Rubinstein-Taybi syndrome (also known as
Broad Thumb-Hallux syndrome) is a condition characterized by short stature, moderate to severe mental retardation, distinctive facial features, and broad thumbs and first toes. Other features of the disorder vary among affected individuals. People with this condition have an increased risk of developing noncancerous and cancerous
tumors,
leukemia, and
lymphoma. This condition is inherited in an
autosomal dominant pattern and is uncommon, occurring in an estimated 1 in 125,000 births.
Features of Rubinstein-Taybi syndrome
A case was described in 1957 by Michail, Matsoukas and Theodorou. In 1963
Jack H. Rubinstein and
Hooshang Taybi described a larger series of cases.
Typical features of the disorder include:
- Broad thumbs and broad first toes
- Mental disability
- Small height, bone growth, small head
- Cryptorchidism in males
- Unusual faces involving the eyes, nose, and palate
1 out of 300,000 children are born with RTS
Genetics
Mutations in the
CREBBP gene cause Rubinstein-Taybi syndrome. The CREBBP gene makes a protein that helps control the activity of many other genes. The protein, called
CREB binding protein, plays an important role in regulating
cell growth and
division and is essential for normal
fetal development. If one copy of the CREBBP gene is deleted or mutated, cells make only half of the normal amount of CREB binding protein. A reduction in the amount of this protein disrupts normal development before and after birth, leading to the signs and symptoms of Rubinstein-Taybi syndrome.
Mutations in the EP300 gene are responsible for a small percentage of cases of Rubinstein-Taybi syndrome. These mutations result in the loss of one copy of the gene in each cell, which reduces the amount of p300 protein by half. Some mutations lead to the production of a very short, nonfunctional version of the p300 protein, while others prevent one copy of the gene from making any protein at all. Although researchers do not know how a reduction in the amount of p300 protein leads to the specific features of Rubinstein-Taybi syndrome, it is clear that the loss of one copy of the EP300 gene disrupts normal development.
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