilical hernia, cryptorchidism, and congenital heart disease.
Probable planar cell polarity effector involved in cilium biogenesis. May regulate protein and membrane transport to the cilium. Proposed to function as core component of the CPLANE (ciliogenesis and planar polarity effectors) complex involved in the recruitment of peripheral IFT-A proteins to basal bodies. May regulate the morphogenesis of hair follicles which depends on functional primary cilia. Binds phosphatidylinositol 3-phosphate with highest affinity, followed by phosphatidylinositol 4-ph
CytoplasmCytoplasm, cytoskeletonCytoplasm, cytoskeleton, cilium basal body
May be involved in adhesive interactions of activated T and NK cells during the late phase of the immune response. Promotes NK cell-target adhesion by interacting with PVR present on target cells. May function at a time after T and NK cells have penetrated the endothelium using integrins and selectins, when they are actively engaging diseased cells and moving within areas of inflammation
Membrane
C syndrome
A syndrome characterized by trigonocephaly, severe intellectual disability, hypotonia, variable cardiac defects, redundant skin, and dysmorphic facial features, including upslanted palpebral fissures, epicanthal folds, depressed nasal bridge, and low-set, posteriorly rotated ears.
A cytochrome P450 monooxygenase involved in the metabolism of retinoates (RAs), the active metabolites of vitamin A, and critical signaling molecules in animals (PubMed:10823918, PubMed:22020119). RAs exist as at least four different isomers: all-trans-RA (atRA), 9-cis-RA, 13-cis-RA, and 9,13-dicis-RA, where atRA is considered to be the biologically active isomer, although 9-cis-RA and 13-cis-RA also have activity (Probable). Catalyzes the hydroxylation of atRA primarily at C-4 and C-18, thereby
Endoplasmic reticulum membraneMicrosome membrane
Radiohumeral fusions with other skeletal and craniofacial anomalies
A disease characterized by craniofacial malformations, occipital encephalocele, radiohumeral fusions, oligodactyly, advanced osseous maturation, and calvarial mineralization defects.
Acts as a transcriptional regulator in bone development. Represses the ALPL promoter activity and antagonizes the stimulatory effect of DLX5 on ALPL expression during osteoblast differentiation. Probable morphogenetic role. May play a role in limb-pattern formation. In osteoblasts, suppresses transcription driven by the osteocalcin FGF response element (OCFRE). Binds to the homeodomain-response element of the ALPL promoter
Nucleus
Parietal foramina 1
Autosomal dominant disease characterized by oval defects of the parietal bones caused by deficient ossification around the parietal notch, which is normally obliterated during the fifth fetal month.
Involved in ciliogenesis as part of a complex involved in intraflagellar transport (IFT), the bi-directional movement of particles required for the assembly, maintenance and functioning of primary cilia (PubMed:27466190). Required for the anterograde transport of IFT88 (PubMed:27466190)
Cell projection, cilium
Short-rib thoracic dysplasia 16 with or without polydactyly
A form of short-rib thoracic dysplasia, a group of autosomal recessive ciliopathies that are characterized by a constricted thoracic cage, short ribs, shortened tubular bones, and a 'trident' appearance of the acetabular roof. Polydactyly is variably present. Non-skeletal involvement can include cleft lip/palate as well as anomalies of major organs such as the brain, eye, heart, kidneys, liver, pancreas, intestines, and genitalia. Some forms of the disease are lethal in the neonatal period due to respiratory insufficiency secondary to a severely restricted thoracic cage, whereas others are compatible with life. Disease spectrum encompasses Ellis-van Creveld syndrome, asphyxiating thoracic dystrophy (Jeune syndrome), Mainzer-Saldino syndrome, and short rib-polydactyly syndrome.
This enzyme is required for electron transfer from NADP to cytochrome P450 in microsomes. It can also provide electron transfer to heme oxygenase and cytochrome B5
Endoplasmic reticulum membrane
Antley-Bixler syndrome, with genital anomalies and disordered steroidogenesis
A disease characterized by the association of Antley-Bixler syndrome with steroidogenesis defects and abnormal genitalia. Antley-Bixler syndrome is characterized by craniosynostosis, radiohumeral synostosis present from the perinatal period, midface hypoplasia, choanal stenosis or atresia, femoral bowing and multiple joint contractures.
Tyrosine-protein kinase that acts as a cell-surface receptor for fibroblast growth factors and plays an essential role in the regulation of cell proliferation, differentiation and apoptosis. Plays an essential role in the regulation of chondrocyte differentiation, proliferation and apoptosis, and is required for normal skeleton development. Regulates both osteogenesis and postnatal bone mineralization by osteoblasts. Promotes apoptosis in chondrocytes, but can also promote cancer cell proliferat
Cell membraneCytoplasmic vesicleEndoplasmic reticulumSecreted
Achondroplasia
A frequent form of short-limb dwarfism. It is characterized by a long, narrow trunk, short extremities, particularly in the proximal (rhizomelic) segments, a large head with frontal bossing, hypoplasia of the midface and a trident configuration of the hands. ACH is an autosomal dominant disease.
As component of the IFT complex A (IFT-A), a complex required for retrograde ciliary transport and entry into cilia of G protein-coupled receptors (GPCRs), it is involved in cilia function and/or assembly (PubMed:20889716). Essential for functional IFT-A assembly and ciliary entry of GPCRs (PubMed:20889716). Associates with the BBSome complex to mediate ciliary transport (By similarity)
Cell projection, ciliumCytoplasm, cytoskeleton, cilium basal bodyCell projection, cilium, photoreceptor outer segmentCell projection, cilium, flagellum
Cranioectodermal dysplasia 4
A disorder primarily characterized by craniofacial, skeletal and ectodermal abnormalities. Clinical features include craniosynostosis, narrow rib cage, short limbs, brachydactyly, hypoplastic and widely spaced teeth, sparse hair, skin laxity and abnormal nails. Nephronophthisis leading to progressive renal failure, hepatic fibrosis, heart defects, and retinitis pigmentosa have also been described.
The small GTPases Rab are key regulators of intracellular membrane trafficking, from the formation of transport vesicles to their fusion with membranes. Rabs cycle between an inactive GDP-bound form and an active GTP-bound form that is able to recruit to membranes different set of downstream effectors directly responsible for vesicle formation, movement, tethering and fusion. In conjunction with IFT57 and KIF17, it drives the localization of specific G protein-coupled receptors, such as the dopa
Cell membraneCytoplasmCytoplasmic vesicle, autophagosomeEndosome membraneCytoplasmic vesicle, phagosomeCytoplasmic vesicle, phagosome membrane
Carpenter syndrome 1
A rare autosomal recessive disorder characterized by acrocephaly with variable synostosis of the sagittal, lambdoid, and coronal sutures; peculiar facies; brachydactyly of the hands with syndactyly; preaxial polydactyly and syndactyly of the feet; congenital heart defects; growth retardation; intellectual disability; hypogenitalism; and obesity. In addition, cerebral malformations, oral and dental abnormalities, coxa valga, genu valgum, hydronephrosis, precocious puberty, and hearing loss may be observed.
An ATP-dependent DNA helicase which unwinds dsDNA with a 3'-overhang in a 3'-5' direction (PubMed:28653661). Does not unwind more than 18 bp of dsDNA (PubMed:28653661). May modulate chromosome segregation. The N-terminal domain (residues 1-54) binds DNA Y-shaped DNA better than ss- or dsDNA (PubMed:22730300). The core helicase domain binds ssDNA (PubMed:22730300, PubMed:28653661)
CytoplasmNucleus
RAPADILINO syndrome
Disease characterized by radial and patellar aplasia or hypoplasia.
As a component of the IFT complex A (IFT-A), a complex required for retrograde ciliary transport and entry into cilia of G protein-coupled receptors (GPCRs), it is required in ciliogenesis and ciliary protein trafficking (PubMed:27932497, PubMed:29220510). Involved in cilia formation during neuronal patterning. Acts as a negative regulator of Shh signaling. Required to recruit TULP3 to primary cilia (By similarity)
Cell projection, ciliumCytoplasm, cytoskeleton, cilium basal body
Cranioectodermal dysplasia 1
A disorder characterized by craniofacial, skeletal and ectodermal abnormalities. Clinical features include dolichocephaly (with or without sagittal suture synostosis), scaphocephaly, short stature, limb shortening, short ribs, narrow chest, brachydactyly, renal failure and hepatic fibrosis, small and abnormally shaped teeth, sparse hair, skin laxity and abnormal nails.
Medicamentos e terapias
Mecanismo: Prostanoid IP receptor agonist
Mecanismo: HMG-CoA reductase inhibitor
Mecanismo: Type-1 angiotensin II receptor antagonist
Mecanismo: Tissue-type plasminogen activator inhibitor
Mecanismo: B-lymphocyte antigen CD20 binding agent
Variantes genéticas (ClinVar)
247 variantes patogênicas registradas no ClinVar.
Classificação de variantes (ClinVar)
Distribuição de 1,352 variantes classificadas pelo ClinVar.
Vias biológicas (Reactome)
88 vias biológicas associadas aos genes desta condição.
Diagnóstico
Os sinais que médicos procuram e os exames que confirmam
Tratamento e manejo
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Onde tratar no SUS
Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)
🇧🇷 Atendimento SUS — Craniossinostose
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Outros ensaios clínicos
86 ensaios clínicos encontrados, 4 ativos.
Publicações mais relevantes
Mostrando amostra de 200 publicações de um total de 3.454
Navigating challenges: a child with Apert syndrome and global developmental delay from a low-income family.
Apert syndrome is a rare congenital disorder characterised by craniosynostosis, syndactyly and distinct facial dysmorphisms. We found a child with Apert syndrome from an economically disadvantaged family residing in an urban slum during a routine home visit by the All India Institute of Medical Sciences Bhubaneswar Extended Health Clinic. The child presented with global developmental delay, unvaccinated status and severe malnutrition, manifesting as underweight and stunted growth. Despite being eligible for free healthcare services under the Rashtriya Bal Swasthya Karyakram, the child remained unlinked to it. Contributing factors to this delayed intervention included the family's low socio-economic status, profound lack of awareness of the condition, poor healthcare-seeking behaviour and insufficient engagement from healthcare workers. Moreover, complex psychosocial issues, such as maternal depression, parental substance abuse, limited social support and insufficient family involvement, further intensified the obstacles to the optimal growth and development of the child, highlighting the multifaceted factors that shape health outcomes in vulnerable populations.
Human cranial stem cells: developmental, pathologic, and therapeutic implications.
Cranial skeletal stem cells are central to skull development, maintenance, and repair. These stem cell populations balance self-renewal with lineage commitment, providing osteogenic, chondrogenic, and stromal outputs required for craniofacial growth. While bone grafting remains the gold standard for reconstruction, limitations in donor supply and morbidity have driven interest in harnessing endogenous regenerative programs. In this review, we synthesize current knowledge of human cranial stem cell biology, drawing on developmental, molecular, and imaging data. We delineate their distinct niches within the sutures, dura, and periosteum, as well as the signaling pathways that regulate their function. We then highlight future avenues of investigation, including high-resolution profiling of human stem cell populations and development of mechanism-based regenerative strategies that integrate cell therapy with scaffold design.
Decreased skull growth in positional plagiocephaly patients undergoing helmet therapy.
Helmet treatment is a worldwide acknowledged method to improve motor function, quality of life and aesthetics in patients with plagiocephaly. The objective of this study is to assess percentile escape in head circumference in newborns receiving helmet therapy (HMT) for plagiocephaly. All patients underwent HMT over 124.32 days on average (SD = 72.56), with 3D scans (Rodin4D neo) taken of their heads before, during and after the treatment. Eight participants were excluded due to insufficient data. Ten patients were excluded for either craniosynostosis or discontinuation of helmet therapy."German Health Interview and Examination Survey for Children and Adolescents" (KiGGS study) served as reference for the assessment of head circumference growth. Percentiles were calculated using the LMS-method. Out of 272 patients (94 females, 178 males), 238 had suitable parameters for the LMS-method. The average age at the onset of therapy was 5.99 (SD = 2.23) months, concluding at 10.06 months (SD = 3.01). The median percentile before HMT was 50.00 (SD = 39.5), which decreased significantly to 25.00 (SD = 33.84) after HMT (p < 0.001). Only 59 patients showed percentile adherence during the treatment. The mean difference in head circumference was 21.51 mm (SD = 14.81), ranging from -44.4 mm to 69.1 mm. Clinical examination revealed that the patients exhibit developmental progress consistent with respective ages. Significant decrease in head circumferential growth was observed following HMT. Even though patients did not show clinical signs of raised ICP, to ascertain the clinical relevance of this percentile escape, conducting longer follow-ups involving a larger cohort of patients is crucial.
[Clinical features and molecular mechanism of infantile cholestasis caused by IFT122 gene variants].
Objective: To investigate the clinical characteristics of infantile cholestasis caused by IFT122 gene variants and the molecular mechanism underlying its impact on primary cilia. Methods: The clinical data of an infant with cholestasis from the Children's Hospital of Fudan University in September 2022 were retrospectively analyzed. The whole-exome sequencing was performed to identify candidate variants, which were validated by Sanger sequencing in the family. Immortalized cell lines were generated using lentiviral infection, followed by immunofluorescence staining to assess the impact of the variants on primary cilia. Intergroup comparisons were performed using the independent sample t-test and Mann-Whitney U test. Results: The proband was a 4-month-old male infant presenting with jaundice, distinctive facial features, and sagittal craniosynostosis. Blood biochemistry indicated elevated direct bilirubin, total bile acids, and transaminases, with markedly increased γ-glutamyltransferase (GGT). Liver pathology demonstrated giant cell hepatitis with cholestasis and bile duct dysplasia. Genetic analysis identified compound heterozygous variants in IFT122 (NM_052989.3) gene c.88G>C (p.Ala30Pro) and c.240G>C (p.Trp80Cys), which co-segregated with the disease in the family. Immunofluorescence analysis demonstrated that the IFT122 gene compound heterozygous missense variants not only significantly reduced the proportion of cilia-positive cells but also led to aberrant ciliary localization of ADP-ribosylation factor-like protein 13B (ARL13B).In addition, ciliary deposition with phosphatidylinositol polyphosphate 5-phosphatase type Ⅳ (INPP5E) was reduced. All differences were statistically significant (all P<0.05). Conclusion: The compound heterozygous missense variants in IFT122 gene not only impair ciliogenesis but also disrupt the ciliary localization of ARL13B and INPP5E, ultimately resulting in high-GGT infantile cholestasis. 目的: 探讨IFT122基因变异引起的婴儿胆汁淤积症患儿的临床特征及其对初级纤毛影响的分子机制。 方法: 病例报告。收集复旦大学附属儿科医院2022年9月1例婴儿胆汁淤积症患儿临床资料,采用全外显子组测序筛选出候选变异,并在家系中进行Sanger测序验证,通过慢病毒感染获得永生化细胞系后进行免疫荧光实验分析变异对初级纤毛的影响,采用独立样本t检验,Mann-Whitney U检验进行组间比较。 结果: 患儿,男,4月龄,临床表现为黄疸、特殊面容、矢状缝早闭,血生化检测提示直接胆红素、总胆汁酸和转氨酶升高,γ-谷氨酰转肽酶(GGT)明显升高。肝组织活检提示巨细胞肝炎伴胆汁淤积,胆管发育不良。基因分析结果显示患儿为IFT122基因(NM_052989.3)复合杂合变异,c.88G>C(p.Ala30Pro)和 c.240G>C(p.Trp80Cys)。细胞免疫荧光提示,IFT122基因复合杂合错义变异显著降低纤毛阳性细胞比例,且导致ADP核糖基化因子样GTPase13B(ARL13B)在纤毛上的定位异常,同时降低了肌醇 1,4,5-三磷酸5-磷酸酶 E(INPP5E)在纤毛上的积累,差异均有统计学意义(均P<0.05)。 结论: IFT122基因复合杂合错义变异不仅损伤了纤毛发生,还导致纤毛膜蛋白ARL13B和INPP5E定位异常,最终引发高GGT型婴儿胆汁淤积症。.
MSC Membrane-Coated circPROSC-siRNA Nanoparticles for Ameliorating Craniosynostosis by Inhibiting Premature Suture Ossification.
Craniosynostosis is a congenital craniofacial disorder caused by excessive osteogenic differentiation of mesenchymal stem cells (MSCs) within cranial sutures. Due to incompletely understood regulatory mechanisms, effective solutions for early diagnosis and minimally invasive therapy remain lacking. In this study, plsama circPROSC is first identified as an independent risk factor for craniosynostosis. Through MSCs osteogenic differentiation and nude mouse ectopic bone formation assays, circPROSC promotes osteogenesis via miR-6815-5p-mediated modulation of the Wnt signaling pathway. Furthermore, MSC membrane-coated siRNA nanoparticles (MM@Lipo/siRNA) targeting circPROSC (si-circPROSC) have been developed to inhibit its expression in the coronal suture by postnatal cranial microinjection, which attenuated premature coronal suture closure in a craniosynostosis mouse model. Collectively, this study provides the first evidence that circPROSC is a promising diagnostic marker and a potential therapeutic target for craniosynostosis.
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Archives of plastic surgeryMolecular diagnosis of rare biallelic CDC45 gene variants causing Meier-Gorlin syndrome-7 using whole exome sequencing.
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Molecular syndromology[Clinical features and molecular mechanism of infantile cholestasis caused by IFT122 gene variants].
Zhonghua er ke za zhi = Chinese journal of pediatricsThe APERT Severity Scale: A Quantitative Tool for Risk Stratification in Apert Syndrome.
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The Journal of craniofacial surgerySecondary Synostosis After Spring-Mediated Cranioplasty for Sagittal Synostosis.
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Journal of neurosurgery. PediatricsA combined machine learning and finite element modelling tool for the surgical planning of craniosynostosis correction.
PloS oneSpring-Assisted Cranioplasty for Metopic Craniosynostosis: Perioperative Metrics in Comparison to Fronto-Orbital Advancement and Strip Craniectomy.
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial AssociationConcurrent Sagittal Craniosynostosis and Anterior Fontanelle Wormian Bone: Radiological Findings and Surgical Management in an Infant With Epispadias.
CureusPredicting surgical outcomes in spring assisted cranioplasty via finite element analysis and animal experiments.
Scientific reportsComparison of Cranial Vault Remodeling Versus Spring Cranioplasty for Nonsyndromic Unicoronal Craniosynostosis: Analysis of Outcomes.
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial AssociationNovel Biallelic TGFBR3 Mutation in Brothers Presenting With Craniosynostosis.
American journal of medical genetics. Part AInactivating GNAS complex locus variants impair G protein-coupled receptor signaling and cause multiple suture craniosynostosis in humans and zebrafish.
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral ResearchLong-term Outcomes Following Craniosynostosis Corrections, A Thirty-Year Retrospective.
Plastic and reconstructive surgeryMidface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model.
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Frontiers in pediatricsEvaluation of long-term aesthetic outcomes of fronto-orbital advancement using a crossing-the-midline greenstick fracture technique in anterior synostotic plagiocephaly.
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The Journal of craniofacial surgeryAssessing the Seromagenicity of Demineralized Bone Matrix Allograft in Cranial Vault Remodeling.
The Journal of craniofacial surgeryComparison of Outcomes between Infants above and below 5 Months of Age Undergoing Endoscopic Craniectomy for Sagittal Suture Synostosis.
Pediatric neurosurgerySocioeconomic and geographic factors associated with the timing of surgical intervention for sagittal craniosynostosis in Georgia.
Journal of neurosurgery. PediatricsExploring the size limits of Bionano optical genome mapping to resolve alternative structures of linked interspersed chromosomal duplications.
Genome medicineCranial base and midfacial morphology in pfeiffer syndrome: A 3D quantitative analysis.
Journal of stomatology, oral and maxillofacial surgeryAnalysis of the Learning Curve for a Surgeon Newly Trained in Frontofacial Monobloc Advancement.
The Journal of craniofacial surgeryUnderstanding normocephalic craniosynostosis: a case-control study on prevalence, clinical features, and neurodevelopmental challenges.
Child's nervous system : ChNS : official journal of the International Society for Pediatric NeurosurgeryManagement of secondary intracranial hypertension in untreated craniosynostosis: a case series and literature review.
Child's nervous system : ChNS : official journal of the International Society for Pediatric NeurosurgeryIsolated frontosphenoidal craniosynostosis with pathogenic FGFR3 variant: a case report and genetic insights.
Translational pediatricsCrouzonodermoskeletal syndrome requires individualized surgical management: Scoping review of a rare complex craniofacial syndrome.
JPRAS openThe Ongoing Evolution of AI in Craniofacial Surgery: From Theory to Reality and Beyond.
The Journal of craniofacial surgeryBenefits of Antifibrinolytics in Minimally Invasive Surgical Repair of Single-suture Craniosynostosis.
Plastic and reconstructive surgery. Global openThe cognition of patients with sagittal synostosis and developmental or behavioral concerns in relation to surgical timing or technique.
Journal of neurosurgery. PediatricsNovel KIF11 Variants with New Clinical Features: Expanding the Clinical Phenotype.
Balkan journal of medical genetics : BJMGClinical Presentation of the Longest Reported Living Individual With Bent Bone Dysplasia-FGFR2-Related.
American journal of medical genetics. Part ANeighborhood Disadvantage Predicts Surgical Approach in Craniosynostosis Repair.
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial AssociationTransient facial nerve palsy following bilateral scalp block in an infant undergoing surgery for craniosynostosis.
Journal of anaesthesiology, clinical pharmacologyMSC Membrane-Coated circPROSC-siRNA Nanoparticles for Ameliorating Craniosynostosis by Inhibiting Premature Suture Ossification.
Advanced science (Weinheim, Baden-Wurttemberg, Germany)Sagittal craniosynostosis with Moebius syndrome; case illustration: first case in the literatüre.
BMC pediatricsConcurrent Chiari malformation type I and hydrocephalus: Integrating mechanistic and pathophysiological insights toward a unified management paradigm.
Experimental neurologyEpidemiology of dento-skeletal dysmorphoses in children treated for craniosynostosis in infancy.
Journal of stomatology, oral and maxillofacial surgeryThe Limited Usefulness of Immediate Routine Postoperative MRI Scans Following Cranial Vault Reconstruction for Craniosynostosis Correction.
The Journal of craniofacial surgeryAnalyzing Variation in Fronto-Orbital Advancement Coding: Insights From 2569 Cases.
The Journal of craniofacial surgeryImaging Modalities in Craniosynostosis: A Systematic Review and Proposal of the ARCANA Protocol for Multimodal Radiation-Free Assessment.
Diagnostics (Basel, Switzerland)Long-term health-related quality of life and satisfaction following fronto-orbital advancement in non-syndromic metopic synostosis: FACE-Q Craniofacial Module and SCAR-Q.
Journal of plastic, reconstructive & aesthetic surgery : JPRASInsights into Suture Stem Cells: Distributions, Characteristics, and Applications.
Current stem cell research & therapyA Unique Case of Pure Bilateral Lambdoid Craniosynostosis and Progression to Mercedes-Benz Syndrome Following Spring Cranioplasty.
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial AssociationTetralogy of Fallot and craniosynostosis - differential manifestation in a familial case of CHDED syndrome caused by novel pathogenic PRKD1 variant.
Journal of human geneticsNew insights into the relationship between skull base fusion and torticollis in children.
Journal of neurosurgery. PediatricsDifference in anterior fontanelle closure between non-syndromic craniosynostosis and normal controls: a retrospective cross-sectional study.
Italian journal of pediatricsMethodological considerations in comparing behavioral outcomes after surgical correction of non-syndromic sagittal craniosynostosis.
Child's nervous system : ChNS : official journal of the International Society for Pediatric NeurosurgeryRisk-Adjusted Returns in Craniosynostosis Surgery: A Financial Investment Perspective.
Plastic and reconstructive surgeryPilot enhanced recovery after surgery protocol: Cranial vault remodeling for craniosynostosis.
Surgical neurology internationalAnesthetic Management of Progressive Deformity of Tracheal Cartilaginous Sleeve in a Pediatric Patient With Beare-Stevenson Syndrome: A Case Report.
Case reports in anesthesiologyEarly posterior cranial vault distraction in syndromic craniosynostosis: orbital and ocular changes.
International journal of oral and maxillofacial surgery[Dynamics of caudal dystopia of cerebellar tonsils in patients with craniosynostosis following posterior cranial distraction].
Zhurnal voprosy neirokhirurgii imeni N. N. BurdenkoComparative Efficacy of Perioperative Blood Conservation Agents in Pediatric Cranial Vault Remodeling: A Systematic Review and Network Meta-Analysis.
NeurosurgeryThe Periosteum in Health and Disease.
Current osteoporosis reportsImpact of barrel stave osteotomy on cephalometric measurements in patients who have undergone endoscopic repair of sagittal craniosynostosis.
Journal of neurosurgery. PediatricsA Novel Noninvasive Screening Method for Early Detection of Sagittal Craniosynostosis Using the Surface Cranial Index.
The Journal of craniofacial surgeryCalvarial Bloom Biomechanics: Dural Tension Governing Cranial Form.
Clinical anatomy (New York, N.Y.)Severe Phenotype of De Novo TSHR Activating Pathogenic Variants.
Case reports in endocrinologyConfirmation of the Hotspot Variant in MAP3K20 Responsible for Deafness, Ectodermal Dysplasia, Craniosynostosis, Ectrodactyly, and Skeletal Anomaly Spectrum.
Molecular syndromologyManagement of upper airway obstruction in syndromic craniosynostosis: A lifespan approach from childhood to adulthood.
Archives de pediatrie : organe officiel de la Societe francaise de pediatrieVACTERL Association and Unilateral Lambdoid Craniosynostosis.
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial AssociationUtility of invasive intracranial pressure monitoring in children with craniosynostosis: relationship to clinical assessment, syndrome and surgical treatment.
Child's nervous system : ChNS : official journal of the International Society for Pediatric NeurosurgerySurgical management of raised ICP in craniosynostosis: experience-based selection of posterior vault expansion techniques.
Child's nervous system : ChNS : official journal of the International Society for Pediatric NeurosurgeryTo Burr or Not to Burr: Preventing Unintended Fractures During Cranial Vault Reshaping.
The Journal of craniofacial surgeryPosterior Vault Distraction Osteogenesis: A Systematic Review and Single-Arm Metanalysis.
The Journal of craniofacial surgeryTime Course of a Single, 0.6 mg/kg Dose of Rocuronium Neuromuscular Block During Sevoflurane or Propofol Anesthesia in Infants-A Prospective, Randomized Trial.
Journal of clinical medicineUtilizing artificial intelligence to increase the readability of patient education materials in pediatric neurosurgery.
Journal of neurosurgery. PediatricsAre There Morphophysiological Airway Alterations in Syndromic Craniosynostosis? A 3D Computed Tomography and CFD Analysis.
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial AssociationGenomic insights into autosomal recessive epilepsy: novel pathogenic variants in ITPA and CLN5 identified in consanguineous families.
Molecular biology reportsDifferential regulation of coronal and lambdoid suture patency by PTHLH and HHIP activity in mice.
Development (Cambridge, England)A Rare Craniosynostosis Phenotype Associated With a Homozygous CYP26B1 Pathogenic Variant in the Absence of Extremity Synostosis.
American journal of medical genetics. Part AHaploinsufficiency of Runx2 restores the cranial sutures in a mouse model of Pdgfrb-related craniosynostosis.
Human molecular geneticsCrouzon syndrome: preimplantation genetic testing for a familial case with a whole and a mosaic variant of the disease.
Vavilovskii zhurnal genetiki i selektsiiDefining the Normal Range of Forehead Convexity in Infants: Moving Toward an Objective Diagnosis of Metopic Craniosynostosis.
The Journal of craniofacial surgeryPredictors of Transfusion Outcomes for Patients Undergoing Surgical Correction of Craniosynostosis: A Multicenter Retrospective Analysis.
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial AssociationMultidisciplinary Collaborative Efforts in Craniosynostosis Surgery-A Rural Appalachian Institutional Experience in Patient Care and Outcomes.
International journal of pediatricsComparison of Esthetic Outcomes After Endoscopic versus Open Treatment for Sagittal Craniosynostosis According to Lausanne Classification.
World neurosurgeryComparative 3-Dimensional Analysis of Pi Versus Posterior Vault Remodeling for Nonsyndromic Single-Suture Sagittal Craniosynostosis Correction.
The Journal of craniofacial surgeryOptimising anaesthetic management during fronto-orbital advancement in an infant with Apert syndrome.
BMJ case reportsWormian bones in simple sagittal synostosis: incidence and correlations.
Child's nervous system : ChNS : official journal of the International Society for Pediatric NeurosurgeryAnaesthetic management of a patient with isolated non-syndromic sagittal craniosynostosis undergoing cranial vault reconstruction in the sphinx position.
BMJ case reportsWhat Not to Miss in Fetal Head and Neck MRI: A Pictorial Essay.
Seminars in ultrasound, CT, and MREndoscopic Spring Mediated Cranioplasty for Management of Coronal Craniosynostosis.
The Journal of craniofacial surgeryA Retrospective Review of Craniosynostosis Reconstruction at a Community Children's Hospital Compared With Academic Centers.
The Journal of craniofacial surgeryHuman-like malformations in anole lizards: Potential cases of "hopeful monsters" resembling chameleon morphology.
Journal of anatomyAdjunct Use of Orthotic Therapy in Patients With Craniosynostosis and Concurrent Plagiocephaly or Brachycephaly.
The Journal of craniofacial surgery[Evaluation of the Infant Skull via Low-dose CT Images Using an Sn Filter and the Iterative Reconstruction Method].
Nihon Hoshasen Gijutsu Gakkai zasshiPractical Use of Mixed Reality for Transfacial Pinning in Monobloc Advancement for Syndromic Craniosynostosis.
The Journal of craniofacial surgeryUse of cartilage-conduction hearing aids in a child with Crouzon syndrome and meatal atresia.
Auris, nasus, larynxA Review of Hypervolemic Hemodilution in Pediatric Neuroanesthesiology.
CureusLifetime follow-up of an adult patient with pediatric-onset hypophosphatasia complicated with advanced chronic kidney disease.
Bone reportsSecondary Cranioplasty After Fronto-Orbital Advancement: Analysis of a National Database.
The Journal of craniofacial surgeryInequities in Operative Age for Infants With Craniosynostosis.
PediatricsFACE-Q craniofacial module: Normative data from a Dutch population in adolescence and young adulthood.
Journal of plastic, reconstructive & aesthetic surgery : JPRASAugmented reality in pediatric craniofacial surgery: clinical experience.
Journal of neurosurgery. PediatricsSurgical treatment and levator muscle protein analysis of congenital ptosis in craniosynostosis: A case-control study.
MedicineCranial base synostosis in mice caused by upregulation of Wnt following partial inhibition of Shh.
BMC biology[Basal encephalocele complicated by nasal liquorrhea in patients with craniosynostosis].
Zhurnal voprosy neirokhirurgii imeni N. N. BurdenkoInhibition of craniosynostosis and premature suture fusion in Twist1 mutant mice with RNA nanoparticle gene therapy.
Science advancesImpact of Intraoperative Hypotension and Blood Loss on Brain Damage Biomarkers in Metopic Craniosynostosis Surgery.
Journal of neurosurgical anesthesiologyAbsence of Syndactyly Associated With the Common Apert FGFR2 S252W Mutation: A Clinical Report and Likely Molecular Explanation.
American journal of medical genetics. Part AGeneration of human induced pluripotent stem cell lines from patients with FGFR2-linked syndromic craniosynostosis.
Disease models & mechanismsManagement of Middle Third Hypoplasia Using Rigid External Device: Long-Term Analysis of Results and Report of Complications.
The Journal of craniofacial surgerySociodemographic Factors Associated with Late Presentation in Nonsyndromic Sagittal Synostosis.
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial AssociationRAB23 loss-of-function mutation causes context-dependent ciliopathy in Carpenter syndrome.
PLoS geneticsDevelopments in diagnostic and surgical techniques in children with sagittal suture craniosynostosis: a systematic review spanning the last 30 years.
Orphanet journal of rare diseasesComprehensive analysis of the EFNB1 gene c.451G>A(p.Gly151Ser) mutation: structural, functional, and pathogenicity insights through in silico analysis.
Computers in biology and medicinePrenatal diagnosis of Apert syndrome with continuation of pregnancy-a report of two cases.
Translational pediatricsThe tectum transversum(TTR) maintains patency of the developing coronal suture.
Research squareAssociações
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Referências e fontes
Bases de dados externas citadas neste artigo
Publicações científicas
Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.
- Navigating challenges: a child with Apert syndrome and global developmental delay from a low-income family.
- Human cranial stem cells: developmental, pathologic, and therapeutic implications.
- Decreased skull growth in positional plagiocephaly patients undergoing helmet therapy.
- [Clinical features and molecular mechanism of infantile cholestasis caused by IFT122 gene variants].
- MSC Membrane-Coated circPROSC-siRNA Nanoparticles for Ameliorating Craniosynostosis by Inhibiting Premature Suture Ossification.
- Connective tissue growth in a mouse model of Kosaki overgrowth syndrome is limited by STAT1.
- Public Insurance Is Associated With Increased Emergency Visits After Craniosynostosis Surgery.
- Mechanical bone loading effects on morphology and mechanobiology in the coronal suture of Crouzon mice.
- Analysis of prenatal ultrasound in diagnosing fetal craniosynostosis and its correlation with genetic anomalies: description of two cases and literature analysis.
- Endoscopic-Assisted Osteotomy with Absorbable Plate as Internal Attachment Point for External Spring Distraction Osteogenesis in the Treatment of Sagittal Synostosis in Infants.
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:1531(Orphanet)
- MONDO:0015469(MONDO)
- GARD:6209(GARD (NIH))
- Variantes catalogadas(ClinVar)
- Busca completa no PubMed(PubMed)
- Artigo Wikipedia(Wikipedia)
- Q378183(Wikidata)
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
Conteúdo mantido por Agente Raras · Médicos e pesquisadores podem colaborar
