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Etiology and genetic factors in clefts of lip and/or palate reported at children's hospital, Lahore, Pakistan.
[kabuki syndrome]
The
etiology
of
cleft
lip
(
CL
)
and
/
or
cleft
palate
(
CP
)
has
been
extensively
studied
in
industrialized
countries
and
is
suggested
to
be
heterogeneous
with
increasing
evidence
that
both
genetic
and
environmental
factors
are
operating
.
To
evaluate
this
assertion
in
a
developing
country
like
Pakistan
,
a
case
finding
cross-sectional
study
was
completed
from
1
(
st
)
July
2010
to
31
(
st
)
May
2011
for
100
cases
of
CL
and
/
or
CP
referred
to
the
Genetic
Clinic
of
the
Children
's
Hospital
,
Lahore
,
Pakistan
.
A
clinical
examination
followed
by
necessary
diagnostic
work-up
was
completed
for
each
case
.
The
cause
of
CL
and
/
or
CP
was
clear
in
18
%
of
the
children
(
n
=
18
)
.
Environmental
causes
were
found
in
6
children
(
four
mothers
developed
hyperthermia
during
the
2
(
nd
)
month
of
gestation
,
one
mother
was
diabetic
,
and
one
mother
was
a
known
case
of
epilepsy
and
took
sodium
valproate
throughout
her
pregnancy
)
.
Six
children
were
suffering
from
known
genetic
malformation
syndromes
(
each
with
Jarcho-
Levin
syndrome
,
Oral
-
Facial
-
Digital
syndrome
type
XI
,
Oral
-
Duplication
syndrome
,
Kabuki
syndrome
,
Fronto-
nasal
dysplasia
and
Nager
syndrome
)
.
Novel
chromosomal
aberrations
were
identified
in
2
children
.
In
82
%
of
the
children
(
n
=
82
)
the
cause
of
oro-
facial
clefts
remained
unknown
.
Impact
of
gender
and
consanguinity
on
the
development
of
CL
and
/
or
CP
was
also
studied
.
Prevalence
of
CP
was
significantly
more
among
female
children
as
compared
to
that
in
males
(
P
<
0
.
05
)
.
Associated
anomalies
were
present
in
18
%
of
the
cases
,
anomalies
of
the
craniofacial
region
being
the
most
common
.
These
findings
were
compared
with
regional
and
international
studies
.
Diseases
Validation
Diseases presenting
"cleft palate"
symptom
22q11.2 deletion syndrome
aniridia
congenital diaphragmatic hernia
cystinuria
hirschsprung disease
kabuki syndrome
kallmann syndrome
monosomy 21
neuralgic amyotrophy
oligodontia
phenylketonuria
This symptom has already been validated