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Child syndrome

MedGen UID:
82697
Concept ID:
C0265267
Disease or Syndrome
Synonyms: Congenital Hemidysplasia with Ichthyosiform nevus and Limb Defects; Ichthyosis, CHILD syndrome
SNOMED CT: Congenital hemidysplasia with ichthyosiform erythroderma and limb defects syndrome (17608003); CHILD syndrome (17608003); CHILD (congenital hemidysplasia, ichthyosiform erythroderma, limb defects) syndrome (17608003)
Modes of inheritance:
X-linked dominant inheritance
MedGen UID:
376232
Concept ID:
C1847879
Finding
Source: Orphanet
A mode of inheritance that is observed for dominant traits related to a gene encoded on the X chromosome. In the context of medical genetics, X-linked dominant disorders tend to manifest very severely in affected males. The severity of manifestation in females may depend on the degree of skewed X inactivation.
Not genetically inherited
MedGen UID:
988794
Concept ID:
CN307044
Finding
Source: Orphanet
clinical entity without genetic inheritance.
 
Gene (location): NSDHL (Xq28)
 
Monarch Initiative: MONDO:0010621
OMIM®: 308050
Orphanet: ORPHA139

Disease characteristics

Excerpted from the GeneReview: NSDHL-Related Disorders
NSDHL-related disorders include CHILD (congenital hemidysplasia with ichthyosiform nevus and limb defects) syndrome, an X-linked disorder that is usually male lethal during gestation and thus predominantly affects females; and CK syndrome, an X-linked disorder that affects males. CHILD syndrome is characterized by unilateral distribution of ichthyosiform skin lesions and ipsilateral limb defects that range from shortening of the metacarpals and phalanges to absence of the entire limb. Intellect is usually normal. The ichthyosiform skin lesions are usually present at birth or in the first weeks of life; new lesions can develop in later life. Onychodystrophy and periungual hyperkeratosis are common. Heart, lung, and kidney malformations can also occur. CK syndrome is characterized by mild-to-severe cognitive impairment and behavior problems (aggression, attention-deficit/hyperactivity disorder [ADHD], and irritability). All reported affected males have developed seizures in infancy and have cerebral cortical malformations and microcephaly. All have distinctive facial features, a thin habitus, and relatively long, thin fingers and toes. Some have scoliosis and kyphosis. Strabismus is common. Optic atrophy is also reported. [from GeneReviews]
Authors:
Mazen Kurban  |  Jinia El Feghaly  |  Lamiaa Hamie   view full author information

Additional descriptions

From OMIM
CHILD syndrome is an acronym for an X-linked dominant disorder characterized by congenital hemidysplasia with ichthyosiform erythroderma and limb defects. The mutations are lethal in hemizygous males (Happle et al., 1980). CK syndrome (300831), an X-linked recessive mental retardation syndrome, is an allelic disorder with a less severe phenotype.  http://www.omim.org/entry/308050
From MedlinePlus Genetics
CHILD syndrome is a condition that affects the development of several parts of the body. The name of the condition is an acronym of the major features: congenital hemidysplasia with ichthyosiform erythroderma and limb defects. The signs and symptoms of this disorder may vary from person to person, but they are typically limited to only one side of the body ("hemi-" means "half," and "dysplasia" refers to abnormal growth). The right side of the body is affected more often than the left side.

People with CHILD syndrome often have a skin condition characterized by large patches of skin that are red and inflamed (erythroderma) and covered with yellow, flaky scales (ichthyosis). This condition is most likely to occur in skin folds and creases and usually does not affect the face. The skin abnormalities are typically present at birth or appear within the first few weeks of life and may improve with time. 

CHILD syndrome may also disrupt the formation of the arms and legs during early development. Some children with this disorder have shortened bones in the fingers or toes, while others have shortened or missing limbs. The limb abnormalities typically occur on the same side of the body as the skin abnormalities. 

Some children have a curvature of the spine (scoliosis) or joint deformities that restrict movement (contractures). In some cases, CHILD syndrome affects the development of the brain, heart, lungs, and kidneys.  https://medlineplus.gov/genetics/condition/child-syndrome

Clinical features

From HPO
Hydronephrosis
MedGen UID:
42531
Concept ID:
C0020295
Disease or Syndrome
Severe distention of the kidney with dilation of the renal pelvis and calices.
Unilateral renal agenesis
MedGen UID:
75607
Concept ID:
C0266294
Congenital Abnormality
A unilateral form of agenesis of the kidney.
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".
Finger syndactyly
MedGen UID:
65139
Concept ID:
C0221352
Congenital Abnormality
Webbing or fusion of the fingers, 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 in a proximo-distal axis are referred to as "Symphalangism".
Single transverse palmar crease
MedGen UID:
96108
Concept ID:
C0424731
Finding
The distal and proximal transverse palmar creases are merged into a single transverse palmar crease.
4-5 toe syndactyly
MedGen UID:
324891
Concept ID:
C1837836
Finding
Syndactyly with fusion of toes four and five.
Absent toe
MedGen UID:
766668
Concept ID:
C3553754
Finding
Aplasia of a toe. That is, absence of all phalanges of a non-hallux digit of the foot and the associated soft tissues.
Absent middle phalanx of 2nd finger
MedGen UID:
867078
Concept ID:
C4021436
Finding
Absence of the middle phalanx of the index (2nd) finger.
Aplasia of the distal phalanx of the 2nd finger
MedGen UID:
867081
Concept ID:
C4021439
Finding
Absent middle phalanx of 3rd finger
MedGen UID:
867117
Concept ID:
C4021475
Anatomical Abnormality
Absence of the middle phalanx of the middle (3rd) finger.
Aplasia of the distal phalanx of the 3rd finger
MedGen UID:
869937
Concept ID:
C4024368
Finding
Absence of the distal phalanx of the middle (3rd) finger.
2-5 finger cutaneous syndactyly
MedGen UID:
870711
Concept ID:
C4025165
Anatomical Abnormality
A soft tissue continuity in the anteroposterior axis between the second to the fifth fingers that extends distally to at least the level of the proximal interphalangeal joints.
Single ventricle
MedGen UID:
56289
Concept ID:
C0152424
Congenital Abnormality
The presence of only one working lower chamber in the heart, usually with a virtual absence of the ventricular septum and usually present in conjunction with double inlet left or right ventricle.
Abnormal cardiac septum morphology
MedGen UID:
1830392
Concept ID:
C5779791
Anatomical Abnormality
An anomaly of the intra-atrial or intraventricular septum.
Short stature
MedGen UID:
87607
Concept ID:
C0349588
Finding
A height below that which is expected according to age and gender norms. Although there is no universally accepted definition of short stature, many refer to "short stature" as height more than 2 standard deviations below the mean for age and gender (or below the 3rd percentile for age and gender dependent norms).
Mild intrauterine growth retardation
MedGen UID:
374360
Concept ID:
C1840006
Finding
Intrauterine growth retardation that is at least 2 standard deviations (SD) below average, but not as low as 3 SD, corrected for sex and gestational age.
Hearing impairment
MedGen UID:
235586
Concept ID:
C1384666
Disease or Syndrome
A decreased magnitude of the sensory perception of sound.
Intellectual disability, mild
MedGen UID:
10044
Concept ID:
C0026106
Mental or Behavioral Dysfunction
Mild intellectual disability is defined as an intelligence quotient (IQ) in the range of 50-69.
Aplasia/Hypoplasia involving the central nervous system
MedGen UID:
871188
Concept ID:
C4025665
Finding
Absence or underdevelopment of tissue in the central nervous system.
Umbilical hernia
MedGen UID:
9232
Concept ID:
C0019322
Anatomical Abnormality
Protrusion of abdominal contents through a defect in the abdominal wall musculature around the umbilicus. Skin and subcutaneous tissue overlie the defect.
Congenital hip dislocation
MedGen UID:
9258
Concept ID:
C0019555
Disease or Syndrome
Micrognathia
MedGen UID:
44428
Concept ID:
C0025990
Congenital Abnormality
Developmental hypoplasia of the mandible.
Scoliosis
MedGen UID:
11348
Concept ID:
C0036439
Disease or Syndrome
The presence of an abnormal lateral curvature of the spine.
Flexion contracture
MedGen UID:
83069
Concept ID:
C0333068
Anatomical Abnormality
A flexion contracture is a bent (flexed) joint that cannot be straightened actively or passively. It is thus a chronic loss of joint motion due to structural changes in muscle, tendons, ligaments, or skin that prevents normal movement of joints.
Vertebral hypoplasia
MedGen UID:
87502
Concept ID:
C0345394
Congenital Abnormality
Small, underdeveloped vertebral bodies.
Short clavicles
MedGen UID:
96529
Concept ID:
C0426799
Congenital Abnormality
Reduced length of the clavicles.
Short ribs
MedGen UID:
98094
Concept ID:
C0426817
Finding
Reduced rib length.
Hypoplastic scapulae
MedGen UID:
337579
Concept ID:
C1846434
Finding
Underdeveloped scapula.
Epiphyseal stippling
MedGen UID:
349104
Concept ID:
C1859126
Finding
The presence of abnormal punctate (speckled, dot-like) calcifications in one or more epiphyses.
Hypoplastic pelvis
MedGen UID:
760700
Concept ID:
C3536734
Anatomical Abnormality
Underdevelopment of the bony pelvis.
Pulmonary hypoplasia
MedGen UID:
78574
Concept ID:
C0265783
Congenital Abnormality
A congenital abnormality in which the lung parenchyma is not fully developed. It may be associated with other congenital abnormalities.
Elevated 8-dehydrocholesterol
MedGen UID:
333461
Concept ID:
C1840013
Finding
Elevated 8(9)-cholestenol
MedGen UID:
327010
Concept ID:
C1840014
Finding
Cleft upper lip
MedGen UID:
40327
Concept ID:
C0008924
Congenital Abnormality
A gap or groove in the upper lip. This is a congenital defect resulting from nonfusion of tissues of the lip during embryonal development.
Depressed nasal bridge
MedGen UID:
373112
Concept ID:
C1836542
Finding
Posterior positioning of the nasal root in relation to the overall facial profile for age.
Alopecia
MedGen UID:
7982
Concept ID:
C0002170
Finding
A noncongenital process of hair loss, which may progress to partial or complete baldness.
Nevus
MedGen UID:
45074
Concept ID:
C0027960
Neoplastic Process
A nevus is a type of hamartoma that is a circumscribed stable malformation of the skin.
Parakeratosis
MedGen UID:
10572
Concept ID:
C0030436
Disease or Syndrome
Abnormal formation of the keratinocytes of the epidermis characterized by persistence of nuclei, incomplete formation of keratin, and moistness and swelling of the keratinocytes.
Erythema
MedGen UID:
11999
Concept ID:
C0041834
Disease or Syndrome
Redness of the skin, caused by hyperemia of the capillaries in the lower layers of the skin.
Congenital ichthyosiform erythroderma
MedGen UID:
86936
Concept ID:
C0079583
Disease or Syndrome
An ichthyosiform abnormality of the skin with congenital onset.
Epidermal acanthosis
MedGen UID:
65136
Concept ID:
C0221270
Finding
Diffuse hypertrophy or thickening of the stratum spinosum of the epidermis (prickle cell layer of the skin).
Small nail
MedGen UID:
537942
Concept ID:
C0263523
Finding
A nail that is diminished in length and width, i.e., underdeveloped nail.
Epidermal nevus
MedGen UID:
83106
Concept ID:
C0334082
Disease or Syndrome
PIK3CA-related overgrowth spectrum (PROS) encompasses a range of clinical findings in which the core features are congenital or early-childhood onset of segmental/focal overgrowth with or without cellular dysplasia. Prior to the identification of PIK3CA as the causative gene, PROS was separated into distinct clinical syndromes based on the tissues and/or organs involved (e.g., MCAP [megalencephaly-capillary malformation] syndrome and CLOVES [congenital lipomatous asymmetric overgrowth of the trunk, lymphatic, capillary, venous, and combined-type vascular malformations, epidermal nevi, skeletal and spinal anomalies] syndrome). The predominant areas of overgrowth include the brain, limbs (including fingers and toes), trunk (including abdomen and chest), and face, all usually in an asymmetric distribution. Generalized brain overgrowth may be accompanied by secondary overgrowth of specific brain structures resulting in ventriculomegaly, a markedly thick corpus callosum, and cerebellar tonsillar ectopia with crowding of the posterior fossa. Vascular malformations may include capillary, venous, and less frequently, arterial or mixed (capillary-lymphatic-venous or arteriovenous) malformations. Lymphatic malformations may be in various locations (internal and/or external) and can cause various clinical issues, including swelling, pain, and occasionally localized bleeding secondary to trauma. Lipomatous overgrowth may occur ipsilateral or contralateral to a vascular malformation, if present. The degree of intellectual disability appears to be mostly related to the presence and severity of seizures, cortical dysplasia (e.g., polymicrogyria), and hydrocephalus. Many children have feeding difficulties that are often multifactorial in nature. Endocrine issues affect a small number of individuals and most commonly include hypoglycemia (largely hypoinsulinemic hypoketotic hypoglycemia), hypothyroidism, and growth hormone deficiency.
Hyperkeratosis
MedGen UID:
209030
Concept ID:
C0870082
Disease or Syndrome
Hyperkeratosis is thickening of the outer layer of the skin, the stratum corneum, which is composed of large, polyhedral, plate-like envelopes filled with keratin which are the dead cells that have migrated up from the stratum granulosum.
Orthokeratosis
MedGen UID:
375169
Concept ID:
C1843359
Finding
Formation of an anuclear keratin layer
Thyroid hypoplasia
MedGen UID:
57720
Concept ID:
C0151516
Disease or Syndrome
Developmental hypoplasia of the thyroid gland.
Adrenal hypoplasia
MedGen UID:
337539
Concept ID:
C1846223
Pathologic Function
Developmental hypoplasia of the adrenal glands.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
Follow this link to review classifications for Child syndrome in Orphanet.

Professional guidelines

PubMed

Cho SK, Ashworth LD, Goldman S
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Farrell MH, Sims AM, La Pean Kirschner A, Farrell PM, Tarini BA
J Pediatr 2020 Sep;224:44-50.e1. doi: 10.1016/j.jpeds.2020.03.042. PMID: 32826027Free PMC Article
Bales AM, Zaleski CA, McPherson EW
Genet Med 2010 Mar;12(3):135-44. doi: 10.1097/GIM.0b013e3181cdeb9a. PMID: 20071995

Recent clinical studies

Etiology

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Atzmony L, Ugwu N, Hamilton C, Paller AS, Zech L, Antaya RJ, Choate KA
Pediatr Dermatol 2022 Nov;39(6):903-907. Epub 2022 Jul 19 doi: 10.1111/pde.15094. PMID: 35853659Free PMC Article
Schmitz K
Pediatr Rev 2019 Jun;40(6):313-315. doi: 10.1542/pir.2017-0243. PMID: 31152106
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Handb Clin Neurol 2015;132:291-316. doi: 10.1016/B978-0-444-62702-5.00022-6. PMID: 26564089
Lai-Cheong JE, Elias PM, Paller AS
Dermatol Ther 2013 Jan-Feb;26(1):46-54. doi: 10.1111/j.1529-8019.2012.01528.x. PMID: 23384020Free PMC Article

Diagnosis

Atzmony L, Ugwu N, Hamilton C, Paller AS, Zech L, Antaya RJ, Choate KA
Pediatr Dermatol 2022 Nov;39(6):903-907. Epub 2022 Jul 19 doi: 10.1111/pde.15094. PMID: 35853659Free PMC Article
Chiesa A, Duhaime AC
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Semin Cutan Med Surg 2004 Jun;23(2):145-57. doi: 10.1016/j.sder.2004.01.008. PMID: 15295924

Therapy

Atzmony L, Ugwu N, Hamilton C, Paller AS, Zech L, Antaya RJ, Choate KA
Pediatr Dermatol 2022 Nov;39(6):903-907. Epub 2022 Jul 19 doi: 10.1111/pde.15094. PMID: 35853659Free PMC Article
Hoge MK, Heyne E, Nicholson TF, Acosta D, Mir I, Brown LS, Shaw RJ, Chalak L, Heyne R
Early Hum Dev 2021 Mar;154:105283. Epub 2020 Nov 25 doi: 10.1016/j.earlhumdev.2020.105283. PMID: 33514479
Hime NJ, Zurynski Y, Fitzgerald D, Selvadurai H, Phu A, Deverell M, Elliott EJ, Jaffe A
Pediatr Pulmonol 2015 Dec;50(12):1383-92. Epub 2015 Apr 30 doi: 10.1002/ppul.23183. PMID: 25931270
Lai-Cheong JE, Elias PM, Paller AS
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Salazar de Sousa J, Almeida V, Bray Pinheiro J
Arch Dis Child 1987 Nov;62(11):1181. doi: 10.1136/adc.62.11.1181. PMID: 2961311Free PMC Article

Prognosis

Karibe H, Kameyama M, Hayashi T, Narisawa A, Tominaga T
Neurol Med Chir (Tokyo) 2016 May 15;56(5):264-73. Epub 2016 Mar 10 doi: 10.2176/nmc.ra.2015-0308. PMID: 26960448Free PMC Article
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Pediatr Pulmonol 2015 Dec;50(12):1383-92. Epub 2015 Apr 30 doi: 10.1002/ppul.23183. PMID: 25931270
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Adv Neonatal Care 2004 Apr;4(2):105-14; quiz 15-7. doi: 10.1016/j.adnc.2004.01.004. PMID: 15138993
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Semin Pediatr Neurol 2003 Jun;10(2):112-9. doi: 10.1016/s1071-9091(03)00019-6. PMID: 14572147

Clinical prediction guides

Rossi M, Hall CM, Bouvier R, Collardeau-Frachon S, Le Breton F, Bucourt M, Cordier MP, Vianey-Saban C, Parenti G, Andria G, Le Merrer M, Edery P, Offiah AC
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Pediatr Emerg Care 2011 Nov;27(11):1009-13. doi: 10.1097/PEC.0b013e318235bb4f. PMID: 22068058Free PMC Article
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Recent systematic reviews

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