Natural history of achondroplasia: A retrospective review of longitudinal clinical data

Am J Med Genet A. 2020 Nov;182(11):2540-2551. doi: 10.1002/ajmg.a.61825. Epub 2020 Aug 31.

Abstract

There are limited data on the longitudinal frequency and severity of the symptoms and complications of achondroplasia. We undertook a retrospective electronic chart review of 114 patients to develop a more thorough understanding of the lifetime impact of achondroplasia. Craniocervical stenosis (involving the foramen magnum with or without cervical vertebrae C1 and/or C2) was noted in nearly 50% of patients with craniovertebral junction imaging; however, corrective decompression surgery was only needed in 6% of patients. No children in our cohort died at 4 years of age or under. Kyphosis was present in most patients but usually resolved in early childhood. Cervical and lumbar stenosis were diagnosed in children and adults while, genu varum, elbow contractures, and radial head dislocations were identified during childhood. Central sleep apnea and obstructive sleep apnea were present in children, while the diagnosis of obstructive sleep apnea was shown to recur in adulthood. Cardiovascular risk factors were present in only 7% of patients. A range of mental health disorders were identified, with most diagnoses being made before 18 years of age. Our data show that achondroplasia has a significant impact on patients' physical health, and complications continue to be reported and require intervention throughout patients' lifetimes. This highlights the need for continuous support beyond pediatric care, by adult care clinicians experienced with managing the long-term complications of achondroplasia.

Keywords: achondroplasia; adult; child; natural history; retrospective study.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Achondroplasia / complications*
  • Achondroplasia / genetics
  • Adolescent
  • Adult
  • Brain / abnormalities
  • Cervical Vertebrae / surgery
  • Child
  • Child, Preschool
  • Constriction, Pathologic
  • Databases, Factual
  • Female
  • Foramen Magnum / surgery
  • Humans
  • Infant
  • Infant, Newborn
  • Kyphosis / complications*
  • Kyphosis / genetics
  • Kyphosis / surgery
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Nervous System Diseases / complications*
  • Nervous System Diseases / genetics
  • Orthopedics
  • Retrospective Studies
  • Sleep Apnea, Obstructive / complications*
  • Sleep Apnea, Obstructive / genetics
  • Young Adult