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Fetal akinesia deformation sequence 4(FADS4)

MedGen UID:
1675450
Concept ID:
C4760578
Disease or Syndrome
Synonyms: FADS4; FETAL AKINESIA DEFORMATION SEQUENCE 4
 
Gene (location): NUP88 (17p13.2)
 
Monarch Initiative: MONDO:0100104
OMIM®: 618393

Definition

Fetal akinesia deformation sequence-4 (FADS4) is an autosomal recessive disorder characterized by decreased fetal movements due to impaired neuromuscular function, resulting in significant congenital contractures and death in utero or soon after birth (summary by Bonnin et al., 2018). For a general phenotypic description and a discussion of genetic heterogeneity of FADS, see 208150. [from OMIM]

Clinical features

From HPO
Cryptorchidism
MedGen UID:
8192
Concept ID:
C0010417
Congenital Abnormality
Cryptorchidism, or failure of testicular descent, is a common human congenital abnormality with a multifactorial etiology that likely reflects the involvement of endocrine, environmental, and hereditary factors. Cryptorchidism can result in infertility and increases risk for testicular tumors. Testicular descent from abdomen to scrotum occurs in 2 distinct phases: the transabdominal phase and the inguinoscrotal phase (summary by Gorlov et al., 2002).
Congenital vertical talus
MedGen UID:
66821
Concept ID:
C0240912
Congenital Abnormality
Congenital vertical talus (CVT), also known as 'rocker-bottom foot' deformity, is a dislocation of the talonavicular joint characterized by vertical orientation of the talus with a rigid dorsal dislocation of the navicular, equinus deformity of the calcaneus, abduction deformity of the forefoot, and contracture of the soft tissues of the hind- and mid-foot. This condition is usually associated with multiple other congenital deformities and only rarely is an isolated deformity with familial occurrence (summary by Levinsohn et al., 2004). The condition is transmitted in an autosomal dominant pattern of inheritance, and sometimes shows incomplete penetrance and variable expressivity. There may be a broad spectrum of deformities, including flatfoot, talipes equinovarus (TEV or clubfoot), cavus foot, metatarsus adductus, and even hypoplasia of the tibia (summary by Dobbs et al., 2006).
Low-set ears
MedGen UID:
65980
Concept ID:
C0239234
Congenital Abnormality
Upper insertion of the ear to the scalp below an imaginary horizontal line drawn between the inner canthi of the eye and extending posteriorly to the ear.
Posteriorly rotated ears
MedGen UID:
96566
Concept ID:
C0431478
Congenital Abnormality
A type of abnormal location of the ears in which the position of the ears is characterized by posterior rotation (the superior part of the ears is rotated towards the back of the head, and the inferior part of the ears towards the front).
Kyphosis
MedGen UID:
44042
Concept ID:
C0022821
Anatomical Abnormality
Exaggerated anterior convexity of the thoracic vertebral column.
Micrognathia
MedGen UID:
44428
Concept ID:
C0025990
Congenital Abnormality
Developmental hypoplasia of the mandible.
Retrognathia
MedGen UID:
19766
Concept ID:
C0035353
Congenital Abnormality
An abnormality in which the mandible is mislocalised posteriorly.
Muscular atrophy
MedGen UID:
892680
Concept ID:
C0541794
Pathologic Function
The presence of skeletal muscular atrophy (which is also known as amyotrophy).
Camptodactyly
MedGen UID:
195780
Concept ID:
C0685409
Congenital Abnormality
The distal interphalangeal joint and/or the proximal interphalangeal joint of the fingers or toes cannot be extended to 180 degrees by either active or passive extension.
11 pairs of ribs
MedGen UID:
326950
Concept ID:
C1839731
Finding
Presence of only 11 pairs of ribs.
Arthrogryposis multiplex congenita
MedGen UID:
1830310
Concept ID:
C5779613
Disease or Syndrome
Multiple congenital contractures in different body areas.
High palate
MedGen UID:
66814
Concept ID:
C0240635
Congenital Abnormality
Height of the palate more than 2 SD above the mean (objective) or palatal height at the level of the first permanent molar more than twice the height of the teeth (subjective).
Short neck
MedGen UID:
99267
Concept ID:
C0521525
Finding
Diminished length of the neck.
Wide nasal bridge
MedGen UID:
341441
Concept ID:
C1849367
Finding
Increased breadth of the nasal bridge (and with it, the nasal root).
Broad neck
MedGen UID:
344099
Concept ID:
C1853638
Finding
Increased side-to-side width of the neck.
Polyhydramnios
MedGen UID:
6936
Concept ID:
C0020224
Pathologic Function
The presence of excess amniotic fluid in the uterus during pregnancy.
Decreased fetal movement
MedGen UID:
68618
Concept ID:
C0235659
Finding
An abnormal reduction in quantity or strength of fetal movements.
Fetal pleural effusion
MedGen UID:
759277
Concept ID:
C3532164
Pathologic Function
Fetal pleural effusion is the accumulation of excess fluid in the layers of tissue (pleura) lining the lungs and wall of the chest. It may be primary, also termed hydrothorax, occurring as an isolated finding or it may be secondary, most commonly resulting from non-immune hydrops.
Absence of stomach bubble on fetal sonography
MedGen UID:
869203
Concept ID:
C4023625
Finding
By the 14th week of gestation it is nearly always possible to visualized the fluid-filled fetal stomach bubble on prenatal sonography. This term refers to the absence of a normal fetal stomach bubble on fetal ultrasonography performed at around 16 to 20 weeks' gestation.

Professional guidelines

PubMed

Ravenscroft G, Clayton JS, Faiz F, Sivadorai P, Milnes D, Cincotta R, Moon P, Kamien B, Edwards M, Delatycki M, Lamont PJ, Chan SH, Colley A, Ma A, Collins F, Hennington L, Zhao T, McGillivray G, Ghedia S, Chao K, O'Donnell-Luria A, Laing NG, Davis MR
J Med Genet 2021 Sep;58(9):609-618. Epub 2020 Oct 15 doi: 10.1136/jmedgenet-2020-106901. PMID: 33060286Free PMC Article
Hellmund A, Berg C, Geipel A, Müller A, Gembruch U
Arch Gynecol Obstet 2016 Oct;294(4):697-707. Epub 2016 Jan 29 doi: 10.1007/s00404-016-4017-x. PMID: 26825730
Mathijssen IB, Henneman L, van Eeten-Nijman JM, Lakeman P, Ottenheim CP, Redeker EJ, Ottenhof W, Meijers-Heijboer H, van Maarle MC
Eur J Med Genet 2015 Mar;58(3):123-8. Epub 2015 Jan 30 doi: 10.1016/j.ejmg.2015.01.004. PMID: 25641760

Recent clinical studies

Etiology

Jühlen R, Grauer L, Martinelli V, Rencurel C, Fahrenkrog B
Sci Rep 2024 Jan 19;14(1):1742. doi: 10.1038/s41598-023-50615-1. PMID: 38242956Free PMC Article
Shafqat G, Fatima K, Hanif F
J Pak Med Assoc 2023 Nov;73(11):2266-2268. doi: 10.47391/JPMA.8513. PMID: 38013544
Syngelaki A, Hammami A, Bower S, Zidere V, Akolekar R, Nicolaides KH
Ultrasound Obstet Gynecol 2019 Oct;54(4):468-476. doi: 10.1002/uog.20844. PMID: 31408229
Hellmund A, Berg C, Geipel A, Müller A, Gembruch U
Arch Gynecol Obstet 2016 Oct;294(4):697-707. Epub 2016 Jan 29 doi: 10.1007/s00404-016-4017-x. PMID: 26825730
Alamillo CL, Powis Z, Farwell K, Shahmirzadi L, Weltmer EC, Turocy J, Lowe T, Kobelka C, Chen E, Basel D, Ashkinadze E, D'Augelli L, Chao E, Tang S
Prenat Diagn 2015 Nov;35(11):1073-8. Epub 2015 Aug 3 doi: 10.1002/pd.4648. PMID: 26147564

Diagnosis

Ravenscroft G, Clayton JS, Faiz F, Sivadorai P, Milnes D, Cincotta R, Moon P, Kamien B, Edwards M, Delatycki M, Lamont PJ, Chan SH, Colley A, Ma A, Collins F, Hennington L, Zhao T, McGillivray G, Ghedia S, Chao K, O'Donnell-Luria A, Laing NG, Davis MR
J Med Genet 2021 Sep;58(9):609-618. Epub 2020 Oct 15 doi: 10.1136/jmedgenet-2020-106901. PMID: 33060286Free PMC Article
Syngelaki A, Hammami A, Bower S, Zidere V, Akolekar R, Nicolaides KH
Ultrasound Obstet Gynecol 2019 Oct;54(4):468-476. doi: 10.1002/uog.20844. PMID: 31408229
Hellmund A, Berg C, Geipel A, Müller A, Gembruch U
Arch Gynecol Obstet 2016 Oct;294(4):697-707. Epub 2016 Jan 29 doi: 10.1007/s00404-016-4017-x. PMID: 26825730
Alamillo CL, Powis Z, Farwell K, Shahmirzadi L, Weltmer EC, Turocy J, Lowe T, Kobelka C, Chen E, Basel D, Ashkinadze E, D'Augelli L, Chao E, Tang S
Prenat Diagn 2015 Nov;35(11):1073-8. Epub 2015 Aug 3 doi: 10.1002/pd.4648. PMID: 26147564
Trounce JQ, Fagan DG, Young ID, Levene MI
Dev Med Child Neurol 1986 Aug;28(4):467-71. doi: 10.1111/j.1469-8749.1986.tb14284.x. PMID: 2944786

Prognosis

Lefèvre CR, Collardeau-Frachon S, Streichenberger N, Berenguer-Martin S, Clémenson A, Massardier J, Prieur F, Laurichesse H, Laffargue F, Acquaviva-Bourdain C, Froissart R, Pettazzoni M
J Inherit Metab Dis 2024 Mar;47(2):255-269. Epub 2023 Nov 27 doi: 10.1002/jimd.12692. PMID: 38012812
Murali C, Li D, Grand K, Hakonarson H, Bhoj E
Am J Med Genet A 2019 Apr;179(4):655-658. Epub 2019 Feb 4 doi: 10.1002/ajmg.a.61060. PMID: 30719842Free PMC Article
Hoellen F, Schröer A, Kelling K, Krapp M, Axt-Fliedner R, Gembruch U, Weichert J
Fetal Diagn Ther 2011;30(4):289-98. Epub 2011 Dec 8 doi: 10.1159/000331401. PMID: 22156407
Bruno C, van Diggelen OP, Cassandrini D, Gimpelev M, Giuffrè B, Donati MA, Introvini P, Alegria A, Assereto S, Morandi L, Mora M, Tonoli E, Mascelli S, Traverso M, Pasquini E, Bado M, Vilarinho L, van Noort G, Mosca F, DiMauro S, Zara F, Minetti C
Neurology 2004 Sep 28;63(6):1053-8. doi: 10.1212/01.wnl.0000138429.11433.0d. PMID: 15452297
Mulder EJ, Beemer FA, Stoutenbeek P
Prenat Diagn 2001 Jul;21(7):581-5. doi: 10.1002/pd.89. PMID: 11494296

Clinical prediction guides

Lefèvre CR, Collardeau-Frachon S, Streichenberger N, Berenguer-Martin S, Clémenson A, Massardier J, Prieur F, Laurichesse H, Laffargue F, Acquaviva-Bourdain C, Froissart R, Pettazzoni M
J Inherit Metab Dis 2024 Mar;47(2):255-269. Epub 2023 Nov 27 doi: 10.1002/jimd.12692. PMID: 38012812
Ravenscroft G, Clayton JS, Faiz F, Sivadorai P, Milnes D, Cincotta R, Moon P, Kamien B, Edwards M, Delatycki M, Lamont PJ, Chan SH, Colley A, Ma A, Collins F, Hennington L, Zhao T, McGillivray G, Ghedia S, Chao K, O'Donnell-Luria A, Laing NG, Davis MR
J Med Genet 2021 Sep;58(9):609-618. Epub 2020 Oct 15 doi: 10.1136/jmedgenet-2020-106901. PMID: 33060286Free PMC Article
Grotto S, Cuisset JM, Marret S, Drunat S, Faure P, Audebert-Bellanger S, Desguerre I, Flurin V, Grebille AG, Guerrot AM, Journel H, Morin G, Plessis G, Renolleau S, Roume J, Simon-Bouy B, Touraine R, Willems M, Frébourg T, Verspyck E, Saugier-Veber P
J Neuromuscul Dis 2016 Nov 29;3(4):487-495. doi: 10.3233/JND-160177. PMID: 27911332
Hellmund A, Berg C, Geipel A, Müller A, Gembruch U
Arch Gynecol Obstet 2016 Oct;294(4):697-707. Epub 2016 Jan 29 doi: 10.1007/s00404-016-4017-x. PMID: 26825730
Mulder EJ, Nikkels PG, Visser GH
Ultrasound Obstet Gynecol 2001 Sep;18(3):253-7. doi: 10.1046/j.1469-0705.2001.00422.x. PMID: 11555456

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