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Four patients with Sillence type I osteogenesis imperfecta and mild bone fragility, complicated by left ventricular cardiac valvular disease and cardiac tissue fragility caused by type I collagen mutations.
[dentinogenesis imperfecta]
Osteogenesis
imperfecta
(
OI
)
type
I
is
a
hereditary
disorder
of
connective
tissue
(
HDCT
)
characterized
by
blue
or
gray
sclerae
,
variable
short
stature
,
dentinogenesis
imperfecta
,
hearing
loss
,
and
recurrent
fractures
from
infancy
.
We
present
four
examples
of
OI
type
I
complicated
by
valvular
heart
disease
and
associated
with
tissue
fragility
.
The
diagnosis
of
a
type
I
collagen
disorder
was
confirmed
by
abnormal
COL
1
A
1
or
COL
1
A
2
gene
sequencing
.
One
patient
was
investigated
with
electrophoresis
of
collagens
from
cultured
skin
fibroblasts
,
showing
structurally
abnormal
collagen
type
I
,
skin
biopsy
showed
unusual
histology
and
abnormal
collagen
fibril
ultra-structure
at
electron
microscopy
.
The
combined
clinical
,
surgical
,
histological
,
ultra-structural
,
and
molecular
genetic
data
suggest
the
type
I
collagen
defect
as
contributory
to
cardiac
valvular
disease
.
The
degree
of
tissue
fragility
experienced
at
cardiac
surgery
in
these
individuals
,
also
reported
in
a
small
number
of
similar
case
reports
,
suggests
that
patients
with
OI
type
I
need
careful
pre-operative
assessment
and
consideration
of
the
risks
and
benefits
of
cardiac
surgery
.
Diseases
Validation
Diseases presenting
"skin biopsy"
symptom
adrenomyeloneuropathy
cadasil
cutaneous mastocytosis
dentinogenesis imperfecta
dracunculiasis
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
fabry disease
harlequin ichthyosis
inclusion body myositis
junctional epidermolysis bullosa
kindler syndrome
lamellar ichthyosis
malignant atrophic papulosis
monosomy 21
oligodontia
primary effusion lymphoma
primary hyperoxaluria type 1
pyruvate dehydrogenase deficiency
sneddon syndrome
waldenström macroglobulinemia
x-linked adrenoleukodystrophy
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