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Melnick-Needles syndrome

Definition: Melnick-Needles syndrome (MNS) is a rare X-linked bone dysplasia characterised by facial dysmorphology and radiographic abnormalities.

Synopsis

- systemic anomalies

  • short to normal stature
  • failure to thrive

- craniofacial anomalies

  • hirsute forehead
  • coarse hair
  • delayed closure of fontanel
  • small facies
  • prominent hirsute forehead
  • full cheek
  • micrognathia
  • prominent supraorbital ridge
  • large ears
  • recurrent otitis media
  • exophthalmos
  • hypertelorism
  • strabismus
  • cleft palate
  • malaligned teeth
  • delayed tooth eruption
  • long neck

- cardiovascular anomalies

  • mitral valve prolapse
  • tricuspid valve prolapse
  • noncompaction of ventricular myocardium

- recurrent respiratory infections
- pulmonary hypertension

- skeletal anomalies

  • narrow shoulders
  • pectus excavatum
  • irregular ribbon-like ribs
  • short clavicles
  • short scapulae
  • small mandible with obtuse angle
  • hypoplastic coronoid process
  • dense skull base
  • delayed paranasal sinus development
  • tall vertebrae
  • kyphoscoliosis
  • anterior concavity of thoracic vertebrae
  • coxa valga
  • iliac flaring
  • hip dislocation
  • short upper arms
  • bowing of humerus
  • bowing of radius
  • bowing of ulna
  • bowing of tibia
  • metaphyseal flaring of long bones
  • genu valgum
  • limited elbow extension
  • short distal phalanges
  • cone-shaped epiphyses
  • acroosteolysis
  • club feet
  • pes planus

- omphalocele (males)
- hydronephrosis
- ureteral stenosis
- skin hyperlaxity (males)
- delayed motor development
- abnormal gait

Etiology

- germline mutations in the gene encoding filamin A (FLNA) (MIM.300017)

References

- Expansion of the Spectrum of FLNA Mutations Associated with Melnick-Needles Syndrome. Foley C, Roberts K, Tchrakian N, Morgan T, Fryer A, Robertson SP, Tubridy N. Mol Syndromol. 2010 Sep;1(3):121-126. PMID: #21031081#