Hand-foot-genital syndrome

From WikiMD's Wellnesspedia

(Redirected from Hand foot genital syndrome)

Hand-foot-genital syndrome (HFGS) is characterized by limb malformations and urogenital defects. Mild bilateral shortening of the thumbs and great toes, caused primarily by shortening of the distal phalanx and/or the first metacarpal or metatarsal, is the most common limb malformation and results in impaired dexterity or apposition of the thumbs. Urogenital abnormalities include abnormalities of the ureters and urethra and various degrees of incomplete Müllerian fusion in females and hypospadias of variable severity with or without chordee in males. Vesicoureteral reflux, recurrent urinary tract infections, and chronic pyelonephritis are common; fertility is normal.[1][2]

Cause[edit | edit source]

Hand-foot-genital syndrome is inherited in an autosomal dominant manner. The proportion of cases caused by de novo mutations is unknown because of the small number of individuals described. If a parent of the proband is affected, the risk to the siblings is 50%. When the parents are clinically unaffected, the risk to the sibs of a proband appears to be low. Each child of an individual with HFGS has a 50% chance of inheriting the mutation. Prenatal testing may be available through laboratories offering custom prenatal testing for families in which the disease-causing mutation has been identified in an affected family member.[1]

Diagnosis[edit | edit source]

Diagnosis is based on physical examination including radiographs of the hands and feet and imaging studies of the kidneys, bladder, and female reproductive tract. HOXA13 is the only gene known to be associated with HFGS. Approximately 60% of mutations are polyalanine expansions. Molecular genetic testing is clinically available.

Additional findings[edit | edit source]

Additional findings that may be present in HFGS according to the latest research are:[2]

  • Limited metacarpophalangeal flexion of the thumb or limited ability to oppose the thumb and fifth finger
  • Hypoplastic thenar eminences
  • Medial deviation of the great toe (hallux varus), a useful diagnostic sign when present
  • Small great toenail
  • Fifth-finger clinodactyly, secondary to a shortened middle phalanx
  • Short feet
  • Altered dermatoglyphics of the hands; when present, primarily involving distal placement of the axial triradius, lack of thenar or hypothenar patterning, low arches on the thumbs, thin ulnar loops (deficiency of radial loops and whorls), and a greatly reduced ridge count on the fingers

Radiographic findings

Urogenital Defects

Females may have the following:

Males may have the following:

Treatment[edit | edit source]

  • Hand or foot surgery is not usually necessary.
  • Ureteric reimplantation and surgical correction of bladder outlet abnormalities are often necessary.
  • Surgical removal of a longitudinal vaginal septum is rarely indicated.
  • Surgery for removal of a uterine septum or reunification of a bicornuate uterus is exceptional in the absence of recurrent mid-trimester pregnancy loss.
  • Hymenectomy may be necessary for tight constriction ring.[3][1].

References[edit | edit source]

  1. 1.0 1.1
  2. 2.0 2.1
  3. Innis JW. Hand-Foot-Genital Syndrome. 2006 Jul 11 [Updated 2019 Aug 8]. In: Adam MP, Ardinger HH, Pagon RA, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK1423/

External links[edit | edit source]

Classification
External resources
Wiki.png

Navigation: Wellness - Encyclopedia - Health topics - Disease Index‏‎ - Drugs - World Directory - Gray's Anatomy - Keto diet - Recipes

Search WikiMD


Ad.Tired of being Overweight? Try W8MD's physician weight loss program.
Semaglutide (Ozempic / Wegovy and Tirzepatide (Mounjaro) available.
Advertise on WikiMD

WikiMD is not a substitute for professional medical advice. See full disclaimer.

Credits:Most images are courtesy of Wikimedia commons, and templates Wikipedia, licensed under CC BY SA or similar.