Greenberg dysplasia

Reviewed February 2012

What is Greenberg dysplasia?

Greenberg dysplasia is a severe condition characterized by specific bone abnormalities in the developing fetus. This condition is fatal before birth.

The bones of affected individuals do not develop properly, causing a distinctive spotted appearance called moth-eaten bone, which is visible on x-ray images. In addition, the bones have abnormal calcium deposits (ectopic calcification). Affected individuals have extremely short bones in the arms and legs and abnormally flat vertebrae (platyspondyly). Other skeletal abnormalities may include short ribs and extra fingers (polydactyly). In addition, affected fetuses have extensive swelling of the body caused by fluid accumulation (hydrops fetalis). Greenberg dysplasia is also called hydrops-ectopic calcification-moth-eaten skeletal dysplasia (HEM), which reflects the condition's most common features.

How common is Greenberg dysplasia?

Greenberg dysplasia is a very rare condition. Approximately ten cases have been reported in the scientific literature.

What genes are related to Greenberg dysplasia?

Mutations in the LBR gene cause Greenberg dysplasia. This gene provides instructions for making a protein called the lamin B receptor. One region of this protein, called the sterol reductase domain, plays an important role in the production (synthesis) of cholesterol. Cholesterol is a type of fat that is produced in the body and obtained from foods that come from animals: eggs, meat, fish, and dairy products. Cholesterol is necessary for normal embryonic development and has important functions both before and after birth. Cholesterol is an important component of cell membranes and the protective substance covering nerve cells (myelin). Additionally, cholesterol plays a role in the production of certain hormones and digestive acids. During cholesterol synthesis, the sterol reductase function of the lamin B receptor allows the protein to perform one of several steps that convert a molecule called lanosterol to cholesterol.

LBR gene mutations involved in Greenberg dysplasia lead to loss of the sterol reductase function of the lamin B receptor, and research suggests that this loss causes the condition. Absence of the sterol reductase function disrupts the normal synthesis of cholesterol within cells. This absence may also allow potentially toxic byproducts of cholesterol synthesis to build up in the body's tissues. Researchers suspect that low cholesterol levels or an accumulation of other substances disrupts the growth and development of many parts of the body. It is not known, however, how a disturbance of cholesterol synthesis leads to the specific features of Greenberg dysplasia.

Related Gene(s)

Changes in this gene are associated with Greenberg dysplasia.

How do people inherit Greenberg dysplasia?

This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition.

Where can I find information about diagnosis or management of Greenberg dysplasia?

These resources address the diagnosis or management of Greenberg dysplasia and may include treatment providers.

Genetic Testing Registry: Greenberg dysplasia (http://www.ncbi.nlm.nih.gov/gtr/conditions/C1300226)
Lurie Children's Hospital of Chicago: Fetal Skeletal Dysplasia (http://www.luriechildrens.org/en-us/care-services/conditions-treatments/institute-fetal-health/Pages/basics/fetal-orthopaedic-surgery/fetal-skeletal-dysplasia.aspx)

You might also find information on the diagnosis or management of Greenberg dysplasia in Educational resources (http://www.ghr.nlm.nih.gov/condition/greenberg-dysplasia/show/Educational+resources) and Patient support (http://www.ghr.nlm.nih.gov/condition/greenberg-dysplasia/show/Patient+support).

General information about the diagnosis (http://ghr.nlm.nih.gov/handbook/consult/diagnosis) and management (http://ghr.nlm.nih.gov/handbook/consult/treatment) of genetic conditions is available in the Handbook. Read more about genetic testing (http://ghr.nlm.nih.gov/handbook/testing), particularly the difference between clinical tests and research tests (http://ghr.nlm.nih.gov/handbook/testing/researchtesting).

To locate a healthcare provider, see How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

Where can I find additional information about Greenberg dysplasia?

You may find the following resources about Greenberg dysplasia helpful. These materials are written for the general public.

MedlinePlus - Health information
- Encyclopedia: Hydrops Fetalis (http://www.nlm.nih.gov/medlineplus/ency/article/007308.htm)
- Health Topic: Bone Diseases (http://www.nlm.nih.gov/medlineplus/bonediseases.html)
Genetic and Rare Diseases Information Center - Information about genetic conditions and rare diseases (http://rarediseases.info.nih.gov/gard/8754/resources/resources/1)
Educational resources - Information pages
- Cedars-Sinai Medical Center: Skeletal Dysplasia (http://www.cedars-sinai.edu/Patients/Health-Conditions/Skeletal-Dysplasia.aspx)
- Orphanet (http://www.orpha.net/consor/cgi-bin/Disease_Search.php?lng=EN&data_id=1632&Disease_Disease_Search_diseaseGroup=greenberg-skeletal-dysplasia&Disease_Disease_Search_diseaseType=Pat&Disease%28s%29/group%20of%20diseases=Greenberg-dysplasia--Skeletal-dysplasia--Greenberg-type-&title=Greenberg-dysplasia--Skeletal-dysplasia--Greenberg-type-&search=Disease_Search_Simple)
Patient support - For patients and families
The Compassionate Friends (http://www.compassionatefriends.org/home.aspx)

You may also be interested in these resources, which are designed for healthcare professionals and researchers.

Genetic Testing Registry - Repository of genetic test information
- Genetic Testing Registry: Greenberg dysplasia (http://www.ncbi.nlm.nih.gov/gtr/conditions/C1300226)
ClinicalTrials.gov - Linking patients to medical research (http://clinicaltrials.gov/ct2/results?cond=%22Greenberg%20skeletal%20dysplasia%22)
PubMed - Recent literature (http://www.ncbi.nlm.nih.gov/pubmed?term=((greenberg%20skeletal%20dysplasia%5BTIAB%5D)%20OR%20(hydrops--ectopic%20calcification--moth-eaten%20skeletal%20dysplasia%5BTIAB%5D)%20OR%20(greenberg%20dysplasia%5BTIAB%5D)%20OR%20(moth-eaten%20skeletal%20dysplasia%5BTIAB%5D))%20AND%20english%5Bla%5D%20AND%20human%5Bmh%5D%20AND%20%22last%203600%20days%22%5Bdp%5D)
OMIM - Genetic disorder catalog (http://omim.org/entry/215140)

What other names do people use for Greenberg dysplasia?

chondrodystrophy, hydropic and prenatally lethal type
Greenberg skeletal dysplasia
HEM dysplasia
HEM skeletal dysplasia
hydrops - ectopic calcification - moth-eaten skeletal dysplasia
moth-eaten skeletal dysplasia

For more information about naming genetic conditions, see the Genetics Home Reference Condition Naming Guidelines (http://ghr.nlm.nih.gov/ConditionNameGuide) and How are genetic conditions and genes named? (http://ghr.nlm.nih.gov/handbook/mutationsanddisorders/naming) in the Handbook.

What if I still have specific questions about Greenberg dysplasia?

Ask the Genetic and Rare Diseases Information Center (http://rarediseases.info.nih.gov/GARD/).

What glossary definitions help with understanding Greenberg dysplasia?

acids ; autosomal ; autosomal recessive ; calcification ; calcium ; cell ; cholesterol ; digestive ; domain ; dysplasia ; ectopic ; embryonic ; fetus ; gene ; hydrops fetalis ; lamin ; molecule ; polydactyly ; protein ; receptor ; recessive ; synthesis ; toxic

You may find definitions for these and many other terms in the Genetics Home Reference Glossary (http://www.ghr.nlm.nih.gov/glossary).

References

Clayton P, Fischer B, Mann A, Mansour S, Rossier E, Veen M, Lang C, Baasanjav S, Kieslich M, Brossuleit K, Gravemann S, Schnipper N, Karbasyian M, Demuth I, Zwerger M, Vaya A, Utermann G, Mundlos S, Stricker S, Sperling K, Hoffmann K. Mutations causing Greenberg dysplasia but not Pelger anomaly uncouple enzymatic from structural functions of a nuclear membrane protein. Nucleus. 2010 Jul-Aug;1(4):354-66. doi: 10.4161/nucl.1.4.12435. Epub 2010 May 21. (http://www.ncbi.nlm.nih.gov/pubmed/21327084?dopt=Abstract)
Duband-Goulet I, Courvalin JC. Inner nuclear membrane protein LBR preferentially interacts with DNA secondary structures and nucleosomal linker. Biochemistry. 2000 May 30;39(21):6483-8. (http://www.ncbi.nlm.nih.gov/pubmed/10828963?dopt=Abstract)
Silve S, Dupuy PH, Ferrara P, Loison G. Human lamin B receptor exhibits sterol C14-reductase activity in Saccharomyces cerevisiae. Biochim Biophys Acta. 1998 Jun 15;1392(2-3):233-44. (http://www.ncbi.nlm.nih.gov/pubmed/9630650?dopt=Abstract)
Trajkovski Z, Vrcakovski M, Saveski J, Gucev ZS. Greenberg dysplasia (hydrops-ectopic calcification-moth-eaten skeletal dysplasia): prenatal ultrasound diagnosis and review of literature. Am J Med Genet. 2002 Sep 1;111(4):415-9. (http://www.ncbi.nlm.nih.gov/pubmed/12210303?dopt=Abstract)
Tseng LC, Chen RH. Temporal control of nuclear envelope assembly by phosphorylation of lamin B receptor. Mol Biol Cell. 2011 Sep;22(18):3306-17. doi: 10.1091/mbc.E11-03-0199. Epub 2011 Jul 27. (http://www.ncbi.nlm.nih.gov/pubmed/21795390?dopt=Abstract)
Waterham HR, Koster J, Mooyer P, Noort Gv Gv, Kelley RI, Wilcox WR, Wanders RJ, Hennekam RC, Oosterwijk JC. Autosomal recessive HEM/Greenberg skeletal dysplasia is caused by 3 beta-hydroxysterol delta 14-reductase deficiency due to mutations in the lamin B receptor gene. Am J Hum Genet. 2003 Apr;72(4):1013-7. Epub 2003 Feb 28. (http://www.ncbi.nlm.nih.gov/pubmed/12618959?dopt=Abstract)

The resources on this site should not be used as a substitute for professional medical care or advice. Users seeking information about a personal genetic disease, syndrome, or condition should consult with a qualified healthcare professional. See How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.



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