Abstract

A rare syndrome is ectrodactyly-ectodermal dysplasia-cleft lip/palate (EEC) syndrome, which may present with lobster claw deformity. The main clinical characteristics indicate involvement of ectodermal and mesodermal tissues, including mesoaxial and longitudinal defect of distal extremity, cleft lip and palate, and developmental defects of ectoderm derives. Renal anomalies and hormonal disorders may be seen in EEC patients. This article discusses endocrine problems in 4 EEC patients diagnosed based on clinical characteristics.

Keywords: Ectrodactyly, ectodermal dysplasia cleft lip, lobstarclow, adipsic hypernatremia

Copyright and license

How to cite

1.
Trabzon G, Gül Şiraz Ü, Uzan Tatlı Z, Hepokur MN, Akın L, Hatipoğlu N, et al. Four cases with ectrodactyly, ectodermal dysplasia, cleft lip/palate syndrome: Clinical evaluation and management and literature review. Trends in Pediatrics. 2023;4(1):55-60. https://doi.org/10.59213/TP.2023.78942

References

  1. Rüdiger RA, Haase W, Passarge E. Association of ectrodactyly, ectodermal dysplasia, and cleft lip-palate. Am J Dis Child. 1970;120:160-3. https://doi.org/10.1001/archpedi.1970.02100070104016
  2. Rodini ES, Richieri-Costa A. EEC syndrome: report on 20 new patients, clinical and genetic considerations. Am J Med Genet. 1990;37:42-53. https://doi.org/10.1002/ajmg.1320370112
  3. Barrow LL, van Bokhoven H, Daack-Hirsch S, et al. Analysis of the p63 gene in classical EEC syndrome, related syndromes, and non-syndromic orofacial clefts. J Med Genet. 2002;39:559-66. https://doi.org/10.1136/jmg.39.8.559
  4. Buss PW, Hughes HE, Clarke A. Twenty-four cases of the EEC syndrome: clinical presentation and management. J Med Genet. 1995;32:716-23. https://doi.org/10.1136/jmg.32.9.716
  5. Alves LU, Pardono E, Otto PA, Mingroni Netto RC. A novel c.1037C > G (p.Ala346Gly) mutation in TP63 as cause of the ectrodactyly-ectodermal dysplasia and cleft lip/palate (EEC) syndrome. Genet Mol Biol. 2015;38:37-41. https://doi.org/10.1590/S1415-475738120140125
  6. Augello M, Berg BI, Albert Müller A, Schwenzer-Zimmerer K. Two case reports with literature review of the EEC syndrome: Clinical presentation and management. Case Reports Plast Surg Hand Surg. 2015;2:63-6. https://doi.org/10.3109/23320885.2015.1086273
  7. Cockayne EA. Cleft palate, hare lip, dacryocystitis, and cleft hand and feet. Biometrika. 1936;28:60-3. https://doi.org/10.1093/biomet/28.1-2.60
  8. Bigatà X, Bielsa I, Artigas M, Azón A, Ribera M, Ferrándiz C. The ectrodactyly-ectodermal dysplasia-clefting syndrome (EEC): report of five cases. Pediatr Dermatol. 2003;20:113-8. https://doi.org/10.1046/j.1525-1470.2003.20203.x
  9. Roelfsema NM, Cobben JM. The EEC syndrome: a literature study. Clin Dysmorphol. 1996;5:115-27. https://doi.org/10.1097/00019605-199604000-00003
  10. Maas SM, de Jong TP, Buss P, Hennekam RC. EEC syndrome and genitourinary anomalies: an update. Am J Med Genet. 1996;63:472-8. https://doi.org/10.1002/(sici)1096-8628(19960614)63:3%3C472::aid-ajmg11%3E3.0.co;2-j
  11. Maclean K, Holme SA, Gilmour E, et al. EEC syndrome, Arg227Gln TP63 mutation and micturition difficulties: Is there a genotype-phenotype correlation? Am J Med Genet A. 2007;143A:1114-9. https://doi.org/10.1002/ajmg.a.31664
  12. Fried K. Ectrodactyly-ectodermal dysplasia-clefting (EEC) syndrome. Clin Genet. 1972;3:396-400. https://doi.org/10.1111/j.1399-0004.1972.tb01473.x
  13. Van Maldergem L, Gillerot Y, Vamos E, Toppet M, Watillon P, Van Vliet G. Vasopressin and gonadotropin deficiency in a boy with the ectrodactyly-ectodermal dysplasia-clefting syndrome. Acta Paediatr. 1992;81:365-7. https://doi.org/10.1111/j.1651-2227.1992.tb12246.x
  14. Gershoni-Baruch R, Goldscher D, Hochberg Z. Ectrodactyly-ectodermal dysplasia-clefting syndrome and hypothalamo-pituitary insufficiency. Am J Med Genet. 1997;68:168-72. https://doi.org/10.1002/(sici)1096-8628(19970120)68:2%3C168::aid-ajmg9%3E3.0.co;2-l
  15. Hatipoğlu N, Kurtoğlu S, Büyükayhan D, Akçakuş M. Hypothalamo-pituitary insufficiency associated with ectrodactyly-ectodermal dysplasia-clefting syndrome. J Clin Res Pediatr Endocrinol. 2009;1:252-5. https://doi.org/10.4274/jcrpe.v1i5.252
  16. Knudtzon J, Aarskog D. Growth hormone deficiency associated with the ectrodactyly-ectodermal dysplasia-clefting syndrome and isolated absent septum pellucidum. Pediatrics. 1987;79:410-2.
  17. Shawky RM, Elsayed SM, Sadik DI, Gad S, Seifeldin NS. Adipsic hypernatremia and bilateral renal stones in a child with ectrodactyly-ectodermal dysplasia-cleft lip-palate (EEC) syndrome. Genet Couns. 2010;21:215-20.
  18. Nimkarn S, Lin-Su K, New MI. Steroid 21 hydroxylase deficiency congenital adrenal hyperplasia. Pediatr Clin North Am. 2011;58:1281-300, xii. https://doi.org/10.1016/j.pcl.2011.07.012
  19. Wedell A, Ritzén EM, Haglund-Stengler B, Luthman H. Steroid 21-hydroxylase deficiency: three additional mutated alleles and establishment of phenotype-genotype relationships of common mutations. Proc Natl Acad Sci U S A. 1992;89:7232-6. https://doi.org/10.1073/pnas.89.15.7232
  20. New MI. Extensive clinical experience: nonclassical 21-hydroxylase deficiency. J Clin Endocrinol Metab. 2006;91:4205-14. https://doi.org/10.1210/jc.2006-1645