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Arthrogryposis multiplex congenita 6(AMC6)

MedGen UID:
1786758
Concept ID:
C5543431
Disease or Syndrome
Synonyms: AMC6; ARTHROGRYPOSIS MULTIPLEX CONGENITA 6
 
Gene (location): NEB (2q23.3)
 
Monarch Initiative: MONDO:0030281
OMIM®: 619334

Definition

Arthrogryposis multiplex congenita-6 (AMC6) is a severe autosomal recessive disorder of skeletal muscle with onset of symptoms in utero. The pregnancies are usually complicated by polyhydramnios and reduced fetal movements. Affected individuals have congenital joint contractures, dysmorphic facial features, distal skeletal anomalies with clenched hands and clubfeet, and edema with fetal hydrops. Fetal demise or termination of pregnancy often occurs after ultrasound detection of abnormalities. Those that survive to birth have significant hypotonia with absent spontaneous movements, respiratory insufficiency, arthrogryposis, and multiple pterygia. Skeletal muscle is hypoplastic, immature, and underdeveloped, with nemaline rods, poorly developed sarcomeres, and poor cross-striation. Death in infancy usually occurs (summary by Ahmed et al., 2018, Rocha et al., 2021). For a discussion of genetic heterogeneity of AMC, see AMC1 (617468). [from OMIM]

Clinical features

From HPO
Hypospadias
MedGen UID:
163083
Concept ID:
C0848558
Congenital Abnormality
Abnormal position of urethral meatus on the ventral penile shaft (underside) characterized by displacement of the urethral meatus from the tip of the glans penis to the ventral surface of the penis, scrotum, or perineum.
Thumbs, congenital Clasped
MedGen UID:
98140
Concept ID:
C0431886
Congenital Abnormality
In the resting position, the tip of the thumb is on, or near, the palm, close to the base of the fourth or fifth finger.
Akinesia
MedGen UID:
43218
Concept ID:
C0085623
Finding
Inability to initiate changes in activity or movement and to perform ordinary volitional movements rapidly and easily.
Large fontanelles
MedGen UID:
105329
Concept ID:
C0456132
Finding
In newborns, the two frontal bones, two parietal bones, and one occipital bone are joined by fibrous sutures, which form a small posterior fontanelle, and a larger, diamond-shaped anterior fontanelle. These regions allow for the skull to pass the birth canal and for later growth. The fontanelles gradually ossify, whereby the posterior fontanelle usually closes by eight weeks and the anterior fontanelle by the 9th to 16th month of age. Large fontanelles are diagnosed if the fontanelles are larger than age-dependent norms.
Increased variability in muscle fiber diameter
MedGen UID:
336019
Concept ID:
C1843700
Finding
An abnormally high degree of muscle fiber size variation. This phenotypic feature can be observed upon muscle biopsy.
Nemaline bodies
MedGen UID:
814369
Concept ID:
C3808039
Finding
Nemaline rods are abnormal bodies that can occur in skeletal muscle fibers. The rods can be observed on histological analysis of muscle biopsy tissue or upon electron microscopy, where they appear either as extensions of sarcomeric Z-lines, in random array without obvious attachment to Z-lines (often in areas devoid of sarcomeres) or in large clusters localized at the sarcolemma or intermyofibrillar spaces.
Arthrogryposis multiplex congenita
MedGen UID:
1830310
Concept ID:
C5779613
Disease or Syndrome
Multiple congenital contractures in different body areas.
Respiratory failure
MedGen UID:
257837
Concept ID:
C1145670
Disease or Syndrome
A severe form of respiratory insufficiency characterized by inadequate gas exchange such that the levels of oxygen or carbon dioxide cannot be maintained within normal limits.
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.

Professional guidelines

PubMed

Ozdemir O, Aksoy F, Sen C
J Perinat Med 2022 Nov 25;50(9):1239-1247. Epub 2022 Jul 1 doi: 10.1515/jpm-2022-0201. PMID: 35771677
Rink BD
Obstet Gynecol Surv 2011 Jun;66(6):369-77. doi: 10.1097/OGX.0b013e31822bf5bb. PMID: 21851751
Ogino S, Wilson RB
Hum Genet 2002 Dec;111(6):477-500. Epub 2002 Oct 3 doi: 10.1007/s00439-002-0828-x. PMID: 12436240

Recent clinical studies

Etiology

Romand X, Gastaldi R, Pérennou D, Baillet A, Dieterich K
Sci Rep 2024 Apr 8;14(1):8206. doi: 10.1038/s41598-024-58083-x. PMID: 38589451Free PMC Article
Taqi D, Nematollahi S, Lemin S, Rauch F, Hamdy R, Dahan-Oliel N
Bone 2024 Feb;179:116955. Epub 2023 Nov 10 doi: 10.1016/j.bone.2023.116955. PMID: 37951521
Filges I, Jünemann S, Viehweger E, Tercanli S
Prenat Diagn 2023 Jun;43(6):798-805. Epub 2023 Jan 12 doi: 10.1002/pd.6299. PMID: 36588183
Dahan-Oliel N, Collins J, Rauch D, Bukovy G, Hamdy R, Rauch F
Bone 2020 Aug;137:115454. Epub 2020 May 25 doi: 10.1016/j.bone.2020.115454. PMID: 32464275
Hall JG, Aldinger KA, Tanaka KI
Am J Med Genet A 2014 Mar;164A(3):700-30. Epub 2014 Jan 23 doi: 10.1002/ajmg.a.36395. PMID: 24459070

Diagnosis

Filges I, Jünemann S, Viehweger E, Tercanli S
Prenat Diagn 2023 Jun;43(6):798-805. Epub 2023 Jan 12 doi: 10.1002/pd.6299. PMID: 36588183
Laquerriere A, Jaber D, Abiusi E, Maluenda J, Mejlachowicz D, Vivanti A, Dieterich K, Stoeva R, Quevarec L, Nolent F, Biancalana V, Latour P, Sternberg D, Capri Y, Verloes A, Bessieres B, Loeuillet L, Attie-Bitach T, Martinovic J, Blesson S, Petit F, Beneteau C, Whalen S, Marguet F, Bouligand J, Héron D, Viot G, Amiel J, Amram D, Bellesme C, Bucourt M, Faivre L, Jouk PS, Khung S, Sigaudy S, Delezoide AL, Goldenberg A, Jacquemont ML, Lambert L, Layet V, Lyonnet S, Munnich A, Van Maldergem L, Piard J, Guimiot F, Landrieu P, Letard P, Pelluard F, Perrin L, Saint-Frison MH, Topaloglu H, Trestard L, Vincent-Delorme C, Amthor H, Barnerias C, Benachi A, Bieth E, Boucher E, Cormier-Daire V, Delahaye-Duriez A, Desguerre I, Eymard B, Francannet C, Grotto S, Lacombe D, Laffargue F, Legendre M, Martin-Coignard D, Mégarbané A, Mercier S, Nizon M, Rigonnot L, Prieur F, Quélin C, Ranjatoelina-Randrianaivo H, Resta N, Toutain A, Verhelst H, Vincent M, Colin E, Fallet-Bianco C, Granier M, Grigorescu R, Saada J, Gonzales M, Guiochon-Mantel A, Bessereau JL, Tawk M, Gut I, Gitiaux C, Melki J
J Med Genet 2022 Jun;59(6):559-567. Epub 2021 Apr 5 doi: 10.1136/jmedgenet-2020-107595. PMID: 33820833Free PMC Article
Society for Maternal-Fetal Medicine, Rac MWF, McKinney J, Gandhi M
Am J Obstet Gynecol 2019 Dec;221(6):B7-B9. doi: 10.1016/j.ajog.2019.09.021. PMID: 31787162
Hall JG, Aldinger KA, Tanaka KI
Am J Med Genet A 2014 Mar;164A(3):700-30. Epub 2014 Jan 23 doi: 10.1002/ajmg.a.36395. PMID: 24459070
Bernstein RM
J Am Acad Orthop Surg 2002 Nov-Dec;10(6):417-24. doi: 10.5435/00124635-200211000-00006. PMID: 12470044

Therapy

Kindler HL, Novello S, Bearz A, Ceresoli GL, Aerts JGJV, Spicer J, Taylor P, Nackaerts K, Greystoke A, Jennens R, Calabrò L, Burgers JA, Santoro A, Cedrés S, Serwatowski P, Ponce S, Van Meerbeeck JP, Nowak AK, Blumenschein G Jr, Siegel JM, Kasten L, Köchert K, Walter AO, Childs BH, Elbi C, Hassan R, Fennell DA
Lancet Oncol 2022 Apr;23(4):540-552. doi: 10.1016/S1470-2045(22)00061-4. PMID: 35358455Free PMC Article
Miao M, Cai H, Wang Z, Hu L, Bian J, Cai H
BMC Musculoskelet Disord 2020 Mar 4;21(1):144. doi: 10.1186/s12891-020-3173-0. PMID: 32131798Free PMC Article
Church C, McGowan A, Henley J, Donohoe M, Niiler T, Shrader MW, Nichols LR
J Pediatr Orthop 2020 Aug;40(7):e641-e646. doi: 10.1097/BPO.0000000000001524. PMID: 32032217
Xu L, Chen Z, Qiu Y, Chen X, Li S, Du C, Zhou Q, Sun X
J Neurosurg Pediatr 2018 Oct 12;23(1):22-29. doi: 10.3171/2018.7.PEDS18347. PMID: 30485184
Paul JC, Lonner BS, Vira S, Feldman D, Errico TJ
J Pediatr Orthop 2018 Oct;38(9):459-464. doi: 10.1097/BPO.0000000000000850. PMID: 27603188

Prognosis

Xu L, Luan W, Wang Y, Sun X, Liu Z, Qian B, Qiu Y, Zhu Z
World Neurosurg 2022 Jan;157:e424-e431. Epub 2021 Oct 20 doi: 10.1016/j.wneu.2021.10.115. PMID: 34687931
Frizzell K, Kozin SH, Zlotolow DA
J Hand Surg Am 2020 Nov;45(11):1084.e1-1084.e7. Epub 2020 Jun 29 doi: 10.1016/j.jhsa.2020.04.025. PMID: 32616410
Society for Maternal-Fetal Medicine, Rac MWF, McKinney J, Gandhi M
Am J Obstet Gynecol 2019 Dec;221(6):B7-B9. doi: 10.1016/j.ajog.2019.09.021. PMID: 31787162
Bernstein RM
J Am Acad Orthop Surg 2002 Nov-Dec;10(6):417-24. doi: 10.5435/00124635-200211000-00006. PMID: 12470044
Hageman G, Willemse J
Neuropediatrics 1983 Feb;14(1):6-11. doi: 10.1055/s-2008-1059546. PMID: 6339980

Clinical prediction guides

Taqi D, Nematollahi S, Lemin S, Rauch F, Hamdy R, Dahan-Oliel N
Bone 2024 Feb;179:116955. Epub 2023 Nov 10 doi: 10.1016/j.bone.2023.116955. PMID: 37951521
Sarveswaran S, Mortenson WB, Sawatzky B
Am J Med Genet C Semin Med Genet 2023 Jun;193(2):139-146. Epub 2023 Apr 27 doi: 10.1002/ajmg.c.32042. PMID: 37102433
Carapancea E, Cornet MC, Milh M, De Cosmo L, Huang EJ, Granata T, Striano P, Ceulemans B, Stein A, Morris-Rosendahl D, Conti G, Mitra N, Raymond FL, Rowitch DH, Solazzi R, Vercellino F, De Liso P, D'Onofrio G, Boniver C, Danhaive O, Carkeek K, Salpietro V, Weckhuysen S, Fedrigo M, Angelini A, Castellotti B, Lederer D, Benoit V, Raviglione F, Guerrini R, Dilena R, Cilio MR
Neurology 2023 Mar 21;100(12):e1234-e1247. Epub 2023 Jan 4 doi: 10.1212/WNL.0000000000206755. PMID: 36599696Free PMC Article
Laquerriere A, Jaber D, Abiusi E, Maluenda J, Mejlachowicz D, Vivanti A, Dieterich K, Stoeva R, Quevarec L, Nolent F, Biancalana V, Latour P, Sternberg D, Capri Y, Verloes A, Bessieres B, Loeuillet L, Attie-Bitach T, Martinovic J, Blesson S, Petit F, Beneteau C, Whalen S, Marguet F, Bouligand J, Héron D, Viot G, Amiel J, Amram D, Bellesme C, Bucourt M, Faivre L, Jouk PS, Khung S, Sigaudy S, Delezoide AL, Goldenberg A, Jacquemont ML, Lambert L, Layet V, Lyonnet S, Munnich A, Van Maldergem L, Piard J, Guimiot F, Landrieu P, Letard P, Pelluard F, Perrin L, Saint-Frison MH, Topaloglu H, Trestard L, Vincent-Delorme C, Amthor H, Barnerias C, Benachi A, Bieth E, Boucher E, Cormier-Daire V, Delahaye-Duriez A, Desguerre I, Eymard B, Francannet C, Grotto S, Lacombe D, Laffargue F, Legendre M, Martin-Coignard D, Mégarbané A, Mercier S, Nizon M, Rigonnot L, Prieur F, Quélin C, Ranjatoelina-Randrianaivo H, Resta N, Toutain A, Verhelst H, Vincent M, Colin E, Fallet-Bianco C, Granier M, Grigorescu R, Saada J, Gonzales M, Guiochon-Mantel A, Bessereau JL, Tawk M, Gut I, Gitiaux C, Melki J
J Med Genet 2022 Jun;59(6):559-567. Epub 2021 Apr 5 doi: 10.1136/jmedgenet-2020-107595. PMID: 33820833Free PMC Article
Bernstein RM
J Am Acad Orthop Surg 2002 Nov-Dec;10(6):417-24. doi: 10.5435/00124635-200211000-00006. PMID: 12470044

Recent systematic reviews

Taqi D, Nematollahi S, Lemin S, Rauch F, Hamdy R, Dahan-Oliel N
Bone 2024 Feb;179:116955. Epub 2023 Nov 10 doi: 10.1016/j.bone.2023.116955. PMID: 37951521
Thakker A, Sharma SC, Hussain NM, Devani P, Lahiri A
J Plast Reconstr Aesthet Surg 2021 Mar;74(3):549-559. Epub 2020 Nov 8 doi: 10.1016/j.bjps.2020.10.085. PMID: 33268044

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