Langer mesomelic dysplasia

Reviewed January 2012

What is Langer mesomelic dysplasia?

Langer mesomelic dysplasia is a disorder of bone growth. Affected individuals typically have extreme shortening of the long bones in the arms and legs (mesomelia). As a result of the shortened leg bones, people with Langer mesomelic dysplasia have very short stature. A bone in the forearm called the ulna and a bone in the lower leg called the fibula are often underdeveloped or absent, while other bones in the forearm (the radius) and lower leg (the tibia) are unusually short, thick, and curved. Some people with Langer mesomelic dysplasia also have an abnormality of the wrist and forearm bones called Madelung deformity, which may cause pain and limit wrist movement. Additionally, some affected individuals have mild underdevelopment of the lower jaw bone (mandible).

How common is Langer mesomelic dysplasia?

The prevalence of Langer mesomelic dysplasia is unknown, although the condition appears to be rare. Several dozen affected individuals have been reported in the scientific literature.

What genes are related to Langer mesomelic dysplasia?

Langer mesomelic dysplasia results from changes involving the SHOX gene. The protein produced from this gene plays a role in bone development and is particularly important for the growth and maturation of bones in the arms and legs. The most common cause of Langer mesomelic dysplasia is a deletion of the entire SHOX gene. Other genetic changes that can cause the disorder include mutations in the SHOX gene or deletions of nearby genetic material that normally helps regulate the gene's activity. These changes greatly reduce or eliminate the amount of SHOX protein that is produced. A lack of this protein disrupts normal bone development and growth, which underlies the severe skeletal abnormalities associated with Langer mesomelic dysplasia.

Related Gene(s)

Changes in this gene are associated with Langer mesomelic dysplasia.

SHOX

How do people inherit Langer mesomelic dysplasia?

Langer mesomelic dysplasia has a pseudoautosomal recessive pattern of inheritance. The SHOX gene is located on both the X and Y chromosomes (sex chromosomes) in an area known as the pseudoautosomal region. Although many genes are unique to either the X or Y chromosome, genes in the pseudoautosomal region are present on both sex chromosomes. As a result, both females (who have two X chromosomes) and males (who have one X and one Y chromosome) normally have two functional copies of the SHOX gene in each cell. The inheritance pattern of Langer mesomelic dysplasia is described as recessive because both copies of the SHOX gene in each cell must be missing or altered to cause the disorder. In females, the condition results when the gene is missing or altered on both copies of the X chromosome; in males, it results when the gene is missing or altered on the X chromosome and the Y chromosome.

A related skeletal disorder called Léri-Weill dyschondrosteosis occurs when one copy of the SHOX gene is mutated in each cell. This disorder has signs and symptoms that are similar to, but typically less severe than, those of Langer mesomelic dysplasia.

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

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

Genetic Testing Registry: Langer mesomelic dysplasia syndrome (http://www.ncbi.nlm.nih.gov/gtr/conditions/C0432230)

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

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

MedlinePlus - Health information
Health Topic: Bone Diseases (http://www.nlm.nih.gov/medlineplus/bonediseases.html)
Educational resources - Information pages
- Cedars-Sinai Medical Center: International Skeletal Dysplasia Registry (http://isdr.csmc.edu/)
- Children's Hospital Boston: Madelung's Deformity (http://www.childrenshospital.org/az/Site2195/mainpageS2195P0.html)
- Orphanet (http://www.orpha.net/consor/cgi-bin/OC_Exp.php?lng=EN&Expert=2632)
Patient support - For patients and families
- Human Growth Foundation (http://www.hgfound.org/)
- Little People of America (http://www.lpaonline.org/)
- RareConnect (https://www.rareconnect.org/en/community/dysnet)
- Resource list from the University of Kansas Medical Center: Dwarfism / Short Stature (http://www.kumc.edu/gec/support/dwarfism.html)
- The MAGIC Foundation (http://www.magicfoundation.org/)

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: Langer mesomelic dysplasia syndrome (http://www.ncbi.nlm.nih.gov/gtr/conditions/C0432230)
PubMed - Recent literature (http://www.ncbi.nlm.nih.gov/pubmed?term=((langer%5BTIAB%5D)%20AND%20(mesomelic%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/249700)

What other names do people use for Langer mesomelic dysplasia?

dyschondrosteosis homozygous
Langer mesomelic dwarfism
LMD
mesomelic dwarfism of the hypoplastic ulna, fibula, and mandible type

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 Langer mesomelic dysplasia?

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

What glossary definitions help with understanding Langer mesomelic dysplasia?

cell ; chromosome ; deletion ; dwarfism ; dysplasia ; gene ; homozygous ; inheritance ; inheritance pattern ; pattern of inheritance ; prevalence ; protein ; pseudoautosomal region ; recessive ; sex chromosomes ; short stature ; stature ; ulna

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

References

Bertorelli R, Capone L, Ambrosetti F, Garavelli L, Varriale L, Mazza V, Stanghellini I, Percesepe A, Forabosco A. The homozygous deletion of the 3' enhancer of the SHOX gene causes Langer mesomelic dysplasia. Clin Genet. 2007 Nov;72(5):490-1. (http://www.ncbi.nlm.nih.gov/pubmed/17935511?dopt=Abstract)
Campos-Barros A, Benito-Sanz S, Ross JL, Zinn AR, Heath KE. Compound heterozygosity of SHOX-encompassing and downstream PAR1 deletions results in Langer mesomelic dysplasia (LMD). Am J Med Genet A. 2007 May 1;143A(9):933-8. (http://www.ncbi.nlm.nih.gov/pubmed/17394206?dopt=Abstract)
Shears DJ, Guillen-Navarro E, Sempere-Miralles M, Domingo-Jimenez R, Scambler PJ, Winter RM. Pseudodominant inheritance of Langer mesomelic dysplasia caused by a SHOX homeobox missense mutation. Am J Med Genet. 2002 Jun 15;110(2):153-7. (http://www.ncbi.nlm.nih.gov/pubmed/12116253?dopt=Abstract)
Thomas NS, Maloney V, Bass P, Mulik V, Wellesley D, Castle B. SHOX mutations in a family and a fetus with Langer mesomelic dwarfism. Am J Med Genet A. 2004 Jul 15;128A(2):179-84. (http://www.ncbi.nlm.nih.gov/pubmed/15214013?dopt=Abstract)
Zinn AR, Wei F, Zhang L, Elder FF, Scott CI Jr, Marttila P, Ross JL. Complete SHOX deficiency causes Langer mesomelic dysplasia. Am J Med Genet. 2002 Jun 15;110(2):158-63. (http://www.ncbi.nlm.nih.gov/pubmed/12116254?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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