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      Hallermann-Streiff syndrome with uncommon ocular features, ultrasound biomicroscopy and optical coherence tomography findings : A case report

      case-report

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          Abstract

          Rationale:

          Hallermann-Streiff syndrome (HSS) is a rare congenital disorder characterized by craniofacial malformations, sparse hair, degenerative skin changes, eye abnormalities, dental defects, and proportionate short stature.

          Patient concerns:

          A 24-year-old Chinese male patient presented to the ophthalmologist because of his sore eye and blurred vision.

          Diagnoses:

          The final diagnosis of presented case is HSS having the main features of the syndrome, however, associated with uncommon ocular features, ultrasound biomicroscopy (UBM) and optical coherence tomography (OCT)changes, including aphakia, glaucoma, long eye axes, cilliary abnormalities, and chorioretinal atrophy.

          Interventions:

          Antiglaucomatous medical therapy failed to reduce the pressure in the right eye and a cyclocryotherapy was carried out. The antiglaucoma eye drops was continued in the left eye.

          Outcomes:

          The intraocular pressure has been reduced to the normal range, but the vision has not improved.

          Lessons:

          In the diagnosis of HSS, we should not ignore the extraordinary information especially uncommon ophthalmic features, UBM and OCT changes. We highlight the necessity of a multidisciplinary approach for accurate diagnosis and appropriate management.

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          Most cited references18

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          A new syndrome; dyscephalia with bird face and dental anomalies, nanism, hypotrichosis, cutaneous atrophy, microphthalmia, and congenital cataract.

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            Hallermann-Streiff syndrome: a case review.

            Hallermann-Streiff Syndrome is a rare genetic disorder that is characterized primarily by head and face abnormalities. Patients show bird-like facies, dental abnormalities, and hypotrichosis with various ophthalmic abnormalities. We report here a 26-year-old woman with Hallermann-Streiff Syndrome and review the literature.
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              Hallermann-Streiff syndrome: experience with 15 patients and review of the literature.

              Hallermann-Streiff syndrome is rare, with approximately 150 case reports in the world literature. The syndrome consists of proportionate nanism; hypotrichosis; atrophy and extreme thinness of the skin, particularly over the facial area; an unusual "bird-like" face with mandibular hypoplasia; a prominent thin, pointed nose; congenital cataracts; and severe dental abnormalities. This appears to be a sporadic mutation, and the inheritance pattern is unknown. Clinical management must focus on the more life-threatening and developmental issues early on, and aesthetic deformities can be addressed after the adolescent growth period is complete. Surgical correction of cataracts should be undertaken early in life to preserve vision. Airway issues need to be addressed early. Other reconstructive procedures, including rhinoplasty, facial augmentation, and mandibular surgery, have been successful and can be performed later in life. We report on our clinical findings in 15 patients with this condition, our attempts at reconstruction, and complications we have encountered in treating this patient population. Five of our patients had produced normal chromosome studies, and none have had similarly affected siblings. Four have had normal, unaffected children. Most of our patients have undergone multiple reconstructive procedures and have done relatively well. Eleven of our patients, however, have encountered significant intermittent respiratory difficulty manifested as early feeding difficulty, recurrent upper respiratory tract infection, sleep apnea, and respiratory arrest. Three patients required tracheostomy because of respiratory difficulty, and one child died of postoperative respiratory compromise. The management of these complicated and difficult patients is discussed.
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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Wolters Kluwer Health
                0025-7974
                1536-5964
                December 2019
                10 December 2019
                : 98
                : 49
                : e18272
                Affiliations
                [a ]Department of Ophthalmology, Fourth Affiliated Hospital of Kunming Medical University (the Second People's Hospital of Yunnan Province), Yunnan Eye Institute, Key Laboratory of Yunnan Province for the Prevention and Treatment of ophthalmology, Provincial Innovation Team for Cataract and Ocular Fundus Disease, The Second People's Hospital of Yunnan Province; Expert Workstation of Yao Ke
                [b ]Department of Radiology, the Second People's Hospital of Yunnan Province
                [c ]School of Information Science and Engineering, Yunnan University, Kunming, China.
                Author notes
                []Correspondence: Hongsong Li, School of Information Science and Engineering, Yunnan University, East Outer Ring Road, Chenggong District, Kunming, China (e-mail: hongsong_li@ 123456163.com ).
                Article
                MD-D-19-04244 18272
                10.1097/MD.0000000000018272
                6919421
                31804366
                8710c3e8-44b6-49cf-ab45-1279ac1efadd
                Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

                History
                : 29 May 2019
                : 27 October 2019
                : 7 November 2019
                Categories
                7300
                Research Article
                Clinical Case Report
                Custom metadata
                TRUE

                anatomy,embryology and development,hallermann-streiff syndrome,image,optical coherence tomography,ultrasound biomicroscopy

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