Table 1.

Differential diagnoses for 3M syndrome

3-M syndromeFloating harbor syndromeIMAGe syndromeIsolated complex I deficiencyMulibrey nanismSHORT syndromeSOFT syndromeSilver–Russell syndrome
Birthweight SDSMean −3.1Mean −2.5−2.0 to −4.0−1.3 to −2.7Mean −2.8 (range −4.0 to 0.5)Mean −3.3−2.7 to −4.3Mean −2.7
Adult height range (cm)115-150M: 106 to 164
F: 98 to 156
M: 160 (n = 1)
F: 142 (n = 1)
Not reported136-150Mean 154112 to 127 cmMean 151
Cognitive functionNormalVariable
Delayed speech
NormalNormalMild motor and speech delayNormalNormal social and motor developmentVariable
Main featuresDolichocephaly, triangular face, prominent heels, pectus deformity, short thorax, winged scapulae, hyperlordosis, hip dysplasia, slender long bones and vertebral bodiesDelayed bone age, expressive language delay, triangular face, prominent nose, deep set eyesMetaphyseal dysplasia, congenital adrenal hypoplasia, male genital anomaliesProminent forehead, long thin philtrum, may have raised lactate, hypertrophic cardiomyopathy, Wolf–Parkinson–White syndromeTriangular face, short broad neck, misshapen sternum, hepatomegaly, increased tumor risk (Wilms, ovarian stromal)S—short stature
H—hyperextensibility of joints/inguinal hernia
O—ocular depression
R—Rieger anomaly
T—teething delay
Triangular face, hypotrichosis, onychodysplasia, short long bones, hypogonadism, high pitched voiceMacrocephaly, triangular face, downturned mouth, limb asymmetry, feeding difficulties, fifth finger clinodactyly, brachydactyly, syndactyly, hypospadias, cryptorchidism, café au lait spots
InheritanceARADPaternally imprintedARARADARMost de novo
GeneticsCUL7, OBSL1 (exons 1-9), CCDC8 mutationsSRCAP mutationsCDKN1C mutationsc.64T>C, p.Trp22Arg NDUFB3 mutationTRIM37 mutations
High prevalence in Finnish population
PIK3R1 mutationsPOC1A mutations11p15 loss of methylation, maternal UPD chromosome 7
3-M syndromeFloating harbor syndromeIMAGe syndromeIsolated complex I deficiencyMulibrey nanismSHORT syndromeSOFT syndromeSilver–Russell syndrome
Birthweight SDSMean −3.1Mean −2.5−2.0 to −4.0−1.3 to −2.7Mean −2.8 (range −4.0 to 0.5)Mean −3.3−2.7 to −4.3Mean −2.7
Adult height range (cm)115-150M: 106 to 164
F: 98 to 156
M: 160 (n = 1)
F: 142 (n = 1)
Not reported136-150Mean 154112 to 127 cmMean 151
Cognitive functionNormalVariable
Delayed speech
NormalNormalMild motor and speech delayNormalNormal social and motor developmentVariable
Main featuresDolichocephaly, triangular face, prominent heels, pectus deformity, short thorax, winged scapulae, hyperlordosis, hip dysplasia, slender long bones and vertebral bodiesDelayed bone age, expressive language delay, triangular face, prominent nose, deep set eyesMetaphyseal dysplasia, congenital adrenal hypoplasia, male genital anomaliesProminent forehead, long thin philtrum, may have raised lactate, hypertrophic cardiomyopathy, Wolf–Parkinson–White syndromeTriangular face, short broad neck, misshapen sternum, hepatomegaly, increased tumor risk (Wilms, ovarian stromal)S—short stature
H—hyperextensibility of joints/inguinal hernia
O—ocular depression
R—Rieger anomaly
T—teething delay
Triangular face, hypotrichosis, onychodysplasia, short long bones, hypogonadism, high pitched voiceMacrocephaly, triangular face, downturned mouth, limb asymmetry, feeding difficulties, fifth finger clinodactyly, brachydactyly, syndactyly, hypospadias, cryptorchidism, café au lait spots
InheritanceARADPaternally imprintedARARADARMost de novo
GeneticsCUL7, OBSL1 (exons 1-9), CCDC8 mutationsSRCAP mutationsCDKN1C mutationsc.64T>C, p.Trp22Arg NDUFB3 mutationTRIM37 mutations
High prevalence in Finnish population
PIK3R1 mutationsPOC1A mutations11p15 loss of methylation, maternal UPD chromosome 7

3-M syndrome has a wide differential diagnosis. Syndromes with macrocephaly and normocephaly have been included. Differential diagnoses include isolated complex I deficiency, caused by a specific NDUFB3 mutation, as demonstrated by Cases 3 and 4.

Abbreviations: AR, autosomal recessive; AD, autosomal dominant.

Table 1.

Differential diagnoses for 3M syndrome

3-M syndromeFloating harbor syndromeIMAGe syndromeIsolated complex I deficiencyMulibrey nanismSHORT syndromeSOFT syndromeSilver–Russell syndrome
Birthweight SDSMean −3.1Mean −2.5−2.0 to −4.0−1.3 to −2.7Mean −2.8 (range −4.0 to 0.5)Mean −3.3−2.7 to −4.3Mean −2.7
Adult height range (cm)115-150M: 106 to 164
F: 98 to 156
M: 160 (n = 1)
F: 142 (n = 1)
Not reported136-150Mean 154112 to 127 cmMean 151
Cognitive functionNormalVariable
Delayed speech
NormalNormalMild motor and speech delayNormalNormal social and motor developmentVariable
Main featuresDolichocephaly, triangular face, prominent heels, pectus deformity, short thorax, winged scapulae, hyperlordosis, hip dysplasia, slender long bones and vertebral bodiesDelayed bone age, expressive language delay, triangular face, prominent nose, deep set eyesMetaphyseal dysplasia, congenital adrenal hypoplasia, male genital anomaliesProminent forehead, long thin philtrum, may have raised lactate, hypertrophic cardiomyopathy, Wolf–Parkinson–White syndromeTriangular face, short broad neck, misshapen sternum, hepatomegaly, increased tumor risk (Wilms, ovarian stromal)S—short stature
H—hyperextensibility of joints/inguinal hernia
O—ocular depression
R—Rieger anomaly
T—teething delay
Triangular face, hypotrichosis, onychodysplasia, short long bones, hypogonadism, high pitched voiceMacrocephaly, triangular face, downturned mouth, limb asymmetry, feeding difficulties, fifth finger clinodactyly, brachydactyly, syndactyly, hypospadias, cryptorchidism, café au lait spots
InheritanceARADPaternally imprintedARARADARMost de novo
GeneticsCUL7, OBSL1 (exons 1-9), CCDC8 mutationsSRCAP mutationsCDKN1C mutationsc.64T>C, p.Trp22Arg NDUFB3 mutationTRIM37 mutations
High prevalence in Finnish population
PIK3R1 mutationsPOC1A mutations11p15 loss of methylation, maternal UPD chromosome 7
3-M syndromeFloating harbor syndromeIMAGe syndromeIsolated complex I deficiencyMulibrey nanismSHORT syndromeSOFT syndromeSilver–Russell syndrome
Birthweight SDSMean −3.1Mean −2.5−2.0 to −4.0−1.3 to −2.7Mean −2.8 (range −4.0 to 0.5)Mean −3.3−2.7 to −4.3Mean −2.7
Adult height range (cm)115-150M: 106 to 164
F: 98 to 156
M: 160 (n = 1)
F: 142 (n = 1)
Not reported136-150Mean 154112 to 127 cmMean 151
Cognitive functionNormalVariable
Delayed speech
NormalNormalMild motor and speech delayNormalNormal social and motor developmentVariable
Main featuresDolichocephaly, triangular face, prominent heels, pectus deformity, short thorax, winged scapulae, hyperlordosis, hip dysplasia, slender long bones and vertebral bodiesDelayed bone age, expressive language delay, triangular face, prominent nose, deep set eyesMetaphyseal dysplasia, congenital adrenal hypoplasia, male genital anomaliesProminent forehead, long thin philtrum, may have raised lactate, hypertrophic cardiomyopathy, Wolf–Parkinson–White syndromeTriangular face, short broad neck, misshapen sternum, hepatomegaly, increased tumor risk (Wilms, ovarian stromal)S—short stature
H—hyperextensibility of joints/inguinal hernia
O—ocular depression
R—Rieger anomaly
T—teething delay
Triangular face, hypotrichosis, onychodysplasia, short long bones, hypogonadism, high pitched voiceMacrocephaly, triangular face, downturned mouth, limb asymmetry, feeding difficulties, fifth finger clinodactyly, brachydactyly, syndactyly, hypospadias, cryptorchidism, café au lait spots
InheritanceARADPaternally imprintedARARADARMost de novo
GeneticsCUL7, OBSL1 (exons 1-9), CCDC8 mutationsSRCAP mutationsCDKN1C mutationsc.64T>C, p.Trp22Arg NDUFB3 mutationTRIM37 mutations
High prevalence in Finnish population
PIK3R1 mutationsPOC1A mutations11p15 loss of methylation, maternal UPD chromosome 7

3-M syndrome has a wide differential diagnosis. Syndromes with macrocephaly and normocephaly have been included. Differential diagnoses include isolated complex I deficiency, caused by a specific NDUFB3 mutation, as demonstrated by Cases 3 and 4.

Abbreviations: AR, autosomal recessive; AD, autosomal dominant.

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