Diaphragmatic Defect-Limb Deficiency-Skull Defect Syndrome

Diaphragmatic defect-limb deficiency-skull defect syndrome is characterized by the association of classical diaphragmatic hernia (Bochdalek type) with severe lung hypoplasia, and variable associated malformations.

Epidemiology

It has been reported only once in four successive foetuses (two females and two males) born to a nonconsanguineous couple.

Clinical description

The spectrum of malformations is wide and includes, besides diaphragmatic hernia and hypoplastic lungs (present in the four foetuses), omphalocele (one case), severe limb hypoplasia (two cases), syndactyly of the toes (two cases), extra spleen (one case), and an ossification defect of the skull (one case).

Antenatal diagnosis

Prenatal diagnosis of diaphragmatic hernia and severe lung hypoplasia detected on ultrasonography made the parents opt for termination of the four pregnancies.

Genetic counseling

Inheritance seems either to be autosomal recessive or due to a gonadal mosaicism in one parent.