Hennekam syndrome is a rare, recently described genetic disorder in which facial anomalies and mental retardation accompany congenital lymphedema and intestinal lymphangiectasia. Several other somatic abnormalities have variously been described, as have milder degrees of lymphatic dysfunction. The authors herein describe a case of Hennekam syndrome in which the diagnostic difficulties were partially overcome by the judicious use of radionuclide scintigraphy to verify the lymphedematous component of the patient's presentation.
Get full access to this article
View all access options for this article.
References
1.
Hennekam R., Geerdink R., Hamel B., et al: Autosomal recessive intestinal lymphangiectasia and lymphedema, with facial anomalies and mental retardation. Am J Med Genet34:593-600, 1989.
2.
Gabrielli O. , Catassi C., Carlucci A., et al: Intestinal lymphangiectasia, lymphedema, mental retardation, and typical face: Confirmation of the Hennekam syndrome . Am J Med Genet40:244-247, 1991.
3.
Opitz J.: Editorial comment on the paper by Crowe and Dickerman: On congenital lymphedema . Am J Med Genet24:127-129, 1986.
4.
Jones K.: Jugular lymphatic obstruction sequence. In: Smith's Recognizable Patterns of Human Malformation. Philadelphia: W. B. Saunders, 1988, pp 560-561.
5.
Mistilis S., Skyring A., Stephen D.: Intestinal lymphangiectasia. Mechanism of enteric loss of plasma-protein and fat. Lancet1:77-80, 1965.
6.
Vardy P., Lebenthal E., Shwachman H.: Intestinal lymphangiectasia : A reappraisal. Pediatr55:842-851, 1975.
7.
Cormier-Daire V., Lyonnet S., Lehnert A., et al: Craniosynostosis and kidney malformation in a case of Hennekam syndrome. Am J Med Genet57:66-68, 1995.
8.
Angle B., Holgado S., Burton BK, et al: Microcephaly, lymphedema, and chorioretinal dysplasia: Report of two additional cases. Am J Med Genet53:99-101, 1994.
9.
Yasunaga M., Yamanaka C., Mayumi M., et al: Protein-losing gastroenteropathy with facial anomaly and growth retardation: A mild case of Hennekam syndrome. Am J Med Genet45:477-480, 1993.
10.
Pecking A., Cluzan R., Desprez-Curely J., et al: Indirect lymphoscintigraphy in patients with limb edemas. Phlebology1:215-217, 1986.
11.
Van derPutte S.: The development of the lymphatic system in man. Adv Anat Embryol Cell Biol51:1-58, 1975.
12.
Szuba A., Rockson S.: Lymphedema: Classification, diagnosis and therapy. Vasc Med (in press).
13.
Lewis J., Wald E.: Lymphedema praecox. J Pediatr104:641-648, 1984.
14.
Partsch H.: Assessment of abnormal lymph drainage for the diagnosis of lymphedema by isotopic lymphangiography and by indirect lymphography. Clin Dermatol13:445-450, 1995.
15.
Ter SE, Alavi A., Kim CK, et al: Lymphoscintigraphy. A reliable test for the diagnosis of lymphedema . Clin Nucl Med18:646-654, 1993.
16.
Case TC, Witte CL, Witte MH, et al: Magnetic resonance imaging in human lymphedema: Comparison with lymphangioscintigraphy. Magn Reson Imaging10:549-558, 1992.
17.
Köstler E.: Das Tröphödem (Nonne-Milroy-Meige). Dermatol Monatsschr162:465-477, 1976.
18.
Leung A.: Dominantly inherited syndrome of microcephaly and congenital lymphedema. Clin Genet27:611-612, 1985.
19.
Crowe C., Dickerman L.: Brief clinical report: A genetic association between microcephaly and lymphedema . Am J Med Genet24:131-135, 1986.
20.
Herzog D., Logan R., Kooistra J.: The Noonan syndrome with intestinal lymphangiectasia. J Pediatr88:270-272, 1976.
21.
Lanning P., Similä S., Suramo I., et al: Lymphatic abnormalities in Noonan's syndrome. Pediatr Radiol7:106-109, 1978.
22.
Rockson S., Miller L., Senie R., et al: Diagnosis and management of lymphedema. Cancer (in press).
23.
Benson P., Gough M., Polani P.: Lymphangiography and chromosome studies in females with lymphoedema and possible ovarian dysgenesis. Arch Dis Child40:27-32, 1965.