Achondroplasia is a type of genetic
disorder that is the most common cause of dwarfism. People with
this condition have short stature, usually reaching a full adult
height of around 4'0" (1.22 meters). The disorder is a result of
an autosomal dominant mutation in the fibroblast growth factor
receptor gene 3 (FBFR3), which causes an abnormality of cartilage
formation. It occurs at a frequency of about 1 in 20,000 to 1 in
40,000 births.
Clinical
features of the disease
* dwarfism (nonproportional short stature)
* shortening of the proximal limbs (termed rhizomelic shortening)
* short fingers and toes
* a large head with prominent forehead
* small midface with a flattened nasal bridge
* spinal kyphosis or lordosis
* varus (bowleg) or valgus (knock knee) deformities
* frequently have ear infections (due to eustachean tube
blockages), sleep apnea (which can be central or obstructive), and
hydrocephalus
People with achondroplasia have one normal copy of the fibroblast
growth factor receptor 3 gene and one mutant copy. Only one copy
of the gene needs to be present for the disorder to be seen. Thus,
a person with achondroplasia has a 50% chance of passing on the
gene to their offspring, meaning that 1 in 2 of their children
will have achondroplasia. However, in 3 out of 4 cases, people
with achondroplasia are born to parents who don't have the
condition. This is the result of a new mutation.
New gene mutations are associated with increasing paternal age
(over 35 years). Studies have demonstrated that new gene mutations
are exclusively inherited from the father and occur during
spermatogenesis (as opposed to resulting from a germline mosaicism
).
Achondroplasia can be detected before birth by the use of prenatal
ultrasound. A DNA test can be performed before birth to detect
homozygosity, where two copies of the mutant gene are inherited, a
condition which is lethal and leads to stillbirths.
Growth hormoneGrowth hormone is a polypeptide hormone secreted by
the anterior pituitary gland which stimulates growth and cell
reproduction in humans and other vertebrate animals. This article
describes human growth hormone physiology, with brief mentions of
the disea (GH) therapy has been proposed as a possible treatment
for the short stature of achondroplasia. However, the people who
participated in the studies on the subject have not yet reached
adult size, so this type of therapy has unknown results. Early
experience with surgical limb lengthening procedures
resulted in a
high incidence of complications, but recent experiences have
improved results considerably.
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