- Cleidocranial Dysplasia Center
- Patient Comments: Cleidocranial Dysplasia - Describe Your Experience
- Patient Comments: Cleidocranial Dysplasia - Symptoms
- What is cleidocranial dysplasia?
- What are the symptoms and signs of cleidocranial dysplasia?
- How common is cleidocranial dysplasia?
- What genes are related to cleidocranial dysplasia?
- How do people inherit cleidocranial dysplasia?
- Where can I find information about treatment for cleidocranial dysplasia?
- What other names do people use for cleidocranial dysplasia?
What is cleidocranial dysplasia?
Cleidocranial dysplasia is a condition that primarily affects the development of the bones and teeth.
What are the symptoms and signs of cleidocranial dysplasia?
Signs and symptoms of cleidocranial dysplasia can vary widely in severity, even within the same family.
Individuals with cleidocranial dysplasia usually have underdeveloped or absent collarbones (clavicles). As a result, their shoulders are narrow and sloping, can be brought unusually close together in front of the body, and in some cases the shoulders can be made to meet in the middle of the body. Delayed closing of the spaces between the bones of the skull (fontanels) is also characteristic of this condition. The fontanels usually close in early childhood, but may remain open into adulthood in people with this disorder.
Affected individuals may be 3 to 6 inches shorter than other members of their family, and may have:
- short, tapered fingers and broad thumbs;
- short forearms;
- flat feet;
- knock knees; and
- an abnormal curvature of the spine (scoliosis).
Characteristic facial features may include:
- a wide, short skull (brachycephaly);
- wide-set eyes (hypertelorism); a
- flat nose; and a
- small upper jaw.
Individuals with cleidocranial dysplasia may have decreased bone density (osteopenia) and may develop osteoporosis, a condition that makes bones progressively more brittle and prone to fracture, at a relatively early age. Women with cleidocranial dysplasia have an increased risk of requiring a cesarean section when delivering a baby, due to a narrow pelvis preventing passage of the infant's head.
Dental abnormalities seen in cleidocranial dysplasia may include:
- delayed loss of the primary (baby) teeth;
- delayed appearance of the
secondary (adult) teeth;
- unusually shaped, peg-like teeth;
- misalignment of the
teeth and jaws (malocclusion); and
- extra teeth, sometimes accompanied by cysts in the gums.
In addition to skeletal and dental abnormalities, people with cleidocranial dysplasia may have hearing loss and be prone to sinus and ear infections. Some young children with this condition are mildly delayed in the development of motor skills such as crawling and walking, but intelligence is unaffected.
How common is cleidocranial dysplasia?
Cleidocranial dysplasia occurs in approximately 1 per million individuals worldwide.
What genes are related to cleidocranial dysplasia?
The RUNX2 gene provides instructions for making a protein that is involved in bone and cartilage development and maintenance. This protein is a transcription factor, which means it attaches (binds) to specific regions of DNA and helps control the activity of particular genes. Researchers believe that the RUNX2 protein acts as a "master switch," regulating a number of other genes involved in the development of cells that build bones (osteoblasts).
Some mutations change one protein building block (amino acid) in the RUNX2 protein. Other mutations introduce a premature stop signal that results in an abnormally short protein. Occasionally, the entire gene is missing.
These genetic changes reduce or eliminate the activity of the protein produced from one copy of the RUNX2 gene in each cell, decreasing the total amount of functional RUNX2 protein. This shortage of functional RUNX2 protein interferes with normal bone and cartilage development, resulting in the signs and symptoms of cleidocranial dysplasia. In rare cases, affected individuals may experience additional, unusual symptoms resulting from the loss of other genes near RUNX2.
In about one-third of individuals with cleidocranial dysplasia, no mutation in the RUNX2 gene has been found. The cause of the condition in these individuals is unknown.
How do people inherit cleidocranial dysplasia?
This condition is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. In some cases, an affected person inherits the mutation from one affected parent. Other cases may result from new mutations in the gene. These cases occur in people with no history of the disorder in their family.
Where can I find information about treatment for cleidocranial dysplasia?
These resources address the management of cleidocranial dysplasia and may include treatment providers.
- Gene Review: Cleidocranial Dysplasia
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Signs and symptoms in babies, toddlers, and children may:
- Be irritable and pull and tug at their ears
- Be fussy
- Have problems feeding or sleeping
- Complain about pain and fullness in the ear
- Have a fever
- A buildup of pus in the ear
- Have signs and symptoms of an upper respiratory infection
Treatment depends upon the type (chronic or acute).
The definition of a genetic disease is a disorder or condition caused by abnormalities in a person's genome. Some types of genetic inheritance include single inheritance, including cystic fibrosis, sickle cell anemia, Marfan syndrome, and hemochromatosis. Other types of genetic diseases include multifactorial inheritance. Still other types of genetic diseases include chromosome abnormalities (for example, Turner syndrome, and Klinefelter syndrome), and mitochondrial inheritance (for example, epilepsy and dementia).
HyperdontiaHyperdontia is a condition in which a person has an excessive amount of teeth (more than 20 primary teeth or 32 permanent teeth). The cause is unknown. Treatment involves tooth removal.
Swimmer's ear (external otitis) is an infection of the skin that covers the outer ear canal.
Causes of swimmer's ear include excessive water exposure that leads to trapped bacteria in the ear canal. Symptoms of simmer's include a feeling of fullness in the ear, itching, and ear pain. Chronic swimmer's ear may be caused by eczema, seborrhea, fungus, chronic irritation, and other conditions.
Common treatment includes antibiotic ear drops.
ScoliosisScoliosis causes an abnormal curvature of the spine. When the cause of scoliosis is unknown the disorder is described based on the age when the scoliosis develops (infantile, juvenile, or adolescent idiopathic scoliosis). In functional scoliosis, curvature develops due to a problem somewhere else in the body. With neuromuscular scoliosis, there is a problem when the bones of the spine are formed. Treatment typically involves observation, bracing, and surgery and is dependent upon the severity of the curvature.
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