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Cenani-Lenz syndactyly syndrome(CLSS)

MedGen UID:
395226
Concept ID:
C1859309
Disease or Syndrome
Synonyms: Cenani syndactylism; Syndactyly Cenani Lenz type; Syndactyly type 7; SYNDACTYLY, TYPE VII
SNOMED CT: Cenani Lenz syndrome (720633009); Cenani Lenz syndactyly (720633009); Cenani syndactyly (720633009); Syndactyly type 7 (720633009)
Modes of inheritance:
Autosomal recessive inheritance
MedGen UID:
141025
Concept ID:
C0441748
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in individuals with two pathogenic alleles, either homozygotes (two copies of the same mutant allele) or compound heterozygotes (whereby each copy of a gene has a distinct mutant allele).
 
Gene (location): LRP4 (11p11.2)
 
Monarch Initiative: MONDO:0008931
OMIM®: 212780
Orphanet: ORPHA3258

Definition

Cenani-Lenz syndactyly syndrome (CLSS) is an autosomal recessive disorder characterized by mainly by anomalies of distal limb development, with fusion and disorganization of metacarpal and phalangeal bones, radius and ulnar shortening, radioulnar synostosis, and severe syndactyly of hands and feet. Mild facial dysmorphism is present in most patients. Kidney anomalies, including renal agenesis and hypoplasia, occur in over half of patients (summary by Li et al., 2010). [from OMIM]

Clinical features

From HPO
Ectopic kidney
MedGen UID:
68661
Concept ID:
C0238207
Congenital Abnormality
A developmental defect in which a kidney is located in an abnormal anatomic position.
Renal hypoplasia
MedGen UID:
120571
Concept ID:
C0266295
Congenital Abnormality
Hypoplasia of the kidney.
Renal agenesis
MedGen UID:
154237
Concept ID:
C0542519
Congenital Abnormality
Agenesis, that is, failure of the kidney to develop during embryogenesis and development.
Syndactyly
MedGen UID:
52619
Concept ID:
C0039075
Congenital Abnormality
Webbing or fusion of the fingers or toes, involving soft parts only or including bone structure. Bony fusions are referred to as "bony" syndactyly if the fusion occurs in a radio-ulnar axis. Fusions of bones of the fingers or toes in a proximo-distal axis are referred to as "symphalangism".
Hypoplasia of the radius
MedGen UID:
672334
Concept ID:
C0685381
Congenital Abnormality
Underdevelopment of the radius.
Hypoplasia of the ulna
MedGen UID:
395934
Concept ID:
C1860614
Congenital Abnormality
Underdevelopment of the ulna.
Broad hallux
MedGen UID:
401165
Concept ID:
C1867131
Finding
Visible increase in width of the hallux without an increase in the dorso-ventral dimension.
Pulmonic stenosis
MedGen UID:
408291
Concept ID:
C1956257
Disease or Syndrome
A narrowing of the right ventricular outflow tract that can occur at the pulmonary valve (valvular stenosis), below the pulmonary valve (infundibular stenosis), or above the pulmonary valve (supravalvar stenosis).
Delayed gross motor development
MedGen UID:
332508
Concept ID:
C1837658
Finding
A type of motor delay characterized by a delay in acquiring the ability to control the large muscles of the body for walking, running, sitting, and crawling.
Micrognathia
MedGen UID:
44428
Concept ID:
C0025990
Congenital Abnormality
Developmental hypoplasia of the mandible.
Scoliosis
MedGen UID:
11348
Concept ID:
C0036439
Disease or Syndrome
The presence of an abnormal lateral curvature of the spine.
Radioulnar synostosis
MedGen UID:
57861
Concept ID:
C0158761
Congenital Abnormality
An abnormal osseous union (fusion) between the radius and the ulna.
Hemivertebrae
MedGen UID:
82720
Concept ID:
C0265677
Congenital Abnormality
Absence of one half of the vertebral body.
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.
Pectus excavatum
MedGen UID:
781174
Concept ID:
C2051831
Finding
A defect of the chest wall characterized by a depression of the sternum, giving the chest ("pectus") a caved-in ("excavatum") appearance.
Metacarpal synostosis
MedGen UID:
867040
Concept ID:
C4021398
Anatomical Abnormality
Fusion involving two or more metacarpal bones (A synostosis of the first metacarpal and the proximal phalanx of the thumb can also be observed, note that the first metacarpal bone corresponds to a proximal phalanx).
Enamel hypoplasia
MedGen UID:
3730
Concept ID:
C0011351
Disease or Syndrome
Developmental hypoplasia of the dental enamel.
Partial congenital absence of teeth
MedGen UID:
43794
Concept ID:
C0020608
Congenital Abnormality
Tooth agenesis in some form is a common human anomaly that affects approximately 20% of the population. Although tooth agenesis is associated with numerous syndromes, several case reports describe nonsyndromic forms that are either sporadic or familial in nature, as reviewed by Gorlin et al. (1990). The incidence of familial tooth agenesis varies with each class of teeth. Most commonly affected are third molars (wisdom teeth), followed by either upper lateral incisors or lower second premolars; agenesis involving first and second molars is very rare. Also see 114600 and 302400. Selective tooth agenesis without associated systemic disorders has sometimes been divided into 2 types: oligodontia, defined as agenesis of 6 or more permanent teeth, and hypodontia, defined as agenesis of less than 6 teeth. The number in both cases does not include absence of third molars (wisdom teeth). Faulty use of the terms, however, have confounded their use. The term 'partial anodontia' is obsolete (Salinas, 1978). Genetic Heterogeneity of Selective Tooth Agenesis Other forms of selective tooth agenesis include STHAG2 (602639), mapped to chromosome 16q12; STHAG3 (604625), caused by mutation in the PAX9 gene (167416) on chromosome 14q12; STHAG4 (150400), caused by mutation in the WNT10A gene (606268) on chromosome 2q35; STHAG5 (610926), mapped to chromosome 10q11; STHAG7 (616724), caused by mutation in the LRP6 gene (603507) on chromosome 12p13; STHAG8 (617073), caused by mutation in the WNT10B gene (601906) on chromosome 12q13; STHAG9 (617275), caused by mutation in the GREM2 gene (608832) on chromosome 1q43; STHAG10 (620173), caused by mutation in the TSPEAR gene (612920) on chromosome 21q22; and STHAGX1 (313500), caused by mutation in the EDA gene (300451) on chromosome Xq13. A type of selective tooth agenesis that was formerly designated STHAG6 has been incorporated into the dental anomalies and short stature syndrome (DASS; 601216). Of 34 unrelated patients with nonsyndromic tooth agenesis, van den Boogaard et al. (2012) found that 56% (19 patients) had mutations in the WNT10A gene (STHAG4), whereas only 3% and 9% had mutations in the MSX1 (STHAG1) and PAX9 (STHAG3) genes, respectively. The authors concluded that WNT10A is a major gene in the etiology of isolated hypodontia. Genotype-Phenotype Correlations Yu et al. (2016) observed that the most frequently missing permanent teeth in WNT10B-associated oligodontia were the lateral incisors (83.3%), whereas premolars were missing only 51.4% of the time, which they noted was a pattern 'clearly different' from the oligodontia patterns resulting from WNT10A mutations. They also stated that the selective pattern in WNT10B mutants was different from that associated with mutations in other genes, such as MSX1, in which second premolars are missing, and PAX9, in which there is agenesis of molars.
Downslanted palpebral fissures
MedGen UID:
98391
Concept ID:
C0423110
Finding
The palpebral fissure inclination is more than two standard deviations below the mean.
Prominent forehead
MedGen UID:
373291
Concept ID:
C1837260
Finding
Forward prominence of the entire forehead, due to protrusion of the frontal bone.
Premature loss of permanent teeth
MedGen UID:
409904
Concept ID:
C1969738
Finding
Premature loss of the permanent teeth.
Anonychia
MedGen UID:
120563
Concept ID:
C0265998
Congenital Abnormality
Congenital anonychia is defined as the absence of fingernails and toenails. Anonychia and its milder phenotypic variant, hyponychia, usually occur as a feature of genetic syndromes, in association with significant skeletal and limb anomalies. Isolated nonsyndromic congenital anonychia/hyponychia is a rare entity that usually follows autosomal recessive inheritance with variable expression, even within a given family. The nail phenotypes observed range from no nail field to a nail field of reduced size with an absent or rudimentary nail (summary by Bruchle et al., 2008). This form of nail disorder is referred to here as nonsyndromic congenital nail disorder-4 (NDNC4). For a list of other nonsyndromic congenital nail disorders and a discussion of genetic heterogeneity, see NDNC1 (161050).
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  
  • CROGVCenani-Lenz syndactyly syndrome
Follow this link to review classifications for Cenani-Lenz syndactyly syndrome in Orphanet.

Recent clinical studies

Diagnosis

Fu Y, Zhou Y, Zhang Q, Dong J, Zheng J, Li M, Liu J
Mol Genet Genomic Med 2024 Jan;12(1):e2319. Epub 2023 Nov 27 doi: 10.1002/mgg3.2319. PMID: 38013226Free PMC Article
Bukowska-Olech E, Sowińska-Seidler A, Szczałuba K, Jamsheer A
Birth Defects Res 2020 May 15;112(9):652-659. Epub 2020 Apr 14 doi: 10.1002/bdr2.1676. PMID: 32286743
Alrayes N, Aziz A, Ullah F, Ishfaq M, Jelani M, Wali A
J Gene Med 2020 Jan;22(1):e3143. Epub 2020 Jan 3 doi: 10.1002/jgm.3143. PMID: 31750994
Hettiaracchchi D, Bonnard C, Jayawardana SMA, Ng AYJ, Tohari S, Venkatesh B, Reversade B, Singaraja R, Dissanayake VHW
BMC Med Genet 2018 Jul 24;19(1):125. doi: 10.1186/s12881-018-0646-1. PMID: 30041615Free PMC Article
Afzal M, Zaman Q, Kornak U, Mundlos S, Malik S, Flöttmann R
Eur J Med Genet 2017 Aug;60(8):421-425. Epub 2017 May 27 doi: 10.1016/j.ejmg.2017.05.004. PMID: 28559208

Therapy

Ohkawara B, Cabrera-Serrano M, Nakata T, Milone M, Asai N, Ito K, Ito M, Masuda A, Ito Y, Engel AG, Ohno K
Hum Mol Genet 2014 Apr 1;23(7):1856-68. Epub 2013 Nov 13 doi: 10.1093/hmg/ddt578. PMID: 24234652Free PMC Article

Prognosis

Fu Y, Zhou Y, Zhang Q, Dong J, Zheng J, Li M, Liu J
Mol Genet Genomic Med 2024 Jan;12(1):e2319. Epub 2023 Nov 27 doi: 10.1002/mgg3.2319. PMID: 38013226Free PMC Article
Bukowska-Olech E, Sowińska-Seidler A, Szczałuba K, Jamsheer A
Birth Defects Res 2020 May 15;112(9):652-659. Epub 2020 Apr 14 doi: 10.1002/bdr2.1676. PMID: 32286743
Alrayes N, Aziz A, Ullah F, Ishfaq M, Jelani M, Wali A
J Gene Med 2020 Jan;22(1):e3143. Epub 2020 Jan 3 doi: 10.1002/jgm.3143. PMID: 31750994
Afzal M, Zaman Q, Kornak U, Mundlos S, Malik S, Flöttmann R
Eur J Med Genet 2017 Aug;60(8):421-425. Epub 2017 May 27 doi: 10.1016/j.ejmg.2017.05.004. PMID: 28559208

Clinical prediction guides

Fu Y, Zhou Y, Zhang Q, Dong J, Zheng J, Li M, Liu J
Mol Genet Genomic Med 2024 Jan;12(1):e2319. Epub 2023 Nov 27 doi: 10.1002/mgg3.2319. PMID: 38013226Free PMC Article
Bukowska-Olech E, Sowińska-Seidler A, Szczałuba K, Jamsheer A
Birth Defects Res 2020 May 15;112(9):652-659. Epub 2020 Apr 14 doi: 10.1002/bdr2.1676. PMID: 32286743
Alrayes N, Aziz A, Ullah F, Ishfaq M, Jelani M, Wali A
J Gene Med 2020 Jan;22(1):e3143. Epub 2020 Jan 3 doi: 10.1002/jgm.3143. PMID: 31750994
Afzal M, Zaman Q, Kornak U, Mundlos S, Malik S, Flöttmann R
Eur J Med Genet 2017 Aug;60(8):421-425. Epub 2017 May 27 doi: 10.1016/j.ejmg.2017.05.004. PMID: 28559208

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