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Limb body wall complex
Disease definition
Limb body wall complex (LBWC) is characterized by severe multiple congenital anomalies in the fetus with exencephaly/encephalocele, thoraco- and/or abdominoschisis (anterior body wall defects) and limb defects, with or without facial clefts.
ORPHA:2369
Classification level: DisorderSummary
Epidemiology
Approximately 250 cases have been reported in the literature so far.
Clinical description
Clinical manifestations vary widely and include limb defects and visceral malformations (95% of cases), spinal abnormalities, absent diaphragm, bowel atresia and renal agenesis. LBWC generally presents as a short umbilical cord, abdominal placental attachment, persistence of an extraembryonic celom, anorectal malformations, urogenital abnormalities, lumbosacral meningomyelocele and kyphoscoliosis. A spectrum of LBWC manifestations is included in the amniotic band sequence (see this term), presenting mostly with craniofacial defects, facial clefts, amniotic bands and/or adhesions. At present, it remains unclear whether these two entities represent a single disorder.
Etiology
The etiology of LBWC remains unknown. Karyotypes have been reported as normal and no correlations with gender, parental age and teratogenic agents have been found. The principal theories are an extrinsic origin by early amniotic rupture, or a vascular origin due to an early vascular accident during embryological development. Single cases of familial occurrence have been documented.
Diagnostic methods
Diagnosis is based on the presenting features.
Differential diagnosis
LBWC should be differentiated from gastroschisis (see this term), which has better prognosis.
Antenatal diagnosis
Early antenatal diagnosis is feasible by ultrasound examination and may be followed by medical termination of the pregnancy.
Prognosis
LBWC is fatal, with death occurring antenatally or early in the neonatal period.
A summary on this disease is available in Deutsch (2009) Español (2009) Français (2009) Italiano (2009) Nederlands (2009) Português (2009)
Additional information