U.S. flag

An official website of the United States government

Format

Send to:

Choose Destination

Mullerian derivatives-lymphangiectasia-polydactyly syndrome

MedGen UID:
343489
Concept ID:
C1856159
Disease or Syndrome
Synonyms: Persistence of mullerian derivatives, with lymphangiectasia and postaxial polydactyly; Renal and craniofacial anomalies with persistence of mullerian derivatives, lymphangiectasis, hepatic failure, postaxial polydactyly; Urioste Martinez-Frias syndrome; Urioste syndrome
Modes of inheritance:
Unknown inheritance
MedGen UID:
989040
Concept ID:
CN307042
Finding
Source: Orphanet
Hereditary clinical entity whose mode of inheritance is unknown.
 
Monarch Initiative: MONDO:0009333
OMIM®: 235255
Orphanet: ORPHA1655

Definition

A rare genetic disease characterized by the presence of Müllerian duct derivatives (rudimentary uterus, fallopian tubes, and atretic vagina) and other genital anomalies (cryptorchidism, micropenis) in male newborns, intestinal and pulmonary lymphangiectasia, protein-losing enteropathy, hepatomegaly, and renal anomalies. Postaxial polydactyly, facial dysmorphism (including broad nasal bridge, bulbous nasal tip, long and prominent upper lip with smooth philtrum, hypertrophic alveolar ridges, and mild retrognathia, among other features), and short limbs have also been described. The syndrome is fatal in infancy. [from ORDO]

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).
Hydronephrosis
MedGen UID:
42531
Concept ID:
C0020295
Disease or Syndrome
Severe distention of the kidney with dilation of the renal pelvis and calices.
Micropenis
MedGen UID:
1633603
Concept ID:
C4551492
Congenital Abnormality
Abnormally small penis. At birth, the normal penis is about 3 cm (stretched length from pubic tubercle to tip of penis) with micropenis less than 2.0-2.5 cm.
Postaxial hand polydactyly
MedGen UID:
609221
Concept ID:
C0431904
Congenital Abnormality
Supernumerary digits located at the ulnar side of the hand (that is, on the side with the fifth finger).
Ventricular septal defect
MedGen UID:
42366
Concept ID:
C0018818
Congenital Abnormality
A hole between the two bottom chambers (ventricles) of the heart. The defect is centered around the most superior aspect of the ventricular septum.
Abdominal distention
MedGen UID:
34
Concept ID:
C0000731
Finding
Distention of the abdomen.
Ascites
MedGen UID:
416
Concept ID:
C0003962
Disease or Syndrome
Accumulation of fluid in the peritoneal cavity.
Hepatomegaly
MedGen UID:
42428
Concept ID:
C0019209
Finding
Abnormally increased size of the liver.
Protein-losing enteropathy
MedGen UID:
19522
Concept ID:
C0033680
Disease or Syndrome
Complement hyperactivation, angiopathic thrombosis, and protein-losing enteropathy (CHAPLE) is characterized by abdominal pain and diarrhea, primary intestinal lymphangiectasia, hypoproteinemic edema, and malabsorption. Some patients also exhibit bowel inflammation, recurrent infections associated with hypogammaglobulinemia, and/or angiopathic thromboembolic disease. Patient T lymphocytes show increased complement activation, causing surface deposition of complement and generating soluble C5a (Ozen et al., 2017).
Liver failure
MedGen UID:
88444
Concept ID:
C0085605
Disease or Syndrome
A disorder characterized by the inability of the liver to metabolize chemicals in the body. Causes include cirrhosis and drug-induced hepatotoxicity. Signs and symptoms include jaundice and encephalopathy. Laboratory test results reveal abnormal plasma levels of ammonia, bilirubin, lactic dehydrogenase, and alkaline phosphatase.
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.
Ventriculomegaly
MedGen UID:
480553
Concept ID:
C3278923
Finding
An increase in size of the ventricular system of the brain.
Inguinal hernia
MedGen UID:
6817
Concept ID:
C0019294
Finding
Protrusion of the contents of the abdominal cavity through the inguinal canal.
Micrognathia
MedGen UID:
44428
Concept ID:
C0025990
Congenital Abnormality
Developmental hypoplasia of the mandible.
Hypotonia
MedGen UID:
10133
Concept ID:
C0026827
Finding
Hypotonia is an abnormally low muscle tone (the amount of tension or resistance to movement in a muscle). Even when relaxed, muscles have a continuous and passive partial contraction which provides some resistance to passive stretching. Hypotonia thus manifests as diminished resistance to passive stretching. Hypotonia is not the same as muscle weakness, although the two conditions can co-exist.
Narrow chest
MedGen UID:
96528
Concept ID:
C0426790
Finding
Reduced width of the chest from side to side, associated with a reduced distance from the sternal notch to the tip of the shoulder.
Flat occiput
MedGen UID:
332439
Concept ID:
C1837402
Finding
Reduced convexity of the occiput (posterior part of skull).
Malar flattening
MedGen UID:
347616
Concept ID:
C1858085
Finding
Underdevelopment of the malar prominence of the jugal bone (zygomatic bone in mammals), appreciated in profile, frontal view, and/or by palpation.
Generalized hypotonia
MedGen UID:
346841
Concept ID:
C1858120
Finding
Generalized muscular hypotonia (abnormally low muscle tone).
Splenomegaly
MedGen UID:
52469
Concept ID:
C0038002
Finding
Abnormal increased size of the spleen.
Pulmonary lymphangiectasia
MedGen UID:
340882
Concept ID:
C1855480
Finding
Abnormal dilatation of the pulmonary lymphatic vessels. Lymphatic fluid in the lung is derived from normal leakage of fluid out of the blood capillaries in the lung. In pulmonary lymphangiectasia, the pulmonary lymphatics are not properly connected and become dilated with fluid.
Thyroid lymphangiectasia
MedGen UID:
383841
Concept ID:
C1856129
Finding
The presence of lymphangiectasis of the thyroid gland.
Pancreatic lymphangiectasis
MedGen UID:
344668
Concept ID:
C1856162
Finding
The presence of lymphangiectasis in the pancreas.
Hypocalcemia
MedGen UID:
5705
Concept ID:
C0020598
Disease or Syndrome
An abnormally decreased calcium concentration in the blood.
Lymphedema
MedGen UID:
6155
Concept ID:
C0024236
Disease or Syndrome
Localized fluid retention and tissue swelling caused by a compromised lymphatic system.
Hypoproteinemia
MedGen UID:
581229
Concept ID:
C0392692
Finding
A decreased concentration of protein in the blood.
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).
Downslanted palpebral fissures
MedGen UID:
98391
Concept ID:
C0423110
Finding
The palpebral fissure inclination is more than two standard deviations below the mean.
Short neck
MedGen UID:
99267
Concept ID:
C0521525
Finding
Diminished length of the neck.
Smooth philtrum
MedGen UID:
222980
Concept ID:
C1142533
Finding
Flat skin surface, with no ridge formation in the central region of the upper lip between the nasal base and upper vermilion border.
Redundant neck skin
MedGen UID:
374440
Concept ID:
C1840319
Finding
Excess skin around the neck, often lying in horizontal folds.
Wide nasal bridge
MedGen UID:
341441
Concept ID:
C1849367
Finding
Increased breadth of the nasal bridge (and with it, the nasal root).
Midface retrusion
MedGen UID:
339938
Concept ID:
C1853242
Anatomical Abnormality
Posterior positions and/or vertical shortening of the infraorbital and perialar regions, or increased concavity of the face and/or reduced nasolabial angle.
Thin upper lip vermilion
MedGen UID:
355352
Concept ID:
C1865017
Finding
Height of the vermilion of the upper lip in the midline more than 2 SD below the mean. Alternatively, an apparently reduced height of the vermilion of the upper lip in the frontal view (subjective).
Alveolar ridge overgrowth
MedGen UID:
400802
Concept ID:
C1865598
Finding
Increased width of the alveolar ridges.
Cleft palate
MedGen UID:
756015
Concept ID:
C2981150
Congenital Abnormality
Cleft palate is a developmental defect of the palate resulting from a failure of fusion of the palatine processes and manifesting as a separation of the roof of the mouth (soft and hard palate).
Hypertrichosis
MedGen UID:
43787
Concept ID:
C0020555
Disease or Syndrome
Hypertrichosis is increased hair growth that is abnormal in quantity or location.
Polyhydramnios
MedGen UID:
6936
Concept ID:
C0020224
Pathologic Function
The presence of excess amniotic fluid in the uterus during pregnancy.
Thickened nuchal skin fold
MedGen UID:
324644
Concept ID:
C1836940
Finding
A thickening of the skin thickness in the posterior aspect of the fetal neck. A nuchal fold (NF) measurement is obtained in a transverse section of the fetal head at the level of the cavum septum pellucidum and thalami, angled posteriorly to include the cerebellum. The measurement is taken from the outer edge of the occiput bone to the outer skin limit directly in the midline. An NF measurement greater than 5 mm at 14 to 17+6 weeks of gestation, or 6 mm at 18 to 28 weeks has been associated with a markedly increased risk for Down syndrome.
Proptosis
MedGen UID:
41917
Concept ID:
C0015300
Disease or Syndrome
An eye that is protruding anterior to the plane of the face to a greater extent than is typical.
Hypertelorism
MedGen UID:
9373
Concept ID:
C0020534
Finding
Although hypertelorism means an excessive distance between any paired organs (e.g., the nipples), the use of the word has come to be confined to ocular hypertelorism. Hypertelorism occurs as an isolated feature and is also a feature of many syndromes, e.g., Opitz G syndrome (see 300000), Greig cephalopolysyndactyly (175700), and Noonan syndrome (163950) (summary by Cohen et al., 1995).

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVMullerian derivatives-lymphangiectasia-polydactyly syndrome
Follow this link to review classifications for Mullerian derivatives-lymphangiectasia-polydactyly syndrome in Orphanet.

Professional guidelines

PubMed

Teede HJ, Tay CT, Laven JJE, Dokras A, Moran LJ, Piltonen TT, Costello MF, Boivin J, Redman LM, Boyle JA, Norman RJ, Mousa A, Joham AE; International PCOS Network
Eur J Endocrinol 2023 Aug 2;189(2):G43-G64. doi: 10.1093/ejendo/lvad096. PMID: 37580861
Teede HJ, Tay CT, Laven JJE, Dokras A, Moran LJ, Piltonen TT, Costello MF, Boivin J, Redman LM, Boyle JA, Norman RJ, Mousa A, Joham AE
J Clin Endocrinol Metab 2023 Sep 18;108(10):2447-2469. doi: 10.1210/clinem/dgad463. PMID: 37580314Free PMC Article
Klein DA, Poth MA
Am Fam Physician 2013 Jun 1;87(11):781-8. PMID: 23939500

Recent clinical studies

Etiology

Chen N, Song S, Bao X, Zhu L
Front Med 2022 Dec;16(6):859-872. Epub 2022 Dec 23 doi: 10.1007/s11684-022-0969-3. PMID: 36562950
Wang C, Wu W, Yang H, Ye Z, Zhao Y, Liu J, Mu L
Trends Genet 2022 May;38(5):468-482. Epub 2022 Jan 31 doi: 10.1016/j.tig.2022.01.005. PMID: 35094873
Tata B, Mimouni NEH, Barbotin AL, Malone SA, Loyens A, Pigny P, Dewailly D, Catteau-Jonard S, Sundström-Poromaa I, Piltonen TT, Dal Bello F, Medana C, Prevot V, Clasadonte J, Giacobini P
Nat Med 2018 Jun;24(6):834-846. Epub 2018 May 14 doi: 10.1038/s41591-018-0035-5. PMID: 29760445Free PMC Article
Dewailly D, Robin G, Peigne M, Decanter C, Pigny P, Catteau-Jonard S
Hum Reprod Update 2016 Nov;22(6):709-724. Epub 2016 Aug 27 doi: 10.1093/humupd/dmw027. PMID: 27566840
Bhide P, Homburg R
Best Pract Res Clin Obstet Gynaecol 2016 Nov;37:38-45. Epub 2016 Apr 1 doi: 10.1016/j.bpobgyn.2016.03.004. PMID: 27103234

Diagnosis

Chen N, Song S, Bao X, Zhu L
Front Med 2022 Dec;16(6):859-872. Epub 2022 Dec 23 doi: 10.1007/s11684-022-0969-3. PMID: 36562950
Gutiérrez-Montufar OO, Zambrano-Moncayo CP, Otálora-Gallego MC, Meneses-Parra AL, Díaz-Yamal I
Rev Colomb Obstet Ginecol 2021 Dec 30;72(4):407-422. doi: 10.18597/rcog.3699. PMID: 35134287Free PMC Article
Rudnicka E, Kunicki M, Calik-Ksepka A, Suchta K, Duszewska A, Smolarczyk K, Smolarczyk R
Int J Mol Sci 2021 Nov 19;22(22) doi: 10.3390/ijms222212507. PMID: 34830389Free PMC Article
Herlin MK, Petersen MB, Brännström M
Orphanet J Rare Dis 2020 Aug 20;15(1):214. doi: 10.1186/s13023-020-01491-9. PMID: 32819397Free PMC Article
Teede H, Misso M, Tassone EC, Dewailly D, Ng EH, Azziz R, Norman RJ, Andersen M, Franks S, Hoeger K, Hutchison S, Oberfield S, Shah D, Hohmann F, Ottey S, Dabadghao P, Laven JSE
Trends Endocrinol Metab 2019 Jul;30(7):467-478. Epub 2019 May 31 doi: 10.1016/j.tem.2019.04.006. PMID: 31160167

Therapy

Viuff M, Gravholt CH
Ann Endocrinol (Paris) 2022 Aug;83(4):244-249. Epub 2022 Jun 18 doi: 10.1016/j.ando.2022.06.001. PMID: 35728697
Wang C, Wu W, Yang H, Ye Z, Zhao Y, Liu J, Mu L
Trends Genet 2022 May;38(5):468-482. Epub 2022 Jan 31 doi: 10.1016/j.tig.2022.01.005. PMID: 35094873
Collée J, Mawet M, Tebache L, Nisolle M, Brichant G
Gynecol Endocrinol 2021 Oct;37(10):869-874. Epub 2021 Aug 2 doi: 10.1080/09513590.2021.1958310. PMID: 34338572
Mimouni NEH, Paiva I, Barbotin AL, Timzoura FE, Plassard D, Le Gras S, Ternier G, Pigny P, Catteau-Jonard S, Simon V, Prevot V, Boutillier AL, Giacobini P
Cell Metab 2021 Mar 2;33(3):513-530.e8. Epub 2021 Feb 3 doi: 10.1016/j.cmet.2021.01.004. PMID: 33539777Free PMC Article
Herlin MK, Petersen MB, Brännström M
Orphanet J Rare Dis 2020 Aug 20;15(1):214. doi: 10.1186/s13023-020-01491-9. PMID: 32819397Free PMC Article

Prognosis

Viuff M, Gravholt CH
Ann Endocrinol (Paris) 2022 Aug;83(4):244-249. Epub 2022 Jun 18 doi: 10.1016/j.ando.2022.06.001. PMID: 35728697
Kumariya S, Ubba V, Jha RK, Gayen JR
Autophagy 2021 Oct;17(10):2706-2733. Epub 2021 Jun 23 doi: 10.1080/15548627.2021.1938914. PMID: 34161185Free PMC Article
di Clemente N, Racine C, Pierre A, Taieb J
Endocr Rev 2021 Nov 16;42(6):753-782. doi: 10.1210/endrev/bnab012. PMID: 33851994
Moolhuijsen LME, Visser JA
J Clin Endocrinol Metab 2020 Nov 1;105(11):3361-73. doi: 10.1210/clinem/dgaa513. PMID: 32770239Free PMC Article
Tal R, Seifer DB
Am J Obstet Gynecol 2017 Aug;217(2):129-140. Epub 2017 Feb 21 doi: 10.1016/j.ajog.2017.02.027. PMID: 28235465

Clinical prediction guides

Nazirudeen R, Sridhar S, Priyanka R, Sumathi B, Natarajan V, Subbiah E, Raghavan KS, Sangumani J
Clin Endocrinol (Oxf) 2023 Aug;99(2):198-205. Epub 2023 Jun 2 doi: 10.1111/cen.14931. PMID: 37265016
di Clemente N, Racine C, Pierre A, Taieb J
Endocr Rev 2021 Nov 16;42(6):753-782. doi: 10.1210/endrev/bnab012. PMID: 33851994
Moolhuijsen LME, Visser JA
J Clin Endocrinol Metab 2020 Nov 1;105(11):3361-73. doi: 10.1210/clinem/dgaa513. PMID: 32770239Free PMC Article
Moridi I, Chen A, Tal O, Tal R
Nutrients 2020 May 28;12(6) doi: 10.3390/nu12061567. PMID: 32481491Free PMC Article
Dewailly D, Andersen CY, Balen A, Broekmans F, Dilaver N, Fanchin R, Griesinger G, Kelsey TW, La Marca A, Lambalk C, Mason H, Nelson SM, Visser JA, Wallace WH, Anderson RA
Hum Reprod Update 2014 May-Jun;20(3):370-85. Epub 2014 Jan 14 doi: 10.1093/humupd/dmt062. PMID: 24430863

Recent systematic reviews

Yang M, Shen X, Lu D, Peng J, Zhou S, Xu L, Zhang J
Front Endocrinol (Lausanne) 2023;14:1148556. Epub 2023 Aug 1 doi: 10.3389/fendo.2023.1148556. PMID: 37593349Free PMC Article
Medeiros LR, Colonetti T, Nagib EC, Rodrigues Uggioni ML, Denoni Junior JC, Ceretta L, Grande AJ, Rosa MI
Obes Res Clin Pract 2023 Jul-Aug;17(4):288-297. Epub 2023 Jun 7 doi: 10.1016/j.orcp.2023.05.012. PMID: 37296002
Shang Y, Zhou H, He R, Lu W
Front Endocrinol (Lausanne) 2021;12:735954. Epub 2021 Nov 1 doi: 10.3389/fendo.2021.735954. PMID: 34790167Free PMC Article
Moridi I, Chen A, Tal O, Tal R
Nutrients 2020 May 28;12(6) doi: 10.3390/nu12061567. PMID: 32481491Free PMC Article
Dewailly D, Andersen CY, Balen A, Broekmans F, Dilaver N, Fanchin R, Griesinger G, Kelsey TW, La Marca A, Lambalk C, Mason H, Nelson SM, Visser JA, Wallace WH, Anderson RA
Hum Reprod Update 2014 May-Jun;20(3):370-85. Epub 2014 Jan 14 doi: 10.1093/humupd/dmt062. PMID: 24430863

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.
    • Bookshelf
      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Recent activity

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...