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Doll-like facies

MedGen UID:
383894
Concept ID:
C1856361
Finding
Synonym: 'Doll-like' facies
 
HPO: HP:0000295

Definition

A characteristic facial appearance with a round facial form, full cheeks, a short nose, and a relatively small chin. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVDoll-like facies

Conditions with this feature

Glucose-6-phosphate transport defect
MedGen UID:
78644
Concept ID:
C0268146
Disease or Syndrome
Glycogen storage disease type I (GSDI) is characterized by accumulation of glycogen and fat in the liver and kidneys resulting in hepatomegaly and nephromegaly. Severely affected infants present in the neonatal period with severe hypoglycemia due to fasting intolerance. More commonly, untreated infants present at age three to four months with hepatomegaly, severe hypoglycemia with or without seizures, lactic acidosis, hyperuricemia, and hypertriglyceridemia. Affected children typically have doll-like faces with full cheeks, relatively thin extremities, short stature, and a protuberant abdomen. Xanthoma and diarrhea may be present. Impaired platelet function and development of reduced or dysfunctional von Willebrand factor can lead to a bleeding tendency with frequent epistaxis and menorrhagia in females. Individuals with untreated GSDIb are more likely to develop impaired neutrophil and monocyte function as well as chronic neutropenia resulting in recurrent bacterial infections, gingivitis, periodontitis, and genital and intestinal ulcers. Long-term complications of untreated GSDI include short stature, osteoporosis, delayed puberty, renal disease (including proximal and distal renal tubular acidosis, renal stones, and renal failure), gout, systemic hypertension, pulmonary hypertension, hepatic adenomas with potential for malignancy, pancreatitis, and polycystic ovaries. Seizures and cognitive impairment may occur in individuals with prolonged periods of hypoglycemia. Normal growth and puberty are expected in treated children. Most affected individuals live into adulthood.
Cystic leukoencephalopathy without megalencephaly
MedGen UID:
416646
Concept ID:
C2751843
Disease or Syndrome
RNAse T2-deficient leukoencephalopathy is a disorder that affects the brain. People with RNAse T2-deficient leukoencephalopathy have neurological problems that become apparent during infancy; the problems generally do not worsen over time (progress). Most affected individuals have severe intellectual disability; muscle stiffness (spasticity); and a delay in developing motor skills such as sitting, crawling, and walking. Some do not learn to walk, and most do not develop the ability to speak. Other neurological features that can occur in RNAse T2-deficient leukoencephalopathy include hearing loss caused by abnormalities in the inner ear (sensorineural deafness), seizures, involuntary writhing movements of the hands (athetosis), uncontrolled muscle tensing (dystonia), and involuntary eye movements (nystagmus). In addition to the neurological problems associated with this disorder, some affected individuals have unusual facial features sometimes described as a "doll-like face."\n\nThe neurological problems in this disorder are caused by abnormalities in the brain. People with this condition have leukoencephalopathy, an abnormality of the brain's white matter that can be detected with medical imaging. White matter consists of nerve fibers covered by a fatty substance called myelin. Myelin insulates nerve fibers and promotes the rapid transmission of nerve impulses. In people with RNAse T2-deficient leukoencephalopathy, myelin is not made in sufficient amounts during development, leading to patchy white matter abnormalities (lesions) in the brain. In addition, individuals with RNAse T2-deficient leukoencephalopathy may have cysts in regions of the brain called the temporal lobes and enlargement of the fluid-filled cavities (ventricles) near the center of the brain. The white matter lesions are primarily concentrated around the cysts and the ventricles. An abnormally small head and brain size (microcephaly) often occurs in this disorder.
Glycogen storage disease due to glucose-6-phosphatase deficiency type IA
MedGen UID:
415885
Concept ID:
C2919796
Disease or Syndrome
Glycogen storage disease type I (GSDI) is characterized by accumulation of glycogen and fat in the liver and kidneys resulting in hepatomegaly and nephromegaly. Severely affected infants present in the neonatal period with severe hypoglycemia due to fasting intolerance. More commonly, untreated infants present at age three to four months with hepatomegaly, severe hypoglycemia with or without seizures, lactic acidosis, hyperuricemia, and hypertriglyceridemia. Affected children typically have doll-like faces with full cheeks, relatively thin extremities, short stature, and a protuberant abdomen. Xanthoma and diarrhea may be present. Impaired platelet function and development of reduced or dysfunctional von Willebrand factor can lead to a bleeding tendency with frequent epistaxis and menorrhagia in females. Individuals with untreated GSDIb are more likely to develop impaired neutrophil and monocyte function as well as chronic neutropenia resulting in recurrent bacterial infections, gingivitis, periodontitis, and genital and intestinal ulcers. Long-term complications of untreated GSDI include short stature, osteoporosis, delayed puberty, renal disease (including proximal and distal renal tubular acidosis, renal stones, and renal failure), gout, systemic hypertension, pulmonary hypertension, hepatic adenomas with potential for malignancy, pancreatitis, and polycystic ovaries. Seizures and cognitive impairment may occur in individuals with prolonged periods of hypoglycemia. Normal growth and puberty are expected in treated children. Most affected individuals live into adulthood.

Professional guidelines

PubMed

Ramasli Gursoy T, Asfuroglu P, Sismanlar Eyuboglu T, Aslan AT, Yilmaz AI, Unal G, Kibar BS, Pekcan S, Hangul M, Kose M, Budakoglu II, Acican D
Eur J Pediatr 2023 Mar;182(3):1067-1076. Epub 2022 Dec 24 doi: 10.1007/s00431-022-04766-4. PMID: 36565324
Karaki C, Kasahara M, Sakamoto S, Shigeta T, Uchida H, Kanazawa H, Kakiuchi T, Fukuda A, Nakazawa A, Horikawa R, Suzuki Y
Pediatr Transplant 2012 Aug;16(5):465-70. Epub 2012 May 11 doi: 10.1111/j.1399-3046.2012.01705.x. PMID: 22574785

Recent clinical studies

Etiology

Poojari V, Shah I, Shetty NS, Mirani S, Tolani D
Trop Doct 2021 Apr;51(2):189-192. Epub 2020 Oct 27 doi: 10.1177/0049475520961935. PMID: 33106122

Diagnosis

Poojari V, Shah I, Shetty NS, Mirani S, Tolani D
Trop Doct 2021 Apr;51(2):189-192. Epub 2020 Oct 27 doi: 10.1177/0049475520961935. PMID: 33106122
Batool H, Zubaida B, Hashmi MA, Naeem M
J Pediatr Endocrinol Metab 2019 Nov 26;32(11):1229-1233. doi: 10.1515/jpem-2019-0235. PMID: 31473689
El-Karaksy H, Anwar G, El-Raziky M, Mogahed E, Fateen E, Gouda A, El-Mougy F, El-Hennawy A
Arab J Gastroenterol 2014 Jun;15(2):63-7. Epub 2014 Feb 12 doi: 10.1016/j.ajg.2014.01.013. PMID: 25097048
Gopalakrishnan A, Kumar M, Krishnamurthy S, Sakamoto O, Srinivasan S
Clin Exp Nephrol 2011 Oct;15(5):745-748. Epub 2011 May 31 doi: 10.1007/s10157-011-0456-7. PMID: 21625891

Therapy

Gopalakrishnan A, Kumar M, Krishnamurthy S, Sakamoto O, Srinivasan S
Clin Exp Nephrol 2011 Oct;15(5):745-748. Epub 2011 May 31 doi: 10.1007/s10157-011-0456-7. PMID: 21625891

Prognosis

Poojari V, Shah I, Shetty NS, Mirani S, Tolani D
Trop Doct 2021 Apr;51(2):189-192. Epub 2020 Oct 27 doi: 10.1177/0049475520961935. PMID: 33106122
Batool H, Zubaida B, Hashmi MA, Naeem M
J Pediatr Endocrinol Metab 2019 Nov 26;32(11):1229-1233. doi: 10.1515/jpem-2019-0235. PMID: 31473689

Clinical prediction guides

Batool H, Zubaida B, Hashmi MA, Naeem M
J Pediatr Endocrinol Metab 2019 Nov 26;32(11):1229-1233. doi: 10.1515/jpem-2019-0235. PMID: 31473689

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