A síndrome de rigidez do polegar-braquidactilia-deficiência intelectual é caracterizada por déficit intelectual, dismorfismo leve, braquidactilia tipo A, sinais de obesidade e anquilose de ambos os polegares. Foi relatado em várias mulheres de uma família (uma menina e sua mãe, sua avó e provavelmente também sua irmã e sua tia-avó), bem como em um caso isolado.
Introdução
O que você precisa saber de cara
A síndrome de rigidez do polegar-braquidactilia-deficiência intelectual é caracterizada por déficit intelectual, dismorfismo leve, braquidactilia tipo A, sinais de obesidade e anquilose de ambos os polegares. Foi relatado em várias mulheres de uma família (uma menina e sua mãe, sua avó e provavelmente também sua irmã e sua tia-avó), bem como em um caso isolado.
Escala de raridade
<1/50kMuito rara
1/20kRara
1/10kPouco freq.
1/5kIncomum
1/2k
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Entender a doença
Do básico ao detalhe, leia no seu ritmo
Preparando trilha educativa...
Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Partes do corpo afetadas
+ 2 sintomas em outras categorias
Características mais comuns
Os sintomas variam de pessoa para pessoa. Abaixo estão as 9 características clínicas mais associadas, ordenadas por frequência.
Linha do tempo da pesquisa
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Genética e causas
O que está alterado no DNA e como passa nas famílias
Nenhum gene associado encontrado
Os dados genéticos desta condição ainda estão sendo catalogados.
Diagnóstico
Os sinais que médicos procuram e os exames que confirmam
Tratamento e manejo
Remédios, cuidados de apoio e o que precisa acompanhar
Onde tratar no SUS
Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)
🇧🇷 Atendimento SUS — Síndrome de polegar rígido-braquidactilia-perturbação do desenvolvimento intelectual
Centros de Referência SUS
13 centros habilitados pelo SUS para Síndrome de polegar rígido-braquidactilia-perturbação do desenvolvimento intelectual
Centros para Síndrome de polegar rígido-braquidactilia-perturbação do desenvolvimento intelectual
Detalhes dos centros
Hospital Infantil Albert Sabin
R. Tertuliano Sales, 544 - Vila União, Fortaleza - CE, 60410-794 · CNES 2407876
Serviço de Referência
Hospital de Apoio de Brasília (HAB)
AENW 3 Lote A Setor Noroeste - Plano Piloto, Brasília - DF, 70684-831 · CNES 0010456
Serviço de Referência
Hospital Estadual Infantil e Maternidade Alzir Bernardino Alves (HIABA)
Av. Min. Salgado Filho, 918 - Soteco, Vila Velha - ES, 29106-010 · CNES 6631207
Serviço de Referência
Hospital das Clínicas da UFMG
Av. Prof. Alfredo Balena, 110 - Santa Efigênia, Belo Horizonte - MG, 30130-100 · CNES 2280167
Serviço de Referência
Hospital Universitário João de Barros Barreto
R. dos Mundurucus, 4487 - Guamá, Belém - PA, 66073-000 · CNES 2337878
Serviço de Referência
Instituto de Medicina Integral Prof. Fernando Figueira (IMIP)
R. dos Coelhos, 300 - Boa Vista, Recife - PE, 50070-902 · CNES 0000647
Serviço de Referência
Hospital Pequeno Príncipe
R. Des. Motta, 1070 - Água Verde, Curitiba - PR, 80250-060 · CNES 3143805
Serviço de Referência
Hospital de Clínicas da UFPR
R. Gen. Carneiro, 181 - Alto da Glória, Curitiba - PR, 80060-900 · CNES 2364980
Serviço de Referência
Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF/Fiocruz)
Av. Rui Barbosa, 716 - Flamengo, Rio de Janeiro - RJ, 22250-020 · CNES 2269988
Serviço de Referência
Hospital de Clínicas de Porto Alegre (HCPA)
Rua Ramiro Barcelos, 2350 Bloco A - Av. Protásio Alves, 211 - Bloco B e C - Santa Cecília, Porto Alegre - RS, 90035-903 · CNES 2237601
Serviço de Referência
Hospital das Clínicas da FMUSP
R. Dr. Ovídio Pires de Campos, 225 - Cerqueira César, São Paulo - SP, 05403-010 · CNES 2077485
Serviço de Referência
Hospital de Clínicas da UNICAMP
R. Vital Brasil, 251 - Cidade Universitária, Campinas - SP, 13083-888 · CNES 2748223
Serviço de Referência
Hospital de Clínicas de Ribeirão Preto (HCRP-USP)
R. Ten. Catão Roxo, 3900 - Vila Monte Alegre, Ribeirão Preto - SP, 14015-010 · CNES 2082187
Serviço de Referência
Dados de DATASUS/CNES, SBGM, ABNeuro e Ministério da Saúde. Sempre confirme a disponibilidade diretamente com o estabelecimento.
Pesquisa ativa
Ensaios clínicos abertos e novidades científicas recentes
Pesquisa e ensaios clínicos
Nenhum ensaio clínico registrado para esta condição.
Publicações mais relevantes
Lamb-Shaffer syndrome in a Chinese adolescent: A case report.
Lamb-Shaffer syndrome (LAMSHF) is a rare neurodevelopmental disorder caused by pathogenic variants in the SRY-related high-mobility group box 5 (SOX5) gene. Clinical features are heterogeneous, and novel variants continue to be reported, expanding the genotypic and phenotypic spectrum of the disease. A 15-year-old male presented with short stature, mild intellectual disability, epilepsy, and multiple congenital anomalies, including facial dysmorphism and right thumb syndactyly. Whole-exome sequencing identified a novel heterozygous variant in the SOX5 gene, c.1160G>A (p.Ser387Asn), located at 12p12.1. Although initially classified as a variant of uncertain significance according to ACMG criteria, its strong correlation with the clinical phenotype supported the diagnosis of LAMSHF. The patient has been maintained on levetiracetam for epilepsy management and is receiving dental care for maxillofacial deformities. A multidisciplinary rehabilitation approach is recommended. Seizures are well-controlled with no recurrence. The patient demonstrates stable cognitive and functional status under current supportive care. This case reports a novel SOX5 variant associated with LAMSHF and highlights the importance of genetic confirmation in patients with unexplained neurodevelopmental features to guide appropriate management and avoid unnecessary interventions.
Clinical Application of Turnover Lengthening of the Palmaris Longus Tendon in Modified Camitz Opponensplasty for Severe Carpal Tunnel Syndrome.
Camitz opponensplasty performed for severe carpal tunnel syndrome (CTS) is sometimes complicated during the dissection of palmar aponeurosis, and it is difficult to obtain sufficient length and strength of the transition tendon. In this study, we modified the Camitz procedure and devised a tendon-lengthening approach that does not involve the palmar aponeurosis. We evaluated this procedure clinically. Our study included 11 patients with severe CTS and opposable thumb dysfunction. All patients underwent the same modified Camitz procedure including turnover lengthening of the palmaris longus (PL) tendon. Grip strength, pulp pinch, lateral pinch, active range of motion (thumb palmar abduction), and Quick Disability of the Arm, Shoulder, and Hand score were compared before and over 6 months after surgery. The mean follow-up duration was 15 months. No postoperative complications such as numbness, pain, or contracture of the thumb were observed. All parameters improved significantly (P < .05) after surgery. At the final follow-up, ultrasonography confirmed the presence and gliding of the transition tendon. Our modified method was effective in all cases, and a hemisected PL tendon seemed effective for opponensplasty for CTS.
Free functional gracilis muscle opponensplasty for thenar reconstruction: Indications, technique, and long-term outcomes.
Thumb opposition is an essential component of human hand function, and loss of the thenar musculature creates substantial disability of the hand. Additionally, first web space contracture as a result of trauma is a substantial limitation in reconstruction of thumb opposition. Reconstruction of thenar function is most commonly performed via opponensplasty tendon transfers. Although beneficial, tendon transfers require cortical retraining and fall short of native function. These may be the only option in the case of median nerve palsy. However, at times, thenar function is lost owing to thenar muscle injury with preserved median nerve function. Common examples include palmar soft tissue trauma and compartment syndrome. In such cases, intuitive thumb opposition can be restored with free functional muscle transfer innervated by the thenar motor branch of the median nerve. In addition, first web space release can be achieved in the same procedure. Here, we have demonstrate the benefits of this procedure versus opponensplasty, review long-term outcomes of successful cases including videographic documentation of function, and provide expert guidance to surgeons considering performing this procedure.
Townes-Brocks syndrome: genotype-phenotype correlations of SALL1 variants in our series and the literature.
Townes-Brocks syndrome (TBS, MIM#107480) is an autosomal dominant disorder linked to SALL1 alterations and characterized by a clinical triad (anorectal, thumb, and external-ear malformations), along with variable features. Renal failure and deafness can occur at any age, making follow-up essential. Some genotype-phenotype correlations have been suggested but data are limited. We collected clinical and molecular data from 49 patients with a SALL1 (likely) pathogenic variant identified in our laboratory or through collaborations, and reviewed the 207 SALL1 related-TBS patients previously reported in the literature. We performed statistical analysis to study genotype-phenotype correlations based notably on the variant position in relation to the glutamine-rich region. In our series, 25% of individuals presented with the clinical triad compared to 49.7% in the literature. The deafness frequency was similar (65%). Renal failure was diagnosed in 39.6% of our patients compared to 29.3% in the literature. Developmental delay or intellectual disability affected 9% of patients. Of the 22 SALL1 variants in our series, 35% were located upstream of the glutamine-rich region, compared to 6.5% in the literature. Statistical analysis was performed on all patients, of which 26 and 200 carried a variant upstream and downstream of the glutamine-rich region, respectively. A significant increase in deafness, dysplastic ear, and thumb malformations and a significant decrease in renal failure were observed in the individuals carrying a variant located downstream of the region, but the patients were significantly younger. Future studies should aim to elucidate the complex pathophysiological mechanisms and prognosis of TBS, functionally and prospectively. SRCAP-related Floating-Harbor syndrome (SRCAP-FHS) is characterized by typical craniofacial features; low birth weight, normal head circumference, and short stature; bone age delay that normalizes between ages six and 12 years; skeletal anomalies (brachydactyly, broad fingertips, clinodactyly, short thumbs, prominent joints, and clavicular abnormalities); severe receptive and expressive language impairment; hypernasality and high-pitched voice; and intellectual disability that is typically mild to moderate. Difficulties with temperament and behavior, present in many children, tend to improve in adulthood. Other features can include hyperopia and/or strabismus, conductive hearing loss, seizures, gastroesophageal reflux, renal anomalies (e.g., hydronephrosis / renal pelviectasis, cysts, and/or agenesis), and genital anomalies (e.g., hypospadias and/or undescended testes). The diagnosis is established in a proband with suggestive findings and a heterozygous SRCAP pathogenic variant identified by molecular genetic testing. Treatment of manifestations: Referral to an endocrinologist for consideration of human growth hormone (HGH) therapy; however, data on use of HGH in SRCAP-FHS are limited. Early intervention programs, special education, and vocational training to address developmental disabilities; communication rehabilitation with sign language or alternative means of communication; behavior management by a behavioral specialist / psychologist with consideration of medication as needed. Standard treatment for refractive errors, strabismus, hearing loss, seizures, gastroesophageal reflux, constipation, kidney and genitourinary anomalies, orthopedic, dental, and cardiac issues; family and social work support. Surveillance: Close monitoring of growth, especially in the first year of life. Bone age and evaluation for signs of early puberty as needed, especially in those on HGH. Monitor developmental progress and educational needs at each visit. Assess for seizures, gastroesophageal reflux, constipation, and manifestations of celiac disease at each visit. Annual behavioral assessment, ophthalmologic evaluation, audiology evaluation, blood pressure measurement, and assessment of kidney function. Monitor kidney anomalies per nephrologist. Kidney ultrasound to assess for cysts in teenage and adult years with follow up as needed. Orthopedic assessment for kyphoscoliosis and clinical manifestations of Perthes disease as needed. Dental evaluation every six months. SRCAP-FHS is inherited in an autosomal dominant manner. The majority of affected individuals have a de novo pathogenic variant. Each child of an individual with SRCAP-FHS has a 50% chance of inheriting the pathogenic variant. Prenatal and preimplantation genetic testing are possible for families in which the pathogenic variant has been identified.
Skipping of Exon 20 in EP300: A Novel Variant Linked to Rubinstein-Taybi Syndrome With Atypical and Severe Clinical Manifestations.
Rubinstein-Taybi syndrome (RSTS) is a rare autosomal dominant neurodevelopmental disorder linked to haploinsufficiency of CREBBP (RSTS1) and EP300 (RSTS2) genes. Characteristic features often include distinctive facial traits, broad thumbs and toes, short stature, and various degrees of intellectual disability. The clinical presentation of RSTS is notably variable, making it challenging to establish a clear genotype-phenotype correlation, except for specific variants which cause the allelic Menke-Hennekam syndrome. Trio exome analysis, data collection via networking and GeneMatcher platforms, transcript processing analysis, and DNA methylation profiling were performed. We identified two unrelated patients with de novo variants in EP300 (NM_001429.4: c.3671+5G>C; c.3671+5_3671+8delGTAA) predicted to cause in-frame exon 20 skipping, confirmed in one patient. In silico 3D protein modeling suggested that exon 20 deletion (comprising 27 amino acids) likely alters the structural conformation between the RING_CBP-p300 and HAT-KAT11 domains. Clinically, both patients displayed severe RSTS2-like clinical features, including autism spectrum disorder, speech delay, hearing loss, microcephaly, developmental delay, and intellectual disability, alongside ocular, respiratory, and cardiovascular abnormalities. Additionally, one patient developed early-onset colorectal cancer. DNA methylation profiling in Subject #1 confirmed RSTS but did not align with the specific episignatures for RSTS1 or RSTS2. We propose that skipping of exon 20 in EP300 is associated with a distinct form of Rubinstein-Taybi syndrome featuring clinical characteristics not fully aligning with RSTS1 or RSTS2. Our findings increase the understanding of RSTS genetic and molecular basis and stress the need for further research to establish definitive genotype-phenotype correlations.
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📚 EuropePMCmostrando 166
Lamb-Shaffer syndrome in a Chinese adolescent: A case report.
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Hand (New York, N.Y.)[Endoscopic-assisted median nerve decompression combined with one-stage tendon transfer for reconstruction of thumb abduction in treatment of severe carpal tunnel syndrome].
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The Journal of hand surgeryAdducted thumb as an isolated morphologic finding: an early sonographic sign of impaired neurodevelopment: A STROBE compliant study.
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Medical hypothesesNecrosis of the thumb after inadvertent injection of diclofenac in the radial artery: a case report.
Journal of pain researchEarly Motor Developmental Milestones and Schizotypy in the Northern Finland Birth Cohort Study 1966.
Schizophrenia bulletinRestoration of motor control and proprioceptive and cutaneous sensation in humans with prior upper-limb amputation via multiple Utah Slanted Electrode Arrays (USEAs) implanted in residual peripheral arm nerves.
Journal of neuroengineering and rehabilitationTemple syndrome as a differential diagnosis to Prader-Willi syndrome: Identifying three new patients.
American journal of medical genetics. Part A[Clinical features of Rubinstein-Taybi syndrome and novel mutation in the CREBBP gene: an analysis of one case].
Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatricsClinical Report: Warsaw Breakage Syndrome with small radii and fibulae.
American journal of medical genetics. Part AHand span influences optimal grip span in adolescents with Down syndrome.
Nutricion hospitalariaRubinstein-Taybi Syndrome Associated with Pituitary Macroadenoma: A Case Report.
CureusRubinstein-Taybi syndrome.
Nihon rinsho. Japanese journal of clinical medicineDe novo 2p16.1 microdeletion with metastatic esophageal adenocarcinoma.
BMJ case reportsFirst case report of inherited Rubinstein-Taybi syndrome associated with a novel EP300 variant.
BMC medical geneticsA comprehensive musculoskeletal and peripheral nervous system assessment of war-related bilateral upper extremity amputees.
Military Medical ResearchPhenotype and genotype in 52 patients with Rubinstein-Taybi syndrome caused by EP300 mutations.
American journal of medical genetics. Part ARemembered preoperative Quick disabilities of the arm, shoulder and hand (QuickDASH) scores.
The Journal of hand surgery, European volumeMosaic trisomy 8 detected by fibroblasts cultured of skin.
Colombia medica (Cali, Colombia)Rubinstein-Taybi syndrome type 2: report of nine new cases that extend the phenotypic and genotypic spectrum.
Clinical dysmorphologyDiagnosis of Van den Ende-Gupta syndrome: Approach to the Marden-Walker-like spectrum of disorders.
American journal of medical genetics. Part ACREBBP mutations in individuals without Rubinstein-Taybi syndrome phenotype.
American journal of medical genetics. Part ATemple-Baraitser Syndrome and Zimmermann-Laband Syndrome: one clinical entity?
BMC medical geneticsEpilepsy in KCNH1-related syndromes.
Epileptic disorders : international epilepsy journal with videotapeIdentification of Subgroups of Women with Carpal Tunnel Syndrome with Central Sensitization.
Pain medicine (Malden, Mass.)Induced knockouts provide insights into human L1 syndrome.
The Journal of experimental medicineMosaic CREBBP mutation causes overlapping clinical features of Rubinstein-Taybi and Filippi syndromes.
European journal of human genetics : EJHG[X-linked hereditary spastic paraplegia due to mutation in the L1CAM gene: three cases reports of CRASH syndrome].
Revista de neurologiaL1 syndrome diagnosis complemented with functional analysis of L1CAM variants located to the two N-terminal Ig-like domains.
Clinical geneticsDental Treatment Considerations for Children with Complex Medical Histories: A Case of Townes-Brock Syndrome.
The Journal of the Michigan Dental AssociationMaternally inherited autosomal dominant intellectual disability caused by 16p13.3 microduplication.
European journal of medical geneticsCREBBP and EP300 mutational spectrum and clinical presentations in a cohort of Swedish patients with Rubinstein-Taybi syndrome.
Molecular genetics & genomic medicineHomozygous FIBP nonsense variant responsible of syndromic overgrowth, with overgrowth, macrocephaly, retinal coloboma and learning disabilities.
Clinical geneticsArthroscopic interposition in thumb carpometacarpal osteoarthritis: A series of 26 cases.
Chirurgie de la mainPrenatal diagnosis of X-linked hydrocephalus in a family with a novel mutation in L1CAM gene.
Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and GynaecologyThe Effect of a Bone Tunnel During Ligament Reconstruction for Trapeziometacarpal Osteoarthritis: A 5-Year Follow-up.
The Journal of hand surgeryNew patients with Temple syndrome caused by 14q32 deletion: Genotype-phenotype correlations and risk of thyroid cancer.
American journal of medical genetics. Part AThe effectiveness of passive physical modalities for the management of soft tissue injuries and neuropathies of the wrist and hand: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration.
Journal of manipulative and physiological therapeuticsExome Sequencing Identification of EP300 Mutation in a Proband with Coloboma and Imperforate Anus: Possible Expansion of the Phenotypic Spectrum of Rubinstein-Taybi Syndrome.
Molecular syndromology'Splitting versus lumping': Temple-Baraitser and Zimmermann-Laband Syndromes.
Human geneticsThree cases with L1 syndrome and two novel mutations in the L1CAM gene.
European journal of pediatricsIdentical by descent L1CAM mutation in two apparently unrelated families with intellectual disability without L1 syndrome.
European journal of medical geneticsHOXA genes cluster: clinical implications of the smallest deletion.
Italian journal of pediatricsAn additional clinical sign of 17q21.31 microdeletion syndrome: preaxial polydactyly of hands with broad thumbs.
American journal of medical genetics. Part AA novel KIF7 mutation in two affected siblings with acrocallosal syndrome.
Clinical dysmorphology3 generation pedigree with paternal transmission of the 22q11.2 deletion syndrome: Intrafamilial phenotypic variability.
European journal of medical geneticsTwo cases of Temple-Baraitser syndrome: natural history and further delineation of the clinical and radiologic phenotypes.
Clinical dysmorphologyRubinstein-Taybi syndrome: clinical features, genetic basis, diagnosis, and management.
Italian journal of pediatricsAssociações
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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.
- Lamb-Shaffer syndrome in a Chinese adolescent: A case report.
- Clinical Application of Turnover Lengthening of the Palmaris Longus Tendon in Modified Camitz Opponensplasty for Severe Carpal Tunnel Syndrome.
- Free functional gracilis muscle opponensplasty for thenar reconstruction: Indications, technique, and long-term outcomes.
- Townes-Brocks syndrome: genotype-phenotype correlations of SALL1 variants in our series and the literature.
- Skipping of Exon 20 in EP300: A Novel Variant Linked to Rubinstein-Taybi Syndrome With Atypical and Severe Clinical Manifestations.
- Lenz-Majewski syndrome in a patient from Egypt.
- Mosaic trisomy 8 detected by fibroblasts cultured of skin.
- Epilepsy in KCNH1-related syndromes.
- Homozygous FIBP nonsense variant responsible of syndromic overgrowth, with overgrowth, macrocephaly, retinal coloboma and learning disabilities.
- The trisomy 18 syndrome.
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:1078(Orphanet)
- OMIM OMIM:188201(OMIM)
- MONDO:0008563(MONDO)
- GARD:4375(GARD (NIH))
- Busca completa no PubMed(PubMed)
- Q55781554(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