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Polydactyly, postaxial, type A1(PAPA1)

MedGen UID:
924305
Concept ID:
C4282400
Congenital Abnormality
Synonym: Polydactyly, Postaxial, Type A1
 
Gene (location): GLI3 (7p14.1)
 
Monarch Initiative: MONDO:0008266
OMIM®: 174200

Clinical features

From HPO
Syndactyly
MedGen UID:
52619
Concept ID:
C0039075
Congenital Abnormality
Webbing or fusion of the fingers or toes, involving soft parts only or including bone structure. Bony fusions are referred to as "bony" syndactyly if the fusion occurs in a radio-ulnar axis. Fusions of bones of the fingers or toes in a proximo-distal axis are referred to as "symphalangism".
Triphalangeal thumb
MedGen UID:
66029
Concept ID:
C0241397
Congenital Abnormality
A thumb with three phalanges in a single, proximo-distal axis. Thus, this term applies if the thumb has an accessory phalanx, leading to a digit like appearance of the thumb.
Preaxial polydactyly
MedGen UID:
87498
Concept ID:
C0345354
Congenital Abnormality
A form of polydactyly in which the extra digit or digits are localized on the side of the thumb or great toe.
Broad thumb
MedGen UID:
140880
Concept ID:
C0426891
Finding
Increased thumb width without increased dorso-ventral dimension.
Postaxial hand polydactyly
MedGen UID:
609221
Concept ID:
C0431904
Congenital Abnormality
Supernumerary digits located at the ulnar side of the hand (that is, on the side with the fifth finger).
Preaxial hand polydactyly
MedGen UID:
237235
Concept ID:
C1395852
Congenital Abnormality
Supernumerary digits located at the radial side of the hand. Polydactyly (supernumerary digits) involving the thumb occurs in many distinct forms of high variability and severity. Ranging from fleshy nubbins over varying degrees of partial duplication/splitting to completely duplicated or even triplicated thumbs or preaxial (on the radial side of the hand) supernumerary digits.
Cutaneous syndactyly of toes
MedGen UID:
320423
Concept ID:
C1834737
Congenital Abnormality
A soft tissue continuity in the anteroposterior axis between adjacent foot digits that involves at least half of the proximodistal length of one of the two involved digits; or, a soft tissue continuity in the A/P axis between two digits of the foot that does not meet the prior objective criteria.
Y-shaped metacarpals
MedGen UID:
348341
Concept ID:
C1861373
Finding
Y-shaped metacarpals are the result of a partial fusion of two metacarpal bones, with the two arms of the Y pointing in the distal direction. Y-shaped metacarpals may be seen in combination with polydactyly.
Broad hallux
MedGen UID:
401165
Concept ID:
C1867131
Finding
Visible increase in width of the hallux without an increase in the dorso-ventral dimension.
Postaxial foot polydactyly
MedGen UID:
384489
Concept ID:
C2112129
Finding
Polydactyly of the foot most commonly refers to the presence of six toes on one foot. Postaxial polydactyly affects the lateral ray and the duplication may range from a well-formed articulated digit to a rudimentary digit.
Preaxial foot polydactyly
MedGen UID:
389171
Concept ID:
C2112942
Finding
Duplication of all or part of the first ray.
Cutaneous finger syndactyly
MedGen UID:
866898
Concept ID:
C4021254
Congenital Abnormality
A soft tissue continuity in the A/P axis between two fingers that extends distally to at least the level of the proximal interphalangeal joints, or a soft tissue continuity in the A/P axis between two fingers that lies significantly distal to the flexion crease that overlies the metacarpophalangeal joint of the adjacent fingers.
Growth delay
MedGen UID:
99124
Concept ID:
C0456070
Pathologic Function
A deficiency or slowing down of growth pre- and postnatally.
Imperforate anus
MedGen UID:
1997
Concept ID:
C0003466
Congenital Abnormality
Congenital absence of the anus, i.e., the opening at the bottom end of the intestinal tract.
Global developmental delay
MedGen UID:
107838
Concept ID:
C0557874
Finding
A delay in the achievement of motor or mental milestones in the domains of development of a child, including motor skills, speech and language, cognitive skills, and social and emotional skills. This term should only be used to describe children younger than five years of age.
Intellectual disability
MedGen UID:
811461
Concept ID:
C3714756
Mental or Behavioral Dysfunction
Intellectual disability, previously referred to as mental retardation, is characterized by subnormal intellectual functioning that occurs during the developmental period. It is defined by an IQ score below 70.
Macrocephaly
MedGen UID:
745757
Concept ID:
C2243051
Finding
Occipitofrontal (head) circumference greater than 97th centile compared to appropriate, age matched, sex-matched normal standards. Alternatively, a apparently increased size of the cranium.
Nail dysplasia
MedGen UID:
331737
Concept ID:
C1834405
Congenital Abnormality
The presence of developmental dysplasia of the nail.
Hypertelorism
MedGen UID:
9373
Concept ID:
C0020534
Finding
Although hypertelorism means an excessive distance between any paired organs (e.g., the nipples), the use of the word has come to be confined to ocular hypertelorism. Hypertelorism occurs as an isolated feature and is also a feature of many syndromes, e.g., Opitz G syndrome (see 300000), Greig cephalopolysyndactyly (175700), and Noonan syndrome (163950) (summary by Cohen et al., 1995).

Professional guidelines

PubMed

Florea L, Caba L, Gorduza EV
Genes (Basel) 2021 Aug 29;12(9) doi: 10.3390/genes12091353. PMID: 34573333Free PMC Article

Recent clinical studies

Etiology

Bjorklund KA, O'Brien M
Hand (N Y) 2022 Nov;17(6):1286-1291. Epub 2021 Feb 25 doi: 10.1177/1558944721994255. PMID: 33631987Free PMC Article
Chocron Y, Kazan R, Abi-Rafeh J, Lessard A, Thibaudeau S
J Plast Reconstr Aesthet Surg 2021 Nov;74(11):2977-2992. Epub 2021 Apr 18 doi: 10.1016/j.bjps.2021.03.094. PMID: 33992559
Ortiz-Cruz G, Luna-Muñoz L, Arteaga-Vázquez J, Mutchinick OM
Am J Med Genet A 2019 Aug;179(8):1432-1441. Epub 2019 May 15 doi: 10.1002/ajmg.a.61193. PMID: 31091006
Ishigaki T, Akita S, Suzuki H, Udagawa A, Mitsukawa N
J Plast Reconstr Aesthet Surg 2019 Jul;72(7):1170-1177. Epub 2019 Mar 2 doi: 10.1016/j.bjps.2019.02.030. PMID: 30898504
Holmes LB, Nasri H, Hunt AT, Toufaily MH, Westgate MN
Birth Defects Res 2018 Jan;110(2):134-141. doi: 10.1002/bdr2.1184. PMID: 29377639

Diagnosis

Sakai Y, Kawamura D, Endo T, Iwasaki N
J Pediatr Orthop 2023 Mar 1;43(3):e244-e248. Epub 2022 Dec 8 doi: 10.1097/BPO.0000000000002323. PMID: 36476945
Elawad OAMA, Dafallah MA, Ahmed MMM, Albashir AAD, Abdalla SMA, Yousif HHM, Daw Elbait AAE, Mohammed ME, Ali HIH, Ahmed MMM, Mohammed NFN, Osman FHM, Mohammed MAY, Abu Shama EAE
J Med Case Rep 2022 Apr 29;16(1):169. doi: 10.1186/s13256-022-03396-6. PMID: 35484558Free PMC Article
Florea L, Caba L, Gorduza EV
Genes (Basel) 2021 Aug 29;12(9) doi: 10.3390/genes12091353. PMID: 34573333Free PMC Article
Chocron Y, Kazan R, Abi-Rafeh J, Lessard A, Thibaudeau S
J Plast Reconstr Aesthet Surg 2021 Nov;74(11):2977-2992. Epub 2021 Apr 18 doi: 10.1016/j.bjps.2021.03.094. PMID: 33992559
Ishigaki T, Akita S, Suzuki H, Udagawa A, Mitsukawa N
J Plast Reconstr Aesthet Surg 2019 Jul;72(7):1170-1177. Epub 2019 Mar 2 doi: 10.1016/j.bjps.2019.02.030. PMID: 30898504

Therapy

Kaur P, Chaudhry C, Neelam H, Panigrahi I
BMJ Case Rep 2021 Jan 28;14(1) doi: 10.1136/bcr-2020-236325. PMID: 33509858Free PMC Article
Mantilla-Rivas E, Tan P, Zajac J, Tilt A, Rogers GF, Oh AK
Plast Reconstr Surg 2019 Jul;144(1):149-154. doi: 10.1097/PRS.0000000000005719. PMID: 31246822
Schrauwen I, Giese AP, Aziz A, Lafont DT, Chakchouk I, Santos-Cortez RLP, Lee K, Acharya A, Khan FS, Ullah A, Nickerson DA, Bamshad MJ, Ali G, Riazuddin S, Ansar M, Ahmad W, Ahmed ZM, Leal SM
J Bone Miner Res 2019 Feb;34(2):375-386. Epub 2018 Nov 5 doi: 10.1002/jbmr.3594. PMID: 30395363Free PMC Article
Caba L, Rusu C, Butnariu L, Panzaru M, Braha E, Volosciuc M, Popescu R, Gramescu M, Bujoran C, Martiniuc V, Covic M, Gorduza EV
Rev Med Chir Soc Med Nat Iasi 2013 Apr-Jun;117(2):321-7. PMID: 24340511

Prognosis

Yao Y, Deng S, Zhu F
Genes (Basel) 2022 Jul 11;13(7) doi: 10.3390/genes13071230. PMID: 35886013Free PMC Article
Bjorklund KA, O'Brien M
Hand (N Y) 2022 Nov;17(6):1286-1291. Epub 2021 Feb 25 doi: 10.1177/1558944721994255. PMID: 33631987Free PMC Article
Hayat A, Umair M, Abbas S, Rauf A, Ahmad F, Ullah S, Ahmad W, Khan B
Genomics 2020 Jul;112(4):2729-2733. Epub 2020 Mar 5 doi: 10.1016/j.ygeno.2020.03.006. PMID: 32147526
Ishigaki T, Akita S, Suzuki H, Udagawa A, Mitsukawa N
J Plast Reconstr Aesthet Surg 2019 Jul;72(7):1170-1177. Epub 2019 Mar 2 doi: 10.1016/j.bjps.2019.02.030. PMID: 30898504
Carpenter CL, Cuellar TA, Friel MT
Plast Reconstr Surg 2016 Feb;137(2):564-568. doi: 10.1097/01.prs.0000475787.67693.e7. PMID: 26818291

Clinical prediction guides

Sakai Y, Kawamura D, Endo T, Iwasaki N
J Pediatr Orthop 2023 Mar 1;43(3):e244-e248. Epub 2022 Dec 8 doi: 10.1097/BPO.0000000000002323. PMID: 36476945
Yao Y, Deng S, Zhu F
Genes (Basel) 2022 Jul 11;13(7) doi: 10.3390/genes13071230. PMID: 35886013Free PMC Article
Saijo H, Yoshimoto H, Kashiyama K, Imamura Y, Iwao A, Tanaka K
J Foot Ankle Surg 2022 May-Jun;61(3):621-626. Epub 2021 Oct 28 doi: 10.1053/j.jfas.2021.10.025. PMID: 34802909
Bjorklund KA, O'Brien M
Hand (N Y) 2022 Nov;17(6):1286-1291. Epub 2021 Feb 25 doi: 10.1177/1558944721994255. PMID: 33631987Free PMC Article
Ishigaki T, Akita S, Suzuki H, Udagawa A, Mitsukawa N
J Plast Reconstr Aesthet Surg 2019 Jul;72(7):1170-1177. Epub 2019 Mar 2 doi: 10.1016/j.bjps.2019.02.030. PMID: 30898504

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