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A male infant was delivered vaginally at 37+4 weeks after an uncomplicated pregnancy with normal antenatal ultrasonography. An abnormal head shape was noted, with normal head circumference, reduced biparietal diameter, orbital hypertelorism, short philtrum and microretrognathia (figure 1A–C). The skull felt soft when palpated. The rest of physical examination was normal. An X-ray (figure 1D), MRI and three-dimensional CT scan reconstruction of the skull (figure 1E,F) showed a severe defect in ossification of the calvaria and widely enlarged sutures. A skeletal survey showed no other abnormalities. Trio whole-exome sequencing identified p.Ser124ter …
Footnotes
Contributors EB collected the patient data, performed a detailed literature search, drafted the initial manuscript and edited the manuscript according to feedback of the other authors. SA, EC and AP participated in the diagnosis of the patient and were involved in the management of clinical case. LP examined and interpreted MRIs. MM, CC and FMR contributed to the analysis and interpretation of data, and reviewed the manuscript. All authors have been involved in the patient’s care, approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.