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Arthrogryposis multiplex congenita 6(AMC6)

MedGen UID:
1786758
Concept ID:
C5543431
Disease or Syndrome
Synonyms: AMC6; ARTHROGRYPOSIS MULTIPLEX CONGENITA 6
 
Gene (location): NEB (2q23.3)
 
Monarch Initiative: MONDO:0030281
OMIM®: 619334

Definition

Arthrogryposis multiplex congenita-6 (AMC6) is a severe autosomal recessive disorder of skeletal muscle with onset of symptoms in utero. The pregnancies are usually complicated by polyhydramnios and reduced fetal movements. Affected individuals have congenital joint contractures, dysmorphic facial features, distal skeletal anomalies with clenched hands and clubfeet, and edema with fetal hydrops. Fetal demise or termination of pregnancy often occurs after ultrasound detection of abnormalities. Those that survive to birth have significant hypotonia with absent spontaneous movements, respiratory insufficiency, arthrogryposis, and multiple pterygia. Skeletal muscle is hypoplastic, immature, and underdeveloped, with nemaline rods, poorly developed sarcomeres, and poor cross-striation. Death in infancy usually occurs (summary by Ahmed et al., 2018, Rocha et al., 2021). For a discussion of genetic heterogeneity of AMC, see AMC1 (617468). [from OMIM]

Clinical features

From HPO
Hypospadias
MedGen UID:
163083
Concept ID:
C0848558
Congenital Abnormality
Abnormal position of urethral meatus on the ventral penile shaft (underside) characterized by displacement of the urethral meatus from the tip of the glans penis to the ventral surface of the penis, scrotum, or perineum.
Thumbs, congenital Clasped
MedGen UID:
98140
Concept ID:
C0431886
Congenital Abnormality
In the resting position, the tip of the thumb is on, or near, the palm, close to the base of the fourth or fifth finger.
Akinesia
MedGen UID:
43218
Concept ID:
C0085623
Finding
Inability to initiate changes in activity or movement and to perform ordinary volitional movements rapidly and easily.
Large fontanelles
MedGen UID:
105329
Concept ID:
C0456132
Finding
In newborns, the two frontal bones, two parietal bones, and one occipital bone are joined by fibrous sutures, which form a small posterior fontanelle, and a larger, diamond-shaped anterior fontanelle. These regions allow for the skull to pass the birth canal and for later growth. The fontanelles gradually ossify, whereby the posterior fontanelle usually closes by eight weeks and the anterior fontanelle by the 9th to 16th month of age. Large fontanelles are diagnosed if the fontanelles are larger than age-dependent norms.
Increased variability in muscle fiber diameter
MedGen UID:
336019
Concept ID:
C1843700
Finding
An abnormally high degree of muscle fiber size variation. This phenotypic feature can be observed upon muscle biopsy.
Nemaline bodies
MedGen UID:
814369
Concept ID:
C3808039
Finding
Nemaline rods are abnormal bodies that can occur in skeletal muscle fibers. The rods can be observed on histological analysis of muscle biopsy tissue or upon electron microscopy, where they appear either as extensions of sarcomeric Z-lines, in random array without obvious attachment to Z-lines (often in areas devoid of sarcomeres) or in large clusters localized at the sarcolemma or intermyofibrillar spaces.
Arthrogryposis multiplex congenita
MedGen UID:
1830310
Concept ID:
C5779613
Disease or Syndrome
Multiple congenital contractures in different body areas.
Respiratory failure
MedGen UID:
257837
Concept ID:
C1145670
Disease or Syndrome
A severe form of respiratory insufficiency characterized by inadequate gas exchange such that the levels of oxygen or carbon dioxide cannot be maintained within normal limits.
Polyhydramnios
MedGen UID:
6936
Concept ID:
C0020224
Pathologic Function
The presence of excess amniotic fluid in the uterus during pregnancy.
Decreased fetal movement
MedGen UID:
68618
Concept ID:
C0235659
Finding
An abnormal reduction in quantity or strength of fetal movements.

Professional guidelines

PubMed

Church C, Bourantas C, Butler S, Salazar-Torres JJ, Henley J, Donohoe M, Miller F, Nichols LR
J Pediatr Orthop 2023 Jul 1;43(6):e500-e501. Epub 2023 Apr 27 doi: 10.1097/BPO.0000000000002410. PMID: 37104809
Nemati A
J Pediatr Orthop 2023 Jul 1;43(6):e500. Epub 2023 Mar 24 doi: 10.1097/BPO.0000000000002390. PMID: 37104752
Rink BD
Obstet Gynecol Surv 2011 Jun;66(6):369-77. doi: 10.1097/OGX.0b013e31822bf5bb. PMID: 21851751

Recent clinical studies

Etiology

Filges I, Jünemann S, Viehweger E, Tercanli S
Prenat Diagn 2023 Jun;43(6):798-805. Epub 2023 Jan 12 doi: 10.1002/pd.6299. PMID: 36588183
Hall JG, Aldinger KA, Tanaka KI
Am J Med Genet A 2014 Mar;164A(3):700-30. Epub 2014 Jan 23 doi: 10.1002/ajmg.a.36395. PMID: 24459070
Vanpaemel L, Schoenmakers M, van Nesselrooij B, Pruijs H, Helders P
J Pediatr Orthop B 1997 Jul;6(3):172-8. doi: 10.1097/01202412-199707000-00004. PMID: 9260645
Hall JG
J Pediatr Orthop B 1997 Jul;6(3):159-66. PMID: 9260643
Preus M, Fraser FC
Am J Dis Child 1972 Dec;124(6):933-43. doi: 10.1001/archpedi.1972.02110180135022. PMID: 4265019

Diagnosis

Laquerriere A, Jaber D, Abiusi E, Maluenda J, Mejlachowicz D, Vivanti A, Dieterich K, Stoeva R, Quevarec L, Nolent F, Biancalana V, Latour P, Sternberg D, Capri Y, Verloes A, Bessieres B, Loeuillet L, Attie-Bitach T, Martinovic J, Blesson S, Petit F, Beneteau C, Whalen S, Marguet F, Bouligand J, Héron D, Viot G, Amiel J, Amram D, Bellesme C, Bucourt M, Faivre L, Jouk PS, Khung S, Sigaudy S, Delezoide AL, Goldenberg A, Jacquemont ML, Lambert L, Layet V, Lyonnet S, Munnich A, Van Maldergem L, Piard J, Guimiot F, Landrieu P, Letard P, Pelluard F, Perrin L, Saint-Frison MH, Topaloglu H, Trestard L, Vincent-Delorme C, Amthor H, Barnerias C, Benachi A, Bieth E, Boucher E, Cormier-Daire V, Delahaye-Duriez A, Desguerre I, Eymard B, Francannet C, Grotto S, Lacombe D, Laffargue F, Legendre M, Martin-Coignard D, Mégarbané A, Mercier S, Nizon M, Rigonnot L, Prieur F, Quélin C, Ranjatoelina-Randrianaivo H, Resta N, Toutain A, Verhelst H, Vincent M, Colin E, Fallet-Bianco C, Granier M, Grigorescu R, Saada J, Gonzales M, Guiochon-Mantel A, Bessereau JL, Tawk M, Gut I, Gitiaux C, Melki J
J Med Genet 2022 Jun;59(6):559-567. Epub 2021 Apr 5 doi: 10.1136/jmedgenet-2020-107595. PMID: 33820833Free PMC Article
Society for Maternal-Fetal Medicine, Rac MWF, McKinney J, Gandhi M
Am J Obstet Gynecol 2019 Dec;221(6):B7-B9. doi: 10.1016/j.ajog.2019.09.021. PMID: 31787162
Society for Maternal-Fetal Medicine, McKinney J, Rac MWF, Gandhi M
Am J Obstet Gynecol 2019 Dec;221(6):B10-B12. doi: 10.1016/j.ajog.2019.09.022. PMID: 31787157
Hall JG, Aldinger KA, Tanaka KI
Am J Med Genet A 2014 Mar;164A(3):700-30. Epub 2014 Jan 23 doi: 10.1002/ajmg.a.36395. PMID: 24459070
Preus M, Fraser FC
Am J Dis Child 1972 Dec;124(6):933-43. doi: 10.1001/archpedi.1972.02110180135022. PMID: 4265019

Therapy

Kindler HL, Novello S, Bearz A, Ceresoli GL, Aerts JGJV, Spicer J, Taylor P, Nackaerts K, Greystoke A, Jennens R, Calabrò L, Burgers JA, Santoro A, Cedrés S, Serwatowski P, Ponce S, Van Meerbeeck JP, Nowak AK, Blumenschein G Jr, Siegel JM, Kasten L, Köchert K, Walter AO, Childs BH, Elbi C, Hassan R, Fennell DA
Lancet Oncol 2022 Apr;23(4):540-552. doi: 10.1016/S1470-2045(22)00061-4. PMID: 35358455Free PMC Article
Thakker A, Sharma SC, Hussain NM, Devani P, Lahiri A
J Plast Reconstr Aesthet Surg 2021 Mar;74(3):549-559. Epub 2020 Nov 8 doi: 10.1016/j.bjps.2020.10.085. PMID: 33268044
Khedr EM, Fawi G, Allah Abbas MA, El-Fetoh NA, Zaki AF, Gamea A
Neuroepidemiology 2016;46(4):253-60. Epub 2016 Mar 15 doi: 10.1159/000444641. PMID: 26974980
Schaefer D, Hefti F
J Bone Joint Surg Br 2000 Aug;82(6):881-4. doi: 10.1302/0301-620x.82b6.10845. PMID: 10990316
Swoboda KJ, Specht L, Jones HR, Shapiro F, DiMauro S, Korson M
J Pediatr 1997 Dec;131(6):932-4. doi: 10.1016/s0022-3476(97)70048-9. PMID: 9427905

Prognosis

Society for Maternal-Fetal Medicine, Rac MWF, McKinney J, Gandhi M
Am J Obstet Gynecol 2019 Dec;221(6):B7-B9. doi: 10.1016/j.ajog.2019.09.021. PMID: 31787162
Wu PL, Yang YN, Tey SL, Yang CH, Yang SN, Lin CS
Pediatr Int 2015 Aug;57(4):746-9. Epub 2015 Jun 25 doi: 10.1111/ped.12616. PMID: 26108272
Bernstein RM
J Am Acad Orthop Surg 2002 Nov-Dec;10(6):417-24. doi: 10.5435/00124635-200211000-00006. PMID: 12470044
Vanpaemel L, Schoenmakers M, van Nesselrooij B, Pruijs H, Helders P
J Pediatr Orthop B 1997 Jul;6(3):172-8. doi: 10.1097/01202412-199707000-00004. PMID: 9260645
Hall JG
J Pediatr Orthop B 1997 Jul;6(3):159-66. PMID: 9260643

Clinical prediction guides

Turgut GT, Altunoglu U, Gulec C, Sarac Sivrikoz T, Kalaycı T, Toksoy G, Avcı Ş, Yıldırım BT, Sayın GY, Kalelioglu IH, Karaman B, Has R, Başaran S, Yuksel A, Kayserili H, Uyguner ZO
Clin Genet 2024 Jun;105(6):596-610. Epub 2024 Jan 26 doi: 10.1111/cge.14490. PMID: 38278647
Taqi D, Nematollahi S, Lemin S, Rauch F, Hamdy R, Dahan-Oliel N
Bone 2024 Feb;179:116955. Epub 2023 Nov 10 doi: 10.1016/j.bone.2023.116955. PMID: 37951521
Koike H, Furukawa S, Mouri N, Fukami Y, Iijima M, Katsuno M
Neuromuscul Disord 2022 Jun;32(6):503-511. Epub 2022 Apr 9 doi: 10.1016/j.nmd.2022.04.002. PMID: 35501275
Laquerriere A, Jaber D, Abiusi E, Maluenda J, Mejlachowicz D, Vivanti A, Dieterich K, Stoeva R, Quevarec L, Nolent F, Biancalana V, Latour P, Sternberg D, Capri Y, Verloes A, Bessieres B, Loeuillet L, Attie-Bitach T, Martinovic J, Blesson S, Petit F, Beneteau C, Whalen S, Marguet F, Bouligand J, Héron D, Viot G, Amiel J, Amram D, Bellesme C, Bucourt M, Faivre L, Jouk PS, Khung S, Sigaudy S, Delezoide AL, Goldenberg A, Jacquemont ML, Lambert L, Layet V, Lyonnet S, Munnich A, Van Maldergem L, Piard J, Guimiot F, Landrieu P, Letard P, Pelluard F, Perrin L, Saint-Frison MH, Topaloglu H, Trestard L, Vincent-Delorme C, Amthor H, Barnerias C, Benachi A, Bieth E, Boucher E, Cormier-Daire V, Delahaye-Duriez A, Desguerre I, Eymard B, Francannet C, Grotto S, Lacombe D, Laffargue F, Legendre M, Martin-Coignard D, Mégarbané A, Mercier S, Nizon M, Rigonnot L, Prieur F, Quélin C, Ranjatoelina-Randrianaivo H, Resta N, Toutain A, Verhelst H, Vincent M, Colin E, Fallet-Bianco C, Granier M, Grigorescu R, Saada J, Gonzales M, Guiochon-Mantel A, Bessereau JL, Tawk M, Gut I, Gitiaux C, Melki J
J Med Genet 2022 Jun;59(6):559-567. Epub 2021 Apr 5 doi: 10.1136/jmedgenet-2020-107595. PMID: 33820833Free PMC Article
Bernstein RM
J Am Acad Orthop Surg 2002 Nov-Dec;10(6):417-24. doi: 10.5435/00124635-200211000-00006. PMID: 12470044

Recent systematic reviews

Passananti E, Bevilacqua E, Di Marco G, Felici F, Trapani M, Ciavarro V, Di Ilio C, Lanzone A, Familiari A
Ultrasound Obstet Gynecol 2024 Dec;64(6):721-729. Epub 2024 Nov 5 doi: 10.1002/uog.27663. PMID: 38642342Free PMC Article
Erden M, Uyanik E, Demeestere I, Oktay KH
Am J Obstet Gynecol 2024 Nov;231(5):480-489. Epub 2024 Apr 15 doi: 10.1016/j.ajog.2024.04.012. PMID: 38621483Free PMC Article
Thakker A, Sharma SC, Hussain NM, Devani P, Lahiri A
J Plast Reconstr Aesthet Surg 2021 Mar;74(3):549-559. Epub 2020 Nov 8 doi: 10.1016/j.bjps.2020.10.085. PMID: 33268044

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